HomeMy WebLinkAboutPermit Building 1993-02-10.--<-
CO M M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATION
225 Fifin Street, Springfield, Oregon 97477
SPRINGFIELc,-3/JOB NUMBER
I NSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK:A??iC:) /ta5r,,r b/rL
ASSESSORS MAP TAX LOT:
*;{eo
PHONE:
02/u ztp, €?7t /STATE:
?7r- b/?a-
CITY:?uB,n.ol
ruTW T/ REMODEL ADDITION DEMOLISH OTHER
STaft€>ia: 55pr<-Cntfr rzlirf r"?t,a/
VALUE: rtaiU 'l*f-
DESCRIPTION OF WORK
NAME ADDRESS PHONEq5/-fraf
ADDRESS EXPI RES PHONE
??-6/7
/Eb
ln
{trr l(dilL- 3)"bs* he,Ui, rlo.ARCHITECT;
CONTRACTOR'S NAME
G EN ERAL:
PLUM BI NG:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
PLUMBING
NO.FEE CHARG E
Single Fixture
Relocated Bld
(new fix. addtl s
)
Water Service
ft.
Sanitary Sewer
ft.
Storm Sewer
ft.
/Backflow Device /D.e
3*. Z Z*z*,/bn
$r 7v7-7ra21a ,2142#a4;%a-iT
TOTAL PERMIT
MECHANICAL
Nr)trtrtr CHARGE
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 7.-o
Stationary evap.
cooler
z Vent Fan/Single
duct 3 6 t-?
Vent
f rom
System apart
AC or htg.
/Mechanical exhaust
hood and duct 4,50
Permit lssuance $10.00
TOTAL PERMIT rhzr,6nu
s
&r /n7.,
)-o HANDICAP ACCESS:
FLOOD PLAIN:
WATER HEATER
* OF UNITS:
LAND USE:
LIGHTING POWER BUDGET:
ZONING
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
SQ. FT.
se. Frc MA;N 6o5i/a 6Zan*;e
se. Frc ,*Fe-+-/3aa x
se. Frc orHER 7%.tv< 6#53
^
z " 41/o
TOTAL VALUE OF PROJ
VALUE
=@r\rv
v?/2?8. y',
z7
-o 25g "oa
'20
P DATE
e 5>2
-O OA
FT,
FT.
BY/z'2 z -73
5%
BUILDING PERMIT
PAVING
PLUMBING
CURB
5% State 5% State
DEMOLITION.at
*?
PERM
MECHA
Su Su
SID
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
SYSTEMS
DEVELOPMENT
FENCE
VALUE
OWNER:
ADDRESS:
@tarunl 4 Zo7*L4
a/o5 frnt**<f Dr r/-d '
r rr)t
)
7.ze/.-9
$/SQ. FT.
?.4s
,
REQUIRED INSPECTIONS
It is the responsibility of the permit holderto 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, J- 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: ln accordance
ELECTRTCAL & and approved. Section 306 0f the State Specialty Code
MECHANICAL: To be made a special inspector shall be employed
before any work is covered. ATTIC DRAFT STOPS & by the Owneri Contractor during
t, CURTAIN WALLS construction of the following work. A
X FOOTINGS & FOUNDATIONS: copy of the special testing reports shall
i"-I" -.0-u'after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are facing materials and before
erected, ail steel in place, but framing inspection'
-
srRUcruRAL CoNCRETE: ln
x
x
X
prior to placing concrete.
CONCRETE SLAB: To be
made af ter all inslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
concrete is placed.
UN DERGROUND: 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
f loor insulation, decking or
floor sheathing.
POST & BEAM: To be made
prior to installation of floor
insulation, decking or f loor
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.
ROOF SHEATHING AND
NAILING: Prior to installing
any roof covering.
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.
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.
F]RE & 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
concrete.
excess of 2500 PS.l. (306 a.1)
STRUCTURAL WELDS:
Performed on the job. (2722 l)
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).
STRUCTU RAL 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.
X
a
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 70'1.055 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that pro.lect 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
7/l-signatu re DateqLl-Lic 2'
A ,f\ n.4
times during constru
VALIDATION:AMOUNT RECEIVED:
RECEIPT *,:
tRECEIVED BY:
DATE PAID
,r
v
,(
V
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 conditions such as
landscaping, parking lot stri ping, etc. must be completed before
requesti ng this i nspection.
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 on the premises.
DATE z.^2-2 7
A toN CO
PLANS REVIEWED BY
v
.V
I
,V
,Y
B NO.ltt s s t
CITY OF SPRINGFIELD SYSTEI'IS DEVELOPMENT CHARGE
}IORKSHEET
(C0MI{ERCIAL & RESIDENTIAL)
G,t=-N N Krn RANAME OR COMPANY:
1n T Bt-i-7 072"_oO - ZL?ooLOCATION:21
c c - ttlew tttl I tla u;EDEVELOPMENT TYPE:
BUILDING SIZE:
1. STORM DRAINAGE
IMPERVIOUS SQ. FT
2. SANITARY SEt^lER-CITY
NO. OF PFU'S
(See Reverse)
5b,93 x o,26
3. TRANSPoRTATI0N . t, ---
Cepe tsi :i,aNt-d*P.tt)oueE'- 0, zi' /769r
NO OF UNITS X TRIP RATE X COST PER TRIP
LOT Si
6 t5b x $0.203 PER SQ. FT.
X $42.08 PER PFU
x $424.31
x $424.31
x $424.31
sQ. Ft.
lb
4. SANITARY SEt,lER-MI,IMC
NO. OF PFU'S
(Use PFU Total From Item 2 A bove )
Ml^lMC CREDIT IF APPLICABLE (SEE REVERSE)
s
$
$15.125 PER PFU + $IO Mt^lMC ADM FEE 252"9
x
X
z4
TOTAL-MWMC SDC
suBTorAL (ADD ITEMS 1,2,3 & 4)
7za t
v2
5 ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X -os
5l
Kip Burdick
SDC Coordinator
G',5o'7to
1"'9
b85,9
4-
3b
g v
TOTAL SDC L56 *
$
,nit Equivalent = Fixture Units INOTE:
FXTURE UNIT.CALCUL ON TABLE: I-IUMUET OI NCW FiXIUTC'
io, L*oO"fs, calculSie only the l{El-additional frxtures)
NUI4BER OF
FITTURE TYPE NEW FIXTURES
I
UNIT
EOUIVALENT
FIXTURE
UNITS
7
---z-
,L
2
1
2
J
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
i
Drinking Fountain--.......
l.-aundry Tub/G
Floor Drain..
lnterceptors For Grease/Oil/Sollds/Etc"""""""'
lnterceptors For Sand/Auto Wash/Etc""""""""'
Clotheswaqher - 3 Or More--.."""""""'
Mobite Hdnie Park Trap (1 Per Trailer)
Receptor For Ref rigeratorflVate r Station/Etc" " ""
Receptor For Commerclal Sink/Dishwasher/Etc"
L
b
lo
Shower, Single'Stall-.
Shower. Gang..----..---
Sink. Bar, Commercial
Urinal. StatlflValt.-.-
Wash Basin/Lavatory, Single""""
Water Closet, Public lnstallation"'
Water Closet, Private-....-
Miscellaneous:
CREDIT CALCULATION TABLE: Based on assessed value'
calculate credits
2
.L
TOTAL FIXTURE UNITS
x $ 6E5'7s
(Rate X Assessed Value)
=$22o
lf improvements occurred after annexation date in tabte'
Credit for Parcd or Land Onty lf Applicable
lmprovement (rf after annexation date)
4 LI
x s.-
(Rate X Assessed Value)
CREDIT TOTAL 75
RUNOFF COEFFTCIENTS FOR STORM DRAINAGE
Residential.. """""""' 0'4
lndustrial........-..
Governmental...
0.9
0.45
0.5
Year
Annexed
Rate per $1,000
Assessed ValueYear
Annexed
Rate per $1,00O
Assessed Value
1986
1987
19BB
1989
1990
199'l
1992
$ 2.24
1.93
1.57
1.18
0.79
o.44
0.28
1979 or before
1980
1981
1982
1983
1984
1985
$.21
3.13
3.08
2_96
2.82
2-68
2-51
tMPERVtous AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
2?e 172
Willamalane
Park & Recreation District
lob No.g5tffil
SYSTEMS DEVELOPMENT CHARCE
WORKSHEET
NAME:
ADDRESS
LOCATION OF PROPOSED BU N ITE:
Street Address if Known:
Platt Name:
1 DEVELOPMENT TYPE
definitions are on the bac
B. Sinsle Familv - Attached
NO OF UNITS
C. Multi-Family Apartment
DR -,,7?,:4'
$1S.0C
PHONE:
1
nlruv Tax Lot Number:1D
(Check appropriate dwelling(s). SDC Calculations and dwelling type
k.)
$SD
A. Single Family - Detached
tI Single Family home Manufactured home not in a park
NO OF UNITS ]X $400 PER UNIT =
X $370 PER UNIT =
NO OF UNITS X $277 PER UNIT =
D. Manufactured Home Park
NO OF UNITS X $280 PER UNIT =
WPRD SDC
2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit
approval. See SDC Credit Worksheet.
3. TOTAL WPRD NEf SDC ASSESSED (lf SDC reduced for Credit)
Commu
$
$
$
$
$
4
ngfieldCity of
on
I
(0-/
zoning, and do€a not roqulre speclflc land ueo
approval.cu
477
Auhorizcd
1.
Permits are non:-transferabLe and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
!iPRIIt.GFIELE,
hr tha
ELECTRICAL PERHIT APPLICATION
City Job Nunber
SCEED{IIJ BELOIJ
A. Nev Residential-Single or
Mu1ti-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.00
$ 40.00
Services or Feeders
Installation, Alterations
or ReLocation:
amps or less
amps to 400 amps
amps to 600 amps _
amps to 1000 amps
Over 1000 amps/vo1ts
Reconnect 0n1y
c
D. Branch Circuits
Nev, Alteration or Extension Per Pane}
a9
225 FTFTH STREET
SPRTNGFTELD, OREGoN 97
INSPECTION REQUEST: 7
OFFICE: 726-3759
2. CO}ITRACTOR
Electrical Contractor
Sum
B
Address 0 I s s0.00
s 60.00
$ L00. 00
$130.00
$300.00
s 40.00
200
201
401
601
Ci ty Phone -7 Lq - q'6
Supe rvisor License Number VS 5 35
Expiration Date to -q5
Constr Contr. Number 571 Yi
Expiration Date
gnature of Supervising Electrician
/*rgu
Ovners Name
Addre
Ci one
OHNER INST
The installation is being made on
property I ovn which is not intended
for sale, fease or rent.
Orners Signature:
DATE:
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
201 amps to 400 amps
-
$ 55.00
over 401 to 600 amps
-
S 80.00
Over 600 amps or fbOO voTts see rrBrr aE6iE
one Circuit -tEach Additional
Circuit or vith Service
or Feeder Permi t I
$ 3s.00
$ 2.00
3ry
--rfi*
E. Miscellaneous (Service/feeder not included)
-Each instal-l-ation
Pump or irrigation
Sign/0ut1ine Light ing-
Limi ted Energy/Res
-Limited Energy/Comm
SUBTOTAL OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAI
$ 40.00
s 40.00
$ 20.00
$ 36.00
5
CITY OF SPR
RECETVED
a)
OREGON
5
\\rA Et cflQvttz
RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726.g769
Office: 726-3759
LOCATION OF PBO
ASSESSORS MAP:
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97 477
TAX LOT
SUBDIVISION:
-
LOT:BLOCK:
/-> y'e-tt tt /4t7oB n PHONE:
a,f?ZIP:STATE:
ADDRESS:
CITY:
NEW
-
REMODEL ADDTT|ON *_ DEMOLTSH OTHER
cDESCRIBE WORKr
EXPIRES PHONEADDRESS
4er-ecrfrr
CONTRACTOB'S NAME
GENERAL:
MECHANICAL:
PLUMBING:
CONST.
CONTBACTOR #
- OFFICE USE _
FLOOD PLAIN:
RANGE:
OUAD AREA:
* OF BLDGS:
SECONDABY HEAT:
SQUARE FOOTAGE:
# OF BDRMS: -__-.-.-=-
WATER HEATER:
OCCY GROUP:
* OF STORIES:
ZONING CODE:
CONSTR. TYPE:
HEAT SOURCE:
# OF UNITS:
-
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be
made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the following work day.
UIRED INSPECTIONS
I TemRorary Electrlc Rough Mechanlcal - Prlor to
cover.l-_l rlnat Plumbing]J plumblng work - When all
ls complete.
Slte lnspectlon - To be made
after excavatlon, but prlor to
settlng forms.
l-l Rough Electrical - Prior tot-l cover.Flnal Electrlcal - When all
electrical work is complete.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover.Eleclrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
nal Mechanlcal - When all
mechanlcal work is complete.
Foollng - After trenches are
excavated.[-l Flreplace - Prlor to faclng
'J materlals and framlng lnsp.
l--l Framlng - Prlor to cover.
l-l WatllCelllng tnsulatlon - Prlor toU cover.
l-l Drywall - Prlor to taplng.
Final Building - When all
requlred lnspectlons have been
approved and building is
completed.Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Underground Ptumblng - Prlor
to fllllng trench.
MOBILE HOME INSPECTIONStlUnderlloor Plumblngl Mechanlcal
- Prlor to lnsulatlon or decklng.Wood Slove - After lnstallatlon.
tf Posl and Beam - Prlor to floor
lnsulatlon or decklng.lnsert - After flreplace approvEl
and lnstallatlon of unlt.
Blocking and Set.Up - When all
blocklng ls complete.
l--.| Floor lnsulallon -.1 Prlor to|J decklng.Curbcut & Approach - After
forms are erected but prlor to
placement of concrete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanltary Sewer - Prlor to fllling
trench.Electrical Connection - When
blocking, set-up, and plumbing
lnspections have been approved
and the home ls connected to
the servlce panel.
Storm Sewer - Prlor to fllllng
trench.
Sidewalk & Drlveway - After
excavation ls complete, forms
and sub-base materlal ln place.
Waler Llne - Prlor to filling
trench.
Fence - When completed,
Rough Plumbing - Prior to
cover.
Slr€et Trees - When all requlred
trees are planted.
Final - After all required
lnspectlons are approved and
porches, sklrting, decks, and
ventlng have been lnstalled.
q SI
OWNER:Qt Q- /^/ 2)
LAND USE:
tln
tf
tl
E
tl
fl
tl
tl
{.fl !{! ,a
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type-
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
1-lS THE PROPOSED WOBK IN THE -' HrsToBrcAL DtsTRlcT, oR oN
THE HISTOFIICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved by the Historlcal
Coordinator prior to permit lssuance.
APPROVED:
ACC'P.L.HSE GAR
N
S
W
E
(A)
X $/SQ. FT. = VAI-UE
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ, FT.
tr,f ain
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Sprlngf ield, includlng the
Development Code, regulating the constructlon and use of
bulldings, and may be suspended or revoked at any tlme
upon violation of any provisions of said ordlnances.
Plans Revlewed By Date
Receipt Nu
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
(c)
N0
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
. FT.
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State fssuance
State Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Mlscellaneous Permits (E)
TOTAL AMOUNT DUE (exctuding electricat)
(A, B, C, Q and E Combined)
4s r
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed appllcailon and do hereby certify that all
lnformatlon hereon 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 Ctty of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work described
hereln, and that NO OCCUPANCy wlll be made of any
structure without permission of the Buildlng Safety Divislon.
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.055 will be used on lhls
project.
I {urther agree to ensure that all required inspections are
reguested at the proper ilme, that each address ls readable
re
Date
s
from the street, that the t card ls located at the front
of the property, and set of plans will remaln
slte at all constructlon.
E
DATE PAID
AMOUNT BEC
RECEIVED
VALIDATION:
BECEIPT NUMB
FT.
SPNINGF]ELE,
%
BACKFLOt^l PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING. SAFETY DIVISION
225 Fifth Street
Springfi e'ld , Oreg on 97 477
Job Locat'ion :
'Lt5o
Assessors MaP #:l1 0) zZ oz)
Offi ce:
INSPECTION LINE:
Tax Lot #:1)7 hr{ )
72.6-3759
7 Z6-37 69
€l-rtAA V-^+--,r'O-0wner:
Address:
Address: L
City:
uI
Tl/'y
{Phone #:qu -Ctz<-
Zi p:4t 7Z-l
Zi p:Qz,17f
City:
Backf'low Permit is $15.00 + $0.75 State Surcharge tZ%' 'LJu't;^ {oo-
Contractor:
Phone #:1z-e _L-)a
A-State:
State:
D
constrddt'ion Contractors Registration #:oTlb Ex pires:
correct.
S gna re a
FOR OFFICE USE
I
By signing this pcrmi.t/gpplication, I. agr99 to call for an inspection once the
backflow preventlon devic'n rtur ueen inslal1ed and is v'isib'le for inspec!lol
iizli-jiiigi.- i aiio iiate thar aii information on this applicat'ion/perm'it is
1r^
Tota'l Amount Col I ected:b zc
Job #:q ats t/Date of Application:?-tr-t - 1.(
Receipt Il:3?tl Issued By:
I
, C'TY OF OfrEGOfiJ
f*
I
i
i
i
I
4
approval,
rn
2?S ,YTYTB STRSRI
srnrlrcrrglD, 0RBGOtl 97 our" (2iJ4\
IIUiPBCIIOII REOTIBSI:
oFFICts: 726-3759
1.' INCAf,TOII
Pernits are non-t rable and exp
lf nork ic not star trlthln 180 daysls suspended for
2. CormacroB OHLT
Electrlcal gontractor
Add a
BI,ECITTC,AI. PERI(rT ATPLICATIOTI
77
izect$lsnaturs, -Cl 'flE CltY Job t{urnber q i )k*/
3. COI{PI.]BTE FEE SCEEOTII.E BBLOS
A. Nev Resldentlal-Slngle or
Hulti-Farully per dvelling unlt.
Serviee Includedc Itens Cost
1000 sq.ft. or less
f,fr Each additional 500- \ sq. ft or portion' thereof
Eaeh l,lantrf,d florne or
Hodular Drrelling. Servlce or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Serviees or Feeders
fnstallation, Alterations
or Relocatlon:
Sun
B
ct tW
Supervisor Llcense sLoLl--g
Explration Date
200 amps or less
201 amls to 40o amps T
401 anps to 600-anPs #601 amps to 1000 amps-
0ver 10@ anps/volts _
Beconneet Only
Temporary Servlces or'Feeders
Insta}latlon, Alteratlon or Relocation
200 anps or less $ 40,00
Z6r am'ps to 400 anDs
-
$ 55.00
Over 4bl to 600 aups T- $ 80.00
Over 600 amps or rbOOT6ffs..see nB' affi
Branch Clicuits
Nev, Alteratibn oi Extenslon Per Panel *
one clrculg ,--/ $ 35. OO >{
Each Addltionalcircult or vith Serilce., .I"iEliei rli*it--- --7 * z.oo &-
Hlscellaneous (Servlce/feeder not included)
ted Energy/Comp
lrrigattontlfnb Light
Energy/Res $ 20.90
$ 36.00
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Constr Con tr. Nunber
itatlon DateExp
c.
D,
E
ll
pvners
Add
cl
0gum.
The. lnstallattoh ls trig nade on
proPerty nhleh t s not lntended
for sale or rent.
Orners Slguaturel
DATE:
-Each lns talIet lon
Slgnl0u rns:Z $
$W*Puinp or 40.00
40.00
Li"ni
Lint
ted
5.. SIJBIOTAL Or'ffiovB5f stdte surchargeI TAL
+3ob nAsnin !€r-
17,:0
VLl'?\.
Iom
, 'leaie
1
I
I
tl P
I)
RECEIVED
1334-{)5-37
,")
of lssuahce or lf
'180 days,
t
Z,
.:l
OFEGOft'Ci,TY OF SPF
use
tFitraGiFrILO
BI.BCtT.IE^L PERI(II APPTJCATIG22:t Errr! SrRElilsturGrtBlr, OilGfi 97
I!*S!8CII( REQtIBlll: 726-l
OIEICI: 726-373,D
-22
ro
I Efll
_qLl
-Farlly pcr
ce Includedr
lnglc ordvelllng unlt.
ctry Job lturbcljlS_/8}
o? ilstAlJ.{ttof,'
P/yps2-rl A/u /
r.o..^D?E? *9.a1 ,'"y'*'/1,&llultl
Servl
Signature SCEEIXII^B BEIOU
A. Neu Resldenrial-S
t-l o3.}f oo a)bjo
Jd] Itsrrtvlrya-
-Tenr,e --]) >/t q._
l.Serslcc or Fccdcrr
fnsta1letlon, Altcret lons
In- or Rcloeation:
Cost Sur
s 40.00
Address 2-At 5 d
Ctty ?-nr,,- ll:,
Supcrvisor Llcense Nunber a LO (/-5
Explratlon oatcJ 0- | - 7f
constr contr. Nunber /^ ) 3 L L
/4 7r+7a.1+
lddr.r"
Phone q)E _u) ),-
200 anps or lest
!Q! aups to lgg anps
-4Ol aups to 60O anps
-6Ol aups to 100O aaps-
0ver 1000 amps/volts
-.econnect only
C. Tenporary Servlces or FeedersInstallatlon, Alteratlon or Relocation
s40
$53
$80
t 200 anps or lesc
201 aapr to 400
0vor 401 to 6fl)
Over 600 arps or
/
arPs _arpc1frDErfs
, L.00 10
.(x!.06 --
"85'a6-o-vc-sec
The installation is being made on
property I onn vhich ls not intended
for sale, Iease or rent.
Ct ty
ovners Signature:
a
OSNER INSTALIATION
D" Branch Clrcuits
Ner, Alteratlon or Extenslon Per Panel
Onc Circult S 35.00
Each Addltlonal
Clrcult or vith Serviceor Feeder Perml t S 2.00
E. Hiscellaneous (Service/feeder not included)
SUBTOTAL OP ABO'TE5f State Sureharge
40
-Each installation
Pump or irrigation SSign/Outline Lighting- S
Limi ted Energy/Res
-
S
Liml ted Energy/Comn S
40
20
36
00
00
00
00
tJ4 4
s
DATE:
)
)
I. ,,r]ltlc
ts.
Scrvleo or
r 'arc
s
Perrltr rrr non-tnnsfcrablc and explnIt co* Ii mt ltlrtd utthla 18O diyr
of lssrurcr or tt vorl, ls suspcndcd for
1S deyr.
t*. otrIrsru us'lalJA:Eox otlLr
Electricel contrac to. tl .l U\ F lt . 1,, .
=\o s 50.00
s 60.00
s100.00
s130.oa
s300.00
SIGN PERMIT APPLICATIC SPI'IINGFTELI,8JOr, NUMBER
lnspectiorr Line: 726-3769
Office: 726-3759
.t225 Fif th Street
Springf ield, OB 97 477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
OWNER:
ADDRESS:
CITY:
I}USINESS NAME, FIRM ETC
s5
TAXLOT
PHONE:
STATE:0(t
.r.ZlP:
DESCRIPTION OF PROPOSED SIGN(Sl: (plcase check and cornplcte all apDropriate inlormationl
' Ftool _ Marquee_ Wall
_ Single Fa
Square Foota0e:
reestanding _ Proiecting
Double Face Billboardce
Vertical Dimension ol sign or enclosure:
Other
Total Height above Gradc:Z I
DirnensionfromGrade // *ll ?t
to bottom of Sign: b - .t' ' '.
M Horizontal width of sign or enclosurc f
Etectrical lnstallation: /"".
-
No
(lf yes additional permit is required) VALUE
€aLnu*d il"ahl wl ?nlu n bpr*,k €nn
a!
List ALL exjsting signage and attach a photograph of oaclt sign:
(al Type
(cl Type
Sq. Ftg
sq. F (d) Type
Sq. Ftg.
Sq. Ftg.
CONTRACTOR/INSTALLER:
ADDRESS
CITY
CONSTRUCTION CONTRiACTORS REG
CITY BUSINESS LICENSE NUMBER:
ISTRATION NUMBER 3lc3_Q,
ft\kt'" K"rlr- fit,t PHoNE: 3t4z'11{4
0r?STATE zl[)
Ll EXPII]ES
EXPIRES: _
OFFICE USE
Sign District Use
Code S
Approved By
Ouad Area:
Zoning:tc-,
Sign Permit Fee:1as)
Z,
X-Etectricat
prior to energizing
DATE:
REOUIRED INSPECTIONS
_ Site
to be made prior
to sign placement
LFootinsprior to placement
of concrete
Attachment
after fasteners are
installed/prior to cover install on
Addi nal Comments /dr Conditions:
By rture, l state and agree, that l have carefully exarnined the conlplcted application and do ltereby certily that all ittformaliort hercirt
rrd correct, and I lurther certily that any and all work perlorrned shall be done in accordance with the Ordinanccs ol the City olis true
i
Springfield, and the Laws of the State of Oregon pertaining to the work described herein. I lurther certify that only contraclors and
ernployees who are in compliance with ORS 701.055 will be used on this proiect.
I f urther agree to ensure that all required inspections are requested at the proper time, that prolecl address is readable f rorn the street, lhat
lhe perrnit card is located at the lront of the property, and the approved set of plans will remairr on lhe site at all times during the installation
ol the sign(s)
-,-Date r)
Date Paid
Received
-0[Signature
Amount Beceived:Validation:
Receipt Nurnber:
d)
Material Sign is constructed of :
,
Tvpe
-
V rinot
#illotion ot sisn
I
,
4
SPl:lINGFIELI,JOB- NUMBER lstSIGN PERMIT APPLICATIO"'
225 Fifth Srreet
Springf ield, OR 97 477
lnspection Line; 726-3769
Office:726-3759
7sD w4,1,5
LOCATION OF PRO
ASSESSORS MAP:
OWNER:
ADDRESS
CITY
t]USINESS NAIME, FIRIVI
WORK:
TAXLOT:
PHONE
STATE ZIP:
!*",,
$sinore ra
Square Footage:
ce
Freestanding -- Projectitlg
Double Face Billboard
It q(l7 t7
5t _
Y
Roof
ther
Total Height above Gradc: -'______
tl
Horizontal Width of sign or ent:losurc l7 -0 *lVertical Dimension of sign or enclosure:
Dirnension lrom Grade
to bottom of Sign:
Material Sign is constructed of
Etectricat tnstattation:
-
Yes )/to..:
(lf yes additional permit is required)
(Z o!_
VALUE
List ALL existing signage and attach a plrotograph of each sign
(a) Type
(c) Type
Sq. Ftg.
Sq. Ftg.
(b)pe
(d) Type
Str. Ftg.
Sr1. Ftg
CONTRACTOR/INSTALLER
ADDRESS:
l\ril, '', K t hrfr --PH.N
r,-213:lLb+-- -
,+CITY: , ?--i.,.445,:j STATE: OR zlP Z
CONSTRUCTION CONTRACTORS REG
CITY BUSINESS LICENSE NUMBER:
ISTRATION NUMBER:
. _EXPltlES:,
2
EXPIRES:__\J:
_(rg
OFFICE USE
Sign District:
Zonirrg:
Sign Permit Fee:
REOUIRED INSPECTIONS:
_ Site
to be rnade prior
lo sign placement
Footing
prior to placernerrt
of concrete
yAttachment
after Jasteners are
installed/prior to cover
)(= t,,,,,
complctiorr ol sign
installation
Land Use
Code Section
Approved By:
Area
Electrical
prior to energizing
DATE
Additional Comments and/or Conditions:
By signature, lstate and agree, that lhave carefully exarnilrcd the corrtpleted applicatiorr and do lrercby certify that all irrforntatiorr lrcrurr
is truc and correct. and llurther certify tl-lat any and all work perlorured shall be done in accordance with the Ordinanccs of the City ol
Springfield, and the Laws of the State of Oregon pertairring to the work described herein. llurtlrer certify that only contractors an(l
ernployees who are in compliance with ORS 7O1.055 will be used on this project.
llurther agree to ensure that all required inspections are requesled at the proper time, lhat projecl address is rc;rdable frorn the strcel, lhar
the perrnit card is located at the front of the property, and the approved set of plans will remairt on the site at all tirnes during the installatiorr
ol the sign(s)
Signature Date
Amount Received
Receipt Nurnber:
Date PaidValidation
Received By
DESCRIPTION OF PROPOSED SIGN(S): (please check arrd cornpletc all apllrtlpriate irlformatitln)
.---._- Marquee
(t
3- n-a,/
SIGN PERMIT APPLICATION
-l-he application orr tlre reverse sidt'rreeds to t)e cornpleterl errtirely. lf you are the sign contractor/installer, or i{ you are
lriring a contractor, you need to nrake sure that both the City of Sprirrgfield Business License Number and the Registration
Number frorn ttre State of Oregorr Construction Contractors Board are listed on the application along with the expiration
tJate of eaclt.
lf the sign you are proposing is illuminated, an electrical permit application also needs to be completed and signed by either
" ,rlr"ruising electrician, limited sign electrical contractor, or if you are the business owner who also owns the building in
which you are occupyirtg, a6d you will be per{orming the electrical installation yourself, you may sign the electrical
applica tiort.
ll there are existing wall and/or f reestanding signs, a photograph(st of each existing sign needs to bo attached to the
applicatiol. The size of each existing sign also needs to be listed on the application.
PLANS
To submit for a sigl permit, you need to prepare two complete sets ol drawings showing all dimensions, total height, and
a plot plan irrdicating where ihe proposud sign will be located. lf you are installing a freestanding sign which exceeds 20
feet in total height, the Iooting detail needs to be prepared and stamped by a registered engineer. Atter the plan review
process is cornpleted, and, if your sign(s) is approved, one setwill be returned to you. The approved set oI drawings need
tr-r be at tlte Site when an irrspection is requested for the inspectors releren6e'
INSPECTIONS
Dep<lnding on your sign(s), you nray be recluirerJ to request one or all ol the following inspections during the installation
of your sigtr
Site:
Fool irrg
Attaclrment
Electrical:
Firral:
To be requested af ter indicating on the lot where the proposed sign will be located but prior to any work
beirrg perforrnerj for the installatiort of the sign. This inspection is required if there is a question on the
locatiort ol the ltroJrosed sigtl.
To be requesred af ter excavation and the {ornrs are installed, but prior to pouring concrete. lf there will be
r:lectrical conduit lllaced in the footing, it must also be in place prior to requesting this inspection.
To be requesterl wtterr all f asterrers are installed but prior to cover.
To be requested alter the electrical connection to the sign is made, but prior to energizing.
After all required ilspections are conducted and approved and the sign installation is complete.
The inspections that are required for your specilic sign will be indicated on the application during the plan review process'
Failure to request ANy of the required inspections could result in sign removal in order to inspect the sign at the required
intervals of work.
To rcquest an irrspectiorr, phone 726-3769. This is a 24 hour recording. On the recording you will need to leave your City
Designated Job Number, location of where the sign is being installed, the type of inspection you are requesting, and when
you will be ready for the irrspection. All inspections called in to the recorder prior to 7:00 a.m. witl be made the same
working rlay, all inspections phoned in after 7:00 a.m' will be made the following work day'
lf you have any questlons regarding the application, required plans or inspections, please feel free to phone the Building
Safety Division at 7 26'37 59.
City of Springl'ield
Iluilding Strt'etY Division
225 Fifth Street
Springlield, Oll 97477
C'TY OF SPR,,VG OREGO't'
,{
):lP;ItiTGFIELO
Th€lollowlng Proiect a3 submttted hae
zoning, and
approval'
does not re sPeciiic landrequi
SPRI}IGPIEU)oR8GOil 97477 zoning-3*..-BIJCTRICAL PERI{IT225 ?TYIE SITBBT
INSPEGTION REOT'BSf,z 726-37ffi" 3-lV-qL1 City Job Nunber
0PPICB: 726-3759' l Arnhorized
1. INNATTOI.I OP INSTALI.ATION-' b;o rili;;-e/,/
J
JOB/DES(ntTT
,/U4r u 4 "7
./
t pr.rt nl,.rr'D?rr? n r22) s nq./ "<-!//,&
sionaturefuSCEBDUI,E BBLOU
Nev Residential-Single or
HuIti-Family per dvelling unit.
Service Included:
Y taac COS t
A
5
I $ as.oo
/ s 1s.oo
s 40.00
Sun
r5P
/frPerrnits are non-transferable and expireif vork is not started vlthln 180 days
of lssuance or lf vork ls suspended for
180 days.
2. COTITRACTOR INSTALI.ATION OITLY
glectrical Contractor
Address d
ciryf n>,-,- lf ; ,Phone
Ex ti e
0rrners Name B{au,rl fu7.4q*
Address ?6 g Frrz )r
Phone g)q -a)r
OgilBR INSTALIATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Otrners Signature:
1000 sq.ft. or less
F l- -lr-'!!---a cA^rJdltr duutlfuladr Jvv
sq. ft or portion
thereof
Each Hanuf'd Home c
Hodular Dvelling
Servlce or Feeder
B. Services or Feeders
InstaLlation, Alterat ions
Inr_ or Relocation:
Supervisor License Number a LA q-5
Explration DateJ 0- /- ?5'
consr.r contr . .nunber [.') ''l''L'L
200 amps or less
201 amps to 400 amps
-401 amps to 500 amps
-601 amps to 1000 amps_
0ver 1000 amps/volts
.econnect only
-Each installation
Pump or irrigation
Sign/Ou tline Light ing-
Limited Energy/Res
Limited Energy/Comm
C. Temporary Services or Feeders
Installatlon, Alteratlon or Relocation
over 401 to 600 amps
-
S 8o.oo
over 600 amps or lOOO-GTts see 'Bu affi
D. Branch Circuits
New, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Addltional
Circuit or vith Service
or Feeder Permit $ 2.00
E. Hiscellaneous (Serviee/feeder not included)
:5,9 s s0.00
$ 60.00
s100.00
s130.00
s300.00
s 40.00
I
s
Ci ty
SUBTOTAL OP ABOVE
5f State Surcharge
TOTAL
/ae*
--r4;*
s 40.00
s 40.00
s 20.00
s 36.00
5
RBCEIVTD BT uq43DATE:d
OREGO'UCITY OF SPR
SPRTt\rGFTELO
%
225 FtfrE SIRBEI
SPRINGFIEII)OREGON 97417 Zoriins..- C*
INSPECTION REQUEST
OFFICE: 726-3759 ' 72F376e.*bulnq
At"tii rot;r lx-i l::i,J" r;,iu
1. IOCATTON
I,EGAL DESCRTPTION1ba2.boo f,r^rrD
JOB
The faliowin6 proicct ao submittod has the
zoning, 8i,1c ouu$ ':or lequire specific land
approvai,BIJCTRTCAL PERHIT APPLICATION
City Job Nuuber q t 9F,t
COHPLETE TEE SCHEDUI,E BELOS
Nev Residential-Single or
Hulti-FamilY Per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or
l{odu}ar Dvelling
Servlce or Feeder
$ Bs.oo
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
A.
us9
200 amps or
201 amps to
401 amps to
601 amPs to
Over 1000
Reconnect
Iess
400 amps
600 amps
1000 amps
Sum
$ so.oo
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
40.oo 40o''
55.00
80. oo
s see rrBr'a566
Permits are non-transferable and-expire
ii-vort is not started lrithin 180 days
oi i""u"nce or if vork ls suspended for
180 days.
2. CONTRACTOR INSTALI.ATION ONLY
Electrical Contractor
Address
cl Phone
Supervisor Licen-se Number
ExP iration Date
Constr Contr. Number
Expi'ration Date
Slgnature of Supervising Electrician
0wners Name
Address
{
TemporarY Services or'Feeders
lnstallaiion, Alteration or Relocation
B
c
amps
0nIy
/voIts
200 amps or less I
201 amps to 400 amPs
-
0ver 401 to 600 amPs
-
Over 600 amps or 1000 volt
D. Branch Circuits
Nev, Alteration or Extension Per Panel
$
$
$
i
Phone q)ot -D>One Circuit
s;"h Additional
Circuit or vith Service
or Feeder Permi t
$ 35.00
$ 2.00
Miscellaneous (Service/feeder not included)
SUBTOTAL OP ABOVE
5Z State Surcharge
TOTAL
.oo
The installation is being made on
pioperty I ovn vhich is not intended
for sale, lease or rent'
Ci ty
Ovne
DATE:
OVNER INST
E
$ 40.00
$ 40.00
$ 20.00
$ 36.00re:
RECEIVED
J
5 40 o
-Each installation
Pump or irrigation
--
Sign/0utIine Lighting--
Limited EnergY/Res
-
Limi ted EnergY/Comm
COM M ERCIAL/ I N DUSTRlAL
PERMIT APPLICATION
225 Fitfn Street, Springfield, Oregon 97477
SPEINGFIELO
JOB NUMBER 74
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:TAX LOT aa,aa
PHONE
o.R.STATE:ZIP:CITY:
ADDRESS:
OWNER
REMODEL ADDITION DEMOLISH OTHERNEW 7r VALUE:
DESCRIPTION OF WORK:
NAME PHONE
ADDRESS PHONE
AD
?
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
EXPIRES
PLUM BING
GENE
CONST.
CONTRACTOR #
PLUMBING
NO.FEE CHARGE
Single Fixture
Relocated Bldg
(new tix. addtl)
Water Service 52> rt --- Oa42t
Drte Sanitary Sewer -\.4.*.tqe. ,/1.,rAl 2**
Storm Sewer ?A@ tt €d€.@
Backf low Device
TOTAL PERMIT a/4b
MECHANICAL
NO FFF EHA EIGF
Furnace/burner & vent
< 100,000 BTUs
Furnacei burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent
f rom
System apart
AC or htg.
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT
_ OFFICE USE _
LAND USE:
HANDICAP ACCESS:
* OF UNITS:
LIGHTING POWER BUDGET:
WATER HEATER:
FLOOD PLAIN:
ZONING
OCCY GROUP:
* OF STOBIES:
QUAD AREA:
Y OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
SQ. FT.$/SQ. FT.VALUE
TOTAL VALUE OF PROJ
X
f" h '- 1P*zYSO. FTG OTHER
SQ. FTG MAIN
SQ. FTG ACCESS
RCPT#PLAN CHECK FEE DATE BY
6/€ ?s
BUILDING PERMIT PLUMBI NG 6/400 DEMOLITION
5% State
Su rcharoe
5% State
Su rcharge 90,75
MECHANICAL FENCE
VALUE $
5% State
Su rcharg e
SIDEWATK
FT.
SUBTOTAL
PERMITS
PAVI NG CUBBCUT
FT.
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
a?t aa: tV, Kat*r f
?7q2,/
?z?-z z
4',a /l; ,,t : ft^/4t6rt *fuGa1 ?^ z 'c
ZC.
L
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 7:0O 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 pLUMB1NG, inspections have been made SpEC;AL ;NSpECT;ONS: 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 duringCURTAIN WALLS cbnstruction of the folowing 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, ail steel in place, but framing inspection' 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 framing' fire
made after al insrab buirdins 3l::5 ::."]ff 316:It";,H;:r" BII:,"JJX3"L,Y5tT',rrr, ,service equipment, conduit, and vents are complete and
:Hi,?;!?Xl;il:"; ?i:i""'TJ n".';::[i,]t"il':,1,J,$[3:l: 3l?:f],?:],?T*,?i,;;S:".in place but before any tighte-ning 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_8.drainage lines. To be made board interior wall covering isprior to covering or fiiling appried. spEcrAL GRADTNG,trenches' ExcAVATToN AND FTLLTNG:
,NDERFL..R: prumbins I:::,it":tf;XA'J3[H]tt' Durins earthwork' (3oo all &
electrical, mechanical. To be according to plans. chapter 29)
made prior to installation of
floor insulation, decking or LATH AND/OR GYPSUM GLU'LAM BEAMS: lnspection
floor sheathing. - BOARD: To be made after all Certificate by an approved
lathing and gypsum board, agency, furnished to the city's
posT & BEAM: To be made interi& and exierior, is in Building Division before
prior to installation of floor place but before any beams are placed' (2501 U'BC'
insulation, decking or floor plastering is applied or before STDS' 25-10J1)'
sheathing. - Sypsum board joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR TNSULATToN & finished' a'7t
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 sHEATHTNG AND iHffi^H?,ti,::#""X'.
NAILING: Prior to installing erected but prior to placing
any roof covering. concrete.
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.
"ln addition to the inspec-
tions specified, the Building
Off icial 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 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
property, and the approved set of plans will remain on the site at all
Signature a,
street, that the permit card is located at the front of the
ctiontimes during
,^r. r/ '{q4
VALIDATION AMOUNT RECEIVED:
RECEIPT S:RECEIVED BY:
DATE PAID:
FINAL ELECTRICAL
FINAL MECHANICAL
FTNAL FIRE DEPARTMENT
SITE PLAN REVTEW 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.
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 on the premises.
ADDITIONAL COMMENTS
PLANS REVIEWED BY DATE
FINAL PLUMBING