HomeMy WebLinkAboutPermit Building 1995-7-13
COMMERCIAL/INDUSTRIAL. SPRINGFIELD
PERMIT APPLICATION L~
225 Fifth Street, Springfield, Oregon 97477 ......~
LOCATION OF PROPO/,ED WORK: gOC\ ,\~ 0 (\\{)110Y'0 0 \).X.&l..J)
ASSESSORS MAP' \l')ry~\ <:=:rlj . TAX LOT: D \ 111(\
- - -
OWNER:Q\ \(\(\ 'f\ \f\ ('\t~ ~ PHONE ",q-ln.K~
ADDRES~ (~Pj\{) ~ \ ~~ \J n I I \ \ \ Q H _) 'c{,cL0Q ~ r.
CITY: ,_"\.1\ i -~~O O[j ~TATE: \~)~o.f\~ ZIP: Y.l4iJ
DESCRIPTION OF WORK: ~ I)'vu ~ Q . \ l-\\ rtrv:~.'\- '.
NEW ......... REMODEL ADDITION DEMOL~~ OTHER VALUE:
9Z-POl55
.
;I:I.....z
JOB NUMBER
q ~)5(X()
INSPECTION LINE: 726.3769
OFFICE: 726.3759
('
.'
. - - --'-, NAME
ARCHITECT: It\ n'l~+
, ADDRESS
01~ ~Lt) I?tAue f2linrrl
CONST. I
ADDRESS C9NTRACTOR . EXPIRES
PHONE
~22Jlr;,c.::J.
CONTRACTOR'S NAME
GENERAL: )I~6/f P~/7~
. .
PLUMBING' JR.T ~r
MECHANICA' .
ELECTRICAl. j 13 G'L~.
PHONE
I
I NO
I
I
i
. , I
I
I 1" I Backflow Device
I qo I FI71Z ~.-</c-
- I I
'\" I
I
I
I TOTAL PERMIT
PLUMBING
MECHANICAL J
FEE r:HARn~ Nn e,EL _CHARGj
I . Furnace/ burner & vent
< 100,000 BTUs
I Furnace/burner & vent I
> 100.000 BTUs
16.&. ""'I Floor furnace and vent 1
-5"-5.'<>-1 Suspended wall or floor I
mounted unit healer
17"5. ""1 Appliance Vent I
separate
/c). =s.1 Statlonary evap. I
cooler
'n? "';-1 Vent Fan/Single I
duCI
I Vent System apart I
from AC or hlg.
I Mechanical exhaust I
hood and duCI
I I
I Permit Issuance $10,00 I
I TOTAL PERMIT I
Single Fixture
Relocated Bldg.
Inew fix. addll)
Water Service
2i?~ft.
Sanitary Sewer
, '2.// It.
Storm Sewer _ _ ~ - ---,
(~L)It.
, "
OUAD AREAJ IfDl 1')
i
- OFFI~ Urf ?
LAND USE: ...s~
HANDICAP ACCESS:
. OF BLDG'"
. OF UNITS'
FLOOD PLAIN'
ZONING: ~ L L
('
OCCY GROUP:
CONSTR. TYPF'
LIGHTING POWER BUDGET:
. OF STORIES:
HEAT SOURce.
WATER HEATER'
SO. FTG MAl N
SO. FT.
ffi 1)A.~
) -
$/SO. FT.
--c<\ '\ ~A.~UE -"-
, p~~
. I
e:?3~B7,5: ..
; . ~ -'I."
I
I
SO. FTG ACCES"
X
X
X
SO. FTG. OTHER
""-
TOTAL VALUE OF PROJECTi ??!;&"7;;-, ,
l .. - I
DATE':~.:Y' [) .q:=) BY bJ \['(;;;. _ )
.. ,
~~/~~ FY..} \9J.2 ~....RCPT' ~?9J
I BUILDING PERMIT
15% Slate
SurcharQe
I MECHA'NICAL
I' 5% State
Surcharoe
I PAVING
13-7'7/.456
10 7.....""
""",. d'::2.
, PLUMBING
t.j I c>. 0,:7 , DEMOLITION I
-=?~. X? ~)'YAY~ X'r1P
/7. ?~?tii'y~ ~
4!//. ~
~
~
5% Slate
Surcharge
I FENCE
VAlliE ~
SID-€WALK
CURBCUT
FT.
FT.
I SUBTOTAL
PERMITS
I SYSTEMS
DEVElOPMENT
I
J9~S' /21 ~
~B2.14~~I~j
" ...... . -,
-> ....-
- . "'..:. . ;. , I
... ... , '.
'T6TA~ PERi.m'FEEs
EXCLUDING ELECTRlr^'
/~ 2&/ 32.
.
REQUIRED INSPECTIONS -
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 mad~ 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.
)I
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 ,cove.red.
ATTIC DRAFT STOPS &
CURTAIN WALLS
I
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
framln'g Inspection.
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.
'I
)l
x
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.
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.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
x
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.
)I
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.
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.
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.
MASON RY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
ROOF SHEATHING AND
NAILING: PrlDr to Installing
any roof covering.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
PAVING: After gravel Is In
place but prior to placing
asphalt or concrete.
SPECIAL INSPECTIONS: In accordance
Section 30.6 of the State Specialty Code
a special Inspector shall be employed
by the Owner/ Contractor during
construction of fhe following work. A
copy of the special testing reports shall
be furnished to the Building DlvlslDn.
x
STRUCTURAL CONCRETE: In
excess of 2500 P.S.1. (306 a.1)
x
STRUCTURAL WELDS:
Performed on the job. (2722 f)
HIGH STRENGTH BOLTING:
During all bolt Installation and
tightening operations. (306
a,6)
SPRAYED ON
FIREPROOFlt,j'G: U.B.C.
Standards 43.8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
x
GLU.LAM BEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.BC.
STDS. .25,10,11).
STRUCTURAL MASONRY: (306
a.7) .
f~rY-,~-P~~
'In addition to the Inspec,
tlons specified, the Building
Official may make or require
other Inspections of any
construction work to ensure
cDmpllance with the Building,
City or Development Code.
/
/
:Y 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.
FINAL BUILDING: Requested after the final plumbing, electrical,
mechanical and Fire Department Inspections are made and
approved. No occupancy of the premises can be I}lade until a
Certificate of Occupancy has been Issued by the Building Division
and posted on the premises.
FINAL PLUMBING
FINAL ELECTRICAL
)(
FINAL MECHANICAL
v
FINAL FIRE DEPARTMENT
, ~T0;t q~~0~. ()5? _~ ~\flll(\O.!( 'J\~~. ) \ \0 ~,U
~~~:\ D\',d,Q 9> t~rf\f\,^6lC l'o Tn ~1 \C-\f){)
/ ~
PLANS REVIEWED BY ~~~ ~~ DATE./!-~. ~'2':.
< /. ~ -'l/'2v ?-/I"~"'7S--
.
. v
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
01 the City of Springfield, and the Laws Df the State of Oregon pertaining to the work described here'ln, and'that NO OCCU'PAt--ICY
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 ens.ure 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 construction.
Signaturo
"
" .
VALIDATION:
AMOUNT RECEIVED: _/,C?,~./.: '"'S":;:>
RECEIPT ': /fi' ~ - -
DatI"
DATE PAID'
RECEIVED BY'
?-v7~
/4"__..." ._" ~
-/JY
.
.OB NO.. q~o?o (0
ATTACHMENT B2
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(PROFESSIONAL OFFICES & INDUSTRIAL)
NAME OR COMPANY: 7--(CAI--l -e. C-o~-p
LOCATION: "'109 "I.I-.l'lf.:-g.t-J.A-IIOr-lAL WAY
\"lo'?\l?oo -Ollll
DEVELOPMENT TYPE: ?L ,_ - T->-IOU~'IP-\I>.-L ~E:LL - -:'!SLDb *' 4
LOT SIZE
SQ. Ft.
X $0.209 PER SQ. FTc;1e,e,6'?)
'- ---
2. SANITARY SF\.!FR-r.TTY -10 Be Pe,E.\1...M\t-.leb <\.1L1012- To O<:c.oPA-t-..lc.."
0-)
~
NO. OF PFU'S x 0.5 X
(See Reverse)
X $43.26 PER PFU
3. TRANSffi[[ATlniJ--To "OE:. 'Dc:.,~IV\It-..1l":D f'~\OR To De.c...Uf'Al-tc..y
NO OF UNITS X TRIP RATE X COST PER TRIP
0.5 X X X $436.19 ~- )
'--- .-/
0.5 X X X $436.19 $
0.5 X X X $436.19 $
4. Sl\t:llIARY SF\.!FR -~1\itlC - T c> "'b.E: 'DE..IE:.l2J\t)\ N.r.!)
NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADMIN. FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAl -MWMr. snr.
$
~-)
'-- .-/
. ,(.,
SUBTOTAL (ADD ITEMS 1. 2.3 & 4) $ 1'6<60 -
5. ADMINISTRATIVE FFES
BASE CHARGE (SUBTOTAL ABOVE) X .. 05
s6C-Coordi~~tor-'
~ ?94-o1)
'-- ----
Date: 4/-zsJQr:; ~o
. MAl snr. $ 5:2..,4--
L.._'l3 .. L J...
~'-~:'--
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