HomeMy WebLinkAboutPermit Building 1995-11-15
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COM M ERCIALIIN DUSTRIAL
PERMIT APPLICATION
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JOB NUMBER
q S\l r)(O
225 Fifth Street, Springfield, Oregon 97477
INSPECTION LINE: 726.3769
OFFICE: 726.3759
LOCATION OF PROPOSED WORK' /'5 <? Jt'lA"..j,
ASSESSORS MAP' \1\ h.~b?JL-
'5T.
TAX LOT:
CAra.r ')
OWNER: ~--r- }..) IGI-foL$
ADDRESS: i ~8' IJI/\A-r I\J ~ 7
CITY' c:..l"lC.ll\llf.-r,,t;;,L{',
PHONF'
DESCRIPTION OF WORK'\ V\td'{\X)\\\f\)
NEW REMODEL ADDITION C'J
STATF' C!:>I?-e
-A... \'N,thAon
oo.ou\0 m","
ZIP' Q7,+77
VALUE:
NAME
ADDRESS
PHONE
ARCHITECT:
CONTRACTOR'S NAME NA
GENERAl'
PLUMBING:(~/I':~=~ ')
.......... ./
MECHANICAL:
ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
'(V..J ( N- ,e, V~
P~oJ(yI
Co!,
17bc;.~ (JC;~
~ ~-( tp.P.f
ELECTRICAl'
I PLlIMBINn
I NO.
ILt Single Fixture
I Relocated Bldg.
Inew fix. addtll
I Water Service
ft.
I Sanitary Sewer
ft.
I Storm Sewer
ft.
I Backflow Device
MECHANICAL
Furnace/burner & vent
< 100,000 BTUs
Furnace/burner & vent
> 100,000 BTUs
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_ ~HAaGI
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$10.00 I
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FEE
I ~HARr.<:
4\ ') .CO
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Floor furnace and vent
Suspended wall or floor
mounted unit heater
Appliance Vent
separate
Stationaryevap.
cooler
Vent Fan/Single
duel
Vent System apart
from AC or hlg.
Mechanical exhaust
hood and duel
Permit Issuance
TOTAL PERMIT
TOTAL PERMIT
- OFFICE USE -
HANDICAP ACCESS:
FLOOD PLAIN'
QUAD AREA-
LAND USF'
. OF BLDG~'
. OF UNIT~'
ZONING'
OCCY GROUP:
. OF STORIES:
CONSTR. TYPF'
HEAT SOURCE:
L1G HTING POWER BUDGET:
WATER HEATER'
SQ. FT.
$/SQ, FT.
VALUE
SQ. FTG MAIN
SQ. FTG ACCES~
SQ. FTG OTHER
X
X
X
*'
'. . .:-.....
TOTAL VALUE OF PROJECT
PLAN CHECK FEr RCPP DAT.
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I BUILDING PERMIT ' PLUMBING "\\ ) lJ{
15% State 5% State 'L flJ_
Surcha~qe SurcharQe
I MECHANICAL ~~, 3J!tJ \.' ?,.V
5% Slale I SIDEWALK-
Surcharae FT.
PAVING I CURBCUT
FT.
BY
DEMOLITION
'I SUBTOTAL
_ PERMITS
1 SYSTEMS
DEVELOPMENT
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. TOTAL PERMITFEES I ~~. C/I
EXCLUDING ELECTRICA'
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REQUIRED INSPECT,IONS
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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 Jnspection requested and when you will be ready
for InspectIon. Requests received before 7;00 a.m. wlll~ade the same working day, requests made after 7:00 a.m. wilt be made
the following work day. V
SITE INSPECTION: To be ROUGH PLUMBING, ," - PAVING: After gravel is In
made after excavation, but ELECTRICAL & . . place but prior to placing
prior to setup of forms. MECHANICAL: No work is to asphall or concrete.
be covered until these
inspections have been made
and approved.
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FOO'T1NGS & 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 accordance
Section 306 of the State Specialty Code
a special Inspector shall be employed
by the OwnerJ,Contractor curing
construction of the following work. A
copy of the special-testing reports shalt
be furnished to the Building Division.
UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work Is covered.
ATTIC DRAFT STOPS &
CURTAIN WALLS
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
piping, 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: Piumblng,
electrical, gas, sanitary sewer,.'. I \,
storm sewer, water and
. _ 'drainage lines. To be made
prior to covering or filling
trenches.
INSULATION & VAPOR
BARRIER: To be made alter all
Insulation and required vapor
~. \ barriers are.ln place but. " '
before any lath or gypsum
board Interior wall covering Is
applied,
HIGH STRENGTH BOLTING:
During all bolt Installatlon and
tlghtenl~g operations, (306
a.6)
SPRAYED ON
FIREPROOFING: U.B.C.
Standards 43.8.
\~\'Y
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 tloor
sheathIng.
.LATH AND/OR GYPSUM
BOARD: To be made after. all
iathlng 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: Inspecllon
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.G.
STDS. 25-10,11),
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to Installation of
decking or floor sheathing.
STRUCTURAL MASONRY: (306
a.7)
*In addition to the inspec.
tlons specified, the Building
Official may make or require
CURB AND APPROACH other inspections of any
ROOF SHEATHING AND APRONS: Alter forms are construction work to ensure
NAILING: Prior to installing erected but prior to placing compliance with the Building,
any roof covering. concrete. CIty or Development Code.
-~NAL~UM;NG-------------SITE~~N~EVIEW~OA~D:MUs~~requ:te~~~~~::nc~
of the date you wish Inspection. All project condItIons such as
landscaping, parking lot striping, etc. must be completed before
requesting this Inspection.
MASONRY: Steel location,
bond beams grouting or
verticals In accordance with
UBC 2415.
SIDEWALK & DRIVEWAY:
Aequlred 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.
FINAL ELECTRICAL
FINAL MECHANICAL
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 untll a
Certificate of Occupancy has been Issued by the Building Division
and posted on the premises.
FINAL FIRE DEPARTMENT
,1\6Tmfr1M:NPilln tJ.QJ f;'lliJLrlJrLfYL(71) ,.Jj;\((;y -f-D ~
rj\~f .( r) 1i\['f)Jl';h't11\yJ '\ " / \ J(rTV10/\ i/') m----"o9,_ol.(fPy.oe--\.
't (j \t ';y'-' - 1'') () - ~. ~
. PLANS REViEWED BV
DATF
By sl gnature, t state and agree, that 1 have carefully examined the completed application and do hereby certl fy 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 OAS 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 constructlon.
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VALIDATION:
AMOUNT RECEI\I"n'~ \ 1'\/00'L4. '-'
\R,E9.EI~l:': ~ \ ""\.\OL-U
DateJ_!{/I_~/7.S~ .
DATE PAID: _! .,,-1 L\~:~ r
RECEIVED B~ \.1 C~ ~~ <i
-I-0-~
Sign~!urf'
. . . JOB NO. "15' 178Co
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR CaMPA 'NY :
Aj2c,
'" I"-H O<.S
LOCATIDN:
. r3B MAli< sT;
DEVELOPMENT TYPE:
ADDITI.N' JJJLL' fo-fBi/o/(,
~I )(TL'R€s TC <=~n"'"D2c:./ftL 13LOG,
BUILDING SIZE:
LOT SIZI~
SQ. Ft.
I. STORM DRATNAGF
IMPERVIOUS SQ. FT.
X $0.21 PER SQ. FT.
G'- ')
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.2. SANTTARY SFWFR-rTTY
NO. OF PFU'S
(See Reverse)
""\
X $43.43 PER PFU
(3040 i)
"- .-/
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X X $437.93 G~ ')
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X X $437.93 $
X X $437.93 $
4. SANTTARY SFWFR-MWMr
NO. OF PFU'S x $18.75 PER PFU + $10 MWMC ADMIN.FEE $
(Use PFU Total From Item 2 Above)
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MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAl -MWMr sor
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
$
~.- )
'---" i
$ 3(''i--
5. ADMINTSTATTVF FFFS.
8ASE CHARGE (SUBTOTAL ABOVE) X ,05 #
. ;'/15 ~
-:t/C'c'j. ;Y1- 0LL/SrOZ Date:
- Troy McAllister
SDC Coordinator TOTAl sor
G1S?e. ")
'- .--'
Zl
$ 31'/-
FIXTUR!= U.NIT CALCULATION T ~BLE:. Number of Ne~ Files X Unit Equivalent = Fixture Units
(NOTE: For remodels, calculate .O.he tlfI additional fIxtures)
.. NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
Bathtub..........".......,.................,....,...... .:...................
Drinking Fountain....................................................,
Floor Drain.,......."".., '_' .;,........:.,...........,....................
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For Sand/-:-uto WasI:t/Etc......oo....oo.....
Laundry Tub/Clotheswasher...................................
Clotheswasher - 3 Or More.......................:..........,..
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall..............................:..................
Shower, Gang..........................................................
Sink: Bar, Commercial, Residential Kitch~n...........,............
Urinal, Stall/Wall.......,....,........................................,.
Wash Basin/Lavatory, Single.............................,....
Toilet, Public Installation.... ....................................
Toilet, Private..,...................:................................
Miscellaneous:
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
TOTAL FIXTURE UNITS
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CREDIT CALCULATION TABLE:
calculate credits separates.
Ir
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4/
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Based on assessed value. If improvements occurred after annexation date in table,
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
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1979 or before
1980
1981
1982.
1983
1984
1985
1986
$3.47
3.39
3.33
3.21
3.06
2.92
2.74
2.46
1987
, 1988
1989
1990
1991
1992
1993
1994
Credit for Parcel or Land Only'lf Applicable
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
=
Improvement (if after annexation date)
=
CREDIT TOTAL = $
Rate per $1,000
Assessed Value
$2.13
1.76
1.35
0.95
0.58
0.41
0.29
0.14