HomeMy WebLinkAboutPermit Building 2003-4-14
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'community Services Div, Building Safety
CITY OF SPRINGFIELD, OREGON
225 5th Str~et,Springfield, OR 97477- Ph. 726-3759
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Job Address '55"38 f} (VI B Lt:<; i OC'
City Job # COI""'i, ZooZ -p.,;; <./1"
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A:MBLESIDE :MEADOWS SUBDIVISION-1ST .A+>DITIo'N
Site Investigation Questionnaire for Consulting Design Professionals
foundation requirements - new structures on residential lots
This form may be used as a temporaryveritication to allow construction to continue
on the job site until the consuI~t's stamped affidavit on the site soil compaction
and stabilization is submitted to the City. This fonn must be completed by a
-licensed design professional (engineer or architect)' or hislher authorized employee,
, and submitted to the building mspector prior to requesting City inspections or
placing foundatimlconcrete. It is important that all questions be answered
, ' completely for the foundation site to, be approved for construction.
,Owner and/or Contractor
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1./ Date of the design professional's site evaluation?
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2. Has the design professional reviewed a copy of the geotechnicaHnformation '
for, the subdivision that was provided with the building permit? Yes~_
If not, please contact this office for ci copy of the report. , The de~ign professional
must be familiar with the geotechnical infonnation before completing this form.
3. 'What was the size and depth of the excavation and lor rill? ~Arlb
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'" Was existing non-structural fill or expansive sollencountered on-the lot? ,
Yes.!ZNo_ If "yes", what types, depths and locations?e-x'Pr;;.Js/ ~ G( 41
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, What measures were taken to remedy the soil condition (include type of
engineered fIll used to stabilize the soil)? P .7' . 5' L-l1lJ} (} ft,.J11/fL
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Community Services Div, Building Safety . Job Address 3S-'3B
CITY OF SPRlNGFIELD, OREGON , City Job # Q;"'"l '
225 5th Street, Springfield, OR97477 Ph. 726-3759
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)s the site as prepared adequate lEI inadequate 0 to maintain constant moisture
contentin the sub grade? Note: Verificationofmoisture stabilization in the sub
grade is a requirement of the geotechnical report, and ml:lst be affinned before
, construction can continue. '
If inadequate, what measure$ are needed to provide constant moisture content in
' the sub grade? (,"'9PttL. Tl c'"'YL ,(,\tJ~"1 " Wv1..iclL' (cVt:<-.' { \ ' ,
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IE; the site as prepared adequate.l8f inadequate 0 to support the proposed
structure? An affirmative answer is requisite to proceeding with construction.
If inadequate, what additional work is needed to provide adequate
, foundation support?
4. . Did the'design professional witnessphicement and compaction of the
engineered rill, or is there a special inspection report iorthcommg from a
qualified agency? 1 witnessed, Placement 8f Speciallnsp/compaction report 0
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, . 5. . The design professional tntend,s to use the following I.Dethod .for installation.
of perforated p~rimeter foofuig drains: '
The - design on the attached drawing .provided by the design professional n.... 0
The method shown on the original construction drawings. ~.....: ~.... . . ..... ...;. D
The typical 'Foundation Drain' drawing attached to permit'.. ~......... ;......:. 0
Perforated perimet~ dr~s are pot required,......... . ...;.... ..... .. .............. B'
Comments: .::; [ Th S' Of L S Y'1vti;;-' t..:k-oJ=>1l.A:YJ To '
QA::'~~ WI'ri\:"'YL~,...... -:; uriC'"" Wlo P(ft?,~"
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Note: City inspectors will inspect installed drains 'prior to cover upon request...
Call: 726-3769 to schedule inspection. .
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Community Services Div, Building Safety
CITY OF SPRINGFIELD, OREGON
225 SlhStreet, Springfield, OR 97477 Ph. 726-37-?9
Job Address 553e
City Job # ,Ce.1M
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Low-point crawl space drains are required to prevent the build-up of excess
moisture inside the foundations during (and after) coristtuction~ This drain
may be installed after foundation placement only with th~~~~ permission
of the desirn nrofessionaL
The design pr<?fessiomil has determined the following:
The crawlspace drazn is required when the foundation is installed..... 0
The'low-point drain can be installed after foundation placement without a
, signtfican! moisture build-up problem within thefouiuiation............. 0
(The low-point drain may be installed at the " . ~tage
. of construction) post 0: beam,framing. roofing, ete. , ,
Has the design professional observed and approved the installation of the
. d'l' . d"? v . l.T
requlre. ow pomt ram. ...:..........:...,................. J..es, HO
if"yes", where is the low pQint drain located under the building and
where does it terminate, at this time? (must be an approved location, i.e.
street gutter; stonn sewer, sump pump and discharge line to the street,
etc.)
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The design professional must determine whether'the appr.oved permit drawings have,
adequate fbundation steeL Is any additional foundation steel required that is not
shown on th~ foundation drawings for the building? " .
, Yes' y.F No. If "yes", descn.be additional steel required (or provide drawing).
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The following statement must be signed by the infiividual doing the observations and
providing direction for the excavation and site preparation work on the property.
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Community Services Div, Building Safety
. CITY OF SPRWGFIELD, OREGON
225 5th Street, Springfield, OR 97477 Ph.726-3759
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Job Address '3 S 3 B (if....,'/? l r)' I tJc', .
City Job #COr"\Zo'O L '- (') i LJ i"
The undersigned design professional (or authorized employee) attests thathe/shi!
observed required moisture stability procedures on this site, and that such procedures
were accomplished before any changes occurred in the moisture content of the sub-
grade underand around the building (where eipansive soils were encountered).' The
undersigned fUrther attests that the sub-grade, as prepared, is adequate to support the
building proposedfor this site.' !
Additional comments:
(Note): A copy of this reportshaIi be kept on site with the approved plans at all
times.
This report shall be followed by an affidavit, signed and stamped ~y the design ,
, , professional under whose auspices this report was completed, affIrming the izrl'ormation
herei~. The si~, e _ stamB '1:affi avit t~gether ~ith .a copy .of this 'report .sh~ be
subillltted ~o or 1" or. equestmg frammg Inspection for the,bwlding.
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Signature J . ttJ~ , ' " " " '
Name DIA ./t b~'~, JlL Title P.e. ,
Company'" o;'..€'t0 l:1{z.o.~ brJ&, f;~~( Jl/L.., . 'P. c ;
Phone 71-fl- <...gg-;,O'Z.-D
Licensee o.~,J ('1~(}vevL,:.
License#0€l:4o.J I (o'i'1c, Pc ,expIres
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The geotechnical report for the Ambleside Meadows - 1st Addition Subdivision
recomniends immediate moisture'stabilization of exposed expansive sub-grades, imd that
expansive soils be over-excavated and replaced with at least 12 inches of fill compacted
to at least 95% of ASTM D698 for foundation preparation. The report also recommends
that measures be taken to prevent water from collecting in or around the foundation areas
' during and ~er the construction process, and that positive site drainage be provided to
reduce the infiltration of surface water into the expansive soils. '
The geotechnical report further emphasizes that the finish grade of landscape ,soil
. , adjacent to the foundation -shQuld be at least 24" above the expansive bearing soils, fmnlv..
comDacted to reduce the infiltration of water at the surface. The adequacy of fill soil, ' ,
material around the building must be verified to the satisfaction of the design ,
professional. ' l
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Community Services Div, Building Safety
CITY OF SPRJNGFIELD, OREGON
225 5th Street, Springfield, OR 97477 Ph: 726-3759
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Job Address 3536 fJM OLE'5It?c
City Job # , COM. 'z.oOL. ~ Cjl.{}S-
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Affidavit
For Site Investigation Questionnaire
, Foundation Sub-Grade Approval for
Residential Building Site in Ambleside Meadows - 1 st Addition
Subdivision
The undersigned hereby afflIIl1S that the excavation, structural fIll and moisture
stabilization methods forthe building site at t.i.e address s~own above was 'observed by
me or an authorized employee of my. fIrm and that the following is true:
',1. The foundation sub-grade is capable of supporting a minimum of 1500,psf, and is'
adequate to support the building proposed for this site..
-2. The moisture content of the excavation was adequately maintained during the site
preparation process and was adequately covered to stabilized moisture content'
. prior to any significant change in moisture content of the sub-grade. _
3. ' The site is adequately graded and drained to prevent the collection of waterin the
, excavated area during construction~
4. The accompanying report titled "Site Investigation Questionnaire for Consulting
Desi~ ~12fessionals" containing fIeld observations and instructions made on. ' ,
. L{ / 'If? [;f/ ( date) for the building site was completed either by
myself or by an employee of my fIrm under my supervision. To. the best of my
knowledge, the information contained ,in that report is complete and accurate.
Name of Licensed Professional (print)
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Signature /JiIL j
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Eugene,Qregon 97402
, , (541) 688-3020
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Field Unit Weight- Sand Cone Method
C.cOm
Per ASTM D 1556
Test Number:
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Job# 't 1.> , l-- ~ 1.--
Date of test: LI_ 15-' 0 :$
Test Location:
Tested By:
Li'I/\sllt.J _ tl(,~"et_i"'\A (Lot.t....
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Material Tested (By visual observation):
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Unit Weight Of Sand Used For This Test
Density Dry Sand (>>1) = 77"' tl PCF
Volume Of Cone (VI) = 0.0389 Ft^3
Field Test Data
Initial Weight of Jar + Sand (WI).................. ~ ~.. ........... .........
Weight .After Testing (W2)... ........... ..............--... ...... .............
Volume Of Hole (WI-W2)/161D1- VI = V2..~.........................
17 45
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" 1 cl K' ()
~ei~of ~~le~~)....I...............................................~
. Moist Unit Weight OrSoil (W3f16N2) = (MI).........................
Moisture Content ~fSoil (t WvtT-'WD)fWJi) III 100 = (MC)............ '
Dry Unit Weight of Soil (MIl (1 + Me/lOO)..............................
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Moisture Content
TotalWt
....1: .......~.........
Can Wt
1,0 =(WW)
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= (WD)
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5" '/
Net Wt
WetWei~
b6.o
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Dry Weight
61-,S
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Notes:
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)''7 p:' ,c"~ 5 ..
7"
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6
oz
oz
Ft^3
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<,.f
oz
pcp.
,%,
PCP' ,
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