HomeMy WebLinkAboutPermit Building 1991-12-30
~
-:;\.,;'MMERCIALIINDUSTRIAL . SP~'NGF'ELD
PERMIT APPLICATION L........
225 Fifth Street, Springfield, Oregon 97477 .... t@
. "l&71<Rt/5tF w",y.
LOCATION OF PROPOSED WORK: t/r.C"iK/Y IICJ k ./ /..., t. !'I<!AII.
II (J? 7_?'--uJ
-JOB NUMBER 9///s:i!<./
INSPECTION LINE: 726-3769
OFFICE: 726-3759
ASSESSORS MAP'
.J7J~,,,r,/,i',,. OK 9 NJ 7
O()'110--:
TAX LOT:
OWNER: . :0..( 2LL 'J IN <-
ADDRESS:SY'bO CiJNN'~ L/1N~
CITY: <fA IN~./t J,od.t IV 0
. . ,
PHON'" 'llt'- t77-lft.7.
Or.':'PI'I'/t:,/J... -0'-11;' ilQE 'ili,. t t z -tl..zJ
STAT'"
et1
ADDITION
DEMOLISH
OTHER
. ZIP:_:lrtF2.~' ~
~('Jt.J ) .
VALUE: . ~
DESCRIPTION OF WORK' AI/v RLJ7AV'U.;:'
I
NEW / REMODEL
I
i . NAME
A'RCHITECT' J".I/lLU:-, .J;7J1N r iJliJ) INC.
,
(l""77)../..-;'"/j~
( 7'>r lI/iN 0
,
ADDRESS
.J,Y.? I/,Y) J7. Lt.t.tJt/./t. 4'l 97'1>1
CO NST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EX,I ES,=. PHONE
. riIGS ~W W~A"..?~$'""<,4 'eBrn 7/'I-~/::?7
GENERAL: 02&::06..... ~...../~ /U.c., .~~~ -9 ~ ~<" ". "200S"?_/ &z;<;- :,:_.-.!:>
PHONE
SOf- 71.5- JiJ,j>
PLUMBING:
MECHANICA' .
ELECTRICAL:J3~.y-.....~ N~~
I, PLUMBING I I MECHANICAL " I
I' NO. I FEE CHARGE I- ~ Nfl """ . rHARG;j
1~2 Single Fixture /0 Y'Z" 1 -z. Furnace/burner & vent 0 . /.7. 60
< 100.000 BTUs
II Relocated Bldg. I I 1 .-{ Furnace/burner & vent 7. SO 1
I . (new fix. addU) > 100.000 BTUs
I':n' Water Service 1 Ljp 1 1 Floor furnace and vent 1
It.
1!i'7'3' Sanitary Sewer I ;Z5 I I Suspended wall or floor I
It. mounted unit heater
1 lilt! i Storm Sewer 1 1 1 / Appliance Vent ~.-" I
It. .$S" separate
li~ I '20 I I / Stationary evap. ~".QO I
Backflow Device cooler
I! I I I z Vent Fan/Single I
duct
I I I 1 -:? Vent System apart I I I
- from AC or htg.
I 1 1 I '3 Mechanical exhaust Iy.~' /~.S.::> I
hood and duct
I I 1 I /2- ~~ d,r,e T"$ I.~ ~~O.&> I
I I I I Permit Issuance I $10.00 I
I TOTAL PERMIT 15.90 I TOTAL PERMIT I 5""2. e>O I
.
\ ~J\)l.k) - OFFICE USE - HANDICAP ACCESS:
a.~AD AREA: LAND USE: ,1=:)?f:{J FLOOD PLAIN:
. OF BLDGS' \ . OF UNITF' ZONING: r0____
OCCY GROUP' CONSTR. TYPF' liGHTING POWER BUDGET:
! \
. OF STORIES: HEAT SOURCE: WATER HEATER:
,
I sa. FT. $/ sa. FT. VALUE
sa. FTG MAIN ~9"2/ X - -~~... . ?2!:,/O~C?
,
sa. FTG ACCESS X
sa. FTG OTHER. : . ~v/~&::'_l-5/~ ~A>L/..
/41";:-1""--'
- ;
TOTAL.VALUE OF PROJECT
4.6~..::::7~
,
.J'~Jj~Hjg,~!EF;..f!!,; ~y~~' ~~ L",_ -!fl!,E ~-9-9/
BY~- ~..-
J" 7 .. ---f -:- ''''~.. .~.....
I BUILDING PERMIT 978, - PLUMBING 5f1t:? -
15% State ~6,q.e> 5% State 7Z <1. G't:J
Surcharge SurcharQe
I MECHANICAL ~'.-::.. 1 FENCE
VALUE $
15% State Z.~P I SIDEWALK "Z~.f;~
Surcharae /10 FT.
I ~AVING -?:37': -:z..~ I CURBCUT /'5. /"
7'11 FT.
I DEMOLITION I
1_~?X~~/...,,;~1Y~
I~.k" 2)~ /~ '3c>
1 SUBTOTAl
PERMITS 22~./5"
I SYSTEMS l\~~ ~:3-l?12 T
DEVELOPMENT 1>--o./<7'S-'f-Z== ~ ft"'"
/t!),5"<:::>7.B7
?ALA'h'/6
I
,
t?P- "50/ ~ 7/"...J;-
. TOTA'L P~'R-MIT FEES I l'2d$ '/3. 32 I!
EXCLUDING I;J.ECTRICAI .
. ~T=I'<. /:tnl. ~.c. 7%i'_~.'?.;:n.'-,-;/.;____ ~R74:: SI..
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.
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.
.
REQUIRED INSPECTIONS
)(
J(. ROUGH PLUMBING,'
ELECTRICAL &
MECHANICAL: No work is to
be covered until these
inspections have been made
and approved.
UNDERSLAB PLUMBING,
. ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
ATTIC DRAFT STOPS &
CURTAIN WALLS
J(
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
fr.aming inspection.
FRAMING: To be made after
the roof, ali 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.
It
;(
CONCRETE SLAB: To be
made after all Inslab building
service equi pment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
c.oncrete 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. .
x
/-
UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
y
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
UNDERFLOOR: Plumbing,
electrical, mechanical. 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
piastering Is applied or before
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.
1\
SIDEWALK & DRIVEWAY:.
Required for all concrete
paving within street rlght,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
USC 2415.
x
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
)(
A
FINAL PLUMBING
A'
FINAL ELECTRICAL
.
'~
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.1. (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: U.S.C.
Standards 43.8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
GLU.LAM SEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.G.
STDS. 25-10,11).
STRUCTURAL MASONRY: (306
a.7)
*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.
\, )( FINAL BUILDING: Requested after the final plumbing, electrical,
x FINAL MECHANICAL mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
;y Certificate of Occupancy has been issued by the Building Division
/" FINAL FIRE DEPARTMENT and posted on the premises.
ADDIT~NALCOMMENTS:ffi OcL...T:;_...._,.,..... ~T""-':" ?"z:.c:.. ~~:'.J~~~7~",.../_4"
.rFE /-S 1?~~ V,e-~ i p/./:::>
\' - - ,,'
PLAN'S REVIEWED SY ""z-~~
. //~
~.
y~ . ~
-1 - ~-~
-- .
DATE /,1111- 3::'~9/
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 ahy"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 p It card Is located at t e front of the property, and the approved set of plan's will remain on the site at all
times during c suction.
Signatu'rp
VALIDATION:
AMOUNT RECEIVED: ./2_~4'5.
:; S//S
32...
RECEIPT #:
Date /2..- 30 -yf
DATE PAID' /:z-;h-"'7/
RECEIVED SY:.W~'
,
~..
.\
~, . ..'
-,
CITY
JOB NO. CJ1118'-\-
OF tRINGFIELD SYSTEMS OEVELOP~T CHARGE .
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
0, F, ""LEX''? :ll.lc. (bf:N./..1Y~ ')
.NAME OR COMPANY:
LOCATION: 9 e., KIU)<S>E: WA.'<
,
'"10-:z.,'2-'"2.'2-0 - ooqo'(~'
DEVELOPMENT TYPE: CC - ~\G.I-\ 10!l-NOVEcl2- 'I<e.'7,AUl2..Al-lT
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT.. ?'404"2- X SO.I86 PER SQ. FT. ~ ~"?~',~
(See Reverse For Runoff Coefficients If Actual. Impery:. Area Is Unknown)
4"17.-"2-, SQ.,f'T. LOT SIZE
"2,"" . t..6Cf
SQ, Ft.
2. SANITARY SEWER-CITY
NO. OF PFU'S ~~ X $38.55 PER PFU
(See Reverse' To Determine Total PFU'S)
3, TRANSPORTATION
'3oS
.$ "2-4108 -
NO OF UNITS X TRIP RATE X COST PER TRIP
'4,"'"'2-? X \"".'1"? X $388.61
"".~:.
.$-?'O-:-1'2-'O~
X
X $388.61
.$ -
X X $388.61 . .$ -
(See Attachment C To Determine Trip Rates) . ,e
. SUBTOTAL (ADD ITEMS 1,2, & 3) .$ 4-,'4'2.f,- '9~./~
~.9'~70/7/..r~ 1"'l!:6 ?3zY*,?~./~ +-$-/77/Y",? ~n ~'#/7"/C::
4, ~AaM~7STRATIVE FEES' ,
BASE CHARGE (SUBTOTAL ABOVE) X ,05 5i :2:~,i~- '1t'?<>(
.~
. -
5, SANITARY SEWER-MWMc' . .
NO. OF PFU'S ,"'1.
TOTAL-CITY SOC. s4""eoo~
. ~76-$.I7
x $13,25 PER PFU + $10 MWMC ADMIN. FEE$\o"?o~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
",
V' -g, .l-Je..
U Kip Burdick
SDC Coordinator
'. \1:>/1 \/.,1
($ -z.6'~)
TOTAL-MWMC SOC $ f'-l-'2..~
TOTAL SOC s-5eS'-\v~ ~
1~~7- ~7
p jjc c::;~c=/=-~ #r~/77(.qcF.: