HomeMy WebLinkAboutPermit Building 1994-08-129 9y tvtE Rc t A L / t N D tr sT Rt AL
PERIIIIIT APPLI9AIION
SPA'A'GF'ELO
225 Fiflh Street, Springfietd, Oregon gt477
LOCATION OF PROPOSED WOR
ASSESSORS MAP:n
h,
JOB NUMBER
INSPECION LtN E: t26-3769
OFFICE: 726-3759
TAX LOT:
5
/,4 t k,q Y ,/',-y'7ttPHONE:
ON
drz€uaean{7?4o/ztPCITY:STATE:
OWNER:
ADDRESS:
New .( HEMoDEL ADDrroN DEMoLISH orHER VALUE qz 7, 56
{-44DESCRIPTION OF WORK:
NAME PHONE
/r;- lgr
ADDRESS EXPIRES PHONE
te€
rL-l
ELECTRICAL:
J'
/
6//
c, . ?6 o sLl, spFa.1z/r/ /,/7 sv3 /
ItsnT {LFLT)q/<
€vceweARCHITECT:
CONTRACTOR'S NAME
G E N ERAL:
ADDRESS
MECHANICAL:
PLU M BI NG:
7/7 )) tl-/62)
CONST.
CONTRACTOR #/-b 7o)'oOuqrzt C-rr
t- /
Furnace/burner & vent
<1
Furnace/burner & vent
BTUs
Floor furnace and vent
oorwalornPv(umounted In heatt
pp ance
cooler
nary evap.
an
duct
e
or htf rom
ca
hood and duct
ec
$10.00Permit lssuance
TOTAL PERMIT
Single Fixture
Relocated B
f ix.
ft.
anitary
ft.
orm
ft
Backf low Device
TOTAL PERMIT
- OFFICE USE -
ry?7-.
/t
HANDICAP ACCESS
ZONING:
OCCY GROUP:
# OF STOBIES:
OUAD AREA:
# OF BLDGS LIGHTING POWER BUDGET:
CONSTR. TYPE:
HEAT SOURCE:
FLOOD PLAIN:
$/SQ. FT.SO. FT
ao
TOTAL VALUE OF P
so. FTG MAIN /%/ x
SQ. FTG ACCESS
SO. FTG OTH
X
x
DATERCPT'
PLAN CHECK FEE
BY
DEMOLIT
PLUMBING2.25PERMITBUILDING
5% State
eState
VA E
FENCE
ANICALM SUBTOTA L
ITSSIDEWALK
5% State
EECURBCFT*
/03 o
I"ff 5',.H'J'EEF8'"^.
/rt/r/xfur-f Co,
t^/ R/0/ttzr
/T t
/< uNDERGRoUND: Ptumbing,
electrical, gas., sanltarli sewer,
storm sewer, water and
dralnage llnes. To be made
prior to covering or filling
trenches.
UNDERFLOOR: Plumbing,
electrical, mechanlcal. To be
made prior to installation of
floor insulatlon, decking or
floor sheathing.
POST & BEAM: TO bE MAdE
prior to lnstallation of floor
insulation, decking or floor
sheathlng.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to lnstallation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams groutlng or
vertlcals in accordance withuBc 2415.
ROOF SHEATHING AND
NAILING: Prior to installtng
any roof covering.
BARRIER: To be made after all
insulation and required vapor
barriers are ln place but
before any lath or gypsum
board interior wall covering is
applied.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.r
-
LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
interior and exterlor, is in
place but before any
plasterlng ls applled or before
gypsum board joints and
fasteners are taped and
f inlshed.
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.
SPRAYED ON
FIREPROOFING: U.BC.
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AN D FILLING:
During earthwork. (306 a.11 &
Chapter 29)
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.
STDS. 25-10,11).
STRUCTURAL MASONRY: (306
a.7)
-ln addition to the inspec.
tions specified, the Buildlng
Official may make or require
other inspections of any
construction work to ensurecompliance with the Building,
City or Development Code.
r+rql
DATE
proj theon.
V\.
reDate EH
By signature, I state and that I have carefully
I further certify that
agree,examlned the completedherein is true and application and do hcorrect, and ereby certify that all inforany and all work mationof the City of performed shall be done inSpringfield, and the Laws of the State accordance with the Ordiof Oregon pertai nancesning to the workwill be made of any structure describedwithout permission of t herein, and that NO Ohe Bultding CCUPANCYSafety Divlsion. Iwho are in compliance with further certify t hat only contractorsORS 701.055 will be u and employeessed on th ls project
I further agree to that all required ins pections are requested at tstreet, that the he proper time, thatcard is located ect address is readable fromront of the property, andtimes during c the approved set o fpl ans will remain on the site at all
Signature
at he
Fr"
VALIDATION o a(_:'
RECEIVED BY:
DATE PAID
AMOUNT RECEIVED:
RECEIPT *:
,,
,n
t/
d
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL F!RE DEPA
SITE PLAN REVIEW BOARD: Must be requested 2 days in advanceof the date you wish inspection. ef f proidci conditions such as
fi9:g?,pirq, parking tot striping, "t". ,l"t'Oe comprelJ6"f"Lrequesting this inspection.
f F.NAL BUTLDTNG:Hequested after the final plumbing, electrical,mechanlcal and Fi re Department in spectio ns are made andapproved. No occu pancy of the pre mises can be made until aCertificate of Occu has been iss by the Buit Divisiondon
pancy
premis es.
AD TIONAL ME
PLANS REVIEWED BY
a Onecowqrv oF sP
J
225 FITTE STPGET
sPRrNGFrEtD, OREGON 9747
INSPECf,ION REQIIEST z 7260FFICE: 726-3759
1 TTON
DESCRTFTTON
The tollowing Proiect
zoning, and does not
approval.
Auihorized
as submtttEd l^ras tho
require speciiic land use
i-r:^t
A
B
c
D
E
SPT JFIELE,
BLECTRICAT PERHIT
City Job Number
SCMDUIJ BELOV
CATION
s 8s.00
$ 1s.00
s 40.00
eLoca t i on
$ 40.00
$ ss.oo
s B0.oo
see trBrr aE6TE-
$ 3s.00
$ 2.oo
Permits are non_transferable and expireif vork is not started "itf,in*i8O daysof issuance or ir voik ;;';;;;;ded for180 days.
2. CONIRACTOR TNSTAII,ATTON ONLY
ELectricaL Contr
, r",orSonitrol Security
Nev Residential-Single orMulti-Family per dv6lting unit.>ervlce Lncluded:
ftems Cost
1.000 sq. f t. or lessEach additional 500sq. ft or portion
thereof
Each Manufrd Ilome or
-_Modular DvellingService or Feeder
Sum
Ci ty u(Je ne
Address p. O.Box 21 00 9
Services or Feedersfns^tal1ation, Alteiationsor Rel-ocation:
200 amps or less201 amps to 400 amps .-
4u1 amps to 600 amps .-
f-91 "ll:^to 1000 urp"-ttver 1000 amps,/volt;
-
seconnect 0n1y
Miscellaneous (Servi ce,/fee-Eacn rnstallation
Pump or irrigation
:lglloy t-l,ine righting-lrmr ted Energy/Ret rmr ted Energy./Comm /
E Phone 46 1 _56 7B
$ s0.00
s 60.00
$100.00
$130.00
s300.00
s 40.00
Supervisor License Number /iAffi pef
Expiration Date -l
Constr Contr. Number 6S14g
Expirarion Date 6_28_96
Signa ture of S upervi Electrician
Ovners Name
Address
Ci ry Yhone b3? - 83 ?/
Temporary Services or Feedersfnstallation, Alteration or R
200 amps or less
:_r, .T!: to 400 amps .-
:r". 191 to 600 .ri" --
over 600 amps or fbOO-FoTts
Branch Circuits
OIINER TNSTALLATTON
The installation is being made onproperry f ovn which i. ior-in.tJndedfor sale. l-ease or rent.
Ovners Signature:
Nev, Alteration or Extension per panel
One Circuit
Each AdditionalCircuit or vith Serviceor Feeder permi t
cier not in"rual-,
s
$
$
s
40
40
20
36
00
00
00
00 ,16.00;^rE;5
O
RECETYED
SUBTOTAL OF ABOVE
?j ll"te Surcharge3Z_Administrative FeeTOTAL
-/1( /)/)
qb
I
CITY OF SPR OREGO'V
SPl{TNGFTELO
The lollowlng projod
zoning, and does not roquire epecific land uso
as subnrftted hes the
approval.Lnl EIACIRICAL PERHTT APPLTCATION225 TIFTE SI'REEf,
SPRINGFTBLD,oRBGoN 97477
INSPECTION REQTIEST:
0FEICB: '726-3759
tz6il&eZ.t+.a City Job xr:urA", %228,?
Authorized COHPI.RTE FEE SCffiDTII,B BELOIT
1 OP INST,Nev Residential-Single or
HuIti-FamiIy Per dvelling unit.
Serviee Included:IJGAL DESCRIPTION
m
A
I tems Cos t
$ Bs.0o
$ 1s.00
$ 40.00
s 3s.00
$ 2.00 qd-,"
Sum
=-aa
permits are non-transferable and expire
lf vork is not started vithin 180 days
of issuance or lf vork is suspended for
180 days.
2. CO}flTACTOR INSTALI.ATION ONLY
Electrical Cont ractor Alert Electric
Add ress 1'970 N. 28th
Cl ty Spri field Phone 7 4j-2 )1?
243 S
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular Dvelling
Servlce or Feeder
o0
rc_
-Supervisor License Number
Expiration P61s l-0-1-94
Constr Contr. Number 20-55C
Bxpi tion Date 10-1-94
trician
Ovners Name
Address
cl ty-Phon"-
OVNER TNSTALI,ATION
The. installatioh is beidg made on
property I ovn vhich is not intended
for sale, lease or rent.
0vners Signature:
DATE:
c.Temporary Services or'Feeders
Installation, Alteration or Relocation
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less 3-201 amps to 400 amPs
-
401 amps to 600 amPs
-
601 amps to 1000 amPs-
Over 1000 amps/volts
-
Reconnect 0nlY
One Circuit
Each AdditionalCircuit or vith Service
or Feeder Permit qA
t,
B.
Inc.
200 amps or less
201 amirs to 400 amps
-0ver 401 to 600 amps
Over 600 amps or 1000 voTls
$ s0.00
$ 60.00
$100.00
$ 130.00
$3o0. oo
$ 40.00
$
$
$
s
40.00
55.00
80.00
ee ilBx aE-
I D. Branch Circuits
Nev, Alteration or Extension Per Panel
B Hiscellaneous (Service,/feeder
-Each installation
Pump or irrigation $Sign/0utIine Lighting- $Limited Energy/Res _ $
Limi ted Bnergy/Comm $
not included)
40.00
40.00
20.00
36.00
RECEIVBD
I
5 SUBTOTAL OP ABOVE 2 qAO"
5Z state surcharge Ff ----aTOTAL r3 ___-T?
--/off 46fld8
JOB NO.
}IAII!E OR COI,iPAI{Y :
LOCAT i OIi:
DEVELOPI'IENT TYPE:
EUILDING SIZE:
l. sToRl.t DRAINA.GE
BAs
iHPtRVIoUS SQ. FT.
NO. OF PFU'S
(Use PFU Tota
2
5. ADHINISTRATIVE FEES
ED oN Revrceo s/r€#
?3
/ G,eeo*r<, PtA,v ( ?5:f)
7 lo7 t{
a. Fr.
s 3r7, trtr
//1.3e
E, tr8 3.G /
CITY OF SPRINGFIELD SYSTEHS DEVELOPMENI CIIARGE
I.IORKSH EET' (coHt'{ERCTAL & RESToENTIAL)
LOT SiZ
I From lten 2
HHi'rc CREDiT IF AppLTCABLE (SEE REVERSE)
x s0.203 PER SQ. FT.
x s42.03 PtR PFU
S15.125 PER PFU + Sl0 Ht{tic ADM FEE
Above )
*@
SUBToTAL (ADD ITEHS 1,2,3 & 4)
AL ABoVE) X .0s
/Au strg DRALYAG€ tu/LL 6o ro DRl h)€tl.
2. SAt{tTARy SEtr'ER- !r|lf"'" s e7s f€ar ro *rrA ulED AETTER Ft, STEaEN kocru(?-rz.Zr.,,
I{0. OF PFU'S
(See Reverse)
3 . TRANSPORIAT IOi{
IiO OF UI{ITS X TRIP RATE X COST PE.q, TRIP
UARE rlouSE I 4 o,7 I x 5424.3i
o(Fr*'x 2.24 x s124.31 s zrf /, ta
x _ x s424.31 s
4. SANITARY SEWER-I.Il{I.lC
81ao.s
F €vtsEo
TdrA L
S.D.c.
ToTAL SDC S 1+s.a3#SDC Coord lna tor
F-tz-24
123.os
COMM ERCIAL/ IN DUSTRIAL
PERMIT APPLICATION
225 Fiftn Street, Springfield, Oregon 97477
LOCATION OF PROPOSED WORK
ASSESSORS MAP:OD
o-7 s .9 L
JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
TAX LOT:
SPRINGFIELO q407 k4
c(8s-+t uPHON E
o<.STATE;ztP
o
7 97 Vo
oO
CITY:eu 6 at-/e ,
ADDRESS;
OWNER
NEW
-
REMODEL ADDITION DEMOLISH OTHER
IF
H
DESCRIPTION OF WORK
LUE:
GENERAL:
Le.
NAME ADDRESS PHONE
ADDRESS EXPIRES PHONE
o-oo b 2./6-?
CONTRACTOR'S NAME
ARCHITECT:
ELECTRICAL:
MECHANICAL:
PLUMBING:
CONST.
CONTRACTOR #
PLUMBING
NO,FEE CHARGE
Single Fixture
Relocated Bld
(new fix. addtl I
)
Water Service
ft
Sanitary Sewer
ft
Storm Sewer
ft.
Backflow Device
TOTAL PERMIT
NO FFF CHA RNFvFurnace/burner & vent
< 100,000 BTUs e B,N
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
4 Suspended wall or f loor
mounted unit heater 6 %-*Appliance Vent
separate
Stationary evap.
cooler
n Vent Fan/Single
duct 7 &R-Vent
f rom
System apart
AC or htg.
Mechanical exhaust
hood and ductvk*V.rzZ I /8.1
Permit lssuance
(
$.10.00
TOTAL PERMIT 4a
ZONING:
LIGHTING POWER BUDGET:
WATER HEATER:
- OFFICE USE _HANDICAP ACCESS:
FLOOD PLAINLAND USE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
'f OF UNITS:
SQ. FT.$/SQ. FT.VALUE
x
X
X
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
PLAN CHECK FEE RCPT#BYDATE
,/42,?Z*
BUILDING PERMIT
DEMOLITION
5% State
Su 5% State
Su
MECHA acr FENCE
VALUE5% St
Su rc SIDEWALK
FT.
SUBTOTAL
PE ITSPAVINGCURBCUT
FT.
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
tY" lz nv Tt ,/&'h^ tu) f
TOTAL VALUE OF PROJECT.--==-=_-
PLUMBING
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 7:00 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 V RoUGH PLUMBING, PAVING: After graver 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 SpEC1AL 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 is covered. ATTIC DRAFT STOPS & by the Owner/ Contractor during
CURIAIN WALLS construction of the following work. A
FOOTINGS & FOUNDATIONS: E,DE^, A^E. r 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 2500 PS.l. (306 a.1)
coNcRErE SLAB: ro be tl:J,::liiiiJ'ilXlfli,'Xi ,^ srRUcruRAL wELDS:
made after all inslab building place and all pipes, chimneys Performed on the iob' (2722't\
service eguipment, conduit, and vents are complete andpiping, accessories and other the rough electrical, plumbing HIGH STRENGTH BOLTING:
ancillary equipment items are and mechanical are approved. During all bolt installation and
in place but before any tightening operations. (306
concrete is placed. INSULATION & VApOR a.6)
BARRIER: To be made after all
UNDERGROUND: Plumbing, insulation and required vapor SPRAYED ON
electrical, gas, sanitary sewer, barriers are in place but FIREPROOFING: U.B.C.
storm sewer, water and before any lath or gypsum Standards 43-8.
drainage lines. To be made board interior wall covering is
prior to covering or f illing applied. SpECIAL GRAD1NG,
;::"i:'."R: p umb ns I5x:'L"':'3m'J3[H]* il;i;Tiil-tll"'5Jb'i]''l
electrical, mechanical. To be according to plans' Chapter 29)
made prior to installation of rr^,Ah ^v.orrir GLU.LAM BEAMS: lnspectionfloorinsulation,deckingorLATHAND'ORGYPSUM
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 interiol and exierior, is in Building Division before
prior to installation of floor ptace but before any beams are placed (2501 U'B.c'
insulation, decking or floor irlastering is applied or before STDS' 25-10J1)'
sheathins.
Jev'\'rrY
tgJi,:lT,."t:il0,#[}""i:o srRUcruRAL MASoNRy: (306
FLooR TNSULATToN & finished' a'7)
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
NAILINGI Prior to installing
any roof covering.
FINAL PLUMBING
F]NAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
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.
PLANS REVIEWED BY
*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,
-cy-:''
D=:r:!r:l'c'f -
DATE
SITEPLANREVIEwBoARD:Mustberequested2daysinadvance
oftn"d"t"youwishinSpection.AllprojectconditionsSUchaS
i.nO""ipi^g, parking lot stri ping, etc' must be completed before
requesting this insPection.
FINALBUILDlNG:Requestedafterthefinalplumbing,electrical,
mecninic.f and Fire Department inspections are made and
ipproveO. No occupancy of the premises can be made until a
C-ertificate of Occupancy has been issued by the Building Division
and posted on the Premises.
ADDITIONAL COMMENTS:
By signature, r state and agree, that r have caref uily examined the completed application and do hereby certify that all information
herein is true and correct, and I f urther certift in"t "nv 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 Builling safety D'r-vision. 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 locaied at the front of the property, and the approved set of plans will remain on the site at all
Si gnature
s-?{-? ytimes during structi on
Date?1-Ltg---r P"*2 4*
VALIDATION
a ^=),?r
RECEIVED BY:
DATE PAID:AMOUNT RECEIVED:
RECEIPT *:
2Z-
CITY OF OREGO'U
-lrltvtr7?r# .
approvd' Dr Err.pr,'ar- pERNTT AppLrcATroN
2?5 firr,E STREEf,
sPRrNcPrEu)' oREGo N 97477 zonine LtrT ELEcIRTcaL PERHTT APPLTcATT(
rltspBcrroN REorrBsr: 726dlw3-tt4Lf citv Job n'-vu' ?/229f
oPErcE: ' 726-3759 Auttrortzed slignatJro , @ scffiDt I^E BELog
The following prolec't as submittad has the
zoning, and does not require epecific land u3e
A. Nev Residential-Single or
Hulti-FamiIY Per dwelling unit'
Service Included:
SPl:rItrcFIELO
5. SUBTOTAL OT ABOVE
5Z State Surcharge
1. UrcATION OP INSTALI,ATION
F
ISGAL DESCRTPTION
JOB
permits are non-transferable and expire
if vork is not started vithin 180 days
of i"",r"nce or if vork ls suspended for
180 days.
2. COI{TR,ACTOR INSTALI"ATION ONLY
Electrical Contractor Alert Electric,
Address 1970 N- 28rh sf-
Ct ty Spring field Phone 7 47-22L3
243 S
Expi ration Date 10-1-94
Constr Contr. Number 2o-ls'e
Ex iration Date 10-1-94
ture o I Electrician
rs Name
I tems
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Manuf'd Home or
Hodular Dvelling
Servlce or Feeder
B. Services or Feeders
Installation, Alterations
Inc. or Relocation:
200 amps or less
201 amls to 400 amPs
-401 amps to 600 amps
-
601 amps to 1000 amPs-
0ver 1000 amps/volts
-
Reconnect OnlY
c.
D.
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less '/ $ 40.00 -A201 amfs to 400 amps
-
$ 55.00
over 4b1 to 600 amis
-
$ 80.00
Over 600 amps or tbOO voT[s see uB" aEF
Branch Circuits
Cos t
$ Bs.oo
s 1s.00
$ 40.00
Sum
s so.oo
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
i
Address
Ci ty
^z-* 1? A , -k4!27
Phone' {*S-7>?
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each AdditionalCircuit or vith Service
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
OVNER
The installatlon is being made on
property I own vhich is not intended
for sale, lease or rent.
Onners Signature:
DATE:
-Each installation
Pump or irrigation
Sign/outline Lighting-
Limited Energy/Res
Limi ted Energy/Comm
s 40.00
$ 40.00
$ 20.00
$ 36.00a.*
Q ;ee
/.2a
RBCEIVED
TOTAL ffie ?Bza
Supervisor License Number
COMM ERCIAL/IN DUSTRIAL
PERMIT APPLICATION
225 Fitlh Street, Springfield, Oregon 97477
LOCATION OF PRO
ASSESSORS MAP:
SPEINGFIELO JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
TAX LOT:
OWNER
ADDRESS
CITY:
PHON E:
STATE:ztP
Mnnf) /tr'hfo rst+U,-Q, Ll/tl-
FIEMODEL ADDITION DEMOLISH s;NEW
-
ER VALUE
RIPTION OF WORDESC
MECHANICAL:
NAME ADDRESS PHONE
ADDRESS EXPIRES PHONE
ELECTRICAL:
ARCHITECT:
CONTRACTOR'S NAME
CONST.
CONTRACTOR #
G EN ERA L:
PLUMBING
PLU MBING
NO.FEE CHARGE
4 Single Fixture t8.)30
Relocated Bldg.
(new fix. addtl)
Water Service
ft
sanitary t"*", \5f),,+Dco
Storm Sewer
ft
Backflow Device
,l I kil. \i,fta,3id JS.q)
\\
/-Lr\hhf '\5 qo.ul
rlYrJSf '15 4D.oo
R lfrite? \3)'+o.oo
TOTAL PERMIT
MECHANICAL
t\l O FFF EHA RGF
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 $10.00
TOTAL PERMIT
_ OFFICE USE _
LAND USE:
ZONING* OF UNITS:
HANDICAP ACCESS:
FLOOD PLAIN
LIGHTING POWER BUDGET:
WATER HEATER
OCCY GROUP:
* OF STORIEST
QUAD AREA:
* OF BLDGS:
CONSTFI. TYPEr
HEAT SOURCE:
SQ. FT.$/SQ. FT,VALUE
TOTAL VALUE OF PROJ
X
X
X
SQ. FTG MAIN
SQ, FTG ACCESS
SO. FTG OTHER
RCPT#DATEPLAN CHECK FEE DT
DEMOLITIONPLUMBI NGBUILDING PERMIT
\5% State
Surch5% State
Surch
MECHANICAL
SUBTOTAL
PERMITSLKSI
FT5% State
SYSTEMS
DEVECURBCUTFTPAVING
T^T^r PFRIvIIT FEES
Lifii b I I.IC ELECT RICA L
,\v
,2-D
It is the responsibilitY of
7 26-3769 (recorder), state
for i nspection. Requests
the following work daY.
REQUIRED INSPECTIONS
the permit holder to see that all inspections are made at'
your City designated job number, job address, type of ins
received before will be made the same working d
the proper time. To reguest an inspection, call
pection requested and when you will be ready
ay, requests made af ter 7:00 a.m. will be made
SITE INSPECTION: To be
made after excavation, but
prior to setup of forms.
UNDERSLAB PLUMBING,
ELECTRICAL &
ROUGH PLUMBING,
ELECTRICAL &
MECHANICAL: No work is to
be covered until these
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.
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
concrete.
PAVING: After gravel is in
place but prior to placing
asphalt or concrete.
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 followlng work. A
copy of the special testing reports shall
be furnished to the Building Division.
STRUCTURAL CONCRETE: In
excess of 2500 P.S.l. (306 a.1)
STRUCTURAL WELDS:
Performed on the job. (2722 t)
HIGH STRENGTH BOLTING:
During all bolt installation and
ti ghteni ng operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.BC.
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. 25-1011).
CTURAL MASONRY:(306
"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.
ROOF SHEATHING AND
MECHANICAL: To be made
before any work is covered.
FOOTINGS & FOUN DATIONS:
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: PIumbing,
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
floor insulation, decking or
floor sheathing.
POST & BEAM: To be made
prior to installation of floor
insulation, decking or floor
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.
NAILING: Prior to installing
any roof covering.
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 OFIS 701.055 will be used on this project.
pections are requested at the proper time, that project address is readable f rom the
e front of the property, and the approved set of plans will remain on the site at all
Signatu Date
I further agree to ensure that all required
locatedstreet, that the permit
times during const
toNVALI AMOUNT RECE
RECEIPT #RECEIVED 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 conditions such as
landscaping, parking lot stri ping, 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 on the premises.
ADDITIONAL COMMENTS
PLANS REVIEWED BY DATE
JOB NO.
CITY OF SPRINGFIELD SYSTEHS DEVELOPMENT CIIARGE
( c ol,,! ERH?I [t#'181,, 0,-,
NAI'IE OR COHPANY:
LOCAT ION:
DEVELOPI.IENT TYPE:
BUILDING SIZE:LoT siz
STORH DRAINP.GE BNeo oN REvtsEo slr€ / 6,eeo*yc, ptA,v t G.C. f.tI s-t-tt/
iHPERVIoUS SQ. FT.x s0.203 PER SQ. FT.
t
7 /o7 Er
. Ft.
s2 r€/.36
//2,39
d
z -?*).
At L s/rF DRA/.IAG€ u/LL 6o ro DRl uE/,4,
2, SANITARY SEh'ER-CITY
APrto v€o SttotEer ro ArrAulEo Aerfee Fl. Sreu€N kocr,r(F-t
3. TRANSPORTATIOi{
NO OF UI{ITS X TRiP RATE X COST PER TRiP
AARE tlouSE I 4 o.l 4 x s421.31
o(Ft*'x 2.24 x s424.31
x _ x s424.31
4. SANiTARY SEI\,ER.I,ll1'I.lC
s
s 15. 125 PER PFU + SIO Hh'IiC ADH FEE s 757. trtr
X S42.08 PER PFU
TOTAL.Mli'MC SDC
SUBToTAL (ADD ITTHS 1,2,3 & 4)
I{0. OF PFU'S
(See Reverse)
23
NO. OF PFU'S
(u
2
se PFU .Total From item 2 Above)
Hir'l'lc CREDIT IF APPLICABLE (SEE REVERSE)
5. ADHINISTRATIVE FEES
8A CHARG TAL ABoVE) X .05
r0r^r_ sDC S 1+es-P
t,883.6 t
81cost
+23.o3
R EV|SEO
TorA t-
S.D.c.
'f,.Ft'
SDC Coord na tor
o
F-tz-24
&/oKAY INVESTMENT CO.
23OO Oekmont WBy, Suite 214
Eugene, Oregon 97 401-5562
tsosl 4854711
August 12,1994
ENGl NEERING DEPARTMENT
ClTY OF SPRINGF]ELD
225 Fourth Street
Springfie Id, Oregon 91 477
Dtr .SHELLEY STREET
McKAY INVESTMENT CO. agrees that we wj, II r-rot rent the portion of our proposed
warehouse that is served by a truck weII to any company that st.ores chemicals'
This is to accomodate Springfield enforcement of the Clean Water Act by
preventing the possibifity of contaminated water from being returned to the
ground .
Very truly yours,
Mc ]NVESTMENT CO.
SI n Kor rtne r
I