HomeMy WebLinkAboutPermit Building 1992-4-26
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CiTY OF Sl'IUNGFIELIJ
BUSINESS 726-3753
.,
INSPECTIONS 726-3769
225 North 5th Strect
BUILDING ~IOVING PERMIT/BUILDING DIVISION
Lics /I . Exp.
o ~;Q~~^TE~ J~~IBE~~-88'33
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OLD ADDRESS
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Legal Dcscription
Addrcss
Building Owncr
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~Ioving Firm ~-
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D~~.~lt~
Addrcss
Dcscription of Building
<-(0
Squarc Footagc
Numbcr Of Scctions
~Ioving Lcngth
Bcing ~Iovcd
Type
~EI~ Ani>3 ~rniSjd bYS;~i Iding, Di v. )
Lcgal Dcscription
\ 1 03 <9 5~4 C04CL)/rA '
, Phonc ~' ,
Phone
Moving Width '2.- ~ Height On Dolly 2.0 I
Of Construction~~VALUATION
/ .
PLANS, FEES, AND CHARGES: Prior to rccci v- ./
ing a pcrmit to movc a building to propcrty
within thc City, the applicant or his/hcr
authorizcd rcprcsentativc must:
1. Submit 2 copics of sitc or plot plan
for nCl1 si tc.
2. Submit 2 copics of foundation plan for
the rclocatcd building.
3. Obtain a permit covering thc ncw founda-
tion, as 11ell as all plumbing/mcchanical
and clcctrical work rclating to thc rc-
locatcd building.
4. Pay Systcms Dcvclopmcnt Chaq:e i.f al'pli-
cahle.
SEWER CAP: Buildings moved from within the SEPTIC TANK REQUIRE~IENTS: l'rior to movin!:,
City limits shall havc the scwcr cappcd at owncr shall havc all sludgc from thc scptic
thc propcrty linc and inspcctcd onc working tank, sccpagc pit or ccsspool rcmovcd hy a
day prior to thc movc. If thc inspcction pcrson holding a scwagc dispoal scrvicc li-
indicatcs that thc scwcr has not bccn prop- c6nsc, and shall fill samc with clcan bar-
crly cappcd, the moving pcrmit will be run gravel or othcr matcrial approvcd by thc
revoked. Director or his authorized reprc~cnt:1tivc.
I CERTIFY TilAT thc abovc informati.on is truc and corrcct, tbitt aE rCl~I'cd contacts h;i1i~'S
becn~dc a~' uth i ations obtained, that the movc will begin at (n Qjcthort ~/JI
0,\. r. d will be complcted by (0 o'clock am/I~on \Lh{l\, 7'"2.-
and-tha no ':la cs in thc route will be made without contacting thc tiu~din'g DIvision I
also ccrtify that I havc becn informcd that NO PERMIT WILL BE ISSUED BEFORE ~ WORKING DAYS,
(lAVE ELASPED, I furthcr ccrtify that my registration with thc Bu'ildcr's Board is in ,'full .\
force and cffcct as rcquircd by ORS 701.055 and 701.070, and that if cxcmpt thc basis is
notcd hcrcon. Basis for ,Buildcr'sdBoard Excmption:,
NA/oIE6-b4(~ &~~ ~(cLl(a j(O~TUR~ '
;(~I jd)
FOR OFFICE USE ONLY ;1
Typc of Construction \J IV OCi::uphnc~'
NOTIFICATION OF ~IOVE: Thc Building Division
will route copics of this application to all
appropriatc divisions, dcpartmcnts and Agen-
cies, HOWEVER, thc applicant must contact
propcrty owners if trces arc involvcd in the
proposed movc, IN ADDITION, thc applicant
must sccure the approval of all appropriate
municipal, county and statc authorities
should the movc originatc or tcrminatc out-
sidc thc City of Springficld.
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Zonc
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1
Sqllarc Footagc
VALUE
Application fcc $18.00 Datc Paid _ ~~ Rcccipt Numbcr
Pcrmit fcc $60.00 -- Datc Paid lol.}W R.s1.cip5t~mbcr
Numbcr of Blocks ovcr 6 0 .60~ Amount ~n~ )
SC\1cr Cap $1.1f.OO ..A% Statc Surcharge u Datc Paid \~.()c)*:l<<2)
~POliCC Departmcnt Willamalanc Park and Rccrcation bRainb0\1 Watcr
Fire Department -Pacific NW Bcll Group W Cablc
-Northwcst Gas 1Lanc Transit District =Lanc COllnty A f, T
OTHER - - speci fy
Plain
Storics:
(;lving' Units
.
DATt!-/cJ-'1t9- '
Groui;
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~ERMIT VALIDATION ,-'
BUILDING MOVING ~IT ........
I. Applicant to furnish (except as i nd i ca ted )
A. Old address for building
B, Legal Description
C. New address for building
(Building Div, will furnish)
D. Legal Description
E. Name, etc. of building owner
F, Name, etc, of moving firm
G. A description of intended' use
H. A description of proposed route
1. A description of the building . .
II. Applicant to contact property owners if trees
involved, and secure authorizations from
other jurisdictions as necessary,
Ill. A site or plot plan, and foundation plan must
be submitted for the new site (2 sets)
IV. Plans must al so be submitted for any other
work relating to the relocated building.
V. Fees & Charges:
A. Application fee due and payable at time
of application
B. Moving permit fees due and payable upon
permit issuance
C, FEES & CHARGES TO BE CALCULATED BY
BUILDING DIVISION STAFF
VI. FOR OFFICE USE ONLY
A. .Plan check data collected
B, Copies of application to appropriate
divisions, departments and agencies PERMIT CLERK
t:l1~OO~I~~~~^C1~& \~1AJ
TRAFFIC DIVISION REPORT:
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70 & ~J1P(l..J7) - 70 P~77i'cr ~L,i7~S SIr,A./kL G"1cu;. MCm?.s TO &-
/""fJ,yt;""l~ 7D A<.5J~ /t./teA ~ ~ //r::,7i'2 /""O/~v ~J Date ~/ 1Ci'?
ENGINEERING DIVISION REPORT: -, - 2)
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ADDITIONAL PROJECT INFORMATION:
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