HomeMy WebLinkAboutPermit Building 1999-10-18CO M M ERCIAL/I N DUSTRIAL
PERMIT APPLICATION
225 Fifth Street, Springfield, Oregon 97471
SPRTNGFIELc,
JoB NUMBE " ?zzz=e
INSPECTION LINE: 726.3769
OFFICE:726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:/?6V-25-7/ rAX Lor: €
STATE:ZIP:
e, %z-7-77OWNER
ADDBESS:
CITY:
"NEW X REMoDEL ADDrroN DEMoLISH orHER VALUE:%
DESCRIPTION OF WORK:
ELECIRICAL:
NAME ADDRESS PHONf
EXPIRES PHONEADDRESSCONTRACTOR'S NAME
ARCHITECT:
MECHANICA
CONST,
CONTRACTOR '
GENERAL:
PLUMBING
NO.FEE CHARGE
Single Fixture
Relocated Bldg.
{new flx. addtl)
Water Servlce
ft.
Sanltary Sewer
ft.
Storm Sewer
ft.
Backflow Devlce
TOTAL PERMIT
NA FFF t1HAAGF
Furnace/burner & vent
<100,000 BTUs
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cool er
Vent FaniSingle
duct
Vent
f rom
System apart
AC or htg.
2 Mechanical exhaust
hood and duct /-z q.e
(//4Ab 6 a4>
Permlt lssuance $10.00
TOTAL PERMIT /-q;4
- OFFICE USE -
LAND USE:
ZONINGI OF UNITS:
HANDICAP ACCESS:
LIGHTING POWER BUDGET:OCCY GROUP:
r OF STORIES:
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
VALUESQ. FT.$/SQ. FT.
TOTAL VALUE OF PROJ
x
x
x
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
?.?fPLAN CHECK FEE RCPT'OATE BY
72zf,
BUILDING PERMIT PLUMBING DEMOLITION
5% State
Surcharoe
5% State
Surcharoeffiw/E:*FENCE
VALUE S
-
5To State " t
Surcharee :7?SIDEWALK
FT,
SUBTOTAL
PERMITS
PAVING CURBCUT
FT.
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
--a
?->
FLOOD PLAIN:
WATER HEATER:
REQUIRED INSPECTIONS
It ls the responslblllty of the permlt holder to see that all lnspectlons are made at the proper time. To request an inspectlon, call
726.3769 (recorder), state your City designated iob number, Iob address, type of inspection requested and when you will be ready
for lnspectlon. Requests received before 7:00 a.m. will be made the same working day, requests made af ter 7:OO a.m. wlll be made
the following work day.
SITE INSPECTIoN: To be X RouGH PLUMBING, PAVING: After gravel is ln
made after excavation, but ' EIEBICf,!& place but prlor to placlng
prlor to setup of forms. <VI'ECHANICABNo work is to asphalt or concrete.ffif,flpr,tiNorivork is to asphalt or conr
UNDERSLAB PLUMBING, inspectlons have been made SPECIAL INSPECTIONS: ln accordance
ELECTRICAL & and approved. Section 306 of the State Specialty Code
MECHANICAL: To be made a special lnspector shall be employed
before any work ls covered. ATTIC DRAFT STOPS & Oy ine Ownei/ Contractor durin!CURTAIN WALLS construction of the following w6rk. A
FOOTINGS & FOUNDATTONS: copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prlor to placing be iurnished io the Bulldiig Divlslon.
excavated and lorms are faclng materlals and before
erected, all steel ln place, but framlng lnspectlon' srRUcruRAL CoNCRETE: lnprlor lo placlng concrete. FRAMING: To be made after excess of 2500 P.s.l. (306 a.1)
coNcRETE SLAB: To be the roof, all framlng, fire
made afrer ail rnsrab buirding 3lr5',:H.":ff Bl'3:Ir;,xj:r" 8ll3,.Hyf3"t H5t,"to?irrn uservlco egulpment, condult, and vents are'complete andplping, accessorles and other
incrrriry equipment rtems are :??H:?[j]igl:,'J'j#[il?: Bl?:f],l[]nolf",?io'l|lX^oln place but before any tighte-nlng operations. (306concrete ls placed' INSULATIoN & vApoR a.6)
BARRIER: To be made after allUNDERGROUND: Plumblng, lnsulatlon and required vapor SpRAyED ONelectrlcal, gas, sanltary sewer, barrlers are ln place but FIREpROOFING: U.BC.storm sewer, water and before any lath or gypsum Standards 43-g.dralnage llnes. To be made board lnterlor walliovering lsprlor to coverlng or filllng applled, - obE^,A, Ah^,trenches. eFr.!vv. SPECIAL GRADING,
,NDERFL..R: prumbrns [:::,S"":'f;m'J3[gt"' El:,flEill":li:dJ::],"t
electrlcal, mechanlcal. To be according to plans. Chapter 29)
made prlor to lnstallation of
floor lnsulatlon, decking or LATH ANDTOR GYPSUM GLU'LAM BEAMS: lnspectlon
floor sheathlng. - BOARD: To be made after all Certiflcate by an approved
lathlng and gypsum board, agency' furnlshed to.the Clty's
pOST & BEAM: To be made lnterlor and 6xierlor, ls ln ' Bulldlng Dlvlslon before
prlor to lnstallatlon of floor place but before any 99q-s are placed. (2501 U.BC.
lnsulatlon, decklng or floor ilasterlng ls appliei or before STDS. 25'10,11).
sheathlng. - Sypsum board Jolnts and
fasteners are taped and STRUCTURAL MASONRY: (906
FLOOR |NSULAT]oN & flnlshed' a'71
VAPOR BARRIERS: To be
made prlor to lnstallatlon of
decklng or floor sheathlng.
MASONRY: Steel location,
bond beams groutlng or
vertlcals ln accordance with
uBc 2415.
ROOF SHEATH]NG AND
NAILING: Prlor to lnstalllng
any roof coverlng,
S]DEWALK & DRIVEWAY:
Requlred for all concrete
paving wlthln street right of
way, to be made after all
excavatlng complete and form
work and sub-base material in
place.
CURB AND APPROACH
APRONS: After forms are
erected but prlor to placlng
concrete.
'ln addltion to the lnspec-
tlons speclfled, the Bulldlng
Offlclal may make or requlre
other lnspections of any
constructlon work to ensure
compllance wlth the Bulldlng,
Clty or Development Code.
FINAL PLUMBING
FlNAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
SITE PLAN REVIEW BOARD: Must be requested 2 days ln advanceof the date you wlsh lnspection. All project condltloni such aslandscaplng, parklng lot striping, etc. must be completed beforerequestlng thls lnspection.
FINAL BUILDING: Requested after the flnal plumblng, electrlcal,mechanlcal and Flre Department lnspectlons are made andapproved. No occupancy of the premises can be made untll acertlflcate.of occupancy has been issued by the Bullding Dlvlslonand posted on the premises.
ADDITIONAL COMMENTS:
PLANS REVIEWED BY D^rE./?79€7'
By slgnature, I state and agree, that I have carefully examlned the completed appllcatlon and do hereby cerilfy that all lnformatlonhereln is true and correct, and I f urther certify that any and all work performed shall be done ln accordance wlth the Ordlnancesof the Clty of Sprlngfleld, and the Laws of the State of Oregon pertalnlng to the work described hereln, and that No OCCUPANCYwlll be made of any structure wlthout permlssion of the Bulldlng Safety Dlvlslon. I further ceril fy that only contractors and employeeswho are ln compllance wlth oRS 7o1.oss wiil be used on this project.
I further agree to ensure that all requlred inspections are requested at the proper tlme, that project address ls readable from lhestreet, that the permlt card ls located at the front of the property, and the approved set of plans wlll remaln on the slte at ailtimes durlng
Slgnat Date
AMOUNT RECEIVED:DArE PAID: /27?2a- 'VALIDATION:
ct
RECEIPT *:RECEIVED BY:
SPRINGFIEL()
};,19,'gr*x;:j:* ff;:J$lii i:, : :1 i ;,,
U225 FIWE STREET
SPRINGFTELD, OREGON
INSPECTTON REQTIEST:OFFICE: 726-3759
ON OP
97 47
->)-bo.4
7264&X6&edStgnaure.Nr^
3
ELECIRICAI PERHIT APP LICATION
I
1q
l/4ola
INSTALLATIquK 6 A.
COHPLETE FEE SCMDULE BELOV
New Residential-Single orMul-ti-Family per avelling unit.Service Included:i-7 ON-)c5a-:>
oO Pa rfQh,rct^1000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Manuf,d Home, or
-
Modular Dvelling
Service or Feeder
Services or FeedersInstallation, Alterationsor Relocation:
Items Cos t Sum
s 8s.00
s 15.00
$ 40.00
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for1B0 days.
2. CONTRACTOR INSTAII.ATION ONLY
Electrical con tractorCRoqJ u"'r( (<
eddress PC.*>?o/200 amps or less
201 amps to 400 amps
-
401 amps to 600 amps
-
601 amps tor1000 amps-over 1000 amps/volts
-
Reconnect Only
B.
S/'Jn. t
eLt <7rlod
C.
00
00
00
00
00
00
S so.
S 60.
s100.
s130.
s300
$40
Ci ty vr.4 Phone
Supervisor License Number 3%dV"S
Expiration Date 5
Constr Contr. Number ?57fO
Expiration Date
Signature of Su pervising EIec trician(g
Temporary Services or Feeders
Install-ation, Alteration or Relocation
200 amps"or less $ 40.00
201 amps to 400 amps
-
S 55.00
over 40L to 600 amps
-
$ e0.00'
-0ver 600 amps or 1000 voITs see ttgtr uffi!-
Branch Circuits
(,
ovners 1r"*ep/i"r Nu<rg B'.rtr( ct ,rll^
Address 9'.<
ci ty-Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Ovners Signature:
Nev, Alteration or Extension Per Panel
one circuit / S 35.00 :'' 5
E
Each AdditionalCircuit or with Service
or Feeder Permi t q S
Miscellaneous ( Service/feeder
-Each installation
Pump or irrigation $
Sign/0ut1ine Lighting- S
Limited Energy/Res
-
SLimited Energy/Comm $
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAI
{D
' --1\.a Ltl2.00 i
not included)
40.00
40.00
20.00
t' ,^'L
iSDATE->'--3o-y5^2
RECETVED B
5
1
fcu r
(a (
COMM ERCIAL/I N DUSTRIAL
PERMTT APPLICATION
225 Fifth Street, Springfield, Oregon 97477
sP'lrl{GFTELO
JOB NUMBER ?zlzft
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSOFIS MAP:TAX LOT M
STATE:ztP:e,3
PHON E:?qz-?>3/
CITY:
ADDRESS:
OWNER:
NEW
^
REMODEL ADDIT|ON DEMOLTSH OTHER VALUE:
DESCRIPTION OF WORK:
ARCHITECT:
CONST,
CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES PHONE
GENERAL:
PLUMBING:
ELECTRICAL:
NAME ADDRESS PHON E
MECHANICAL:
PLUMBING
NO.FEE CHARGE
Single Fixture
Relocated Bldg
(new fix. addtl)
Water Service
ft.
Sanitary Sewer
ft.
Storm Sewer
ft.
Backf low Device
TOTAL PERMIT
6
r
1*
-'2.a n ng e
f rom or
p ance
Floor furnace and vent
hood and duct
nary evap.
cooler
duct
em
Permit lssuance
TOTAL PERMIT
$10.00
O6
Fu rnace / bu rner & vent
<1
Furnace/burner & vent
>1 BTUS
orspend
mounted unit heater
LAND USE:
ZONING* OF UNITS:
HANDICAP ACCESS:
FLOOD PLAIN:
LIGHTING POWER BUDGET:
WATER HEATER:
_ OFFICE USEu
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
SQ. FT.$/SO. FT,VALUE
TOTAL VALUE OF PROJ
X
x
x
SO. FTG MAIN
SO. FTG ACCESS
SQ, FTG OTHER
RCPT#PLAN CHECK FEE DATE BY
tVzrts ?a# Abr/8=e*a-€r / - t - ii/ rt /-;, ZbF; fur,bA 6zr= acV47=,.
DEMOLITION
/+.3
-a
FT.
FT.
BUILDING PERMIT
BTOTAL
PLUMBING
CURBCUT
5% State
SIDEWALK
E
o
5% State
PAVING
5% State
e
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
SYSTEMS
DEVELOPMENT
/?-D1e.
REOUIRED INSPECTIONS
It is the responsibility of the permit holder to see that all inspectlons are made at the proper time. To request an inspection, call
126.3769 (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.
stTE INSPECTION: To be ,u ROUGH PLUMBING, PAVING: After gravel is in
made after excavation, but ELECTRICAL & ' place but prlor to placlng
prior to setup of forms. 4@4@No work is to asphalt or concrete.-Ee aEliffitfuntil these
UNDERSLAB pLUMBING, inspections have been made SPECIAL INSPECTIONS: ln accordance
ELECTRICAL & and approved. section 306 0f the state specialty code
MECHANICAL: To be made a special inspector shall be employed
before any work ls covered. ATTIC DRAFT STOPS & Oy ine Ownei/ Contractor during
. CURTAIN WALLS construction of the following work. A
FOOTTNGS & FOUNDATTONS: copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are faclng materials and before
erected, ail steel in place, but framing lnspection' srRUcruRAL CoNCRETE: ln
prior to placing concrete. FRAMING: To be made after excess of 2500 PS.l. (306 a.1)
coNcRETE SLAB: To be the roof' all framlng' fire
made arter ail insrab buirdins 3lf5'::.':fl 3,T:I?f,nl:r" B:Is..Tyf3"tH5tTirr22 o
service equipment, conduit, and vents are'complete and
:l'J'?,?;""?",1;il!? ?i:'.:'::J :X? H:Zglffil:fl'X;;[3:?: Bl?If],?E:nol*,?f*IHX"oin place but before any tighte-nlng operations. (306concrete is placed. INSULATION & VApOR a.6)
BARRIER: To be made after all
UNDERGROUND: Plumbing, insulation and required vapor SpRAyED ONelectrical, gas, sanitary sewer, barriers are in place but FIREpROOFING: U.BC.storm sewer, water and before any lath or gypsum Standards 43-g.drainage lines. To be made board interlor wall covering lsprior to covering or fiiling appried. spEclAL GRADTNG,trenches. 4r..,
,NDERFL..R: p,umbins Y$r;s'"'"'fm'J3l:5"' if,fUtlii-tlP,5Jb'i}"t
electrical, mechanical. To be according to plans. chapter 29)
made prior to installation of
floor insulation, decklng or LATH ANDTOR GYPSUM GLU'LAM BEAMS: lnspectlon
floor sheathing. BOARD: To be made after all Certificate by an approved
lathing and gypsum board, agency, furnished to the city's
posr & BEAM: To be made interioJ and exierlor, ls in ' Building Divlsion before
prior to installation of floor place but before any beams are placed' (2501 U'B.C'
insulatlon, decklng or floor plasterlng ls applled or before STDS"25'10J1)'
sheathing. ' qypsum board joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR TNSULATToN & flnished' a'71
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
ROOF SHEATHING AND
NAILING: Prior to installing
any roof coverlng.
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.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
-ln addition to the inspec.
tions specified, the Bullding
Officlal may make or require
other lnspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all lnformation
herefn is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordlnances
of the City of Springfield, and the Laws of the State of Oregon pertainlng to the work described herein, and that NO OCCUPANCY
will be made of any structure without permission of the Building Safety Divlsion. I further certify that only contractors and employees
who are in compliance with ORS 701.055 will be used on this project.
I furtheragree to ensure that all required inspections are requested at the propertime, that project address ls readable from the
ard is located at the front of the property, and the approved set of plans wlll remaln on the site at all
7/,Signature Date
street, that the rm
times during
VALIDATIO ,2-28AMOUNT RECEIVED
RECEIPT *:BECEIVED BY:
DATE PAID:
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All proJect condltlons such as
landscaping, parking lot striping, etc. must be completed before
requesting this inspectlon.
FINAL BUILDING: Requested after the final plumbing, electrlcal,
mechanlcal and Flre Department inspections are made and
approved. No occupancy of the premises can be made until a
Certiflcate of Occupancy has been issued by the Building Division
and posted on the premises.
ADDITIONAL COMMENTS:
PLANS BEVIEWED sa17 2^2^a 7
,Y
225 PTFTH STREET
SPRTNGTIELD OREGON 97
INSPECTION REQIIBST: 7
OFFICE: 726-3759 Authori,zed
LOCATION OF INSTALLATION
1660 Mohawk Blvd
LEGAI DESCRIPTTON
Church )?D3 2-9 )/
JOB DESCRIPTION
Insrall se
Ovners Name Twin Rivers Bapc
1
The lollowlng prolect es subrnfrled hs thc
zoning, end do€e not requlre apecl{lc land
!iPRtItlGFIELD
uso
ELE TRICAT PERHIT APPLICATION
City Job Nunber Z Z
SCMDULE BELOV
Nev Residential-Single or
Multi-Family per dvelling unit.
Serviee fncLuded:Items Cost
1000 sq.ft. or fess
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
O CAAA
em
A
c
Sum
2. COMRAC:TOR INSTALLATION ONLY
Electrical Contractor Ince*.r."d E1 ".Eronl.or Relocation:
Address 232 W. 5ch sYscems' t"?oo amps or ress
Permits are non-transferable and expire
if vork-is not started vithin L80 days
of issuance or if vork is suspended for
180 days.
Ci ty Eugene Phone 485 - t+45 6
Supervisor License Number 1528JLE
Expiration Date L0lt le6
constr contr. Number 20-375cLE
Expiration Date to/Lle4
ture sing Electrician
Temporary Services or Feeders
Installation, Alteration or Refocation
200 amps or less $ 40.00
ior .*i" to 4oo amps
-
$ 55.00
over 4b1 to 6oo amps
-
$ Bo.oo
Over 600 amps or fbOO voTts see uB" a66vE-
Branch Circuits
Nev, Alteration or Extension Per Panel
201 amps to 400 amPS _
401 amps to 600 amps _
601 amps to 1000 amPs-
Over 1000 amps/voIts
Reconnect 0n1y
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
B
D.
i s c Church
$ s0.00
$ 60.00
$1oo.0o
$130. 00
$300.00
$ 40.00
$ 3s.00
$ 2.00
Address 1660 Mohawk 81
Cily SPringfield Phone
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
f or sale, l-ease or rent .
Owners Signature:
DATE:
Miscellaneous ( Service/feeder
-Each instalfation
Pump or irrigation $
signzoutline Lighting- $
t iilited Energy/Res
-
$
Limited rnergy/comm --Z- $
E
5
not incl-uded)
40.00
40.00
20.00
36.00 @o
-rtgg-
) -1611-
CITY OF OREGON
RECEIVED
firo alnr a
CO M M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATION
225 Fitlh Street, Springfield, Oregon 97477
SPrlINGFIELO JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PFIOPOSED WORK lbbo Aoet+at.rr< Buyr\{4Lt N6F'r EcA
ASSESSORS MAP:
owNER: -fvt U Ptvf-Ds t34.+tl9t o*;rtce pHoNE:
ztP, q14r11
ADDRESS
CITY:3PQ1tlCnA)u.O STATE:rrlL
t(obO p16l-t"*ra.,r[ i\vt0
NEW
-
REMoDEL Y ADDrrroN DEMoLTSH orHER
AS[-D-odr 9ave CCI
VALUE: ?7.oc'tl ^
D9-t r,€tNbDESCRIPTION OF WORK:
MECHANICAL:
ELECIRICAL:
NAME ADDRESS PHONE
ADDRESS EXPIRES PHONE
OA
ARCHITECT:
CONTRACTOR'S NAME
CONST.
>" 2 coNTRACToR #
G EN ERAL:
4+tUar.. )
PLUM BI NG
PLUMBING
NO.FEE CHARGE
Single Fixture
Relocated Bldg.
(new fix. addtl)
Water Service
ft.
Sanitary Sewer
ft.
Storm Sewer
ft.
Backf low Device
TOTAL PERMIT
M EC HAN ICAL
NO FFF (:HA EIGF
Furnace/burner & vent
< 100,000 BTUs
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cool er
Vent Fan/Single
duct
Vent
f rom
System apart
AC or htg.
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT
- OFFICE USE _
5300
0.( -
HANDICAP ACCESS
* OF UNITS:
LAND USE
LIGHTING POWEB BUDGET:
WATER HEATER
FLOOD PLAIN
ZONING
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
SQ. FT.$/SQ. FT.VALUE
RCPT#BY
TOTAL VALUE OF PROJ
X
X
X
PLAN cHEcK FEE / 3/,25
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
BUILDING PERMIT PLU M BI NG DEMOLITION
570 State
Surcharqe
5% State
Surcharge
MECHANICAL FENCE
VALUE $
5% State
Su rcharqe
SIDEWALK
FT.
SUBTOTAL
PERMITS
PAVING CURBCUT
FT.
SYSTEMS
DEVELOPMENT?2 a
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
1J
?t, ; *6
7t,,j 2S 3 / rAX Lor ASffi
o^rE /2 -7 -2 3
*afl*4/a
I
V REQUIRED INSPECTIONS V
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 made the same working day, requests made after 7:O0 a.m. will be made
the following work day.
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 asphalt or concrete.
be covered until these
UNDERSLAB pLUMBING, inspections have been made SpECIAL INSpECTIONS: tn accordance
ELECTRICAL & and approved. Section 306 of the State Specialty Code
MECHANICAL: To be made a special inspector shall be employed
before any work is covered. ATTIC DRAFT STOPS & by the Owner/ Contractor during
CURTAIN WALLS construction of the following w6rk. A
FOOTINGS & FOUNDATIONS: copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are facing materials and before
erected, all steel in place, but framing inspection' srRUcruRAL CoNCRETE: ln
prior to placing concrete. FRAMING: To be made after excess of 25oo P.S.l. (306 a.1)
coNcRETE SLAB: To be the roof' all framing' fire
made after au insrab buirdins 3l::5::.':fl 3,T:It;,;;:r" ilIy'"J"',f3^t,Y5tT',rrr, ,
service equipment, conduit, and vents are'complete and
:Hl3'i""".",:;H:? ?i:i:'5J :H';::li;ti51'iJ;[?:l: Bl?Xf],?E]nolX".1","11HX"0in place but before any tightening operations. (306
concrete is placed. TNSULATION & VApOR a.6)
tU BARRIER: To be made after all
^ UNDERGROUND: Plumbing, insulation and required vapor SPRAYED ONejEglsglllas, sanitary sewer, barriers are in place but FIREPROOFING: U.B.C.ffiffi1ft3i1"0" B::?:',:iJ,,';J1"3i',n"'J#,Tn," Standards 43.8
prior to covering or f illing apptied. SPECIAL GRADING,trenches.
,NDERFL.oR: p,umbing il::,S""="'f;m'J3[[]"' il;iJ!'iii-til:,5Jb'l],"1
electrical, mechanical. To be according to plans. chapter 29)
made prior to installation of
floor insulation, decking or LATH ANDTOR GYPSUM GLU'LAM BEAMS: lnspection
floor sheathing. BOARD: To be made after all Certificate by an approved
Iathing and gypsum board, agency' furnished to the city's
posr & BEAM: To be made interior and exierior, is in Building Division before
prior to installation of floor place but before any beams are placed' (2501 u'Bc'
insulatlon, decking or floor plastering is applied or before STDS' 25-10'11)'
snedurrtg. gypsum board joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR TNSULATToN & finished' a'7\
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
MI\SONRY: Steel location,
bond beams grouting or
verticals in accordance with
u3c 2415.
ROOF SHEATHING AND
NAILING: Prior to installing
any roof covering.
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.
CURB AND APPROACH
APRONS: After forms are
erected but prior to Placing
concrete.
*ln 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.
By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information
herein ls 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 Springf ield, 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 front of the property, and the approved set of plans will remain on the site at all
times during construction.
l>-/4 43DateSignature
7
,lrz4 eLL
VALIDATION AMOUNT RECEIVED:
RECEIPT *:RECEIVED BY:
DATE PAID:
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
AD TIONAL COMMENTS:
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 stri pi ng, 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 made until a
Certificate of Occupancy has been issued by the Building Division
and posted premises
PLANS REVIEWED BY o^rE /2-+*'
REgIDENTIAL - COTANERCIAL
SIDEIIJALK / CURrcUl
APPL ICATIOI.I / PER|IIT
SPFI!NGFIELD
225 NORTI-{ FIFTI] gTREET
gPRlhlGFIELD, OREGOI I 314'l'1
ENG INEERING D IVI9IOI.i
ffitcE No. 126-)1>3
IN9PECTION LINE' 126-3169
h,
JOB ADDRE9S;60
A95E95OR9 HAP NO./') - O3 - 2s'3 ( rAxLorNo'{8oo
gJBDIVI9ION,
orr.hiER, TIU t ,"t {ZrqqtJ BqlVsf aq2pz{/
ADDRE99,
aa A=-PHONE NO.
RECEIPT NO:
CA*
CHECK TL>*&
*
CHECKED FOR DEL ING'JENCIEg
9IGNED'
DAiE,
La3aT
UIOFK DE9CRlPflCtl,
sTDETuaLK; Y cuRB grDE
-
sETBA6K _
cuRts-cur: X- REgrDEr.irrAL
-
col-jr-lERrcAL
-
g=COND DRI\EIIAY ( 5EE TRAFIC )
eaJl€9 AFPLICATION FoR A 9ECOND DRI\6IIJAY(T-4.1a)
oR A COTJNTY APPLICATIoN FoR FACILITY PERIIT (C 9b-2oi)
IF IN TI{= U65.
DATE tr APFLICATION 3o 3
oiLt,iER
+
CoN;RACTOR '''oE- (*tr_OtSU
CONTRAC;OR
REGrgrRATron *o.*
ADD, ,55 PHONE:
PROCEDUFE FoR fNgPECTlohl RE@tlE9T'
CALL 12b.3169 (R=CORDER ) STATE YOUR CITY D=SIGNAT=D JO3 N'.JI.13=R, JO7 ADDRE9S,TYP= cFN9PECTION REAUE9TED AlD IIHEN YOU II]ILL B= R=A>Y FOR INSPECTICT,{, c:c>NTRACTclRg OR Ou}l=Rg NAY= ANDPHoN= NI.HBER REaUE9TS RECEIVED ts=FoRE 1,oo 41 ulLL BE IIADE i]-1= 94J'1= DAy, REaUES;9 -:-1-=R.TooAI'1 IIJILL BE I,1ADE TI-]E NEXT IIORKING DAY
QZt zct^EXIgTII.IG BUILD ING PEFA-1IT No. ( lF l-^=t = l
*'YOUR CITY DE'IGNATED
'O- XO.
'SfgEE 30d.
X SIDEIUAL< / DRIVEuJAY
FOR A].L CONCRETE PAVING IUITi-JIN
THE STREET R,IGIT OF IIJAY, TO 3E
I1ADE AFTER ALL EXCAVATING
19 COI1PLETE A{D FOB1 UJOFa<
AND 5UB-BAgE I1ATERIAL 15
IN PLACE
X cU@ / APPROACH APROI'JI
AilER FORI,1g AE ERECTED
BUT PRIOR TO POURNG
CONCRETE.
FEE9: gIDEUJALK5
?o'x, t54 +
l3
loOO
TOTA PERIIIT FEE:
g1o.oo + rA.lb/LF.( X
NF UJALK
e lG#Z3ro
cuRB-cuT
|1O.oO+@)A/LF.(X)
tlarR s
CO|.II.IERICAL DRI\€II]AYg 9HALL
HAVE 5'TO A'FLAIR93'. @" gTA{DARD
UJALK X,
)
24 fe'
I |.4A\€ CA,REFULLY EXA}1INED 'i.iIE COI"IPLETED APPLICATIO\] FOR PER.IIT, ;I{D DO |..{EREBY CERTIFY iH,lT ALLiNFO, IATION I-.IEREON 15 TRIJE AND CORR=CT, AND I FURTI-.{ER CERTIFY TI.,1AT ANY AND ALL U,oR< PERFO3,1=D9i-]ALL BE DONE IN ACCORDANCE I.,I,,ITH TI]E.ORDNANCES G TiIE CITY G SPRINGFIELD, AND THE LAI.IJS OF THEgTA.I.E OF OREGON PERTAINING TO THE IJORK DEgcRIsED HEREIII, AND .I.I".{AT xo bciueaNcY IIJILL BE I.1ADE# ANY STRLICTURE tlJlTi'louT FEtrilSglct'l oF THE BUILDING DlvlgloN. t ruerueaclFir;r lsar oNLy coNiRAcToRgAND El"lPLoYEEg ujllo ARE tN cotlpLlANcE rutrH oe<g loio>> uJrLL BE ugED oN ruis pRo;ecr.
9IGNED
a.*---
DATE
Dq -q3
REOU IRED IN9PECTIOI{S
DATE:v lto lqt
APPLICANT (PROPERTY OWNER) :
ADDRESS 0F APPLICANT: tb6o
APPLICATION FOR A SECOND DRIVEVAY
-fla/r rr/ E-l L/GfLt BA/ilS f C Pvz?1,1
APPLICANT'S TELEPHONE NO. z 1A7->LO \ 141 -nLr{ (iqlr1-> .nc-rSc*-)
l4l o t++.,rJlz- B uzlr -
ADDRESS OF PROPERTY FOR 2ND DRIVEVAY: IQ,@O fid t++rnzla . BL./f\
The folloving conditions must be ansvered affirmatively in order for this
application to be considered for approval:
1). Property is either a single family residence or duplex.
YES_ N0 +-
2). The proposed drivevay vi11 take direct access from a minor street(not a collector or arterial street). YES N0 k
3)The drivevay vi1I have a minimum setback of 30 feet from the curb
return of an intersection (for corner lots). YES X N0_.
4)The proposed drivevay (parking area) must have a minimum depth of
18 feet betveen the front property line and the garage, carport,
fence or va1I, if any (identical to setback for garage).
YES *-- N0_.
s)The second drivevay must have direct access to a garage, carport,
rear yard or the side yard vhere the vehicle, trailer or boat viI1
be stored. YES_ N0_. UA
If the vehicle, trailer or boat is to be parked/stored in the sideyard, there must be a minimun setback of 5 feet betveen the store{
vehicle and the side property line. This setback is for fire '
fighting access.and to comply vith the intent of the zoning code.
Setback satisfied? \ES d N0_.
The proposed parking/sto-rage area must not create a vision
obstruction to adjacent property drivevays or to any vehicular
movement on a public street. Satisfied? YES.f N0
6).
7).
This application sha11 include an I l/2'r x 11rr draving shoving existing
drivevays, and the proposed drivevay. Please include dimensions, and
measurements to road intersections and/or bordering drivevays.
A11 applications outside the city limits of Springfield that are within the
Urban Grovth Boundary require a Lane County permit.
Applicant hereby agrees to install the requested drivevay to City of Springfield
standards. The apf,licant further agrees [o have 6" of concrete in the sidevalk
area adjacent to tire proposed drivevay and further agrees to pave the area
behind ihe back edge bf the sidevalk, or drivevay apron, adjacent to the
drivevay vith a miiimum depth of 3r'of asphaltic concrete or vith a minimum
J"ptt, of 6u of portland cement concrete. -The area behind the sidevalk shall be
paved to the prbperty line or for a distance of 4 feet vhich ever is greater.
The applicant agrees that if he/she does not pave the area behind the sidevalk
vithin'30 days 6f cutting the curb opening, the City_of_springfield has the
.rifi"rity of-close the dlivevay accels by the removal of the curb cut. AIl
incurred costs shall be assumed Uy ttre applicant and if unpaid, said cost shall
become a lien of the ProPerty.
Vhen this application is approved by the 9i!V'__the applicant (p-roperty ovner)
,u"t oUt"in'i driver.y p"rrit from ttre puUlic llorks Department Engineering
Division.
PERMIT FEE
0n an improved street (existing curb):
$I"O.OO plus $.15 per 1inea1 foot of curb cut'
0n an unimproved street (not curbed): $12'00
On currently unimproved streets that are under construction:
$12.00.
PROPERTY OIINER' S SIGNAT1IRE:fr*/ CZ* tuq lwtt Dtutuzr E(w-7?cr @)
a
b
c
04EO-40&- sAtYT L aM4-
DATE: I l -30 -n t 792 ->2t i
f orr*orED BY:
DATE:
BUILDING PERMIT NO.:
DATE:
TRA 9-1
ATTACHMENT:City of Springfield Standard Draving No' 3-11
Dated 1.0/B/82
ffz/',l=qtZS6I
S?brw{) 4ory55
CITY OF SPR"VGFIELD, OREGO'U
SPRli.r.FlELO
225 ?TYIB SlTEBf,
SPRTNGPIBLD, oREGoN 97477
INSPECTION RBOUBST: 726-3769
oPPICE: 126-3759
1. LOCATION OP INSTALI,ATION,/Zao r?o*y'tq7<tr>,
I,EGAL DESCRIPTION/\O=-*7,-r dn54
JOB
Pe ts are rans ra and exp lre
lf uork is not started vlthin 180 days
of lssuance or lf vork ls suspended for
180 days.
2. COI|TRACTOR INSTALI.ATION ONLY
Address f,y')-5,7],n-r.y''". -zta' 4"2
Supervisor Licen:e Number /F7/ S
Expi ration Date //i'- ?' 3
Constr Contr ,. Nunbet '7 .z t7/
Explratlon Date ,//- 7 3
of ing Electrlclan
Owners Name
Address
Electrlcal Contraclor )n/r'Y iL.- c77t( Z-1
m
ELB TRICAL PBRHIT APPLICATION
city Job Nwaer ?z /25€
3. COHPI.JTE TBB SCEEDTII.E BELOU
A. New Resldential-Single or
HuIti-FamiIy per dvelling unit.
Service Included:
I tems Cos t
$ 8s.001000 sq.ft. or Iess
nach additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
-Hodular Dwelling
Servlce or Feeder
$ 1s.00
$ 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
Sum
I
200 amps or less Z
201 amps to 400 amps /401 amps to 600 amps
601 amps to 1000 amPs_
0ver 1000 amps/vo1ts .1
Reconnect 0nIy
200 amps or less
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000 voT[
Temporary Services or'Feeders
Installatlon, Alteration or Relocation
s s0.00
$ 60.00
$100.00
$130.00
s300.00
$ 40.00 %
.aa@
c
D
E
$
$
$sse
40.00
55.00
80.00
,e xBrr aSoIE
$q 7im vnone ?/6-7V/
OSNER INSTALI,ATION
The lnstallatlon ls belrig made on
property I own vhlch is not intended
for sale, Iease or rent.
Omers Signature:
DATB:
Br4nch, c-i rcu i rc R b r2a2.ffirSZft
(,, (ffir,ffinsion Per Paner
'0ne Circuit $ 35.00
Each AdditionalCircult or vith Service
or Feeder Permlt
-
$ 2.00
Mlscellaneous (Servlce/feeder not included)
-Each installatlon
Pump or irrigation
-
Slgn/0utIine Lightlng-
Limited Energy/Res
SUBTOTAL OP ABOVB
5f State Surcharge
TOTAL
$
s
s
$
40.
40.
00
00
00
00
20
a.a
5 #
RBCBIVED
36
Clty Sr,?!r.-'4rt/cD thone ,7/A- S fft
t-
DATE
FROM
NUMBER
D CAME TO SEE YOU
u
AREA CODE
M3
.M,P
O RETURNEDYOURCALL
tr URGENT
D TELEPHONED
PHONE
8-u
frnfrn
%/a?'/s
EXT
SIGNED
225 FIFTE STRBET
SPRTNGFTELD, oREGoN 97477
INSPBCTION REQUBSTz 726-3769
OFPICB: 726-3759
si rr* - 'IELD
BIJCTRICAL PERHIT APPLICATION
City Job Nunber %/a56
coxPl.rEE SCEEDT'LE BELOTI
Nev Residential-Single or
Multi-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
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s. oo
$ 40.00
AUIho
CC
)-lO-93
SJ:--
1 OP INSTALI"ATION/VoHnn:(
JOB
a NEI,)
permits are non-transferable and expire
if vork is not started r.rithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALI,ATION ONLY
A
B. Services or Feeders
Installation, Alterations
l2S<or Relocation:
c
Sum
ON
t
)+ Electrical Contract", Jrlal 9z-r<-
+( aaaress P( \ &{- r[S
X city'.*AttlE8; phone€5e,-3blS.
,,X Supervisor License Number
)C rxp:.ration Date,
-+ constr contr. Number
-Y Expiration Date
200 amps or less I
201 amps to 199 amps 7-401 amps to 600 amps
601 amps to 1000 amps_
Over 1.000 amps/voIts /
Reconnect 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
-0ver 401 to 600 amps
Over 600 amps or 1000 voTt
s s0.00
s 60.00
s100.00
$130.00
$300.00
$ 40.00
/p-e:-@.e-
@
$
$
$
40
5s
80
00
.00
.00
+
Signature of ing Electrician
Ovners Name
Address
Ci ty Phone
OVNER
The installation is being made on
property I ovn vhich is not intended
for saIe, lease or rent.
0cners Signature:
DATE:
s see rrBrr a
D Branch Circuitsft UrXDAT€
7o Bg Pa,Waasgo AT
Nev,Alteration or Extension Per Panel
One Circuit S 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2,00
B. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
sign/outline Lighting-
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVB
5Z State Surcharge
TOTAL
-1.t
$40
s40
$20
$36
00
00
00
00
-/3
RECBIVBD
a 5 4
cffv oF
5l.t t I.'a (;l: lr: L u
n'l:<l r' '- . " 'r' ' ". .' . .-,:,., ,..,,,,,
225 FIFTII STRIiIiT
SPRINGFIELD, oREGoN 97477 f f
INSPECTI0N RBQUBSTz 72-6-3769 S'- l--
*-air
OFFfCE: 726-3759 n$* 1?-l b- ?a
1. LOCATION OI? INSTALLATION
lLl,o [Mo*rhlK R LV A.
ON
JOB DESCRIPTION
nlF-uj ClUk l+r"Tloil.
Permits are non-transferable and expire
if vork is not started vlthin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY B
Elcctrical Contractota
A<ldr:css Z{ \^l<
ci ry4UJilEE- Phone 83 &= -BJJD-
Supervisor License Ntimber \zAD-b
Expiration Date
constr contr. Number
Signature of Su ctrician
ELBCTRICAL PERHIT APPLICATION
Ci ty Job Number
COHPI,BTB I'BB SCIIEDULE BELOU
A. Nev Residential-Single or
HuIti-FamiIy per dwelling unit.
Service Included:Items Cost
1.000 sq.ft. or less
Each additional 500
sq. ft or portlon
tlrereo f
Each Manuf'd fiome or
$ Bs.oo
$ 1s.00
Modular Dvelling
Service or Feeder
Services or Feeders
Installatlon, Alterations or
Relocation:
200 amps or less
20L anrps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/voIts
Reconnect 0nIy
Sum
$ 40.00
s s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Temporary Services or Feeders
Installatlon, Alteration or Relocation
Expiratio" D"te .#g@ tg 3l'q'l 200 amps o.r less $ 40.00
$ ss.00
$ 80.00
see ltBrr aEffi
Ovners Name
Add ress
ci ty tr\S"\{e.S Ptrone €5[o'3b]
OUNER INSTALLATION
The installation is being made on
property I ovn vhich is not interrded
for sale, Iease or rent.
Ovners Signaturc:
201 amps to 400 amps _
Over 401 to 600 amps _0ver 600 amps or 1000 volts
One Ci rcui t
Each A<lditional
Circuit or vith Service
or Feeder Permi t
Branch Circuits
Nev, Alteration or Extension Per Panel
$ 3s.00
D
s 2.00 _
E. I'liscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utIine Lighting-
Limi ted Energy/Res
SI'BTOTAL OF ABOVB
5Z State Surcharge
TOTAL
00
00
00
00
$40
s40
s20
s36
5
DATE:
RRCII PT
RI|CNIVIiD II
d)
roB No .nztz+t-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0MIi|ERCIAL & RESIDENTIAL)
Twrxt €tVtB r9a C*tuecr\NAME OR COMPANY:
\L o Mor+A \AlK 9uVo .\-'t o 22ZbVl - o5loooLOCATION:
QC - Aupt rot-\DEVELOPMENT TYPE:
BUILDING SIZE: Zo,qBB *e'rr' - NIE!ueouEr'LoT SIZ
STORM DRAINAGE
iMPERVI0US SQ. FT.x $0.i92 PER SQ. FT.
2 SANITARY EI,lER- C ITY
NO. OF PFU'S GI X $39.78 PER PFU
(See Reverse)
3. TRANSPORIAIISII
eave q@ Cw?u+o.torS ?W <1G9(
NO OF UNiTS X TRIP RATE X COST PER TRIP
sQ. Fr.
I +
?a,98l o.b+x $401.05
x $401.05
x $401.05
A
X
X
$
q{
SUBT0TAL (ADD ITEMS 1,2, & 3)11e-1
4. ADMIN ISTRATIVE FEES
5
BASE CHARGE (SUBTOTAL ABoVE) X -05
TOTAL-CITY SDC S AETEf
/
SANITARY SEWTR_Mt,'lMC
N0. 0F pFU,S bl lW x $13.62 PER PFU + $10 MtltMC ADMIN. FEE 5 8'h69
(Use PFU Total From Item 2 Above)
MI,JMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
Kip Burdick
SDC Coordinator
5>to 7b
q?-
TOTAL SDC S 3OIAIZ
q
FIXTUBE UNIT CALCULATTON TABLE: Number of New Fixtures XI'nitEquivalent = Fixture Units (NOTE:
For remodels, calculate only the NEJ additional fixtures)
FIXTURE TYPE
Bathtub..
Drinking Fountain.....
Floor Drain.
I nterceptors For G rease/Oil/Solids/Etc-.-..'...-......'
I nterceptors For Sand/Auto Wash/Etc--....--.-... ""'
Laund ry Tub/Clotheswasher.... --
Clotheswasher - 3 Or More..--
NUMBER OF
NEW FIXTURES
L+
4
UNIT
EQUIVALENT
FIXTURE
UNITS
b
b
'\NJe)
2
1
2
3
6
2
o
o
1
J
2
1/
Z
2
1
o
t+
Mobile Home Park Trap (1 Per Trailer)'......-.'...-...
Receptor For FlefrigeratorAVater Station/Etc.-.'...
Receptor For Commercial Sink/Dishwasher/Etc.
Shower, Single Stall.
Shower, Gang...
Sink, Bar, Commercia|...................
Urinal, Stall/YVall...
Wash Basin/Lavatory, Single........
Water Closet, Public lnstallation...
Head
L+
,q
Water Closet, Private..
Ii/iscellaneous
TOTAL FIXTURE UNITS GI
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table,
calculate credits
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
N.4 x$
(Rate XN.ft Assessed Valge)x $_
(Rate X Assessed Value)
CREDIT TOTAL = g
^l
.4.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1985
1986
1 987
19BB
1989
1990
1 991
$2.16
1.90
1.60
0.25
0.87
0.50
0.16
1979 or before
1980
1 981
1982
1983
1984
$2.83
2.76
2.7'l
2.60
2.46
2.33
RUNOFF COEFFICIENTS FOR STORM DHAINAGE
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
1-
1-
COM M ERCIAL/ I N DUSTRIAu
PERMIT APPLICATION
225 Fifth Street, Spri ngfield, Oregon 97477
LOCATION OF PROPO
ASSESSORS MAP:
SP'IINGFIELO
t
JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
TAX LOT:
t ol,o( )t [\]OWNER:
ADDR
CITY:STATE:
PHON E:
ZIP:
VALUE:DEMOLISH OTHER
DESCRIPTION OF WOR
NEW
-
REMODEL ADDITION
NAME ADDRESS PHONE
ADDRESS EXPIRES PHONE
G ENERAL:
CONTRACTOR'S NAME
ARCHITECT;
PLUM BI NG:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR-}
PLUMBING
NO.FEE CHARG E
-.Q Single Fixture ,/a =#Relocated Bldg.
(new f ix. addtl)
/Water Service < ra 'ft a4
/Sanitary Sewer 1&ft €
Storm Sewer i€O' tt 20
/Backflow Device ,/a
TOTAL PERMIT 7ga
MECHANICAL
NO FFF EHA RGF
Furnace/burner & vent
< 100,000 BTUs 6 eo
?Furnace/burner & vent
>100,000 BTUs 7da .3
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
coolerzVent Fan/Single
duct .€
Vent System apart
from AC or htg.
/Mechanical exhaust
hood and duct
6 Or* Oo;zezs
Permit lssuance $10.00
TOTAL PERMIT 1?,#
I
UrDu)
OFFICE USE -s30c)QUAD AR LAND USE:
WATER HEATER:
# OF BLDGS
OCCY GROUP:
* OF STORIES:
LIGHTING POWER BUDGET:
Y OF UNITS:
HANDICAP ACCESS:
FLOOD PLAIN
ZONING
CONSTR. TYPE:
HEAT SOURCE:
$/SQ. FT.VALUE7r,e
?etr7W
le?€, Z7oX
X
SQ. FT.
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
TOTAL VALUE OF PROJ
PLAN DATE BY
//, f z>.da
/02?.oa PLU M BI NG 78a.'-BUILDING PERMIT DEMOLITION
5% State
Su rcharoe I 1,1,5% State
Surcharoe /? .'"Pt* frErza.? fE€ea,5e/o,'//?.[^'LE" lSOn'7 -F aa2.MECHANICAL -:Cz*zEry a t /4(/a
5% State
Su rcharqe
sroEwnl(
FT.
'/SUBTOTAL
PE RM ITS 2v/79=
//o. f,o CURBCUT.a.La*< *tFT.SYSTEMS
DEVELOPMENT
PAVING #qorOY2 F
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
7,lvr*
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 made the same working day, requests made after 7:00 a.m. will be made
the following work day.
SITE INSPECTION: To be ROUGH PLUMBING, v PAVING: After gravet is in
made after excavation, but ELECTRICAL & place but prior to placing
prior to setup of forms. MECHANICAL: No work is to asphalt or concrete.
be covered until these
/ UNDERSLAB PLUMB|NG, inspections have been made SpEctAL tNSpEcTtoNS: tn accordance
ELECTRICAL & and approved. Section 306 of the State Specialty Code
MECHANICAL: To be made .t
-
a special inspector shall be employed
before any work is covered. ATTIC DRAFT STOPS &- by the Owner/ Contractor duri ngCIJnifAh+.1ffi++S- construction of the following w6rk. A
To be made after trenches are FIREPLACE: Prior to placing be'furnished io the Building Division.
excavated and forms are facing materials and before
erected, all steel in place, but framing inspection' srRUcruRAL GoNCRETE: ln
prior to placing concrete. x FRAMING: To be made after excess of 2500 PS.l. (306 a.1)
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.
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.
UNDERGROUN D: PIumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
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.
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
f inished.
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.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
STRUCTURAL WELDS:
Performed on the job. (2722 t\
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.B.C.
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
GLU-LAM BEAMS: lnspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.C.
STDS. 25-10,11).
STRUCTURAL MASONRY: (306
a.7)
'ln 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.
/
J
Y
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
f loor insulation, decking or
floor sheathing.
POST & BEAM: To be made
prior to installation of floor
insulation, decking or f Ioor
sheathing.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
v RooF SHEATHTNG AND
NAILING: Prior to installing
any roof covering.concrete.t6aBE
FINAL PLUMBING
X
X
FINAL ELECTRICAL
FINAL MECHANICAL
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 stri ping, etc. must be completed before
requesting this i nspection.
X FINAL BUILDING: Requested after the final p
mechanical and Fire Department inspections
approved. No occupancy of the premises can
Certificate of Occupancy has been issued by
lumbing, electrical,
are made and
be made until a
the Building DivisionV FINAL FIRE D ENT and pos on the premises
ADDITIONAL COMMENTS:2
PLANS REVIEWED BY oarc /2-2V'*t
By signature, I state and agree, that I have caref ully examined the completed apptication and do hereby certify that all information
herein is true and correct, and I f urther 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.
required inspections are requested at the propertime, that project address is readable from the
of the property, and the approved set of plans will remain on the site at all
Signature Aa*/1---Date 3
I further agree to ensure that all
is located at the fro
n.
street, that the
times during c
DATE PAID:
RECEIVED
ON AMOUNT RECEI
RECEIPT #
A
AU /-GSITE PLAN REVIEW DEVELOPMENT AGREEMENT
THIS DEVELOPMENT AGREEMENT, hereinafter "Agreemento, is entered into this 23-0",
of 1992 (the "Effective Date") by and between the CITY OF
SPRINGFIELD, hereinafter "City", and Twin Rivers Baptist Church, hereinafter "Applicant", in
accordance with Sections 31.090,3.070(3),3.080(3),3.090(3), and 3.100(3) of the Sprinsfield
Development Code.
RECITALS
WHEREAS, on the 5th day of October, i 992, the City approved the Final Site Plan (Journal
Number 92-05-105) submitted by the Aoplicant for the purpose of allouring the expansion of the
existing Twin Rivers Baptist Church facility located at 1660 Mohawk Boulevard, (Assessor's Map 1 7-
03-25-31, Tax Lot 5600).
WHEREAS, in consideration for Site Plan approval, the issuance of a Building Permit, and the
issuance of an Occupancy Permit, as specified in the Springfield Development Code, Section 31.090,
Applicant agrees to comply with allthe standards of the Springfield Development Code and Springfield
Municipal Code which may be applicable to this development project unless modified or excepted by
the Site Plan Review Development Agreement, Planning Director, Planning Commission, Building
Official or their agents, or the Fire Marshal, which modifications or exceptions shall be reduced to
writing.
WHEREAS, in consideration for the Site Plan Approval, the issuance of a Building Permit, and
the issuance of an Occupancy Permit, as specified in the Springfield Development Code, Section
31.090, Applicant agrees to comply with the following specific conditions imposed by the City as part
of the Site Plan approval:
1. All improvements shall be constructed/installed as shown on the revised Final Site Plans dated
October 5, 1 992, provided however that storm drainage facilities shall be constructed/installed
as approved by the City's Building Division.
2. The proposed fence shall not extend beyond the 1O-foot setbacks from the property lines along
Mohawk Boulevard and 17th street.
All improvements shall be constructed/installed as shown on the revised final Landscape Plans,
dated October 5, 1992, which are included as a component of the Final Site Plan.
Approved street trees shall be planted along Mohawk Boulevard, at approximately 3O-foot
spacing, as shown in red on the Landscape Plan. The street trees shall be planted no farther
than 10 feet from the property line.
Four approved shrubs shall be planted between eacf two trees along the north boundary to
achieve a continuous hedge, as shown in red on the Landscape Plan.
A total of 3 signs showing the international symbol of accessibility for the accessible parking
spaces shall be installed. One of these shall indicate "van-accessible" and shall be located
adjacent to the space farthest to the west, as shown on the Final Site Plan, The other two
may be mounted on the building wall, as shown in red on the Final Site Plan. One of these
shall be directly across from the line separating the center of the next space to the east. The
other shall be located directly across from the line separating the two spaces farthest to the
east, and shall include double-pointed arrow, indicating that the sign refers to both spaces.
.)
J
4
$te Plan Development Agreement Page 1
5.
6.
r?.-i,
2
4
T!-.IEREFORE, IN CONSIDERATION OF THE FOREGOING RECITALS \A/HICH ABE EXPRESSLY T\4,ADE A
=.LiTnE'I-LJIC 4,-nrrtrtrn,T r-!T\, ^f,rt.DDll^^t.!Til:Dtrtr Qtr/''\llf'\\qfc., ntrt vt ttttu huttLLtvtLttt, vtt I ntry nt I Ltvnrtt nvtrLL n9 I vLLvLl9.
AGREEMENT
FINAL SITE PLAN. The Applicant has submitted a Final Site Plan in accordance with Section
3i.080 of the Springfieid Development Code.
STANDARDS. The Applicant agrees to fulfill all applicable standards specified in the Springfield
Development Code and the specific standards listed in "RECITALS" prior to occupancy, unless
certain standards have been deferred to a laterdate in accordance with Section 31.040 of the
Springfield Development Code.
CONDITIONS. The Applicant agrees to fulfill all specific conditions of approval required by the
City listed in "RECITALS" priorto occupancy, unless certain conditions have been deferred to
a later date in accordance with Section 31.040(4)(b) of the Springfield Development Code.
MODIFICATIONS. The Applicant agrees not to modify the approved Final Site Plan without
first notifying the City. Modifications to the Final Site Plan shall be reviewed in accordance
with Section 31.100 of the Springfield Development Code.
5. MAINTAINING THE USE. The Applicant agrees to the following:
(a)The building and site shall be maintained in accordance with the provisions of the
Springfield Development Code in order to continue the use.
(b)It shall be the continuing obligation of the property owner to maintain the planting
required by Section 31.040 of the Springfield Development Code in an attractive
manner free of weeds and other invading vegetation. ln addition, plantings in the
vision clearance area shall be trimmed to meet the 2 1 12 foot height standard in
accordance with Section 32,070 of the Springfield Development Code.
(c)Parking lots shall be maintained by the property owner or tenant in a condition free of
litter or dust, and deteriorated pavement conditions shall be improved to maintain
conformance with these standards.
(d)Undeveloped land within the development area shall be maintained free of trash and
stored materials in a mowed and attractive manner. Undeveloped land shall not be
used for parking.
6 ln addition to all other remedies which may be provided by law or equity (including but not
Iimited to penalties provided by applicable State Law or City Ordinances), Applicant agrees that
the City may enforce the Applicant's responsibflities by withholding Applicant's Final
Occupancy Permit, and terminating any Temporary Occupancy Permit which may have been
granted.
Any Final Site Plan approved becomes null and void if construction does not commence within
two years of the date of this Agreement.
7
Site Plan Development Agreement Page 2
1
.i
tN \A4TNESS THEREOF, the A,pplicant and the City have evecuted this Agreement as of the date fi'st
hereinafter r,^vritten.
/^(4)h2.t?"x-
Date
STATE OF OREGON, County of Lane
L Ee* ^oo
BY
1992. Personally appeared the above named
/-!:E\
{/,8#i"\
', .-= /
OFFTCIAL SEAL
ooi.;r,!A [EecKLOrY
N0TAriY rLiB!-lC . OitEG0lt
.crc,lrir.,4 isglarN No. 0101 33
tiY il'1:;flbs::Ji: i!.i;iis ACT. ll. lSE
vuho acknowledged the foregoing instrument to be their voluntary act. Before me:
CITY
BY br,o lL.l - . L. +'v,<-
Date
STATE OF OREGON, County of Lane
oEneionrlt 5'Srvices bi rbcto r
A&</r>pr 15W 1992. Personally appeared the above named
who acknowledged the foregoing instrument to voluntary act. Before me:
Public for on
My Commission expires rylteT qL
Site Plan Development Agreement Page 3
l)r- .q\,a-/ ftn, , ) t)
Not5ry Public for OreUrt
My Commission expires lO - t.3, - g <
\o .t9.4*