HomeMy WebLinkAboutPermit Mechanical 1993-6-15
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COMM ERCIAL/IN DUSTRIAL
PERMIT APPLICATION
INSPECTION LI N E: 726.3769 ,
OFFICE: 726.3759
225 Fifth Street, Springfield, Oregon 97477
SPRINGFIELD
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JOB NUMBER
q?-,Qs;L J
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
<~~O ~rA~
II ():J ':l~ ~8 '
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TAX LOT:
nO4/) I
DESCRIPTION OF WORK:
mil ~JhJ '~,L/~,
C)2,-=?:,Itf() ~ JL, C)~
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if K
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PH 0 N E: .....:J '-1-"1 - '--1.;)./)
OWNER'
ADDRESS:
CITY'
STATE:
Q/2
ZIP: 3'J V'/8
NEW
y
REMODEL
ADDITION
DEMOLISH
OTHER
.$
VALUE,
,-.-
NAME
ADDRESS
PHONE
ARCHiTECT'
CONTRACTOR'S NAME
GENERAl' W\,., ~.r C)..<.-c..", .
PLUMBING'
ADDRESS
CONST, ,
CONTRACTOR'
EXPI RES
PHONE
MECHANICA' .
ELECTRICA' .
Single Fixture
Relocated Bldg.
(new fix, add\1l
Water Service
Furnace/burner & vent
< 100,000 BTUs
Furnace/burner & vent
> 100,000 BTUs
MECHANICAL
I ~
1
1
~~~
I
,I'YAi
I
I, I
1
1
1
1
1
I
1
$10,00 I
I
PLUMBING
NO,
FEE
CHARGE
NO
ft.
Floor furnace and vent
Suspended wall or floor
mounted unit healer
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
ducl
Vent System aparl
from AC or htg.
Mechanical exhaust
hood and duct
Sanitary Sewer
ft.
It,
Storm Sewer
Backflow Device
Permit Issuance
TOTAL PERMIT
TOTAL PERMIT
QUAD AREA: ~ \\:(\ .J
- OFFICE~~
LAND USE: ~L'1----1q
HANDICAP ACCESS,
FLOOD PLtIN:
ZONING: \ _ ,NLl
LIGHTING POWER BUDGET:
. OF BLDG~'
. OF UNITS'
OCCY GROUP'
CONSTR. TYP~'
. OF STORIES:
HEAT SOURCF'
,WATER HEATER'
SQ, FTG MAl N
-' ,S0 FT,
'....aJis..oS--
-"')0-._
~-'"_..
x
fI?!~
1 :"!..':..r-r-
VALUE
-=1 "'- I .0"'0 /"3? ~/.:B. 23'
SQ, FTG ACCESS X
SQ, FTG OTHER ~"-'m'f';;-"'I~ ~..L.-:;;:;"'}3q/..,,-~,,..,.... /::4/.;?err:>
TOTAL VALUE OF PROJECT /~. V&. ~
~
PU,flI.CHECK FE\' :2., I~ .I~~ _,RC~T'. ''is'1'XL/
~~/J"V ~~ n~........ < ~7_.c!:T "'li"""
DATE
'-1/,0, ICi~
BY
6:)Q
I BUILDING PERMIT
15% State
Surcha~e
1 MECHANICAL
15% State
SurcharQe
1 PAVI NG
/l4'/-/f'~
. -
;Z~.~
I PLUMBING
I DEMOLITION
FT,
I I
~w.....;_;JL?~~~1
I~ I' ~-;;,.q~1
I SUBTOTAL 1 I
PERMITS . 1)/ h ..tf113
16m~~~MENT I 'II '-1-8 if g iI$
5% State
SurcharQe
FENCE
VALUE $
SIDEWALK
CURBCUT
FT.
'.
TOTAL PERMIT FEES I
EXCLUDING ELECTRICAl
IL>~.~I
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It Is the respon'siblllty 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,
UNDERSLAB PLUMBING,
, ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel In place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all lnslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
In place but before any
concrete is placed.
UNDERGROUND, Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing,
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.
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MASONRY: Steel location,
bond beams grouting or
verticals In accordance with
UBC'2415, "
".':
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
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FINAL PLUMBING
y
FINAL ELECTRICAL
Y FINAL MECHANICAL
.y FINAL FIRE DEPA~NENT
ADDITIONAL COMMENT"" 1 if (\ ~
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.
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REQUIRED .INSPECTIONS
'it
PAVING: After gravel Is In
place but prior to placing
asphalt or concrete.
ROUGH PLUMBING,
ELECTRICAL &
MECHANICAL: No work Is to
be covered until these
inspections have been made
and approved.
SPECIAL INSPECTIONS: In accordance
Section 306 of the State Specialty Code
a special Inspector shall be employed
by the Owner! Contractor during
construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
ATTIC DRAFT STOPS &
CURTAIN WALLS
FIREPLACE: Prior to placing
facing materials and before
framing Inspection.
::.,..
STRUCTURAL CONCRETE: In
excess of 2500 PS,I. (306 a,1)
v
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.
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations, (306
a,6)
STRUCTURAL WELDS:
Performed on the job, (2722 f)
;(
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, .
SPECIAL GRADING,
EXCAVATION AND FilliNG:
During earthwork, (306 a,11 &
Chapter 29)
SPRAYED ON
FIREPROOFING: U,B,C,
Standards 43.8,
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
1/ 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 before
gypsum board joints and
fasteners are taped and
finished,
GLU.LAM BEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed, (2501 u.Be,
STDS, 25.10,11),
STRUCTURAL MASONRY: (306
a,7)
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.
.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.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
x
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.
llI' 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
(:\3 . ~~osted on the premises,
, - ,19\
PLANS REVIEWED BY ~/ <:Isr- ?4 -
(' -(7- ,( 'l
f DAT~
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 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 ont the prop': , and the approved set of plans will remain on the site at all
times during construct I n.
Slgnaturo, .
VALIDATION,
RECEIPT N:
Date
6"-1'\ - 9.3
/
V
EIVED: Jf'.o::rJl.C!>/
A' 95'.0
DATE PAID:
RECEIVED BY'
16:/5,-:731
:?'~ -
,
. .OB NO. q~oo;,"2-1
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(PROFESSIONAL OFFICES & INDUSTRIAL)
NAME OR COMPANY: MA-:1'f\I"--, 1)~j::::n~.
LOCATION: '?2-Bo \-\.\6d-l-PrAI'"U::., "Ro . lr O-z,"2,BoO - 00'-4-0 I
DEVELOPMENT TYPE: L-M -r - OFF 1c..E. A-oDI'IIl:lN
........
BUILDING SIZE:
~I 00 ?o... r1'_
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. 0.5 x N. It . X $0.192 PER SQ. FTG - )
----- -----
.-~t
.' 2. SANITARY SEWER-CITY
NO. OF PFU'S 0.5 X Q X $39.78 PER PFU G-8-)
(See Reverse) '----- -----
3. TRANSPORTATION
CoPE': 1-+0. MAIJUf'A<.:ru~IKc,. ~ c::>.,?/'1&5>f-
NO OF UNITS X TRIP RATE X COST PER TRIP
0.5 X ~,\ X o.,S X $401.05 0~~~
0.5 X X X $401.05 $
0.5 X X X $401.05 $
SUBTOTAL (ADO ITEMS 1,2, & 3) $ '-f-fo(p2;:.
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05 ~ 'Z~~),
- ~
TOTAL-CITY SDC $ t.f'3"i ~
5. SANITARY SEWER-MWMC
NO. OF PFU'S C) x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ ~
(Use PFU Total From Item 2 Above)
~~L~ c.llIlq~
U kip Burdick
SDC Coordinator
TOTAL-MWMC SDC
TOTAL SDC
$
G --e- )
-------- -
$ 4gq~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
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