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HomeMy WebLinkAboutPermit Signage 1984-8-4 ,-~ .r. ~ CITY OF SPRINGFIELD 225 North 5th Street INSPECTIONS 726-3769 BUSINESS 726-3753 BUILDING MOVING PERMIT/BUILDING DIVISION OLD ADDRESS l.-'1" !,,..,t:!>. CV~~ Legal Description Building Owner TA-UJ 1'IM.I:- INf'<- Address I we.... Moving Firm Address "R\C.l-\.uo~~ ~ SU.(DA~ f\.OI.lH.- Movlfle. Description Of Intended Use it (..0 T "'''''-A'''I' Description of Route f.(VTL,d.. <"'11 NEW ADDRESS (Furnished by Building Div.) ~ " )' ,f). dIWi Legal Description \fO~~~?/L Cl~~.\\\) Phone (f) Y; ) 1?'1.-"\. "1-- Lics # Exp. Phone ~2-0~"l rZ"6-Y{- ::.'-{'l S-.f3) · CITY DESIGNATED JOB NUMBER Y R-i,/e297- 'EA0~ (5.A SI.) f-,xIT oN1'o L-ClI U.Ai),t\ Cf'J M c..k&:N'L (.(. JAI.IJI,- fRO All ~vr<l L:~'O Description of Building o/'I'- A Sf. ..Square Footage Number Of Sections Moving Length Being ~Ioved \ J-v-' . ( " l' It I, I Moving Width 2...7..... Height On Dolly I (> Type Of Construction W~oQ VALUATION NOTIFICATION OF ~IOVE: The Building Division will route copies of this application to all appropriate divisions, departments and Agen- cies. HOWEVER, the applicant must contact property owners if trees are involved in the proposed move. IN ADDITION, the applicant must secure the approval of all appropriate municipal, county and state authorities should the move originate or terminate out- ,id, <h, Ci<y of Sp""fi"', ~ SEWER CAP: Buildings moved from within the City limits shall have the sewer capped at the property line and inspected one working day prior to the move. If the inspection indicates that the sewer has not been prop- erly capped, the moving permit will be revoked. PLANS, FEES, AND CHARGES: Prior to receiv- ing a permit to move a building to property within the City, the applicant or his/her authorized representative must: 1. Submit 2 copies of site or plot plan for new si te. 2. Submit. 2 copies of foundation plan for the relocated building. 3. Obtain a permit covering the new founda- tion, as well as all plumbing/mechanical and electrical work relating to the re- located building. 4. Pay Systems Development Charge if appli- cable. SEPTIC TANK REQUIREMENTS: Prior to moving, owner shall have all sludge from the septic tank, seepage pit or cesspool removed by a person holding a sewage dispoal service li- cense, and shall fill same with clean bar- run gravel or other material approved by the Director or his authorized representative. / .' " ./ I CERTIFY THAT the above information is true and correct, that all~quired contacts)have been~e and ;\Ut;lI~fizations obtained, that the move will begin at \ "'l \ )) Sl' clock ~pm . on ~.l (\ . ~-t ~4 and will be completed by ..B: ~D 0 I clock 8'pinon '06c., "l g"j and that no chadges in the route will be made without contacting the Building Division. I also certify that I have been informed that NO PEID1IT WILL BE ISSUED BEFORE 5 WORKING DAYS HAVE ELASPED. I further certify that. my ,registration with.the Builder's Board is in full force and effect as required by ORS 701.055 and 701.070, and that if exempt the'basig-is ~ noted hereon. Basis for Builder I s Board Exemption: 7fi", rh I~ ~, -.., '.)l NJ\l.IE Q.1(.LIAOt\lCJ SG.<.oI\/" /,(.0\1(2.- ./i..\Ul.l!SIGNATURE~ IAJVJm-\O DATE ~<.t- r-I FOR OFFICE USE ONLY Zone C J0 J Flood Plain~TYPe of Construction \/tJ Occupancy Group ~p , Stories \ Living y"nits~ Square Footage \\Q~ VALUE 4\,\00.00 Application fee $18.00 Date Paid \1.-1)~ Receipt Number I () r-:2.A,O Permi t fee $60.00 -- Date Paid \t- f')... ~ Receipt Number 1 0 ~f=rlO Number of Blocks over 6 @ . 60~ C7S Amount \....") J.R-, .Q... cl.r'.l) ~, Sewer Cap $10.00 + 4% State Surcharge -- Date Paid V'/ ___Police Department Willamalane Park and Recreation Fire Department Pacific NW Bell' ---Northwest Gas ....I-'-}ime Tresit ~trict . OTHER _-.- ~pecifY.lli.~'\\ ~.ll"\... :":-:~.l.~. .\?"~".. ~'\J . ~ainbow Water / SUB ___Group W Cable ~Lane County A. & T \. ')1\ ll0 'SL\ \'\rlCLD ~ , . . .... . ,......_ ,~c..\o.=..~'.~._........._,... " .."""c~,~'_'."'''_' -~......,." ~:I~D::~OVINIRMIT'~' ........ ,.~ -;' . ",-.- 1. Applicant to furnish"(except as indicated') 'A, ,Old address for builaing' :, '".' , ".;>-,-,. B. Legal Description " .,'. ".:~~. .:. , C. New address for building . "'....(Bui'llb,ing I),iv..~~fultn:;shl.;;""';;-; ',,'';'" "" , D. Legal Description '. _ E. --Name, etc. of building owner': . F. Name, etc. of moving firm .. -" ....G.. A description of intended use . _' .. ~ .__A description of proposed route I. A description of the building II. Applicant to contact property owners if trees involved, and secure authorizations from other jurisdictions as necessary. III. A site or plot plan, and foundation plan must be submi tted for the new site (2 sets) IV. Pl ans mu~ tal 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 8. Copies of application to appropriate divisions, departments and agencies .. ", BUILDING DIVISION REPORT: ." ~ ';'.. '.P.ER~~T .VALIDATION,:." ,~<<;~;: 'Ii#-:,~ ~'9? 0 "~,_.),': ~..\~. Pcl~ ,1 &:;Vf1t' ';'-" ,,- .. '"'_ ~:<-."':~...:-'rt.. ;'7.,"'t'~. ".;~~';'.i:--... ':5~} '~" . :..,:'~-~, ~. .. -'" . ~ PERMIT CLERK~ / ~lt;:.~ t.t,..~j,!... :~:~:~~" "... '':'1~1l' ;' ~7' "::;?-.: . ....;. ,....- -.:". ~~ !,pp~v TRAFFIC DIVISION REPORT: . ~ t: ~k'..A ". ~\~ ENGINEERING DIVISION REPORT: ~. """ '--,':;'!:. ~,..,... ..~:.:. ....t...........,.,.- ADDITIONAL PROJECT INFORMATION: Da te /':l.SI'-e, . t.f..-~~. - Date lz.l~l.a4 J;i,W~/L - 4--& ~ By . Date -. t CITY OF SPRINGFIELD , ,. INSPECTIONS 726-3769 225 North 5th Street BUSINESS. 726-3753 BUILDING MOVING PERI-lIT/BUILDING DIVISION OLD ADDRESS z.-q" !, nth Legal 6v~-' Description ., Building Owner TA-Ul 'lIMt:- lNT',- Address Iwc- Moving Firm Address R\C.IA,uo",~ ~ SU.I"oC\~ f\.Q\.)SL- MO\)I/'I'" Description Of Intended Use it 01 T 1'I""-A-"''- Description of Route htvTi-1l. <"'" NEIV ADDRESS (Furnished by Building Di v.) ~") JJ..dIw\ Legal Description \1 O~ f)..~;~'2. \\ ~~ \\\') Phone (9"6 ) ~l.- I.. '1-- Lics # Exp. Phone :,2-05"{ ;'2"6-)1(- )'i'-l yj)) . CITY DESIGNATED JOB NlJl.IBER Y RLj fJ'XCJ7 (5.A SI.) +.oX'IT' o N'lo V;;J, oN M<..I<&:.I\I1...I.(. j,l1.\J\ U.MI~ f R 0.<0\ Sour~ i:^J'O of-I>- A Sf. Description of Buildin~ 'lV-I , <,-'1 , 'lI h .square Footage Moving Length Moving lVidth z... 7 Height On Dolly 11 . Number Of Sections Being ~Ioved \ Type Of Construction W~().;) VALUATION '. NOTIFICATION OF MOVE: The Building Division will route copies of this application to all appropriate divisions, departments and Agen- cies. HOWEVER, the applicant must contact property owners if trees are involved in the proposed move. IN ADDITION, the applicant must secure the approval of all appropriate municipal, county and state authorities should the move originate or terminate out- side the City of Springfield. SEIVER CAP: Buildings moved from within the City limits shall have the sewer capped at the property line and inspected one working day prior to the move. If the inspection indicates that the sewer has not been prop- erly capped, the moving permit will be revoked. I PLANS, FEES, AND CHARGES: Prior to receiv- .</ ing a permit to move a building to property, within the City, .the applicant or his/her .~ authorized representative must: 1. Submit 2 copies of site or plot plan for new site. . 2. Submit.Z copies of foundation plan for the relocated building. 3. Obtain a permit covering the new founda- tion, as well as all plumbing/mechanical and electrical work relating to the re- located building. 4. Pay Systems Development Charge if appli- cable. SEPTIC TANK REQUIREMENTS: Prior to moving, owner shall have all sludge from the septic tank, seepage pit or cesspool removed by a person holding a sewage dispoal service li- cense, and shall fill same with clean.bar- run gravel or other material approved by the Director or his authorized representative. I CERTIFY THAT the above information is true and correct, that all required contacts~ave been made and authorizations obtained, that the move will begin at o'clock am/pm' on and will be completed by }3: ~D 0' clock @pm on 1){.oc-, C{ '~ and that no changes in the route will be made without contacting the Building Division. I also certify that I have been informed that NO PE~4IT IVILL BE ISSUED BEFORE 5 IVORKING DAYS HAVE ELASPED. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055 and 701.070, and that if exempt the'basis-is ~ noted hereon. Basis for Builder's Board Exemption:~ rJ\ A~ ~,-~ U1 NA/oIE QIUIAOt\lCJ SWDIV' /,lOIHt ~\UtV'SIGNATURE (MIM II..) VJrerJ DATE ~C{-01 FOR OFFICE USE ONLY Zone C Ir 1 Flood Plain ~TYPe of Construction Stories \ Li ving ypi ts 0 Square Footage Application fee $18.00 Date Paid Permit fee $60.00 -- Date Paid Number of Blocks over 6 @ . 60~ C?:5 Occupancy Group VALUE Receipt Number Receipt Number Amount Sewer Cap $10.00 + 4% ___Police Department ___Fire Department ___Northwest Gas ___OTHER -- specify State Surcharge -- Date Paid ~ lVillamalane Park and Recreation Pacific NIV Bell ---Lane Transit District ___Rainbow lVater / SUB ___Group IV Cable ___Lane County A. & T 5?l/" ~91 , BUILDIN~OVING PERMIT.' - -:-." .' , .~ ..PERMIT VALIDATION.,.: ";~';".;..f~': 'fii/:' 0~ 970 "' 0,_..', ~ . _~. WJ .... l&III~~.p.,'_" :'--, .; . . , VI. I. Applicant to furnish (except as indicated) A. Old address for building B. Legal Description C. New address for building ....(Buillbing o'i.v. ~,ful;iiijsh);t.,;, '. '--, ',. 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 I. A description of the building II. .Applicant to contact property owners if trees involved, and secure authorizations from other jurisdictions as necessary. A site or plot plan, and foundation plan must be submitted for the new site (2 sets) IV. Plans must also be submitted for any other work relating to the relocated building. 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 FOR OFFICE USE ONLY A. Plan check data collected B. Copies of application to appropriate divisions, departments and agencies ".; ...-1... III. V. PERMIT CLERK~ ~ "~ BUILDING DIVISION REPORT: ';.;'!~..' 1"'5'~",,';:', ",;',;\=>",-;' -,' ," :::}5::- .-'-:,""- . -, ". TRAFFIC DIVISION REPORT: ~?7~ !,~~~~-A3V Da te /":l .~~ ........ " ~" ", "'\ ~J..-R-sv~, - Date lz..l~l84 ENGINEERING DIVISION REPORT: .~:..~~. .i;2lC:. ; ~.~... '-~' <:..:--l~ '.;"'l~ JJf,/'Vr.J'1~1 z -4--,~ <J ADDITIONAL PROJECT INFORMATION: By . Date'