HomeMy WebLinkAboutPermit Building 2004-4-27
....
Community S..:..,~ Div, Building Safety
CITY OF SPRINGFffiT .n, OREGON
225 Sth Street, Springfield, OR 9.7477 Ph. 726-3759
Job AddreSs
City Job if,
-
AMBLEsmEJ\1EADOWS SUBDIVISION-IS! ADDITiON
Site Investigation. Questionnairefor Consnltin~ nesign.Professionals
fOllnti~tiorrrbquirements. - new' ~Uw...W1CS_ on~residentiallots
This. fo.Lm.u-]. he:.nsed:as.a:.~u:u. J t.:;~ :::Nriion:.to.aIlow: constrnction:.to continue
on:.tl1e:job: ~:j.. "lltilthe:ron!lmI~A"t'~dJI~~navitnn-thp-'~soil~"'i~ction .
and:stah T -. . h ., - 'ro::th ~ TIl-' f ~be:. leted:b
1 I.I..A.WI..-I~ 11111 I..tl' It ~::: .~ I~ a.1 an ......;.: - . w..~ - ya.
licens-..J~n - ...1' - l~'" . -ied;': . "4h ." Ih "oJ. 1 .
CI...L. ca::;::'':~LU.lfo,...........nnSlr ~......,... ...- .1.1... ... j:.u'.~ ..L r'. .i"IL.....~~, oyee,
. anrh:nl....IitP.lt.. Hre=fi"nT::C:"'l"~~fI~u~GLJ.:~ons:or
. plitMn~n'u.I:~on-('..... ,;. tP:;'Tti-.: :~'.'Ld)l"V.....i ?;..."",iI~T"po;:fjnn~~ered::.' .
CVLUl:'Ietely:fOdhEfonnn~finn-dfp1~:~~.u;..~or;~~-:. .
ownet:1mdlm:Contr.JdOr-~~, ~7Aa;~~t.o~pev . "." .
'-L..Dateofth~~desigIrprof~o~~~~~:~V9~~fton?;\:A';~i1-:61' '1 4 -le- 04
2_ Has ~ d~on professional'reviewed a copy of tbegeatechnical infu~u..ation :
f~~~.snbdivision ~ was provided .wiG..t.the,bniI~ ~~~? . YesyNo_.
If not, please contact this ojfice for a copy 'of the report.. . The design professioriaI
must bt!jamiliar with the geote~ information before completing this form.
3. Whatwas the size and depth of the excavation and IQr fill? . .
ex c.AVA1""(O~.1 Co (') N (:ll<r~ (Ud (?) TI! ~A 1.E.\. ber11.lt, oF. ~'C-I-Il.H- c.... T"l...
~. '7'. c;' -#' .
- :. '-- ,
}J I? ~l<(lO,n...U~ ~1/ l I.~<: ~€'''':'./ ~~('P'r'N~ A.I ~ 'i SIre:
... "
/
. Was ~g non-stro..i.w..J fill or expansiVe sail eIk.u~ on.the lot?
Y es~ No;"" If "yes", what types, &.I:'fus and locations?
~o I,U:>... - c;T'f7.n,r-:n;\'?~ F"fLl." I.VA-( l:1o.Lc..u\.(t..Irr1l6"D A-,.- i!4,-o!,
-s= " . . ."" - " ., ~., .
(1-)
s (-,,::;"
l-l-) ~~~.! l"q...tDt\T1AllI'll'.\,) 5r)l\,( c..1l'....(~l', DF e)(D~~l\Jf, 50l\'5.,
~PA~S\l{'~ ~OI\'C; ~l~n l\;r t>~t+L f1l.~ ~NIr' -Fi7or g \:..'&..,1.0 1)0\6 ~lAAi;\d::
:fa -r}.k;, l:.~TJ'r...,,: Ct.~ of 'T-' I?~~(/l LUT7,-:. (M.k)(llMtlM 1/,
. What m:asures were taken to remedy the soil condition (include type of
eng:i.n.;.....~ fill used to stabilize the soil)? :t:N ~.t-h\. I ~. I1f '3 ~ - ~ . C/l..tA.\tf~ 8Pc.L .
1t.J<:'Tltu A-i)k~r'lJ~ ~' of %... - ~ CiW(~1\ R..~~t..-Ar ~C:l.~-L-&A-tl..~e 51.,N3
'flLL -t1') (~~t'.'t'! _:-f,.,'- g~,j}o, t>1047'1-;Yl. L'1-,t".<.:. Dr f'bn-1&r.. C,,) ""',,\, t., ,t)(_ ~
1
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Community Servic::s Div, Building Safety
CITY OF SPRINGFlELD, OREGON
225 5th Street, S...:us::eld, OR 97477 Ph. 726-3759
Job Address
City Job::
E'XCe;(JT.1lfE" UpSLofJf. "::;(I'\(~. AT' ~r4L..Df'~ sln~. ~)(TT2N.D Th
C)1.t~ E.~ of e..J.'"f"A.INI .HJ W~.I, ~ .=i.:>o-iiNt,\,
C DMrp-A (" ~ ~ 'r'Il.l,,\ t-T'\.A tl..tn.. F=-It.L- To 92.~.f) 12..'i:;\"fu' ,,,s-;
c.. DM~t1 .,,) f\.-1 0 j), iF1 ~\ . r'a..cc.. TOR--
, I
Is the site as J:lJ.!;,J:laredadequate. ~inadequate 0 to maintlin constantmoistnre
contentin..the.suhgrade? Note: Yerificationofmoisrluestabilizarionin the sub
grade is a requirement of the geotecluzical report; and 1Tl1lSt be ajjirmed bejore
consrruczion can: Q.Il~ULe.
If in~ri~:lt~;. Whatrncasures:are:I1,....,;A"~ to: provide. constantmni"'i..w.c:contentin
. the=snL..~? . . .
. ..
i~:&~m~!~~
4. Did the drsignprofessionaI ,,;L...ess pbh ,'" ,,,,nt and COUllf:",.rtiOIl of the
engin,;.Q."J fiIi; or is there a speciaI insPection report fo~....~g L. ULU.a .
. qnalifiM ~'~cy?J witneSsed PIacement 0 Special Insp/cmnpaction report 5]'"
. '.
5. The d:" -101" proI~naI intend~ to nsethefon~;'I~:....g ~ fo~ ~on.
of~o.Led~:..-ettarfooting~ '. .
The.d~ on the "trnrl1ed ch4W~ provided by the design !-,J.O.,l~onal _.~.. ~
The ..:....~shown on the nriOjn~l construction drawin~_.....u._.............. 0
The 'i.J~ 'Fonndation~' dJiwinO' attached to Frif ............~....~.... 0
. . :>
.Perf...~.r-v~ drains are not required ................~.. u u........... ...... 0
Co~
Note: City lnspectors will inspectinstaIled drains prior to cover upon request...
Call: 726-3769 to schedule inspection.
2
Community Services Div, Building Safety
CITY OF SPRINGr1t.LD, OREGON
225 Sib Street, Springfield. OR 97477 Ph. 726-3759
Job Address
City Job #
. .
Low-point crawl space drains are required to prevent the bnild-up of .excess
moisture inside the foundations during (and after) coristtuction... This drain
may be insbUM after foundation placement onlv with the exoress nenniss:ion
of the d~ nrofessionaL, . .
a. The design professiomil has determined the following:
The crawl space drain is required when the foundation is instal1ed.. _.. 0
Thi itJw-point draul' can be installed. after fowularianplacement without a
si~ 11UJisrure'bui1d~upproblem wiihin the fouiuJarion............. ~.
(TtieJow'-point:dr~4.,liLIJ.be:instaIleitaUhe - - ,. ~ .stage
nf-c lctz'on) pos1 &:bea:m.-".-.g;.~.)_. ac..
"J Uti lo.p J___" .' .
. .
b._~;o~l'.LUJ~bser.v~prav~ofthe:
..pn,,;....,1-T""-.9-YO..:-.... T -- ,. . Ves.'h ),TO. V--
I ~~,!,.t l'UU~~_.__._...._.._........._...___~.l..~,_ ~_Y.
_ 'if~;: W~~low.Point:iL.~Jocated:under::diiJJiliIdiiig;~~ .
. .... }'!.~~~.-ii-i.;.;~/~.aJ.~'E.(14)-!:.~/,e?:Jm:usrbe:an:~~ u!':d-~~~-Le.~
. street:gutfer,-:stomr::sewer;:Slu/~. pump:aritEdiic1iarge.::JiiztiO:ifiOtrietp..:.
.~). - .
The design.'p1UK.ssional must ~e whether1be a,p"p.l.V ,,00 .t'~ -drawings have. '. .... .
adequate. foundation steel. Is any additional foundation steel""'fu.U.c.dthat is not
shown on the fonndation'drawings for the building? .' ''-. . .' _
Yes l!o ./ - If "yes", describe. additional steel required (or provide draWing).
--. . _. -.'--
'-----,-, ,.
The following statement mUst be signed by the individual doing the observations and
providing direction for the e:a:avation and site preparation work on the property.'
3
Community Services Div, Building Safety
CITY OF SPRINGFIELD, OREGON
225 Sib Street, Springfield, OR ![74n Ph. 726-3759
Job Address
City Job::
The undersigned design professional (or tl1lthorized employee) attests that he/she
observed required 11UJisture stability proced:ures on this site, and that such procedures
were llCCDmplisheti before any cJuznges OCCllTT'ed in the moistui-e content of the sub.
grade.uruier and around the building (where expansive soils were encountered). The
u.ruiersigned.fiirt:her. attests that the sub-grade, as prepared, is adequate to support the '.
buiIdin.g 1" ul'osed for this site.
AdditiOnal~mpnk:
'-
. ~ote)::A::copy~kept:v~,,;~;; thP-~proved:plan~"atam.:o,. .
": .. times;. . .' '
. .
. -.'Tliis:~)rt:shaiuie:f611o~~3ffin~vit;!cie!1ffi'a1]o"s~-4:b1tl1e:~in:::'
:'~pIOf~~~" ;. 'ces:thiS~'-' rt:w3s: . "oleted;ii'~~II;;,g,thC:ii1fonnation
. '.' ..........,..., '.' """ .' ,,~. ' .." ....:rcpIJ ,," COTnp.". .... ".
. "Jiere.;n~':n€Sien.ed{~~affirl~ViitOgetber.With a"cOpy of thisteport' shall.be-
, sub~:tP1hiS~OffiCe priOl" toieqnesting Lawing inspection' for the.bUilding."': '
: Signa~ K~ rr-b~r.n. _r ~. f:. /l. e::
Name~",.: FA&li c~.ur s-e. 9. f..' TIfle ~1,N'" OM ~
Company 111.1u..Je.-H" 6lbrl,jF:~ru:..k.. L'NC:
Phone 14 ~ D~ i'1 .
.Liceilsee . 'R.,(1;,...,e ~fi.\,A:, tA\w.I
.. License 41 . 5" 4l.f2c pr=
. ~'pUW I 2. - :1('- '1..br.o ~
. .
,The geoteclmical iepart foitbe Ambleside Meadows - lit Addition Subdivision ..
~.wmends ;"'".M1~t~ mni....w.w stabi1i~tinn of ~t'...sed ~ve snb-grades, and that
expansive soils be ovcr-exw...o.k.d and replaced wiLh at least 12 inches of:fill compacted
to at least95% of ASTM D698 for IULWdation p.1wJ:U1I31ion. The report alsoreco.mmpuds .
that ~u.u..,) betaken to preVent water llu.w. coll"",~ in or around the foundation areas
during and after the constiuction process, and that positive site drainage be provided to '
reduce the infiltration of ;)~ water into thC expansive soils.
The geoteclmical I';'pvLL further \;,.l.Upha!ci7.e5 that the :finish grade of landscape soil
. . adjacent to the foundation should be at least 24" above the expansive bearing soils. firmlv
comn3cted to reduce the. infiltration of water at the ~~ The adequacy of fill soil
material ~uuod the building must be verified to the satisfaction of the design
professional
4
Community Services Div. Building Safety
CITY OF SPRINGFIELD, OREGON
225 5th Street. Springfield. OR 97477 Ph. 726-3759
.Job Ad~
City Job ~
Affidavit
For Site Inv~aation. Qtlemnnmrire
Fonnrl ~tiOD- .~n lJ=.Gr<rde= A j!J:1.l v v Mar
Residp.nn ~ r Rnildirra:- Site"in-:-: AmhJe.~irl~Meadows--l stAddition
. . ~
Slll1diVi~ion:
TIie..-nnri", ,,; wflf".rl-h!"J"eby.::ailti IlIrth~Hh.. -~*~II'- ;u.'l'~ i"l"l fill ~rbnoi.stme-..
0" _ . .
stabilization:metb.ods:f~L1e:bnild'n!:_ ,,; ;r:.llfth~r10T"'"'"~uuw~:was:observed by
me: oom-:mthorized:.:.wployee:o.i::my fii III i1ncl-1tim-tl:ie'fOlk,w~is:1Iue::':
'. L ~'_TliI;..fuu..rl~ri~nejs'~~~~G.~~~~ ;:.:ta' ...;..:..tllw'of1500:psf;' and is,.
- adeqiiate:tO:~r'~Jjinlrii~~o~~pOSed.fv" ill;~'~:-
-2. .Th~ mohi.w.c; content' of the excavation \Y2S adequatcly mmnt~ined during the.site
preparation p..v..es5 and was adequately' covered to stabili7.ed moisture content.
, priOr to 'anycign;i1cant chari.ge in moi:.i.u..." content of the~. .
3. The site is adequately graded and drained to t'..~t~ the collection. of water in the
excavated area during construction.
4. The ~UlfJCUlying report titled."Site Investigaiian~onn3iIcfor-Consi1lting,
Design r~vf~Ona1s" cOn~ field o~ ,cUdms and instnx:tio~.made on . .
, . -4 -1..1 . Dol \ 4"1."'.1> 4. s ~~) fat the building site w2s'''-UUJ!Ileted either by
myself or by an employee of my :finn under my ~ ,&00. To the best of my
. knowledge, the infonnation contained in that ..~l is '-U~ete and ~cue..
? '
Name of Licensed Professional (print) ~
FA-I3ll.l v~
SlgD;itUre:;ZP'''': F~~~ ~~!.?-/)
Date 5 - 5- ~4
, EXPIRATION DATE:Ir.~l\-fl( J
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---hformatim ~ 'New Inspection
RSI ToB":UOn' ,R&-lnspecUon
.....<lII - W&U 0 Standby TIme:
........ r..-.1ldIr
ITY wor'~
ILEAGE &,)
~
1040-A Shelley Street
Springfield, OR 97477
(541) 7..6-9649
, '
Client:: I.-s.8.L '-? c).o,lfF t:JElL
Address
. lProJectNo.;122.. - U DI?..,,~ -: Z- DataPerfonne<< 4- ...~O -D4-
proj.Name:~~ I ~S~ B.p.Number:
proJ. Locatlon: tTechnlclan: 'D '-- f
E.qulpment: Troxler Model~oSN: '2.1 ~~
JRS
..
Laboratorv Sol1lAgflregsfe Dala:
-Moisture Density RelaUonship of . at '
Moisture DensIty RelatIonship of at
Moi~!!}:~ensIN RelatlonshIO~; 14-~ 0 ,:: at
Field ~Bns'tv Test R_osu,ts:J5wr.., pO.AD
TEST'
WOo :
[ . dated.
.' dated..
%molsture. was furnished bV (client) (contractor) (suooller) (other.
. '
% moisture" Is from our report number ,
% moisture _ Is from our reoort number
I" APPROX.
TeST ELEV.
1 /--Owl5L-LA1c;J....t 1J "F'O011tJ~ ,.JEfi..{;
2 11 ... I),,) . ~ I
1
3 PI.. ...,) $, ., f
4. '#'- ., j, ~ . ' .., 1 '_
5 ~~esr,~~ .~Jll..\(?
6 'tt.1..UeJ/!-Lewe;J..; W r5'-. ().j, ~ ~
1 ~ iii ~ ~: 1::::- F'OariN(.l
8 ().tI;P€/L ltNlEL ~ e- A'ST. tJ. ~
9 . n ''1 ..~ e . fooniJ4r,
10 J.Aoj~1?- Le::v~. e-~ . .~n4 '
11 .., , s." 41'3. HXn1'~
, J", .;
12 . ,
. Teslsperformad at ~ish=;d grad~r)~~'~~ ,inl:::hed gTad~) ~r(~S&' ~~~~~I alerial) '--itrench backfill) oth~;:"-- T.
, ~ " ' Fc.rL8L.-06 AD
Test results were verbally reported io: Lf1.l!..i!..J.-I'~Pe:P .
APPROXIMATE Ti:ST LOCATION
Additional Romaff<s:
PROBE
DEPTH
~u
(
,
I
. WET DENSITY DRY DENSITY PERCENT PERCF.NT REQ.UIRED
USSI~~..:r' laS/CU. ,:. ' ~Ol!T~. COMPACTION COMPACTION
l71t~~..~ ~j;~~:~ 'I f
, /4' ~ 4- '!Ll.f :3. I ~.(r., I
) ~'11 (g I ~.~,g It.... q~. B I
I?ql {5 13.~13 ~.:3 ~~
~ 142.1- I ~7.1 ,~.3 !~.,q
p4-'L.2... J ~7.4- ~ ?6 -, (0.8
L4~.9 .~ 1c.O ij~
t44..~ I~~.{P ~.~ J 3
'/56.f? I~.G ~,4- ff,~'
',~lr>,b /?,z.4- ~.,. ;.q~,7_
1..40Q
for
-
for
. ,.- I '
3/4-"--or ~P~~. QuA~~
COMMENTS
. ,
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I:h7
104D-A Shelley Street
Springfield. OR 97477
(5411 746-9649
New 1.nspoctlon ' ;; ~ ~(. _)).
Re-lnspecUon _ ~ ~ W""
Standby TimeQ>".;~', /f","
. , ," ,^~, - ,,0'
~\'~,r
, '
t:"IC' - - -"',ITVWOR
IiGiII~
r..sh.1bBlIildOn 0
, ................
l\ xj-\. t-'
lEAGE
'URS
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Pr~o.: 71-7-
proJ. I\!ame: c::
Proj. Location:
, -
, EquIpment: Troxler
Dale Performed:
B.P. Number:.
TechnIcian:
Client: I
Address
I.
I
.J
LabonJtorv SollfAggrega(e Data:
I '
MoIsture Densllv Relatlonshlr;>> of
. - ~., ,- . . . .
Molswn; DenstlvRelattonship o{
iM,~~~~J!Denslty Rela,!?n.~hlP ~;., "
Field Density Tes' Results: ,
, "
, : TEST ,
t!Q.
ior
, for
'W ~.~~()
. ",,1!J:;l- ".f at,. ,. % moisture. is from our report number . dated. ,
, at 0;' moIsture, Is from our report number ' daled
, (4'1.... 0 _~ at._.., _," u ,%' ~oisture. was furnished by /~nt) (contractor) (suppller} (other:,
PcRCe.~T PERCENT I nEQ;ED 1
MOISTURE C07r'lPACTlot~COMPAcnON
WE" "l;iNSITY DRY DENS
LBS/CU. FT. ,UlS/CU. FT.
COMMENTS
PROBE
DEPtlf
" APPROX.
. TEST ELEV.
APpnOX1MATE TEST l.OC~""ON
'A .i11:u
1
UI qz.4 '-t2, h
<1~ .~
'1' ~. ~
, "7'8 .9
~~,(p
:fff ,t.>-t-
-ttJ " Q
:!jj- ~,t
,!1, r R
: C!f'3. ~ '.;,.. -,-
,
1.Lo\&, Lc~\~. ~ (w.hc.tt '~^e).b-,
2 " w. S~(w.hJt. "-l
3 "~~' J~ ~ ((). ': "--.
4 ;. '._ L;'A~ {p.. "
1.~ . ~~O (E." J ~
---_._~
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I ~ 2.-z...
I t7.1.. 9 -~.:.;,
iJ2,O Z/.I
l.rL/. . S -LI
I 34 . <, -
/2.0.1
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......... IIb.-,
..~ ~f'
1.lq~ ' 1 ;1.3:13
, , I 33..:.!l.1 "2.h. I./..
)?~~J2X. 0
~ 1/3'-1. J '1').1. 9 '~g
~ . (31 '0 /2.7 ,S" 4~ ~
....... ~"\l ..vl ~ I <.b.. -) '?;7
(fill male!iall (trench ~ckfill) other:
"" l'1S".7 /3/. ~ '3. y
H LnX.
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5
e
7 tm~ ~ uJ:_'5~ (.~, .\-vlt
B ,~"". ~ ' fE.
9 j'.~ J~cO~ r~. .
~, '. ~ ' -
10 ~ L-,~ ~N'o.~\,
11'5 \i-..... I -..:l ': "'-
'T~:lst~~dC.~~M.f;;~m~~d ....;:i~Ock;
Q <1........."0-. v-''''IC.( "WOl.v;\' f' "'...........
Test results were verbally report:d lO:J!..~~lJ ,in
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.'\!.!~lUcnal Reffiflrns:
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:i~7~~\ I," l r~~l_ ,I!.~
,/,~,. !~f~t~~~t~~~ili~~c- C '- . ;~~ ~',:,~~:,~~~;C-' ' ,,"{f=:)~'
.~'-'-"""":"""<~~" ~'. .,,;.." , . ~.\:~;~_. '.'" : . -;~"': ..,..~ 'DA'YUarr".
~:~~!~~~*~~Hf~#t~~~;i~9~~~':;:~~j"f:'~~\~~~:f:f~.~:~;:i/)~;~J~~4~~~~:~'~;i~~ ',,_.. '..:(:ae:~~~, "
0(%(~ ",' ---...__.....,'>.,..~ .'" ....,..",~~_.~....,"'''.~ "',' .,. ,....,'t.J.,...,.", .. .',...".lUJ,.=ll1I6ltlI!iE.. .)
~ ~~f~S\\;?~;~~\~~~~t;@:Btt( 'f'%f1f;:: '. ~~t.
~ ii_~~_~~' , ~'~~~,'~ ~'.l' '~.~~.l$I4.~~~
/ \ :Z\M*~U:V...UJ7i92%
EXISTING "DI6IN::t:k ~I<I:tAIlV~ACl1().1
LWfS11JC!3ED ALL:~IN %~I'1<VwIt:l(.
:h~\r..;.UCLb1:v~~
GRCUJD 'ca.p~U::V.IV:~
ra:A11VECCM'ACTl().l
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file
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SEE RETAINING HALL lEI9J5
FCQ BAaa=JLl r<EClJ1J<EM:NTS
ENGIM:t:i<t:v :FILLJ<ECIJIra:teJTS:
CON51l<UCT'FILL.OV8<:ENIII<t: 7FOQT'PRINT 'OFJ~UILDING
,EXTEND'FILl...36I:BE'(OO:CXJIt:K:ED€€OF FOOTING ()J
, ALl..~SIDE5: EXU:;tII '11-E lJPSI..(J:JE ,SIDE.
EXTEND FILL 121 WOOClJT8( ED€€ OF FOOTING CN mE lP:uPE S/r:;E
ENGINEER FILL REQUIREMENTS