HomeMy WebLinkAboutPermit Mechanical 1995-11-17
COMM ERCIAL/lN DUSTRIA~
PERMIT APPLICATION
.
~
INSPECTION LINE: 726,3769
OFFICE: 726,3759
225 Fifth Street, Springfield, Oregon 97477
LOCATION OF PROPOSED WORK'
ASSESSORS MAP: / "7 t') ~
"2,,8 c::; .1 .
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OWNER:
ADDRESS:
CITY'
Irr-'
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'<AS
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JOB NUMBER
A'
,
"'iT,
TAX LOT
o/SD7~C;
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PHONE:
~~~ -1//11
DESCRIPTION OF WORK: N,~'/"r frz) f7nt
NEW ......--- REMODEL
ADDITION
DEMOLISH
NAME
ARCHITECT'
CONTRACTOR'S NAME
ADDRESS
5. 17'5tU"A!/,f r-t"
,
GENERAl'
T. --1.
PLUMBING:
MECHANICAL:
ELECTRICAl'
DW A..J i3tJ. .
PLUMBING
NO
, FEE I
CHARGE
Single Fixture
Relocated Bldg,
(new fix, addtl)
Water Service
'"
It.
Sanitary Sewer
It.
Storm Sewer
ft.
Backflow Device
TOTAL PERMIT
STATE:
/"t-o"e:7 .
ZIP:
A'~r~
- --
OTH ER
ADDRESS
CO NST,
CONTRACTOR'
I
10
I
I
I
I
I
I
I
I
I
I
I TOTAL PERMIT
MECHANICAL
Furnace/burner & vent
< 100.000 BTUs
Furnace/burner & vent
> 100.000 BTUs
Floor furnace and vent
Suspended wall or floor
mounted unit healer
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or hlg.
Mechanical exhaust
hood and duct
Permit Issuance
QUAD AREA:
LAN D USE:
- OFFICE USE -
FLOOD PLAIN:
HANDICAP ACCESS:
# OF BLDG~'
# OF UNIT~'
OCCY GROUP'
CONSTR, TYpo,
HEAT SOURCE:
# OF STORIES:
SQ, FT,
$/SQ, FT,
SQ, FTG MAIN
SQ. FTG ACCES~
X
X
SQ. FTG OTHER
x
PLAN CHECK FFe RCPT#
, BUILDING PERMIT PLUMBING
15% Stale 5% State
Su rcha':.,Q8 Surcharge
MECHANICAL 1';;:),-- FENCE
1 rSv--.xo /0. /P.o VALUE $
5% State ... 1.-;;..,0 SIDEWALK
Surcharae ,7<: -+,4~ FT,
I PAVING CURBCUT
FT,
ZONING'
<97477
r ~ F -
VALUE:
PHONE
EXPIRES
PHONE
I
, EEE_'_CHARGi
I
I
I
I
I
3~ A/dJ.1
I
I
I
$10.00 I
/ 5',dO I
LIGHTING POWER BUDGET:
WATER HEATER:
VALUE
TOTAL VALUE OF PROJECT
DATe
BY
DEMOLITION
"
SUBTOIAL
PERMITS
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES I
EXCLUDING ELECTRICA'
;;2t '" ~,o
,
.
REQUIRED INSPECTIONS
.
It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call
726.3769 (recorder), state your City designated job number, job address, type of Inspection requested and when you will be ready
for inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made
the following work day.
SITE INSPECTION: To be
made after excavation, but
prior to setup of forms.
UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work Is covered.
><' ROUGH PLUMBING,
ELE~
,....-M'E'CHANICAL;:>JD work is to
--oe-covered until these
inspections have been made
and approved.
PAVING: After gravel is in
place but prior to placing
asphalt or concrete.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
FIREPLACE: Prior to placing
facing materials and before
framing Inspection.
SPECIAL INSPECTIONS: In acco'rdance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Ownerl Contractor during
construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
ATTIC DRAFT STOPS &
CURTAIN WALLS
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
pi pi ng, accessories and other
ancillary equipment items are
in place but before any
concrete Is placed.
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are in
place and all pipes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanical are approved.
STRUCTURAL CONCRETE: In
excess of 2500 P.S.1. (306 a.1)
STRUCTURAL WELDS:
Performed on the job. (2722 f)
UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
INSULATION & VAPOR
BARRIER: To be made after all
insulation and required vapor
barriers are in place but
before any lath or gypsum
board Interior wall covering Is
applied.
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.B.C,
Standards 43.8.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
POST & BEAM: To be made
prior to installation of floor
Insulation, decking or floor
sheathing.
LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
Interior and exterior, is In
place but before any
plastering is applied or before
gypsum board Joints and
fasteners are taped and
finished,
GLU,LAM BEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.C.
STDS, 25,10,11).
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
STRUCTURAL MASONRY: (306
a,7)
MASONRY: Steel location,
bond beams grouting or
verticals In accordance with
UBC 2415,
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub.base material in
place.
"In addition to the inspec-
tions specified, the Building
Official may make or require
other Inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
FINAL ELECTRICAL
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish Inspection. All proIect conditions such as
landscaping, parking lot stplping, etc. must be completed before
requesting this Inspection.
FINAL BUilDING: Requested after the final plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
FINAL PLUMBING
'X'"
"
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
ADDITIONAL COMMENTS:
..e--Lcc.:~./C':A-/ ,./JMA?/T /'f~~) -4/A..l..l.h:1 ,J(!~~/T;;rt. q-~/7n1
PLANS REVIEWED BY
DAT"
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information
herein Is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances
of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY
will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees
who are in compliance with ORS 701.055 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from the
street, that the permit card Is located at the front of the property, and the approved set of plans will remain on the site at all
times durln~trrry~
~ature ~ "--:\~' _______ Date 1/-/'.:(- /'S-
I'ign -() - '" ----
VALIDATION: AMOUNT RECEIVED: ? ~ 20
/q /_ Z /
DATE PAID:
/~7/5J
, -~~
RECEIPT ":
RECEIVED BY:
( .. --- -
-
.OB NO. CfSo"'J(p<;;
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: LIE-? c"A,..{OrY.~ "f:,Efl.v'/c..E
. ,
LOCATION: ?o&? ?, A -Sr,
/7o?7'?500 - Do 2..00
DEVELOPMENT TYPE: ~c.. ~ '5rbR.A-(,E:; 13LD6 '
:PM
BUILDING SIZE: 40>10:.0 c 'UlOO ~f". ~,( -ZSl lOT SIZE
,
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS. SQ. FT. -z.'2.24- X $0.209 PER SQ. FT. ~%t~
2. SANITARY SEWER-CITY
NO. OF PFU'S .....e- X $43.26 PER PFU G-b- )
(See Reverse) ----- -----
3. TRANSPORTATION
c..o9~ I~D - vJ"'lLe-I-\o~u.J6'" 0 "<\-!ic,,o;,F-
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $436.19
G:4?"'~
----- -----
$
$
z. .0
X () ,"14 X $436,19
X X $436.19
4. SANITARY SEWER-MWMC
NO. OF PFU'S ~ x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
$ -ft-
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$
TOTAl-MWMC SOC C --& ,.)
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ Itlo ~
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~ '---. ~LJa.. Date:J'" /u he;,
'--~. Kip Burdick ' . 'TOTAt Soc;
SOC Coordinator
~~~~
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