HomeMy WebLinkAboutPermit Board of Appeals 1992-10-20CO M M ERCIAL/ IN DUSTRIAL
PERMIT APPLICATION
225 Fiflh Street, Springfield, Oregon 97477
SPNINGFIELO JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK:/A.re/ J [yQ, Ut? 3r^, ,o,, ,n^'.* ou u lr pL er+ )
ASSESSORS *O'. /Vd7 -? G- H TAX LOT aTto>
cfiYi *crl+FteuD srATE:
7zL - 1-tiePHON E
?'7Y77ztPo?
r-JFot^rN co rSTR0c;7lo .l, lI{(
lz88 lv\ailAurE IBL\/P.ADDRESS:
OWNER
*r* J REM.DEL ADDrroN
>+LE-^
VALUE -7 c>ooo !DEMOLISH OTHER
DESCRIPTION OF WORK:
ARCHITECT
NAME ADDRESS PHONE
9gg-6zz-
126-7nf
G EN ERA L:
CONTRACTOR'S NAME
PLU M BI NG
MECHANICAL:
ELECTBICAL:
ADDRESS
8^ yAatFtL p-\orvr€-
CONST.
CONTRACTOR #*7726o EXPIRES5- 97 PHONEa26- 777f
7'1 L -jozfUI2ToLl Al c oNETEuc-Tro^l
azog, , -ToN/
L.rNN't ELecaRtL
PLU MBIN G
NO.FEE CHARGE
Single Fixture
Relocated Bldg
(new f ix. addtl)
Water Service
ft
Sanitary Sewer
ft
Storm Sewera/&. fu ft./5@
Backflow Device
Ailfu-z&?i%3brAa*
TOTAL PERMIT 745F
MECHANICAI
NO trFF CHA RGF
Furnace/burner & vent
<1 0Q000 BTUs
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
coo I er
d Vent Fan/Single
duct /9,*
Vent System apart
from AC or htg.
Z Mechanical exhaust
hood and duct l(1ag{91)2@
Permit lssuance $10.00
TOTAL PERMIT 27,@
WAT HEATER:
LIGHTING POWER BUDGET:
-o
* OF UNITS:
LAND USE:
* OF BLDGS:
QUAD AR
HANDICAP ACCESS:
FLOOD PLA
ZONING
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
* OF STORIES:
SQ. FT.VALUE
/O a /25 b6A
tu
/o
X
X
X
TOTAL VALUE OF PROJ
5o
$/so. FT.
5a 2oSQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
PLAN CHECK FEE RCPT#
arl'
DATE BY,/a-?z?P
s7
BUILDING PERMIT y'4500 PLUM BI NG DEMOLITION
5% State
Surcharqe w 5% State
Sqrcharge
po
/o.7sMECHANICAL)ssbE FENCE
VALUE $P4*n*,q7@
5% State
Surcharge /,3 g SIDEWALK ?/ n./ 3,G€SUBTOTAL
PERMITSPAVINGr*\3 fr,50 CUBBCUT
FT.
SYSTEMS
DEVELOPMENT 7:2
\
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
2240
/a/4ra.-*1rt
'7
zrZ'.%
?=t+./
V 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
made after excavation, but
prior to setuP of forms.
until these
x
x-
X
>(
x
x
x
UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in Place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before anY
concrete is placed.
><UNDERGROUND: PI
Plectri
dra nage lines be made
* TNSULATToN & 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
SPECIAL INSPECTIONS: ln accordance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Owner/ Contractor during
construction of the following work. A
copy of the special testing reports shall
be f urnished to the Building Division.
STRUCTURAL CONCRETE: IN
excess of 2500 P.S.l. (306 a.1)
STRUCTURAL WELDS:
Performed on the iob. (2722 t)
HIGH STRENGTH BOLTING:
During all bolt installation and
ti ghtening operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.BC.
Standards 43-8.
GLU.LAM BEAMS: lnspection
Certif icate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.C.
srDS. 25-10,11).
STRUCTU RAL MASONRY: (306
a.7)
tln 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 PAVTNG: After gravel is in
' place but prior to placing
asphalt or concrete.work is to
inspections have been made
and approved.
ATTIC DRAFT STOPS &
CURTAIN WALLS
FIREPLACE: Prior to placing
facing materials and before
framing inspection.
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are in
place and all pipes, chimneYs
and vents are complete and
the rough electrical, plumbing
and mechanical are aPProved.
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 & AF., .'I"#AY;
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.
prior to covering or f illing applied. SpEC;AL GRAD;NG,trenches. \ ./ EXCAVATION AND FILL'NG:
uNDERFLooR: Prumbins , ->- I:::tL"'=^tf;l*tJfl[H]tt' Durins earthwork' (306 all &
electrical, mechanical. To be according to plans. Chapter 29)
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.
CURB AND APPROACH
APRONST After forms are
erected but Prior to Placing
concrete.
By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all inforniation
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 Springf ield, and the Laws of theState of oregon pertaining to the work described herein, and that No oCCUPANCY
will be made of any struciure 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, tn.t tn" permit card is located at the front of the property, and the approved set of plans will remain on the site at all
mes during construction.
.at_ 2_o -gnature L Date lo- Z-o- Qy.
-?a
VALIDATION:ZAMOUNT RECEIVED:
RECEIPT #RECEIVED BY:
DATE PAID:
Y FINAL PLUMBING
-X F'NAL ELEcTRtcAL
,u FINAL ME.HANtcAL
Y SITE PLAN REVIEw BoARD: Must be requested 2 days in advance- of the date you wish inspection. AII project conditions such as
landscaping, parking lot striping, etc. must be completed before
requesting this insPection.
FINAL FIRE DEPARTMENT
A COMM
3 o
FINAL BUtLDING: 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.
DATEPLANS REVIEWED BY
roB No - 4zl32l
CITY 0F SPRINGFIELD -SI!-TI$1S
DEVELoPMENT CHARGE
WORKSHEET
(C0MHERCIAL & RESIDENTIAL)
NAME OR COMPANY:
r!!032b|- ob$o
LOCATION:
MPRwDEVELOPMENT TYPE:
1. STORM DRAINAGE
IMPERVIoUS SQ- FT.x $0.192 PER SQ- FT
X $39.78 PER PFU
Q. Ft.
4
2 SAN ITARY EI.IER-CIT Y
NO. OF PFU'S
(See Reverse)
3 T SPO RTATI ON
NO OF UNITS X TRIP RATE X COST PER TRIP
L /,oo5 x $401.05
x $401.05
x $401.05
ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL ABovE) X '05
5. SANITARY SEWER-MWMC
$13.62 PER P
Above)
SUBTOTAL (ADD ITEMS I,2' & 3) $ZtoZgb!
-91lo-
X
X
X
)
$
4
$?:7 5
NO. OF PFU'S
(Use PFU Tot
MhlMC CREDIT IF APPLICABLE (SEE REVERSE)
K"ip Burdi ck
SDC Coordinator
FU + $10 Mt,lMC ADMIN. FEE $
8,4
TOTAL-MWMC SDC
L
al From Item 2 +3t
G2-
3 ?-
TOTAL SDC S Z.I7 U73
l$t 4;I ,J tl
TOTAL-CITY SDC
FIXTURE UNIT CALGUIATION TABLE:
For remodels, calculate only the NET additional lixtures)
Number of New Fixtures X Ui-rt Equivalent = Fixture Units (NOTE
Bathtub.......
Drinking Fountain--.--
Floor Drain.
I nterceptors For G rease/Oil/Solids/Etc""""""""'
Interceptors For Sand/Auto Wash/Etc"""""""""
FTXTURE ryPE
Laundry Tub/Clotheswasher'
Shower, Single Stall-.-------""
Shower, Gang...-.---.-.
Sink, Bar, Commercial.
Urinal, StallflVall-
Wash Basin/Lavatory, Single"""""
Water Closet, Public lnstallation'
Water Closet, Private-.--."'
Miscellaneous:
NUMBER OF
NEW FIXTURES
UNIT
EQUIVALENT
FIXTURE
UNITS
--a--
--q-
---q--
lu
7L
L
2
Z
+
TOTAL FIXTURE UNITS
2
1
2
J
6
2
6
6
1
3
2
1/
2
2
1
6
4
Clotheswasher - 3 Or More""""""
Mobile Home Park Trap (1 Per Trailer)"""-"""""
Receptor For RefrigeratorAVater Station/Etc""""
n"""b,ot For Commercial Sink/Dishwasher/Etc"
eadH
cREDlr cALcuLATtoN TABLE: Based on assessed value. lf improvements occurred after annexation date in table'
calculate credits seParates.
2 .97 x $ q.^b .-Lq2b'.->
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
(Rate X Assessed Value)x$
(Rate X Assessed
CREDIT
RUNOFF GOEFFICTENTS FOR STORM DRAINAGE
0.4
0.9
0.45
0.5
+HL. = $ /&?('41
lndustrial...--
Year
Annexed
Rate per $1,000
Assessed ValueYear
Annexed
Rate per $1,000
Assessed Value
1985
1 986
1987
19BB
1989
1990
1991
$2.16
1.90
1.60
o.25
0.87
0.50
0.16
'1979 or before
1980
1981
1982
1983
1984
$2.83
2.76
2.71
2.60
2.46
2.33
IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT
+
C'TY OF
sl'rarN(;FtGL(,
225 FIFTB STREET
SPRINGFIELD, oREGON 97477
INSPE(f,ION REQIIEST. 726-3769
0FPICE: 726-3759
PERHIT APPLICATION
City Job Number
3.)COHPLBTB PBE SCHBDULE BELOII
A. Nev Residential-Single or
HuIti-PamiIy per dvelling unit.
Service Included:Items Cost
dtu
&
L €D
fhe f(,,,u,rrnittad has the
I
/{uthorized
ON1
Sum
r JOB DESCfiIPTION A./Outr)\ov AIq+n-
Permits Are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
2 CONTRACTOR INSTALT^ATION ONLY
IElectrical Contractor
Address tbt fr
fit] Q**rlc
$ 8s.00
$ 1s.00
$ 40.00
B Services or Feeders
Installation, Alterations or
Relocation:
200 amps or I
201 amps to 4
401 amps to 6
601 amps to 1000 amps_
Over 1000 amps/vo1ts
Reconnect Only
C. Temporary Services or Feeders
Installation, Alteration or Relocation
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
200 amps or less
201 amps to 400 amps
-0ver 401 to 600 amps _Over 600 amps or 1000 volt
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation $
Sign/outIine Lighting- $
Limited Energy/Res _ $
Limited Energy/Comm S
SUBTOTAL OF ABOVE
5Z State Surcharge
TOTAL
Supervisor License Number
?zb-? 87{
1.b54-.5
---'l-
Ci ty Phone
Expiration Date
constr contr. Number ?3/O /
Expiration Date 2/
Signature of Supervislng Electrician
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
ess
00 amps
00 amps
$
$
$ss
40.00
55.00
80.00
ee nBtr a6ove
not included)
40.00
40.00
20.00
0vne
Addr
Ci ty
Name
ess
D. Branch Circuits
Nev, Alteratlon or Extension Per Panel
one Circuit $ 35-00
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
Phone
TION
The installation is being made on
property I ovn which is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
RECEIPT
E
5
RECEIVED B
Ir\ C)O\ \_-/
A\D OO