HomeMy WebLinkAboutPermit Building 1995-1-10
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CO M M ERCIAL/I N DUSTRIAL
PERMIT APPLICATION
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95003fl
JOB NUMBER
225 Fifth Street, Springfield, Oregon 97477
INSPECTION LINE: 726-3769
OFFICE: 726-3759
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LOCATION OF PROPOSED WORK'
ASSESSORS MAP:
OWNER'
ADDRESS:
CITY'
TAX LOT:
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U/mD P.R/O")t/CT..e0 CJ<".I3J// / A//&#H)'N'"
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.sP..k?/A/fSP/fi/J STAT'" r7,L<
--"744- -q4t'2!;)
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ZIP' ?' 7477
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DESCRIPTION OF WORK: CClf.Jt/&?T ?,0
NEW REMODEL ~ADDITION
CONTRACTOR'S NAME ADDRESS
":'GENERAI MC;<PNZIE ({/MMJ=Rr./AL.
MA-
NA
AI FKT/7FC~
ARCHITECT'
PLUMBING:
CA'(9J// L/,(JA)() ,
'C:, ~
VALUE' ;1') t')&fD
, ,/
PHONE
DEMOLISH
OTHER
NAME ADDRESS
l /r2/N.IVl AMUN~N /""7J/;;q'OAL' Ftlc?
- . CONST
CONTRACTOR'
4~~9l\
~44 -)?7A3'
PHONE,
~0.1l4.~
JIM,
EXPI RES
'l:Al.q(p
MECHANICA"
j. -,. ELECTRICAL:
I NO
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t~'10Q
.P)-8.R/1~ ~41':J{J1")
PLUMBING
MECHANICAL
FEE
Nn ~~~
f':l-ItdH:::1=
CHAR!;!;
Single Fixture
Relocated Bldg.
(new fix, addtl)
Water Service
Furnace/burner & vent
<100.000 BTUs
Furnace/burner & vent
>100.000 BTUs
Floor furnace and vent
Suspended wall or floor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent System apart
Irom AC or htg,
Mechanical exhaust
hood and duct
ft.
Sanitary Sewer
It.
It.
Storm Sewer
Backflow Device
Permit Issuance
$10.00
TOTAL PERMIT
\0f1:xJ - OFFICE USE -
QUAD AREA: LAND USE: 5?['{)
. OF BLDGS: , OF UNIT~'
OCCY GROUP' ~ CONSTR. TYPE: a;'-A?
-
. OF STORIES: I HEAT SOURCF'
SQ. FT, $/SQ. FT.
SQ, FTG MAIN X
TOTAL PERMIT
HANDICAP ACCESS:
FLOOD PLAIN:
ZONING: -L1Yl :L
LIGHTING POWER BUDGET:
WATER HEATER'
VALUE
SQ, FTG ACCESS X
SQ, FTG OTHER . ~h ,.=;-,.-- ~/......='-
/.. -; , -7 ~> ,.
52 33
TOTAL VALUE OF,PROJECT .~_- '->
OATE4/0/5''' BY /~
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PLAN CHECK FEE
RCPT' /C:;7'c:. 3
I BUILDING PERMIT
5% State
Surcharpe
MECHANICAL
15% State
Surcharae
I PAVING
]I '/~';'3j.Or- THIS I"E-i'M'7
d ~ 5"'70,}" f>~,f"'17 '130/20
Zb.;Sp
7'..053
"7. V-::>
I PLUMBING
5% State
Surcharoe
FENCE
VAllJF. $
sib-EWALK
~UBTOTAL
PERMITS
SYSTEMS
, DEVELOPMENT
DEMOLITION
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~(;. 9?: J
,/ &"0.<3,)..5-.-1' I
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CURB CUT
FT, I
/2. 5"~O. - ;J./O)y' J'
TOTAL PERMIT FEES ,
E1SCLUDING ELECTRICAl
~'?7V. '30 2f?<:t".-rr ~ t'!:).c-Cd1&Jrl'-...v ~........
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REQUIRED INSPECTIONS
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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.
A SITE PLAN REVIEW BOARD: Must be requested 2 days In advance
of the date you wish Inspection. All project conditions such as
landscaping, parking lot striping, 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.
f?tU~€ ~6.
UNDERSLA8 PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work Is covered.
y ~""'I-I PlUMBING,
ECTRICA!)&
MECHANICAL: No work Is to
be covered until these
inspections have been made
and approved.
ATTIC DRAFT STOPS &
CURTAIN WALLS
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.
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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.
CONCRETE SLAB: To be
made after all Inslab building
service equipment, conduit,
piping, accessories and other
ancillary equi pment Items are
In place but before any
concrete Is placed.
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.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
UNDERGROUND: Plumbing,
elec"trlcal, gas, sanitary sewer,
storm sewer, water and
d ral nage II nes. To be made
prior to coverIng or filling
trenches.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to Installation of
floor Insulatlon, decking or
floor sheathing,
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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 belore
gypsum board Joints and
fasteners are taped and
finished.
POST & BEAM: To be made
prior to Installation of floor
Insulation, decking or floor
sheathing.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to Installation of
decking or floor sheathing.
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.
MASONRY: Steel location,
bond beams grouting or
verticals In accordance with
UBC 2415.
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
FINAL PLUMBING
x
FINAL ELECTRICAL
x
FINAL MECHANICAL
Y FINAL FIRE DEPARTMENT
ADDITIONAL COMMENTS: ~"?'~ ~i7'
OV,,~ rQymJ.J-jit9QO//Jnj
PAVING: After gravel Is In
place but prior to placing
asphalt or concrete.
SPECIAL INSPECTIONS: In accordance
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,
STRUCTURAL CONCRETE: In
excess of 2500 P'S,L (306 a.1)
STRUCTURAL WELDS:
Performed on the Job, (2722 f)
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations, (306
a.6)
SPRAYED ON
FIREPROOFING: UB.G,
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a,11 &
Chapter 29)
GLU.LAM 8EAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 UB.G,
STDS: 25-10,11),
STRUCTURAL MASONRY: (306
a.7)
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'In addltlo to the Insp
tlons spec fled, the 8ull Ing
Official may make or require
other Inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
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PLANS REVIEWED BY //.....,~~--:_"'"";> DATE.:.:6.....,.r3:~S--
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By signature, I state and agree, that I have carefully examined the completed appljcatlon and do hereby certify th~t 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 during construction.
Slgnaiu.~l\d J ~[CWl"J_ Date_~-J~-q~
VALIDATION:
AMOUNT RECEIVED: /7 ~26
RECEIPT #, /6 ~ $I"
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DATE PAID- :.,-2Y,)'~
RECEIVED BY' . ','r - -"-,c
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. ATIACHHENT 81
. .8 NO. 9<;00]0
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
.--WOBKSHEET
~ERCI~ RESIDENTIAL)
NAJ.lE OR COHPANY: I/)~ /~ ;;'",..k/ ~
LOCATION: ~C.'l3 4 f.r~AJA- ,f~
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DEVELOPI1ENT TYPE: ~ J,rwr tfnf~ ~L (M),t ~ ~
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BUILDING SIZE: lOT SIZE" SQ. Ft.
1. STORM ORAINAGE
IHPERVIOUS SQ. FT.
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Nt) A.ob J. 04,(64
$ dt 'I.S~90.'10
/ &-t/>. "$~17
'13"1,).0 ~JI
$ , ",fA
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X $0.209 PER SQ. FT.
2. S8HlIARY SFWFR-CTTY
NO. OF PFU' S . No ,4p,o ~ FIITUtt!S X $43.26 PER PFU
(See Reverse) -
3. TRANSPORTATTON
NO OF UNITS X TRIP RAtE X COST PER TRIP
1.25"<;1 X /1.$5" X $436.19
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,$ 7s,.?o.f!/ ~',
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$,5"'" f:.:t,j> 2.
S.IU.
X "?:z.~ X $436.19
1;;..1 os;:"
X j.6c."1 jX $ (19)
~7.:>..z,-jj>
TOTAL ARJ!A or BtllJ-P/A/&.
. It> ~...o ,tN. ,A-,('M 01'" TtY/s
i'$~/1f/r '" Co f-SI>" 1 "
SUBTOTAL (ADD ITEMS 1.2, & 3)
< (",4->-
$ Ii 8'4/.0"0....
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4. SANTTARY SFWFR-MWMC
, NO. OF PFU'S #0 A"'.o~ X $17.19 PER PFU + $10 MWMC ADMIN.FEE $ ..v.:4
. (Use PFU Total From Item 2 Above) /
HWMC CREDIT IF APPLICABLE (SEE REVERSE) $
IQIAf -M\JHC SDC . S ~
/
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$ 1/ Y'~1. tHJ
5. AOMTNTSTATTVF FFFS
B~E CHARGE .(~U~ ABOVE) X .05
~ ~~ Date: /-;2.)-;7.s
/ Ma'r,y \itJ~ f\U
SDC~oordtnator
$ 5'12,05-
rillS
$ 1:1.1-33.0> I'I!.e/II/r
- ----
. /1f* $ 5"~90.JO s~.I'M""i
9301.2.0
TOTAl SDC
82. SOC. }f .eArp: /,01 E P/'"IZe-T tuHGN ,M'/WhA ~
fG,eHtlr WA,S..t:A;.t:.U,I!.oiT&IJ., (/,"p$. ''13)