HomeMy WebLinkAboutPermit Building 1981-05-26INFORMAIION TINE
INSPECIION UNE
72t3769
Job Addresr
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clIY oF SPRINGTIEtD
COIUBINATICN APPI.ICATION/PERMII
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7?An53
Ftg. Moin x Volue
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Phone
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So. fto. Acce3t.
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lh"* -oat -Aflter -R'P'Volue of Work: da/A,ooo'
SingleDescribe Work
Demo-C
Bui
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Ure
ERGY 5:EN
Heo
H
Sq. Flg, Moin
- --fen
Permit lnfo:
nce With
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DNc
Addre sr Phone
c.)(lics. no.)
DESIGN TEAM (odJ res r)(noma)
?ri
,t.1ech
ddre ne
s
I
ETECTRICAT
FEE CHARGECHARGE
L-
MECHANICALPLUMEING
NO-
Me<honicol
NO.i,'-F?E i CIiARGEi.o. I furnocel'burner io
I
Residence oi
-*.q.
ft.Eoth ringle fixture
Applionce vent
seporote
New circuils, olterotion:
or exiensions,aat5!9Relocored building
(new fix. odditionol)
Sfoiionory evop.
ccolerSERVICES
I
S.F. Reridence
(l both)Vent fon with
sinqie duclTemporory ConslructionDuolex (l bolh) eoch
Vent syslem oporl from
heoting or A.C.AmprAciditionol bolh
Mechonicol exhous,
hood ond duct,-4?/S.ryTa6lhl@ Butt DNq
too-uo AAP9I
Wood stove/ heoter/a.09/0.d9I-/oofcaL
\y'oter 3erYi(e
Sewer
Heot PumpFEEDERSSewer
Air hondler to
10,000 CF^^Ampr.
Air hqndler over
r0,000 cFM
tssu*NcE oFrPeRMlT
VJHERE SIATE tAW REOUIRES rhqr the Elcrtricol work be done by the Elerrri<ol Conlrocroa, the clcclricol portiort of lhis pcrmit sholl not be valid until o
TOIAT CHARGES15,09TOTAT CHARGES
Lip,IGNATURE
4qog
E
of ony
req uireci
slruclurepertoining
proiect,
certify thot oll informotion hereon is frue qnd correct, ond I furtherfor permit, ond do herebYI HAVE CAREFULLY EXAMINED rhe compleied opplicotion
qccordonce with the Ordinonces of the the Lcws of the Stote of Oregoncertify thol ony ond oll work performed sholl be done in
of rhe Building Division- I furtherPANCY will be mode
Cily of Springfield ond
withoul the permissionto the work dercribed herin, ond thot NO OCCU
by ORS 70I.055, thot if exempt rhe bosis for exemption is notedrirtrolion wilh the Euilder's Boord is in f ull force ond effect o serlify thot my reg
subontroctors ond employees who ore in omplionce with ORS 70.I'055 will be usad onheron, ond thot only
lobal hor bon rigned by on Elcctri<ol Controctot ond ottcshcd lo tha elearicol ponel,
TOTAT CHARGES
Bosir for Builder'r Boord excmpiion;
NArUE (pleose print)
FOR OTFICE USE ONTY
b42]2Sysiems Development
Ch"ree l!.5j4--;1*8(trbPP
Plon Ck. Comm/lndBUITDING PERMIT 20,o9
0,89
Per Fee
Plon Ck. Res
Per Fee30%
Chorges ond
Su rcho rge s
Aao+ h@i-Da"c6baz #74r,&Totol Comb. Permit
aE 09/ 4'---PI.UMBING PERMIT
nce
Demooo*
Chorges ond
5 urcho rg e s
t4,33ELECTRICAT PERMIT
Sidewolk I
C Povi
a9Chorges ond
Surchorges
/ t,6:
TOIAT
MECHANICAT PERMIT
Chorger ond
Surchorge:
o
Addrers p O. k
-6
Fts' oiher ---- -' i;;;; i,.;i: 4 TrroP
\/ Ll I lnil<
.,.e aanc-
Flood Plqin
6 .b9
Curb Cut /8'
coMEl NATTON AppLtcaTtoN z/pEx,<,ti-(cAp)
l. Appliconr ro furnish
A. Job Address
B. tegol DescriptionI. exomple-tox lot ,l00, Lone County Mop Reference'l 7 03 43
2. exomple-Lot l. Block 3, 2nd Addition to Springfield Estores
C. Nome, etc, of owner ond construction lender
D- Energy Sources
l. exomple-heot/'electricol ceiling/or forced oir gos
2. exo m o I e-wo ter heoter, ele.trko l,i o.-lolE7--+
_- PERMIT VALIDATION
fu<- 5G5X5
Uhil- 4obB
Permit Clerk
PROJECT CONDTTTONS TO BE SATISFIED BEFORE OCCUPANCY:
{
Additionol Proiecl lnformotion
PLANS REVIEWED BY:
nome signotu dote 5-?to'l?6 I
\
\
E. Squore footoge sr voluotion, etc.t. g411p]g-I250 sq. foot house, 500 sq. foor goroge
2. e-Erni]E-iTlIw proiect, checki-ew-ii oddition, cieck
odd, etc.
F. Building permit informotion:
l. exomple-construct single fomily house with on ottoched
goro9e
2. exomple-remodel existing goroge into fomily room
3. giGFi-"-convert single fomily residence into
restourront (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building Division
Stoff must be oble to contoct oppropriote persons regording
design informotion or iob site corrections, etc.
ll. AbLievioted Plumbing, Mechonicol & Electricol Schedules
A. Except where blcnk spoces occur in the description portion
of the Mechonicol ond Electricol Schedules, the opplicont
need fill-in only the No. Boxes odiocent to the oppropriole
item(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Division
I. To conserve spoce on the permil form the schedules .:
hove been obbrevioted
2. lf the item(s) to be instolled ore nol covered on the obbrevi'
. oted schedules you should consult rhe full schedules
C. BUILDING DIVISION STAFF WILL FILI OUT ALT FEES AND
CHARGES ON THE SCHEDULES
lll. Applicont to sign ond dote
Whenever possible, the iniriol opplicotion will be used os o
worksheet only. Where possible, Building Division Stoff will
prepore o typewritten copy ond return it to the opplicont ot
the time the octuol permit is issued for his signoture.
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ol the time of the opplicolion,
ond no plons will be processed unlil these fees ore poid. All
other fees ond chorges ore due ond poyoble when the permit
is issued.
V. FOR OFFICE USE ONI,Y
/
-t'IAI A
DE CITY OF SPRINGFIELD
l(ay 22, l98l
MEMO TO:
FROM:
SUBJECT:
q,4(
Tom Sheirbon, Permits Coordinator
Gary McKenney, Traffic Techn'ic'ian
Building Moving Permits #Bl034l and #8.l0342
The fol'lowing corrnents apply to permit #81034I:
1. This move will be permitted on'ly between the hours of 0500 and
0900 on Sunday, May 3l , l98l to avoid congest'ion a'long Mohawk
Bl vd.
2. At "Q" Street and Mohawk Blvd. The pedestrian signal pole'in the
"Q" Street island must be unbolted at the base and "laid down"
to clear the structure. This work will be performed by a City
Traffic Technician and the permit holder will be billed according'ly.
3. 'rQrr Street is a county road and a permit to move on it must be
obtajned from Lane County prior to irSSUdhce of a City permit.
In addition to the above,the following conments apply to permit #8.l0342:
4. S'ince this bui'lding is 34'6" wide and the "curb to curb" width
on Mohawk Blvd. is 24' in some'locations, it will be necessary
for the mover to remove and replace several roadside traffic signs.
In the v'icinity of the "Taco Bell" shop, it may be necessary for
the wheels of the mov'ing dolly to tnavel onto the sidewalk. The
permit holder wi'll be billed for any damage to public property
at this or any other po'int along the route.
5. The curb to curb width of North lSth Street is 32' with several
mail boxes at the curb and numerous street trees within 3'of the
back of curb. The mover should be reminded of this constricted' area and advised to double check it for possib'le prob'lems.
For both of the above permits, the mover will be responsible for placing
and removing "No Parking" signs as needed to provide for a safe move.
GM/bj
TRA IO-4
mflN,t 0 D A U
I
:
I;ISPECTIONS 726-3769
0ld Address
933 Mo Hewl1 v3Lp
CiTY OF SPRIiIGFIELD
BUS IIIESS 7?6-3753
BUILDIi.IG I4O IIIG PERIIIT--BUILDING DIVISIOII.-346 MAIN ST.
N A K
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d
A
NLega 1 Descri pt on
60
"rn P.O, ,i74Y t
P eE^/ f{4 3q19 'Ro'B i
ng rm name
l7-o3'31"- 27 fL 31
Nelv Address (furnish
2o i2 /V /S
egal Descript ron
RNUSL/N6 AaPET /f / AOar
3-z s-zo
!S'f.
3
exp res
ed
IA
by 81dg. Div
n q'l a res i]frr-=
€0c
a rCSS
oeEoeti
rcs.p one
(:-ttodsGno 3q7q RatstN 4{C E&1y6 /?44o
scr pt ono n n use:
e6Jr eNrt
rp t ono 0u
L t Lp/ Nq
Descr
tS4 Sf, .ru DefV/y,4f/at//\0HntllH t STQT_ET
Descr-lpfibn of Bui 1ding:
Square Footage /,40a Floving Length 5d
Heig ht on Do11y /7 '6i' Nr*ber of sections being rnoved
Type of Construct'ion lryots p Fe.ArrG
//
Movi ng I'ii dth 346'7ra0 6Rn6€
Val uati on
?I,W
27' L
ilot.ificatjon of Move: The Buildjng Div'ision urill route cop'ies of th'is appllcation to
ir i appropri ate di v'isi ons, departmdnts and agencies. H0l'JEVER, THE APPLICANT I'IUST CoN-
incr piropEnry oIIi,IERS IF rnrrs.ARE INVOLVED IrI rHE PROPOSED MOVE. IN ADDITION' THE AP-
PLICAI{T I,IUST SECURE THE APPROVAL OF ALL APPROPRIATE I{UNICIPAL, COUNTY AND STATE AUTHOR-
ITIES SHOULD THE I4OVE ORIGINATE OR TERI'IINATE OUTSIDE THE CITY OF SPRINGF]ELD.
s, Fees, and Charges: Plior to receiving a permit to move a building to property
in tfre City, the ipplicant or his/her authorized representative must:
SuOmit trvo- iopies bf a site or plot_p1an for the new s'ite.
irU*it two coi:ies of a foundation plan for the relocated building.
Qbtajn a permit coveling the new foundation, as well as al1 plumbing, mechanical
and electiical work reliting to the relocated build'ing.
Pay the Systems Development Charge, 'if applicable'
Sewer Cap: Builclings to be moved from lvithin the City'limits shall have the set{er
capped at the prop.ily-iir. uia-intp.Ct.aonuworkrng day prior to the move' if the
inspection indicates inat tfre s.rr.i'has not been pr5perly capoed, the moving permit
Pl an
w'ith
1.
2.
3.
4
w'il I be revoked.
the ba s'i s 'i s no ted
ING DAYS HAVE ELASPED. I further ce
is in full fo rce and effect as requi
rti fy that tnY
red by ORS 701
reqi strat'iorr wi t
.055 and 701 .070
ui red contacts
, and that i f exei'rot
mpl eteci bY clock @pm on
ng sr on.
and w'il I be na d t contacting t e u
I also certifY that I have been in formed that N0 PERMIT I'IILL BE IS SUED BEFORE 5 I^IORK.
h the Bu'i I der' s Board
I certify that the above informatt'
e beeh made and authorizations obta i neC ,
on 'is true and correct, that all req
move wjll beg in at o' cl ock
hav
Cffi pn on G3l- l%l ?nd be. co
that no chang'eS fn the route
hereon. Basis for Bu;G.ff . pS chlftA
that theqo'
e uli thou
ilder's Boa Exeno tion:
i2 Date /q. /??i
l\lame Si gnature
FOR OFFICE USE ONLY
Zones
-t"l-
Flood Pla'in iJ C> T
Li vi ng Uni ts 'Q-tu-e S
ype/const. -V-P--occv
quare Ftg. Ql 7 5.72* uutu
Group P.3-
"S4emg:1.
/c,19Apol i cation Fee
Permit Fee
/5 e
o9
-q,e
Server Cap
TOTAL 76,N9ilo. of Blocks over 5 0 .5Cd per block/2^5 =7
Il Pol 'ice Departnent tr llj I I amal ane Park & Recreati on D'i st.
trlFire Department trPacific Northwest Bell
Dspringfield Utilit-v Board Di{orthr';est l{atural Gas
tr Rar'nbot.t llater Dist.
E Tel eprompter
E Other
Stories ODE
I
BUILDING MOVINT - - -, IIT
Applicant to furnish (except as jndicated)
A. 0ld address for buildingB. Legal DescriptionC. New address for building
(Building Div. will furn'ish)D. Lega 1 Descri pt'ion
E. Name, etc. of building ownerF. Name, etc. of moving firmG. A description of intended useH. A description of proposed routeI. A description of the building
Applicant to contact property owners if trees'involved, and secure authorizations from
other jurisdictions as necessary.
A site or plot p1an, and foundation plan must
be subm'itted for the new s'ite (2 sets)
Plans must also be subrnitted for any other
work rel at'i ng to the rel oca ted bu i 1 d i ng .
Fees & Charges:A. Appl'ication fee due and payable at t'imeof appl i cati onB. Moving penm'it fees due and payable upon
permi t i ssuanceC. FEES & CHARGES TO BE CALCULATED BY
BUiLDING DIVISION STAFF
FOR OFFICE USE ONLYA. Plan check data collectedB. Cop'ies of application to appropriate
divisions, departments and agencies
BUILDING . DIViSION REPORT:
- - -RMIT VALIDATION
PERMIT CLERK
II.
III.
IV.
V.
VI
D fraJ Date 5'27al
TRAFFIC DIVISiON REPORT:56 *rrtrctaA ataurd.
Dgte f-Z?fl
ENGINEERING DIVISION REPORT:
or@ H>5-r?-Bt
By Date
ADDITIONAL PROJECT INFORMATION :
By Da te