HomeMy WebLinkAboutPermit Building 1999-10-06SPFiI{GF!ELD
225 North Fifth Street
Springfleld, OR 97477
Locatsion of Proposed Work: 1402 MOIIAWK BLVD
Assessors Map #: L7032533
COMMERCIAI./INDUSTRIAL PERMIT APPI,ICATION
CITY OF SPRINGFIELD iIOb NUrNbEr:
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
office:
Inspection Line:
Page 1
99L158
726 -37 59
725 -37 59
Tax Lot #: 10004
CITY OF SPRINGFIEI-D,
O\^,ner: .7. E. B . INVESTMENTS
Address: 1385 OAK ST. SUITE 1
Description Of Work: REMODEL/ADDfTION
Phone #: 485-1506
City/State/ ztp: EUGENE OR, 97401
REMODEL Value:0.00
Name
J. E . KRAUSE
Address Phone
Architect:
General:
Plumbing:
Mechanical-:
El-ectrical:
Cont,ract,or
EMG ASSOCIATES 0l.22941-
525 NW 54TH ST VANCOITVER WA 9865300
MODERN PLUMBfNG 0087906
11120 SW TNDUSTRIAL WAY TUALATIN OR
CHAMPTON HEATIN 0101515
HILLSBORO OR
SIMPSON ELECTRI 0084885
MCMINNVILLE OR
Const.
ConEractor #Expires
03/04/oo
t2/te/ee
04 /2e / oo
03/oL/01,
Phone
61,0-596-4048
69]--6l.56
648-4LtL
560-1,74L
PLIruBING - - -
No
9
Fee Charge
90.00
10.00
l_00.00
Single Fixture
BACKFLOW DEVTCE
TOTAL PERMIT
No
MECIIANICAL
Furnace/burner & vent < 1OOO,OO0 BTUs
Mechanical exhaust hood and duct
Vent Fan,/Single Duct
SUPPLY FAN
APPLIANCE VENT
GAS PIPTNG
Permit Issuance
TOTAL PERMIT
Fee
ATTENTION:Cregon law re-quires you to
follow rules adopted by the Oregon Utiiity
Notification Center" Those rules are set forth
10
Charge
L2 .00
.50
.00
.00
.00
.00
.00
2 6
6
3
a
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
numberforthe Oregon Utiliiy Notification
Center is 1-AA1 -332'c ?Ml.
43.50
HANDICAP ACCESS: Y
-- oFFrcE usE --
QUAD AREA: 2CNW LAND USE: 3999
Item $/Sguare Feet ValueSguare Feet x
NOTTCE:
THIS PERMTSHALL EXP'RE IFIHE WORKAIIHOBIZED UNDER THrS PCNrVrrr lS iOr
COIvIMENCED OR tS ABANDONED FO;
ANY lSODAYPERIOD.
SPFiNGFIELD
Job Number: 991158
CITY OF ONEGON
Page 2
fNTERfOR REMODEL
TOTAL VALUE OF PRO.'ECT
78, 800.00
78,800.00
Plan Check Fee:2.42 Rec #: 35317 Date: 08/25/99 Rec By: LORNE PLEGER
BUILDING
Surcharge/aAmin
MECHANICAL
Surcharge/admin
PLUMBING
Surcharge/admin
PLAN REVTEW CREDIT
CITY SDC FEES
SUBTOTAL PERMITS
TOTAL PERMIT FEES EXCLUDTNG ELECTRICAT
370
37
43
3
100
10
-1
00
00
50
36
00
00
50
34).4 , 4L2
1,4,974.70
L4,974.70
ao
REQUIRED INSPECTIONS
It is the responsibility of t.he 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.
Special Inspections: In accordance with Section 305 of the State Specialty Code
a special inspector shall- be employed by the Owner,/Contractor during
construction of any following "*" work. A copy of t.he special testing reports
sha11 be furnished to Building Safety.
In additj-on to the inspectlons specified, the Building Official- may make or
require other inspections of any construction work to ensure compliance with
the Buildj-ng, City or Development Code.
ITNDERFLOOR PLTUBING - Prj-or to insul-ation or decking.
ROUGH PLTIMBING - Prior Io cover.
ROUGH GAS - after line is j-nstal-led and capped 1f not attached to an
appliance
ROUGH MECHANICAL - Prior Io Cover.
ROUGH ELECTRICAL - Prior to cover.
FRAMING - Prior to cover.
DRYWALL - Prior to taping.
MECH/SUB: FOLLOWING ROUGH MECHANTCAL APPROVAIJ, PRIOR TO COVER
CEIIJING GRID
FINAL PLIII{BfNG - When all plumbing work is complete.
FINAL GAS - When all gas work is complete.
GAS SERVICE - After line is installed and line has been connected to a
minimum of one appliance. pressure test done at this point.
FfNAL MECHANICAL - When all mechanical work is compJ_ete.
FINAIJ ELECTRICAL - When all electri_caI work is complete.
FINAL/SUB
SPRINGFIELD
Job Number: 991158
CITY OF SPilNGFIELD, ONEGON
Page 3
FINAL FIRE - When all Fi-re Department requirements have been meL.
been met.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
--- ADDITIONAI. COMMENTS
Plans Reviewed By: LORNE PLEGER
Building Site Revj-ewed By: BOB BARNHART
Date: 09/29/99
By signature, I state and agree, that I have carefully examined the compJ-eted
application and do hereby certify that al-f information hereon j-s true and
correcL, and I further certify that any and alf work performed shalf 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 strucLure without permission of the
Community Services Division, Building Safety. 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 i-s readable from the sLreet, that the
permi-t card is located at the front of the property, and the approved set
of plans will remain on Ehe site at al-f tj-mes during construction.
c.1 )C_c. {l-.--le C"\
Signature Date
--- VALIDATION ---
Receipt Number
Date Paid
Amount Received
Received By
3s277
0 b fq
/fo 1/
JoURNAL \ . JoB No. 3j/58__ATTACHMENT A
CITY OF SPRINGFIELD SYSTBMS DEVELOPMENT CHARGE
WORKSHEET
NAME OR COMPANY:
' 9oo Lor stzE-se. Ft
l. STORM DRAINAGE - 4l n-zzJ {zr4"tze
IMPERVIOUS SQ. FT x s0.232 PER SQ. FT
2. SAMTARY SEWER-CITY
NO. OF PFU'S X548.27 PER PFU
5.t
(See Reverse Side)
LOCATION
DEVELOPMENT TYPE-Dr,i-t
BSHDBIG SZE
X r?5?
4. SANITARY SEWER-MWMC
4Zx /J X $486.73 PER TRIP ./.Z.,lca{
3. TRANSPORTATION
NO OF LINITS X TRIP RATE X COST PER PM PEAK HOI-IR TRIP
s
x $486.73 PER rRI> . ll t t 6rC >
A.
Pe-L,'t
COST;,
Y', ar9 >
X/,>qa%PB
= z! //?8 2/,0
fu1{v.,tro,No' oF FEU'S / I '?)
FEU; 3 I6SL
B.MPROVEMENTCOST:.7q
= /tZ)/.,,, e x' 6 -- >
NO. OF FEU,S T. fl X . V. PER FEU .- /AI *SG
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMIMSTRATIVE FEE
TOTAL-MWMC SDC
SUBToTAL (ADD ITEMS t,2,3 & 4)
5. ADMINISTRATTVE FEES:
BASE CHARGE (SUBTOTAL ABOVE) X .05
<s
$ 10.00
/2
s '1, '?q "
$ZryE
$be69
DC
ATTACH'A.
Date :/1 ,i i
TOTAL SDC
/v
S .6---
S [zl]
qdg ,7 rt")-
J/'
s ///, z//Z-__
FIXTURE UNIT CALCUL ' TION TABLE: Number of New Fixo
(NOTE: For remodels, calculate only the Nl- dditional Iixtures)
NUMBER OF
FIXTURE ryPE NEW FIXTURES
X Unit Equivalent: Fixrure Units
UNIT FIXTURE
EQUTVALENT UNTIS
2
I
2
3
6
2
6
6
I
)
2
I
2
2
:l
6
4
Drinking Fountain.
Floor Drain..
Interceptors For Grease/O iVSolids/Etc.
Interceptors For Sand/Auto Wash,/Etc.
Laundry Tub/Clotheswasher/Ir4op Sink....................
Clothesrvasher - 3 Or More............
Mobile Home Park Trap (1 Per Trailer)..
Receptor For Refrigerator/lVater Station/Etc...........
Receptor For Commercial Sink/DishwasherEtc......
Shorver, Single Stall..
Shos'er, Gang.
S inh: Bar, Commerc ial, Residential Kitchen............
Urinal. StallrWall.....
Wash Basin/Lavatory, SingIe...........
Toilet. Public Installation.............
Toilet . Private..........
Miscellaneous:
TOTAL FiXTI'RE L]NITS
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after amexation date in table, caicuiate
credits
--2-
.7
a//
-n
n
,)
e-
l[lead
,'l 4
Year
Annexed
Rate per $ 1,000
Assessed Value
Credit for Parcel or Land Only If Applicable
Improvement (if after annexation date)
x$
(Rate X Assessed Value)x$
(Rate X Assessed Vaiue)
CREDIT TOTAL : S
audL dLa t
Year
Annexed
Rate per $ 1,000
Assessed Value
1979 or before
1980
198 I
1982
I 983
1984
l 985
1986
1987
1988
s4.47
4.38
4.32
4.20
4.03
3.88
3.68
J.Jd
3.03
2.62
1 989
1990
1991
t992
1993
t994
1995 -
1996
1997
1998
2.18
1.75
1.35
t.t7
1.03
0.86
0.71
0.57
0.39
0.18
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
Residential...
Commerical..
Industrial......
Governmental......................
0.4
0.9
0.5
0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
t
FIXUNIT.WPD
SPRINGFIEI,D
Proiect
Proiect
Feature
DEPAETMENT OF PUBLIC TI/oRK'
ENGINEERING DIVISION
Name CJ.D.f fnr, fD P Fa Po Jort
Prepared
Checked
l/ rl
COMPUTATION
SHEET
tSheet t of
-
oate /o-4-79
Date
-
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/6, 6 ( f/@r/= {,/z ={
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,
EAGLE EYE PIZZA, INC.
AN INDEPENOENTLY OWNED AND OPERATED FRANCHISE
1786 NW gTH STREET. CORVALLIS. OR 97330
Sep.3A 1999 AZzz?Pn P1FRDI'I : EAGLE EYE PIZZR, INC.FRX NO. :
Better Ingreclients. o
Bette iPizza.
Mr. Ken Vogeney
City of Springfield
Public Works Dept.
Mr Vogeney,e/30t99
After reviewing the information from my Papa John's store here in Eugene , I've come
up with thc following information regarding the traffic count numbers we had discusscd.
As an aver8ge benvcen the hours of 4 p.m- and 6 p.m. we have 8.2 deliveries (our
delivery drivers) and 5.7 take out orders (Customers picking up and taking home).
If you should be in need of any further information, please let me know.
Thank You,
Tim G. Mitchell
Owner/Operator
Plzzi
il
qtrP-3tt-1ggg . 15:25 95).P.AL
1
@Better Ingredients.
Bettef Ptzza.
To Whom it may concern;t0l4/99
Ilere is the backup information from the letter dated 9/30/99 to Mr. Ken Vogeney of the City of
Springfield, Public Works Dept. I've went ahead and actually ran a 8 week average for the information
requested. The numbers based upon this 8 week average are 10.85 driver deliveries and 9.0 customer pick-
up's, between the hour's of 4 p.m. and 6 p.m. ( Notice the highlighted # of orders per hour).
Also, to clarifo our type of business. We are only a Delivery and take-out business. We have no sit-down
eating within our stores.
If I can be of any further assistance, please let me know. Don't hesitate to page me as I don't spend much
time actually in the office.
Sincerely,
Tim C. Mitchell
Owner/Operator
Office (541)484-1910
Pager (54 I )7 I 0-850 I
EAGLE EYE PIZZA, INC.
AN INDEPENDENTLY OWNED AND OPERATED FRANCHISE.I786 NW gTH STREET. CORVALLIS, OR 97330
PIZ,ZA
--.--z1_-
FVI lrrxt, rJtl
llr06:55It LaboP For eBt for the wee k 1O/trl' 's to 1o/17ltg9s
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Arerage nunbet of pittas rld: t?r ioU"Dtt t['stoir: rran rlabtr: '5,[6
lverage h0urs pEr ree( rorlel )r sati.iio tier nenDtrt: 50,10
;? 3t 17,0t3 2[ ?l.c
[.s0 t.ll
!lE.s0 llt.0?
69 t5 r?.0
t8 32 20.0
6,50 6.ll
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londay t e57
Iuesdat $ lCrf
lednesdat | 9g
ittursCar I tgFP
r0r r0/0r/r999
tl!Oiri5 ll Labor
PAPA JOHH ] S
Forecast for the
PIZZA - STORE 11N7
seek 1a/ t I / 1999 to 1O/ 17 / 1 99s
Prlt ?
tridlt $atricay Sunda v
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Input assurotioos
leels of historv cata used: 8
Areri!( nurber oi drliv:"jes otr tl!' ati lr 1v':^' l'00
l!€|.e!€ nuooer of cirias nad:0ii n9',ir i9' ii'i[:f i l::tn ?ir''
ligrt!€ ic,,,tf I ,ar riill rcf xii rr 5a'a"q: i!3r oilri:;' 50' 01
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FROI,I :PHONE NO. :Hus. 23 1999 g?iA?PFl P1
gFHINGFIELEI
has the lollowing
The
AV
er the Ore
use
o Utility
6s are set forth
,ELBSTtsICAL PBRHIT ASPLrCAfiON
les by
Ci tY Job Nr.uber 2Q.
zonlng rules
in 1
225 FtrI.v STREEf,Date
SPRIITGFIELD, OBEGON
INSPECTION
OPEICET 726-3739
1. LOCATION OT
IJGAL DESCRIPTION
JOB
CtabtftS
fii ,rr}dUl
Supervisor License Number 4lrt-s
Expiration Date /5 ^ o
Constr Contr. Number
Erpirat lon Date 3-t -o
of Supervising trician
Orners Name
Address
CitY Phon "@4%
OIINER
ti iir
PEE SCEEDTI^E BEIOS
. A. Nev Residential-$ingle or
HuLti*Family per duelling unit-
Service Included:
I tems
1000 sq.ft' or less
Bach additiona] 500
sq. ft or Portion
thereof
Each t{anuf 'd Hone' or
Modular 'Dvelling
Sertice or Peeder
B Services or Feeders
Installation, Alteratlons
or Relocatlonl
is1
L, -)
Cost Sum
$ 8s.00
$ 1s.00
$ 40.00
Permits are non-transferable and erpire
it uortc is not started vithin 180 days
of irsu"n"e or if vork is suspended for
180 daYs-
Z. COETITACTOR INSTAII.ATION OI{LY
Elec trical contrac to rfu6utt.
5eeddr
Ctty - llq
200 amps or less
ior "r'p= to 400 amps
-401 amps to 500 amps
-
60L anps to 1000 qmPs-
over 1000 amps/volts
-
Reconnect 0nlY
$
$
$
s
00
00
00
00
50
50
100
130
$ 40.00
$ ss.00
$ 80.00
see f,8ilafiDS
1000 volts
I
$ 40.00
Temporary Services or Feeders
rnstallalton, Alteratlon or Relocation.
c
D
200 amps"or less
201 arups to 400 ?'PS
-:-over 401 to 600
0ver 600 amps or abTG-
Branch Circuits
Nev, Alteration or Extension Per Panel
onecircui, I g35.oo fuO
Each Additional
:l'F::1":'rll*.'"'"8- $ 2.oo L@
not included)
40.00
40.00
20.00
rt
$
$
$
$
CITY OF SPFINGFIELD,OHEGOA'
RECEIVED TOTAL
z*
The installation is being made
l;:'::il,
"lf;dHtHi.no'l
in
on
tended -Each ins talIat ion
Pump or
1ne
ted EnergY/Conm0vners Signa
DATE:
Itr !
OFEGO'VCITY OF
INSPECTTON REQIIBST: 7
0FFICE: 726-3759
Date
1. LOCATTON OP rustAl}Idfitrgl0ture
tllo'LHCHM?a 3 t oo()Y
)000
senraicrrel.o
EI,ESTRICAL PERHIT APPLICATION
City Job Nunber {
rEE SCffiDI'IJ BBLOS
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular Dvelling
Service or Feeder
$ 8s.00
s 1s.00
$ 40.00
A
JOB
Sum
00
0000-
ee rrB,t a6'Ove
/U'i
P
I
1
o icatlot
2
Electrical contractor 6i
^,,Tt'lc'Address tLlo ONrymtx Kb,
ciry (N@Je Phone Mb-b4b
Supervisor License Number 9bttu-
Expiration oarc , lC,-l'fr
-
constr contr' Number '?O' aAic-lS
Expiration Date to -t-q1
Signature of Supervising Electrician
owners nt,iltlS
Address
Ci ty
FOR
OVNER TNSTALI.,ATION
The installation is being made on
property f ovn vhich is not intended
for sale, Iease or rent.
OrJners Signature:
DATE
B. Services or Feeders
fns tallation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
601 amps to 1000 amps-
Over 1000 amps/volts
-Reconnect Only
tf
s s0.00
$ 60.00
$100.00
$130. O0
$300.00
$ 40.00
c
D
Temporary Services or Feeders
fnstallation, Alteration or Relocation
200 amps or less S
20L amps to 400 amps
-
S
Over 401 to 600 amps
-
$
0ver 600 amps or 1000-IoITs s
Branch Circuits
40.
55.
-80.
S 1r0 DAY PfiEl"oP
Nev, Alteration or Extension Per Pane1
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not' included)
-Each installation
Pump or irrigation
Sign/0ut1ine Lighting I _Limited Energy/Res _Limited Energy/Comm
5. SUBTOTAL OF ABOVE
?Z State Surcharge
3% Administrative Fee
TOTALRECEIVED
fE V,+D , -,9,trD
w
225 TIFTE STREBT
Th€
SPRINGTIELD,77
s 40.00
$ 40.00
$ 20.00
$ 36.00
SIGN'PERMIT APPLICATIOTv
225 Fifth Street
Springf ield, OR 97 477
SPFINGFIELO JO- .{UMBER 5
Zfr,
lnspection Line: 726'3769
Office: 726-3759
SITE ADDRESS:
ASSESSORS MA
OWNER:
tlo+ t40t+tL l,Ub-'
P:
PHONE;
TAX LOT:
14azADDRE
,CITY:SpwnbAaa STATE:(W ZIP:
BUSINESS NAME, FIRI.I EEC.:?w*5o++^Is
DESCR|PTION OF pROpOSED SIGN(S): (please check and complete all appropriate information)
K watt
-
Freestanding
-
Single Face
-
Double Face
Square Footage:
Vertical Dimension of sign or enclosure:4fr
Total Height above Grade:14'v,"
Horizontal Width of sign or enclosure:
VALUE
SIGN
c-
_ Proiecting
_ Billboard
_ Roo{
_ Other
_ Marquee
t,,tl a b
Dimension from Grade
to bottom of Sign Enclosure:
Material Sign is constfucted of:
l0'"b"IbCfrE
tlt *IU t
cal lnstallation: ;l Ves No
List ALL existing signage and attach a photograph of each slgn:
low {ia*40w
to 96 BauN?
(al Type
(c) Type
Sq. Fts..
Sq. Ftg.
(b) Type
(d) Type
Sq. Ftg.
Sq. Ftg.
CONTRACTOR/IN STALLER:E*b",Tpe,PHONE:4CIb-5b4b
l2-ta 0t'Wx<X Rfr/AADDRESS:
STA zt?t 4lt+cz
CITY:
CONSTRUCTION CONTRACTORS REGISTRATION NUMBER:ob EXPIRES:2-7 _ol
CITY BUSINESS LICENSE NUMBEB:b6 pl?--7C * oO
OFFICE USE
Sign District:,Use:57 Ouad Area:Jolt u)
Zoning:Cc--Code Sectiol:
Approved By:Sign Permit Fee , f,.lo
REOUIRED INSPECTIONS:
_ Site
to be made Prior
to sion placement
,DATE:I D- Dla oa
Footing
prior to placement
of concrete
V Attachment
after fasteners are
installed/pnor to cover
Electrical
prior to energizing
electrical installation
,./rin^r
completion of sign
installatiort
. By signature, lstate and agree, that lhave carefully examined the.completed application and do hr:reby certify that all information hereir
is true and correct, and I lurther certify tnat any ano all work performed shall be done in accordance with the ordinances of the citv o
Springfield, and the uiws or the state of oregon pertaining to the work described herein. I further certify that only contractors an
emplJVees who are in compliance with ORS 701.055 will be used on this proiect'
I lurther agree to ensure that all required inspections are requested at the proper time, that proiect address is readable from the street' thi
the permit card is located at the f ront of the property, and the approved sei of plans will remain on the site at all times during the installatio
ol the sign(s).
Signature 8rA,Tr'L Q-to"q1Date
Amount Received:Date Paid:Validation:
Receipt Number:o 3s7 7L
{o
Beceived By:
o ?1
, lf thele are existing wall and/or freestanding signs, a photograph(s) of each exlgtlng stgn needs to be attached,to the
applicatlon. The size ol each existing sign also needq to bo listed on the qpplication,'t
, SIGN PERMIT APPLICATION
The application on the reverse side needs to be comploted entirely. lf you aro tho sign contractor/installer, or if you are
hiring a contractor, you need to make sure that both the City of Springfield Buslness Llcense Numbbr and:the Registration
Number from the State of Oregon Construction Contractors Board are listed on tho application along with the expiration
date of each.
lf the sign you are proposing to install is illuminatod, an oloctrical permit application also needs to bo comPleted and rsignsd
by either a supervising electrician, limitod sign electrical contractor, or if you are the buslness owner who also owns the
building in which you are oc'cupying, and you will be performing the electrical instatlation yourself; Vou may sign the
electrical application.
PLANS
sets of drawings showing allTo submit for a sign permit, you height, and
exceeds 2Oa plot plan indicating where the lf you are installlng a
feet in total height, the footing detail needs to be prepared and stampod by a registered engineer or architect. After the
plan review process is completed, and, if your sign(s) is approved, ono set of plans will be roturned to you. The approved
set of drawings need to be at the site when an inspection is requested for the inspectors reference.
INSPECTIONS
Depending on your sign(s), you may be required to request one or all of the following inspections during the installation
of your sign:
Site: To be requested after indicating on the lot where the proposed sign will be located but prior to any work
being performed for the installation of the sign. This inspection is required if there is a'question 'on the
location of the proposed sign.
Footing: To be requested alter excavation and the forms are installod, but prior to pouring coRcrete. lf there will be
electrical conduit placed in the footing, it must also be ln place prior to requosting this inspection.
Attachment: To be requested when all fasteners ars installed but prior to cover.
Electrical: To be requested arter the electricaltonnection to the sign is made, but prior to energizing.
IFinal: After all required inspections are conducted and approved and the sign installation is complete.
The inspections that are required for your sign installation will be indicated on the applicatiofr during the plan review
process. Failure to request ANY of the required lnspections could result in slgn removal In orderlto inspect the sign at the
required intervals of work.
i
To request an inspection, phone 726-3769. This is a 24 hour recording. On the recording you your City
Designated Job Number, locatiori of where the sion ls being instatled, the typg,of lnspection you and when
need to greparc two complete
proposedr'sign will be located.'
you will be ready for the inspection. All inspections called ln.to tho rocorder priot to 7:00 a.m. will be made the same
working day, all inspections phoned in after 7:00 a.m. will be made the following work day,
lf you have any questions regarding the application, required plans or inspections, please feel free to phone the Building
Safety Division at 726-3759
City of Springtield
Building Safety Division
225 Fifth Street
Springfield, OR 97477
I
'I
,.
hw{tNqs
TAX LOT
PHONE:
ZtP:
3PRINOFIELD 5
STAf,E:
r-1
t10 DL 140
z 257?-
JOB NUMBER
LOCATION OF PROPOSED WOBK:
ASSESSOBS MAP:
CITY:
ADDFIESS:
OWNER:
COM MERCIAL/IN DUSTRIAL
PERMIT APPLICATION
225 Flfth Street, Sprlngfield, Oregon 97477
INSPECTION LINE: 726-3769
OFFICE: 726-3759
\,/NEW X BEMODEL ADDITION DEMOLISH OTHER
,l
I U/rfA Aj{u6-w
38@_VALUE:
OESCRIPTION OF WORK:
MECHANICAL:
I
I
i
PHONEADDRESSNAME
EXPIRES PHONE
z->- oi 4Yb-ss'/bNC,CONTRACTOR'S NAME
ABCHITECI:
CONST.
CONTRACTOR 'inzebADDBE"$S
12)o@ll4-
PLUMBING:
NO-trEE CHARGE
Slngle Flxture
Relocated Bldg.
(new flx. addtl)
-WEIEiServlce
fr.
Sanltary Sewer
ft.
--St,orm-Sewer
fr.
Backflow Devlce
TOTAL PERMIT
EFtr (:HAR.GEINO
FurnaCe/burn€r & vent.
<100.000 BTUg
Furnace/burnsr & v€nt'>100.000 BTUs
Floor furnaoe end vent
-Susponiloilwall or tloor
mount€d unlt heater
TF-pfm-o6$nf
eeparate
evap.--SIaIonsry
cooler
-VenI Fan/Slngle
duct--Fn[Syatem apart
from AC or hlo.
-MtchsnLsl-xhaust
hood and duct
$10.00P€rmll lssuanoe
TOTAL PERM]T
t
I
HANDICAP ACCESS:
ZONING:
FLOOD PLAIN:-:LAND USE:
OCCY GROUP:
r OF STORIES:
OUAD AREA:
r OF BLDGS:
LIGHTING POWER BUDGET: J
WATER HEAf,ER:-
CONSTF. TYPE:
HEAT SOURCE:
- oFFlcE usE,-
VAt.UE$/so Fr.so. FT.
TOTAL VALUE OF PROJECT-
,
-
x
x
x
SO. FTG MAIN
SO. FTG ACCESS
SO. FTG OTHEB
RCPT'rPLAN CHECK FEE BYDATE
$$,?L
ELXLDING PENMIT \r1,5"PLUMBING D.EMOLITION
rch 4 Ti " r.tl 3% 8t8te
Suroharos
MECHANICAL FENCE
VALUE 8
-
5% Stale
Surcharoe
SIOEWALK
FT.
SUETOTAL
PERMITS
PAVING OURBCUT
FT.
TOTAL PEBMIT FEES
EXCLUDING ELEorHICAL
t AnnL{
SYSTEMS
DEVELOPMENT
a
REOUIRED INSPECTIONS .. , :,..r"'l'
It ls the responslblllty of the psrmlt holdor to see that all lnspectlons arE made at the proper tlme. To request an lgspeotlon, call ;
726.3709 (recorcior), state your Clty deslgnatod Job number, job address, type of lnspectlon roquested and when you wlll bo ready I
for lnspectlon. Requeste recelved before 7;00 a.m. wlll be made the same worklng day, requests made afterTIOO a.m. wlll be made
the followlng work day.
made after exoavatlon, but ELECTRICAL & place but prlor to placlng
prlor to setup ol forms. MECHANICAL: No work ls to asphalt or conQrets-
' be coverecl untll these
UNDEBSLABPLUMBING,lnspectlonshavebeenmadesPEclALtNsPEcTloNS:lnaccordance
ELECTRICAL & and approved. sectlon 306 0f tha state speclalty code
MECHANICAL: To bo made a speclal lnspector shall be employed . '
before any worf is covereo. ATTIC DRAFT STOPS & uy ine Ownei/ Contractor durlng -
CURTAIN WALLS constructlon of tho followlng work. A :
FOOTTNGS & FOUNDATIONS: EroEor A^E. coPy of the speclal lestlng relorts thall
To bo mado after trenchea are FIREPLACE: Prlor to placlng be furnlshed to the Bulldlhg Dlvlslon.
excavated and forms are faclng m.aterlals and before
.erectod,all8te€llnplac6,bUtframlnglnspectlon.
prlor to placlng concrete. FRAMIN.: To bE made after excess of 2500 P.S.l. (306 a.1)
coNcR.ErE SLAB: ro be $SJ...............,i:! i[J'3['.j1fl;'L"" ,^ srRUcruRAL wELDS: - ''
made aft€r all lnslab bulld.lng ptace aid att ptpes,-chlmneys Performgd on the lolc, (2722 l'1,'servlceequlpment,oondult,indventsare'cbm6leteand
plpl.!.9'accessorles and other the rough electrlcit, ptumblng HIGH STRENGTH BOLTING:
anclllary equlpment ltems are and meEhanlcal are'ipproyedl Durlng atl bolt lnstaltatlon andln place but before any tlghtehlng operatlons. (3Q6
concrets la placed. 1NSULATTON & VApOR a.6)
BARBIER: To be made aftEr all
UNDERGROUND: Plumblng, lnsulatlon and requlred vapor SPRAYED ON
electrlcal, gas, sanltary sewer, barrlers are ln place but FIREPROOFING: U.BC. l
storm sewer, water and . before any lath or oypsum Standards 43.8.
dralnage llnes. To be made board lnt6dor wall bovprlng ls j
prlor to coverlng or fllllng applled. SpECIAL GRAIjING,
;:T[..oR: pumbns, [31:,s"f"rHJPlLHl"' lltgt'll*tx,*:'lt"e ;
eloctrlqat, meohanlcal. To be accordlng to plans. hapter 29) ' 1 l
made prlor to lnetallatJon ot
floor lnsulatlon, decklng or
floor sheathlng.
POST & BEAM: To be made
prlor to lnstallatlon of floor
lnsulatlon, decklng or floor
sheathlng.
FLOOB TNSULATION &
VAPOR BARBIERS: TO bE
rnade pilor to lnstallatlon of
decklng or floor eheathlng.
MASONRY: Steel locatlon,
bond beams groutlng or
vertlcals ln accordance wlth
uBc 2415.
ROOF SHEATHING AND
NAtLING: Prlor to lnetalllng
any roof coverlng.
FINAL PLUMBING
.FINAL ELECTRICAL
FINAL MECHANICAL
FTNAL FtRE DEPARTMENT
AOD]TIONAL COM
LATH AND/OR GYPSUM
BOARD: To bs made after all
ldthlng and gypeum board,
lnterlor and exterlor, ls ln
plaoe but bofore anY' plasterlng ls apPlled or before
gypgum board Jolnts and
fasteners are taPod and
f lnlshed.
SIDEWALK & DRIVEWAY:
Bequlred for .all concrete
pavlng wlthln streot rlght o(
way, to be made aftei all
exoavatlng compl€te and form
work and sub-bage materlal ln
plaoe.
CUBB AND APPROACH
APBONS: Alter forme are
erected but prlor to plaolng
concrgte.
GLU-LAM BEAMS: lnspectlon :
Certlflcate by an approved
agency, fuinlshed to the Clty'e'
Bulldlng Dlvlelon before
beams are placed. (2501 U.BC.STDS.25-10;11). :
./.
STRUCTURAL MASONRY: (306 -
v'
I F r^-g-+
'tn adtitton to the lnepec-
Bulldlngtlons spoclfled, the
Ofllclal may maka or requ lre
other lnspectlons of any
constructlon work to ansu
compllance wlth the Bulldlng,
Clty or Devetopment Code.
SITE PLAN REVIEW BOARD: Must bo requestBd 2 daye ln advancE
of tha dale you wlsh lnsPectlon. All project condlttone such as '
landscaplng, parklng lot strlplng, etc. muat bo oompleted belore '
reguestlng thls lnsPectlon.
G: Requ€8t€d alter the flnal plumblng,.electrlcal,
Flre Department lnspectlona are made and '. '
FINAL BUILDIN
mechanloal and
approved. l
CertlflcatE
and posted
No oooupancy of the premlses can be made untll a
ol Occupancy has
on the premlses.
been lssued by the Bulldlng Dlvlslon
' '1 r'i '
PLANS BEVIEWEO BY DATE
By slgnature, I state and agree, that I have carefully examlned the completed appllcatlon and do hereby certlfy that all lnformatlon
heroln ls true and correct,-and I furthEr oertlly that any and all work performed shall be done ln accordance wlth th6 Ordlnanoes
of the Clty of SprlngfleiJ,Lnd the Laws of thb Stato of oregon pertalnlng lo ths work descrlbed hereln, and that No occUPANCY
wllt be made of any ltruJture wlthout permlsslon of the Bulldlng Safety Dlvlslon. I further certlfy that only contraotors and employees
who are ln compllanoe wlth ORS 701.055 wlll be used on thls project'
I further agroe to ensur€ that all requlred I
atre€t, that the permlt card ls looated at
nspect lons are roguested at the ProPer tlme, that proJect address ls rEadable from the
front of the property, and the apProved sot of plans wlll remaln on tho slte at 8ll
tlmes durlng construct
z9r-k nt,I
Slgnature
VALIDATION:AMOUNT BECEIVED:q(,10 .n\s 7 ?c
Date
DATE PAID:
RECEIPT E:RECEIVED BY:
q-Lb4
CITY OF SPR OREGO'V
225 TIFTE STBEET
SPRTNGFIELD OREGON
INSPECf,ION REQTIEST:
L{a >l/l o
DESCRTPTION3z(b /o oo{
Ci ty
Supe rvisor License Number '7q 2{ 9
SPHINGFIELE,
PBRT{IT APPLICATION
Job Number
FEE SCEEDTILE BELOII
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof s 1s.00
Manuf'd Jlome- or
WORK
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
f ? // {f
Sum
$ 8s.00
$130.00
$300.00
$ 40.00
Electrical Cont ractor gt*f,eP/ A.s/4&l<Y 1
Address etra tua{ "rf
6,tidU Phone *|tl -l L'79
Permits are non-transferable and expire
if vork is not started vithin 180 days
oi i""r.nce or if vork is suspended for
180 days.
2. COIiITRACTOR INSTALI.,ATION ONLY FOR
, Alterations
n:
200 amps or less ,1
201 amps to 400 amPs
-
401 amps to 600 amPs
-
601 amps to 1000 amPs-
Over 1000 amPs/volts
-
Reeonnect OnIY
Temporary Services or Feeders
fnstallaiion, Alteration or Relocation
200 amps'"or less I
201 amps to 400 amPs
-
Over 401 to 600 amPs
-
over 600 amps or fOOOEfts
-Each installation
Pump or irrigation
-
Sign/OutIine Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
THIS
A'THORIZED
c
$ s0.00
s 60.00
s100.00
tu
aEF
s 40.00
$ ss.00
$ 80.00
see lrBrl
pf , f ,rExpiration Date
Constr Contr. Number n b"7 I
Exp iration Date -L
ture of ing Electrician
I r,ro
<"
Address lv 6i o/t\( 5t
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
$ 3s.00
$ 2.00
E.Miscellaneous (Service/feeder not included)
D
Ovners Name ou^)blbs
OIJNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, Iease or rent'
Osners Signature:
Ci ty EldU Phone
DATE:
$ 40.00
s 40.00
$ 20.00
s 36.00v05SUBTOTAL OF ABOVE
7% State Surcharge
32 Administrative Fee
TOTALBACEIVBD
7
OFFICE: 726-3759 Date
1 LOCATION OP
$ 40.00
i
, JOB DESCRIPTION
N Z-fiil zctc,x tutlF€