HomeMy WebLinkAboutPermit Building 1994-06-28C O III $I ERC'A t /, N D U SIR'A t
PEBMII APPLICATION
225 Fifth Street, Springfield, Oregon 97477
LOCATION OF PFIOPOSED WORK:
SPF'NGFtELD
JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE:726-3759
TAX LOT:
a.
ASSESSORS MAP:\qr)
DEMOLIT loNzze"FluMetNc>aBUILDINGPERMIT /5% State
Su rc5% State
Surch FEN
LUEMECHANICAL SUBTOTAL
RMFT.
SI
5% State
rcha
PHoNE: 638-*=/a
CITY:STATE:ZIP:e7//effi.
OWNER
ADDRESS:
VALUE:ADDITIOBEMODEL
DESCRIPTION OF WORK:
DEMOLISH OTHERNEW *
PLUMBING;
MECHANICAL:
ELECI'RICAL:
PHONEADDRESSNAME
EXPIRESADD
9c A?y,
co RACTOR #PHONECONTRACTOR'S NAME
ARCHITECT:CONST,
G EN ERAL:
Single Fixture
Relocated Bl
fix. ad
e
1+
an ft.
errm ft e
Backflow Device
TOTAL PERMIT
& ventF u rnace /
< 100
Furnace/burner & vent
BTUs
Floor furnace and vent
oorore
tI heat Inu
ance
separate
at onary evap.
cooler
ng
duct
nt
f rom
em apa
or
hood and duct
n exec
$10.00Permit lssuance
TOTAL PEBMIT
fz<z.#-
- OFFICE USE -
ZONING H:I-
LIGHTING POWER BUDGET:
QUAD AREA LAND USE:
OCCY GROUP:
# OF STOBIES
CONSTR. TYPE:
HEAT SOUBCE:
HANDICAP ACCESS:
WATER HEATER:
-
$/so. FT.
X r=+>
TOTAL VALUE OF PROJ
4
VALUE
C>t*
SQ. FT.
SO. FTG MAIN
SO. FTGJ€€'SS
SO. FTG OTHEB
DA1E ,-ft?/ BY
BCPT#c
EMS
?v y2. /7
TOTAL PERMIT FEES
eiduuotxo ELECTRIcAL
E e522.7?
-?7a;?u-'
)
/29.n
fq,as
PAVING
cuRBCuT5T rT.
R E OU R ED I N S P ECT o NS reouest an inspection' call
;;;;;". You will be readY
?i[t i,oo a'm' will be made
made at th e pro per ti me.To
th at al NS pectlons are pecti re qu estedpermiholdtoseedtypeofNSon
respo nsi bi li ty of he ated lob n um ber,lob ad ress,d re qu ests mad ettthestateyourCitydeslgnmadethesameorkingay,
726-3769 (record er)eived before 7:00 m.be
{or ins pection Re qu ests rec PAVIN G:Afte gravel S n
he fol lowlng work d ay.
ROU t H PLU MBING pl but prior to pl aci n g
NSPECTlO N To be &ace
SIT E bu EL ECT RICA L AS ph alt or o nc rete.
m ad e af te excavati on M ECHAN rcA L:No WO rk S to
p rior to setu p of f orms.be covered U n ti these rdance
inspections have
and apProved.
bee n mad e SP ECt A L NSP ECTI ON S:n ac co
U N DERS LAB P LUM BIN G,Secti on 306 of th e State S peci al ty Code
ELECTRICAL &S pec al NS pe ctor S hal be em p oyed
M ECHAN ICAL:To be made ATTIC DRA FT STOPS &by the Ow ne Con tractor d u ri ng
befo re any work s c overed CU RTAI N WA L LS nstructi n of he fol OW o rk.co o ng
,X
/
x
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 equlpment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
concrete ls placed.
UN DERGROUND: Plumblng,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage llnes. 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 sheathlng.
POST & BEAM: To be made
prior to installatlon of floor
insulation, decking or floor
sheathlng.
FLOOR INSULATION &
a,
x
,ar
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, ls in
place but before any
plastering ls applled or beforegypsum board joints and
fasteners are taped and
f inlshed.
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 iob. (2722 t)
HIGH STRENGTH BOLTING:
During all bolt installation and
ti ghteni ng operations. (306
a.6)
SPRAYED ON
FIREPROOtrlNG: U.B.C.
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.1'l &
Chapter 29)
GLU-LAM BEAMS: lnspection
Certificate by an approved
agency, furnished to the City,s
Building Division before
beams are placed. (2501 U.BC.
STDS. 25-10,11).
STRUCTURAL MASONRy: (306
a.7)
n:3?,P,Sil',X!,";,I1,3i ", ,u .TDEWALK & DRTVEWAy:
deckins or rroor sne;i;i;s:' 3ff:U"j Jffi"l|;""??ii,ni ",MASONRY: Steel tocation,
bond beams grouting orverticals in accordance withuBc 2415.
ROOF SHEATHING ANDNAILING: prlor to lnstailing
any roof covering.
way, to be made after all
excavating complete and formwork and sub-base material inplace,
CURB AND APPROACH
APRONS: After forms areerected but prior to placing
concrete.
*ln addition to the i nspec-tions specified , the BuildingOfficial may m ake or requireother inspect ions of anyconstructionwork to ensurecompliance with the Building,City or Development Code.
-1- FINAL eLUMBTNG
/ FrNAL ELEcTRTcAL
i- FINAL MEcHANTcAL
4 FINAL FIRE DEPARTMENT
t/SITE PLAN REVIEW BOARD:. Mus.t be requested 2 days in advanceof the date you wish inspection. Alt aroj;;iconditions such as
L11o:93,0,nt, parking tot striping, "t". .L"t'Oe compieleJL"6iurequestlng this inspection.
--/-- 1I4L BUTLDTNG: Requested after the final prumbing, erectrical,mechanical and Fire Department inspections are made andapproved. No occupancy of the premises ".n ou maol- ,intir acertlfrcate of o.ccupaniy has been issued ov ine arliii"g Divisionand posted on the premises.
ADDITIONAL COMMENTS
PLANS FIEVIEWED BY
Date 1
sl natuBys statet9,and th at hagrge,ave caref u examly lned comhe'etedpl cathplap anlon dereitsn do hereandtruec certiorrectby atthdantufy al nerrthrtce rmatfoatth tontyananyalldWOrkshperformedalbeohedonnciofcordtynelfianceSprianddwithhesLawstheOrdnofheEScStateofanonnOregpertaitothngeworkltdescmadebeofbedhereianyrestructun,and hatthwiOU N oissi occ PAUpermnoof NCYBuhetdingviDiSafetysion.rtfu herarewhon certi thcom onatancety conplhRSoly tractors.055701 a ndWibesedU emplthonis oyeesproject.
fu hert toreeag ensure that al U red NSreq ectionp ares uesreq atted the pro tiththatpe hattreet,e rne,ropermcardItp addject reSoc SS ISatated readthe leab frorono mhe hemv,propert andESurid theco apngon.nstructl proved ofset ans Wipl il rem AI n n he Si te alat
Signature
VALIDATION
6AMOUNT RECEIVED:
RECEIPT *:
RECEIVED BY:
DATE PAID:
DAIE z-2;2-?/
C'TY I'F SPN'ilG OREG ot,
0t/2?/92 ! Ll.22 Gooa i EoEs
t-70'z300oo t%r
225 FIEIE SMgEf,
sPn$cPr8LD, onBGoN 97477
INSPBCII0T f,EQllESf,r 726-3
0lEICEr 726-3159
0r AuthorLed
SPFD DEV. SER.
a9 submltted
require speclflc
, 1000 sq.ft. or less'
UW*)Zach addltlonal 500
sg. ft or Portlonthereof
Each Hcnuf'd Eome or
Modular Dvelllng
Servtcc or Fecder
O ooz
APPLICATIOIIt.7C{L
L
IICAL co-
Pcnttr lrt n9D-tnnrfcrebls and explretf vork ts not startGd vlthln 180 daye
of lssurncc or 1l vork ls suspended for
180 dayr.
2, @MNACTON I!|SEAIJ.ATIOII ONIT
Elcctrlcal Contractor
t"lutr tNc
Addrcu PO Bct *)kt
Ctty Job Nuober
rEg SCEBDI'IJ BBI,OS
ev dcntla I-Stng1c or
l{ultl-Frntly pcr dvrlllng unlt.
Servlcc Includedt
I t:urg Cos t
$ 85.00
Sun
JOB
Slgnrturr ol Supcnrlc Blectrlclan
Omcre
Addrcrr
Cltv Phonr
OINDN, INSTALI.ATION
llro lnrtrllatlon lr bclng mrde on
proDrrty I ovn vhtch lr not tntendcd
for ralcr lctsc or rant.
Ormur Slgnrturct
D[tEr
B. Servltes or Feederg.
fnstall8tton, Altcratlons or
R:Iocatlonl
200 amps or lcss
201 amps to 400 aoPs
-
401 ampr to 600 amps
-
601 amps to 1000 EDps-
Over 1000 amps/volts
-
Beconnect Only .
-
$ 15.00
$ 40.00
40.00
55.00
90.00el trBr sEffi
ss0
$60
$100
$130
$
s300
00
00
00
00
00
00
a
Supervlsor Llccnec Ntimbqr 2.aou 5
Trmporery Scrvlcco or Fcrdcrg
InsiaUrilon, A1t:ratton or Belocatlon
c.
40
200 amps or legs
201 amps to 400 tnPs
-
0ver 401 to 600 cnrps
-
Over 600 amps or 1000 voltg
Each Addltlonal
Clrcult or vlth Scrvtcc-
or Feeder Perml t / X
-Each lnstrlletlon
Ptrmp or lrrlgatlon
Slgn/0utI1ne LlghtlnS-
Ltmltsd Enrrgy/Rer €
Llnrl tcd EncrgY/Comn
-
s
s
$
3
D. Branch Clrcultg
Ncv, Altcratlon or Ertonrlon Pcr Pancl
s 35.00 3Sf
. -/O9s ?,00 Jb -
B. l,llsccllaneour (Scrvlcc/fcedsr not lncludad)
s
s
$I
.00
.00
.00
.00
c!-
40
40
20
36
5. SIETOIAT OP ABOVE
5tr State Surchargc
TOTAL
h --E?lt6ft
Ia
,r.
5a'l llItLa'lULlJ
1.I
crty-hP,iJ5 , *on -1QQfu6)l/'
E4plrattor. Drt.
conrtr contr. Nurbu@.
Exptratlon rnrc- /0 - l Ll '
COMM ERCIAL/I N DUSTRIAL
PERMIT APPLICATION
225 Fillh Street, Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
SPEINGF]ELO JOB NUMBER "laINSPECTION LINE: 726-3769
OFFICE: 726-3759
TAX LOT:
e i
PHONE:
CITY:
Eq, ' Fa"-,,ua G-coa
9)yyo
ADDRESS:2t9o !r^rrr.
STATE: OA ZIP:
OWNEB:
DEMOLISH OTHER VALUE:
DESCRIPTION OF WORK;
NEW X REMODEL ADDITION
PLUMBING:
lrtrn!.,lAt\llnAl .
trt trnTatna I
NAME ADDRESS
at l'l ,bJa og ^jEry,
ADDRESS
9zz?s
CONTRACTOR'S NAME
ARCHITECT
GENERAL:
PHONE
-'r9/'063 7
PLU MBIN G
NO trFF CHARGE
Single Fixture
Relocated Bldg
(new fix. addtl)
Water Service
ft
Sanitary Sewer
ft
Storm Sewer
ft
Backflow Device
-i4bvt
(
TOTAL PEBMIT
MECHANICAL
NO trtrtr CHA RG F
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
Statlonary evap.
cooler
duct
Vent
from
System apart
AC or htg.
Mechanical exhaust
hood and duct
- //o/4?
-Permlt lssuance $10.00
TOTAL PERMIT
- OFFICE USE _
LAND USE:
ZONING* OF UNITS:
HANDICAP ACCESS:
FLOOD PLAIN
LIGHTING POWER BUDGET:OCCY GBOUP:
# OF STORIES
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:WATER HEATER:
SQ. FT.S/SQ. FT.VALUE
SQ. FTG MAIN
SO. FTG ACCESS
SO. FTG OTHER
X
X
TOTAL VALUE OF PROJ
D^rE *222/ ByPLAN CHECK FEE <z,at /RCPT#
?/2. t2
BUILDING PERMIT eq4.z,PLUMBING DEMOLITION
5% State
Surcharoe ffi '41. /62+. UA,5% State
Surcharge
MECHANICAL -FENCE
VALUE $
5% State
Surcharqe
SIDEWALK
FT.
SUBTOTAL
PERMITS
PAVING CURBCUT
FT.
SYSTEMS
DEVELOPMENT
)( TOTAZ s?e 4lrAReE Fa'< FoTrr PEtrrt/r t4E"/r74t's'
a,r7a4 ,7FK ?aavr7 TCTAL PERMIT FEES
EXCLUDING ELECTRICAL
Bren"/, Eaqtnetrrnq 3to h fl g, grina,f;e//. A,er'Coru3r.
CONTBACTOR # EXPIRES PHONE
REQUIRED INSPECTIONS
It is the responsiblllty of the permit holder to see that all inspectlons are made at the proper time. To request an inspection, call
726-3769 (recorder), state your Clty designated job number, lob 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 after 7:00 a.m. will be made
the following work day.
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, inspectlons 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 is covered. ATTIC DRAFT STOPS & ny ine ownei/ Contractor during
CURTAIN WALLS construction of the following work. A
.X FoorlNcs & FouNDATIoNS: ETDEDT AFE. r copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prlor to placing be furnished to the Building Division.
excavated and forms are facing materlals and before
erected, all steel in place, but framing lnspection' srRUcruRAL CoNCRETE: ln
prior to placing concrete. v FRAMING: To be made after excess of 2500 PS.l. (306 a.1)
coNcRErE SLAB: ro be t1:"1;:lji'lJ'iiixlfl;tx[ ,n v srRUcruRAL wELDS:
made after all lnslab building ^r-^- ^6i ^,r ^16^^ ^hi-^^rr. PerformerJ on the iob l,?.7?2 t)
service equipment, conduit, '";;;;i; il!""5ilpr"i; .n;f '
:iiJ,?,?;".'.",:;il:".i ?l:',"T5.l :X? ';::H,l['ii:,1'fJ;l33lt: Bl?lf],?EL?T*,?,'"THX^o
in place but before any tightenlng operations. (306
concrete ls placed. INSULATION & VApOR a.6)
BARRIER: To be made after all\'/ UNDERGROUND: Plumbing, insulation and required vapor SpRAyED ON
electrical, gas, sanltary sewer, barrlers are ln place but FIREPpOOFING: U.BC.
storm sewer, water and before any lath or gypsum Standards 43-8.
drainage llnes. To be made board interlor wall covering is
prlor to covering or filling applied. S'ECIAL GRADING,trenches.
,NDERFL..R: p,umbins,
-
il::,*"#fm'J3[H]"' Eliflfii[tii.l,5ib'i],"1'
electrical, mechanlcal, To be according to plans. chapter 29)
made prlor to installatlon of
floor insulatlon, decklng or LATH ANDTOR GYPSUM GLU'LAM BEAMS: lnspection
floor sheathlng. 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 lnterlor and exierlor, ls in ' Building Division before
prlor to lnstallaflon of floor place but before any beams are placed' (2501 u'Bc'
lnsulatlon, decklng or floor frlastering ls applie6 or before STDS' 25-10'11)'
sheathlng. gypsum board Joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR rNsuLATroN & flnished' a'7)
VAPOR BARRIERS: To be
made prlor to lnstallation of
decking or froor sheathing.
MASONRY: Steel location,
bond beams grouting or
vertlcals ln accordance with
UBC 2415.
RooF sHEATHING AND :Hl3^H'^fi"t::ffX'"
NAILING: Prlor to lnstalling erected but prior to placing
any roof coverlng. concrete.
SIDEWALK & DRIVEWAY
Required for all concrete
paving withln 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-
tlons specified, the Building
Official may make or require
other inspections of any
construction work to ensure
compliance with the Building,
Clty or Development Code.
FINAL PLUMBlNG
FINAL ELECTRICAL
FINAL MECHANICAL
V 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
landscaplng, parklng lot stri ping, etc. must be completed before
requesting thls inspection.
FINAL BUILDING: Requested after the final plumbing, electrical,
mechanlcal and Fire 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.
,r
.r
ADDITIONAL COMMENTS:
PLANS FIEVIEWED BY DATE Z:491
By slgnature, I state and agree, that I have carefully examlned the completed application and do hereby certify that all lnformation
herein is true and correct, and lfurther certify that any and all work performed shall be done in accordance with the Ordinances
of the City of Sprlngfield, 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 Buildlng Safety Dlvlslon. I further certify that only contractors and employees
who are in compllance with ORS 701.055 will be used on this project.
I furtheragree to ensure that all requlred inspections are requested at the propertime, that project address is readable from the
street, that the permlt card ls located at the front of the property, and the approved set of plans will remaln on the site at all
times durlng constructlon.
5- eo'9?Signature Date
?t>. ftVALIDATION:/24>AMOUNT RECEIVED:
RECEIPT *:RECEIVED BY:
DATE PAID
SIGN PERMIT APPLICATION
225 Fif ttr Street
Springfield, OR 97 477
S''IIINGFII:Lr,JOt] NUrUtiUt
__*lspect ton
Olfice: 726 3759?fi,
1 69
SITE ADDRESS
ASSESSONS T\IAP
161 30r l_1d
I AX LOT
OWNER: Eug Farmert s Co PHONE 688-8 210
2590 Drairie RoadADDNESS
CITY:Eugene STATE: OB ZtP: 97 402
BUSINESS NAME. FIRM ETC Eueene Farmerrs Co-oo
DESCBIPTION OF PROPOSED SIGN(Sl: (please check and complete all appropriate informationl
X Wall __ Freestanding _ projecting
(set of 3 Pan Chhnnel Letters)X Single Face _ Double Face Billboard
Square Footage:7.5 Total Height above Grade: 17'
Vertical Dimension ol sign or enctosure I8 tt Horizontal Width of sign or enctosure
_ Roof
_ Ottrer -_
Marquee
Dimension from Grade
to bottom of Sign Enclosure:
Electrical lnstallation: X Yes No VALUE
(lf yes a<Jditional electricaffirmit is requiredl OF StGN15.51 $1094 .00
Material Sign is constructed of: plastic & sheetmetal
List ALL existirrg sigrrage and attach a photograph of each sign
(al Type
(c, Type
Sq. Ftg.
Sq. Ftg.
(bl rype
(d) Type
Sq. Ftg
Sq. Ftg
CONTRACTOR/INSTALLER: PAY-O-LITE SIGNS INC.
ADDRESS: 101 N. Seneca
CITY Eusene
CONSTRUCTION CONTRACTORS BEGISTRATION NUMBER
CITY BUSINESS LICENSE NUMBER: q4 oi 7 q
STATE: OR ztP: 97 402
7 t490 EXPIRES:
EXPIRES:
2-t-95
6-i o-q s
OFFICE USE
Sigrr District:
Code Section:
Approved
Ouad Area
Zorring
Sign Permit Fee
@
DATE:\\
REOUIRED INSPECTIONS
_ Site
to be made prior
to sign placement
Footing
prior to placement
of concrete
Attachmcnt
after fasteners are
installed/prior to cover
Electrical
prior to energizing
electrical installation
_ Final
completion of sign
installation
Additional Comrnents and/or Conditions:
By signature, I state and agree. that I have carefully examined the cornpleted application and do herelly certify that all irrlorrnatiorr hcrcirr
is true artd correct, and I further certily that any and all work performed shall be done in accordarrr:e with the Ordinarrces of tho City ot
Springfield, and the Laws of the State ol Oregon pertaining to the work described herein. I further certify that only contractors and
ernployees who are in compliance with ORS 701.055 will be used on this project.
I f urther agree to ensure that all required inspections are requested at the proper time. that proiect address is readable f rorn tlre strect, tltat
the permit card
of the sign(sl.
is located at the Iront ol property, and the approved set of plans will remain on the site at all times during the irrstallatiorr
Date 9-9-94Signature
Amount Received
Receipt Number:
Date Paid: 2*2 >Validation:
/%
4*
Received By
2*/
t
PHONE: 68R-2500
Land Use: 5m 5CN(
\\
SIGN PERMIT APPLICATION
225 Fifttr Strcet
Sprirrgfield, OR 97 477
1616 N.30rh
SPNIN(}':IELr)
qt,
JOB Nt'N/8[tl
-.' lspeCliOn a 3
Of{ice: 726 3759
SITE ADDNESS
ASSESSORS MAP:
field OP
TAX LOT
OWNER Eugene Farmerts Co -oD P}IONE:688-8210
2-690 Prairie RoadADDRESS
CITY:Euqene STATE: OR ZtP: q7 40?
BUSINESS NAME, FINM ETC Eugene !'armerrs C o-op
DESCRIPTION OF PROPOSED SIGN(Sl: (please check and complete all appropriate information)
X Wall __ Freestanding _ Projecting(set of.3 Pan Channel letters)X Single Face _ Double Face Billboard
_ Hoof _ Marquee
_ Other
Total Height above Grade t7'
Horizontal Width of sign or enclosure 5t
Squarc Footage:7 .5',
Vertical Dimension ol sign or enclosure
Dirncnsion from Grade
to bottom ol Sign Errclosure:15.5'
l8tt
Electrical lnstallation: X Yes _ No VALUE
(lf yes additional electrical permit is requiredl OF SIGN $1094.00
Material Sign is constructed of olastic & stee tal
List ALL existing sigrrage and attach a photograph of each sign:
(a) Type
(c) Type
Sq. Ftg.
Sq. Ftg.
(bl Type
(d) Type
Sq. Ftg
Sq. Ftg
CONTSACTOR/TNSTALLER: P,AY-O-LIt. SIGNS, INC.PIIONE: 68 8 -2 5 00
ADDRESS: 101 N. Seneca
CITY:Eugene
CONSTRUCTION CONTBACTORS REGISTRATION NUMBER:
CITY BUSINESS LICENSE NUMBER: 94037 9
STATE: OR Ztp: 97402
7 L490 EXPIRES:
EXPIRES:6-3 0-95
OFFICE USE
Sigrr District
Zorring
Sign Permit Fee
Land Use:Ouad Area
r\oae
Code Section
Approved By:DATE
REOUIRED INSPECTIONS
---- Site
to be made prior
to sign placement
Footing
prior to placement
of concrete
Attachment
after fasteners are
installed/prior to cover
Electrical
prior to energizing
electrical installation
Final
completion ol sigrr
installation
Additional Comments andior Conditions
By signature. lstate and agree, that lhave carelully examined the cornpleted application and do hercby certify that all irrforrrratirlrr trcrcin
is true and correct, arrd lfurther certity that any and all work performed shall be done in accordanr;e with the Ordinarrces of the City of
Springfield, and the Laws of the State of Oregon pertaining to the work described herein. I further certify that only contraclors and
employees who are in compliance with ORS 701.055 will be used on this proiect.
I f urtlrer agree to ensure that all required inspections are requested at the proper time, that proiect aclrJress is readablc f rorn tlre slrect, that
the permi t card is located at the front of the property, and the approved set of plans will remaln on the site at all times during the irrstallation
ol the sign(s)
Signature Date 9-9-94
Date Paid:Z:*-Amount Received
Heceipt Number:v-Validation 4J
Received By
?-t -q5
3CNC
72)e---
SIGN PERMIT APPLICATION
225 Filltr Srreet
Sprinof ield, OR 97 477
JOB NrrMBrtl_Q-e?_ _A _
,,slil,s) I)?*,.,
Otfice: 726 3759
SPNINGFIELr)
h,
SITE ADDRESS
ASSESSONS M
6 Ii 30th l-n field OP
AP
OWNEB: Eugene Farmerts Co_o p
TAX LOT
pHoNE: 688-8210
ADDRESS: 26
CITY
r
Eugene STATE: OR ZtP: 97 402
BUSINESS NAME, FIRM ETC.
DESCRIPTION oF PROPOSED slcN(s): (please check and complete all appropriate information)
x Wall
(set of 3v Sinole F+
__ Freestanding
Square Footage:7.5 Total Height above Grade: 17'. '
Vertical Dimension of sign or enclosure: lg "Horizontal Width of sign or enclosure: 5 t
Dirncnsion lrom Grade
to bottom of Sign Enclosure: 15. 5 t
Pan Channel letters)ace Double Face'
Projecting
Billboard
_- Roof
Other --
Marquee
Material Sign is constructed of: plastic
Electrical lnstallation: X yes -- No Vn LUE(ll yes additional electrical permit is ierlriredl OF StGN:
& sheetmetal
$1094.00
List ALL existing signage and attach a photograph of each sign:
(al Type
(cl Type
Sq. Ftg
Sq. Ftg
(bl Type
(dl Type
Sq. Ftg
Sq. Ftg
CONTBACTOR/1NSTALLER. RAY-O-LITE SIGNS, IliC.
ADDRESS
pHONE: 68R-2500
101 ttt. S eneca
CITY Eugene
CONSTNUCTION CONTRACTORS REGISTRATION NUMBER 7 1490
CITY BUSINESS LICENSE NUMBER:qltn17 9
STATE: OP Ztp: 97 402
EXPINES
EXPINES
2-t-95
5-i 0-
OFFICE USE
Sign District:
Zoning:
Sign Permit Fee:
Land Use 5 Ouad Area
t e Code Section:
Approv DATE:
REOUIRED INSPECTIONS
___ Site
to be made prior
to sign placement
Footing
prior to placement
of concrete
Attachrnerrt
after fasteners are
installed/prior to cover
Electrical
prior to energizirrg
electrical installation --
Firral
completion of sigrn
installal ion
Additional Comments and/or Conditions
By signature, I state and agree, that I have carefully examined the completed application arrd do lrcrt--lty certify that all irrlorrnation hcreirr
is truc arrd correct, arrd llurther certify that any and all work perlormed shall be done in accordarrce with the Ordinarrccs of tlrc City of
Springfield, and the Laws of the State ol Oregon pertaining to the work described lrerein. llurttrer certify that only contraclors an(,
employees who are in compliance with ORS 701.055 will be used on this proiect.
lfurther agree to ensure that all required inspections are requested at the proper time, that project address is rcadablc frorn tlre slrc(rt, that
the permit card is located at the front ol the property, and the approved set of plans will remain on the site at all times during the installatiorr
of the sign(s
Signature Date e-9-94
Amount Beceived: lb Date Paid: a '2-t a </
4z
Validation:
Receipt Number
&
Received By:v'
I'a rmpr I o Cn-on
SIGN PERMIT APPLICATION
225 Fifttr Strcet
Springfield, OR 97 477
1616 rv.30rh
JoB NUM,E,, qt\b\!teST'TI]NGFIELD
Zfi,
,nspt:ction Line: 726,3769
SITE ADDNESS
ASSESSOT]S MAP:
S rl-field 0R
OWNER: Eugene Farmerrs Co -oD
TAX LOT
PHONE: 688-821o
ADDRESS: 2690 Prairie Road
CITY Eugene, 0R.STATE: OP ZtP: 97 402
BUSINESS NAME, FIRM ETC.: Eusene I'armer t s Co-on
DESCRIPTION OF PROPOSED SIGN(Sl: (please check and complete all appropriate information)
Dirnerrsiorr from Grade (15 t 0va1 & Electrical lnstallation: X yes -_-- No
to bottorn of Sign Ertclosure: 8 | reader) (ll yes additional electrical permit is requiredl
_ Roof _ Marquee
_ Other
VALUE
OF SIGN:S5- 650 (Cwa1 & render
-
Wall
-X
Freestanding
-_
Single Face X Double Face
_ Projecting
_ Billboard
Square Footage: 80.5 (32.5 0va1_& 48 readerboardiotat Height above Grade (.?-Ot Oval & 14' readerboard)
Vertical Dimension of sign or enclosure: (5 t Oval & 6' readeq)e1;2ontal Width of sign or enclosure (6' Gval & 8' Readerboard)
)
Material Sign is constructed ol: plastie & iheetmeta'l
List ALL existing sigrrage and attach a photograph of each sign: NONE
(a) Type
(cl rype
Sq. Ftg.
Sq. Ftg.
(bl rype
(dl Type
Sq. Ftg
Sq. Ftg
CONTRACTOR/INSTALLER: RAY-O-LITE STGNS. flIC PHONE: 683-2500
ADDRESS:1nl NI Qan ?A
CITY Eugene
CONSTRUCTION CONTRACTORS REGISTBATION NUMBEB
CITY BUSINESS LICENSE NUMBER: 94037 9
STATE: OR ZtP: 97402
7 t490 EXPIRES:
EXPIRES:6-3 0-95
OFFICE USE
Code Section:
Approved
Ouad Area
Zoning
Sign Permit Fee:DATE:
REOUIRED INSPECTIONS:
-_- Site
to be made prior
to sign placement
Footing
prior to placement
of concrete
Attachrnent
after fasteners are
installed/prior to cover
Electrical
prior to energizing
electrical installatiorl
__ Final
conrpletion of sign
installation
Additional Comments andior Conditions:
By signature, I state and agree, that I have carefully examined the completed application and do herc.lly certify that all irrlorrnatiorr hr:reirr
is true arrd correct. arrd I further certify that any and all work performed shall be dorre in accordance with the Ordirrances of thc City of
Springlield, and the Laws of the State of Oregon pertaining to the work described herein. I lurther certify that only contractors and
employees who are in compliance with ORS 701.055 will be used on this project.
I f urther agree to ensure tlrat all required inspections are requested at the proper time. that proiect address is readatrle lrorn tlle strcct, llrat
the permit card
of the sign(sl.
Signature
is located at the front of property, and the approved set of plans will remain on the site at all times during the installation
Date 9-9-94
Amount Received
Receipt Number:
Date Paid: €2>9 7fu-Validation ?-,'+
Beceived By:7
Sign District:_ Land Use:
crcel not
225 FIFTH STREET
SPRINGFIELD, OREGON 9
INSPECTTON REQTIEST:
OFFICE: 726-3759 /i',i.ir,..,iiieC
1. TOCATION OF INSTALI,ATTON
I,EGAL DESCRIPTION
JOB DESCRIPTION
Connee t to ex{ cti ng Cf rcuits
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CO}TTRACIOR INSTALI.,ATION ONLY
E1e ctrical Contractor RAY-O-LITE SIGNS
Address 101 N.S e,n e-ca
City Eugene
l,
Phone 688-2 500
Supervisor License Number 291SIG
Exp iration Date 1-1 -96
Constr Contr. Number 71490
Expiration Date 2-l-95
si ture of Electrician
0vners ene I'armerrs Co
Address 2690 iri e Rad
Ci ty Eugene Phone 688-8210
OIiNER INSTALLATION
The instal-lation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
Ormers Signature:
DATE:
?tii:xs:3#iJ#fi,jcv,ine
B. Services or Feeders
Installation, Alterations
INC. or Relocation:
200 amps or less
201 amps to 400 amPs _
401- amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
ETECTRTCAL PERHIT APPLICATION
City Job
FEE SCffiDUIJ BELOII
Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:ftems Cost
1000 sq.ft. or fess S 85.00
nach additional 500
sq. ft or portion
thereof S 15.00
Each Marruf 'd Home or
-Modular Dvelling
Service or Feeder $ 40.00
SPllIircFIELD
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
Z.-'.r:r:i.. *iiLJ
Sum
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
00
00
00
00
C.
D
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or less $ 40.00
over 401 to 600 amps
-
$ 80.00
Over 600 amps or 10OO vofts see rrB'r a6F
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit S 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Outline Lighting z
Limited EnergY/Res
Limited EnergY/Comm
$
$
$
$
40
40
20
36
8o. oo
5 80. 00
4 .00-*lt-
RECEIVED
225 gl,frg S1TBBT !
SPRTNGPTELD, OREGoN 97477
INSPBCTION REQUEST:. 726-3769
OPEICB: 726-3759
1 LOCATTON OP ON
I.EGAL DESCRIPTION/^ ^-7z'< 6/?aS
JOB DESCRIPTION
Permits are non-transferable and expire
if vork ls not started vithln 180 days
of lssuance or lf vork is suspended for
180 days.,
2. CONISACTOR INSTALI.ATION ONI.Y
E1ectrlcal Contractor R0SE C0RP
Address 8997 DAY LANE
Cl ty FIIGFI{L
Supervisor Llcense Number I 5GBS
Exp iration Date 1 9
Thr rollowlng proloct as eubmlttaC hes the
,. .i, and-dbee not require epe':iii( ie":m
zontno- W -
ELE TRTCAL PERHIT APPLTCATION
, Y'11 '1+City Job Nurbur ?/aZ/Z
.,. .. h, iiiftrd slsnaru re;].[Jp!!%!f E .IgE "-SSEEDULE BE LOV
Nev Residential-Sing1e or
HuIti-Family per dvelling unit.
Service Included:
I tems Cos t
SPRI'\lCFIELO
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home or ]-
Hodular DvelIing
Servlce or Feeder
B. Services or Feeders
InstaIIation, Alterations
or Relocation:
r ral.
A
Sum
Constr Contr. Number 54431
Explratlon Date g/90/gS
Slgnature o sing Electrician
own e rs w^^" .€tZ, #E fuxlf= 6
"rr'?ufr1ffi.dYea*€zra
OUNER INSTALIATION
The.lnstallatioit is beidg made on
property f oun vhlch is not intended
for sale, lease or rent.
Ovners Slgnature:
DATts:
$300.00
s 40.00
c.
D. Branch Circuits6?' Nev, Alteration or Extension Per Panel
Temporary Services or Feeders
Installation, Alteratlon or Relocation
200 amps or less S 40.00
201 amps to 400 amps
-
S 55.00
over 401 to 600 amps
-
$ 80.00
0ver 600 amps or 1000 voTts see rrgrr "[ffi-
200 amps or less
201 amps to 400 amps -E
401 amps to 600 amps
601 amps to 1000 amps-
Over 1000 amps/volts
-Reconnect 0nly
-Each installation
Punrp or irrigation $Sign/Outline Lighting- SLimited Energy/Res
-
S
Llmi ted Energy/Comm $
as s0.00
s 60.00
s100.00
s130.00
$ 8s.00
$ 1s.00
$ 40.00
1
ai
One Circuit S 35.00
Each Additional
Circuit or with Service
or Feeder Permit _".2 g 2.00 fA
E. Hiscellaneous (Service/feeder not included)
00
00
00
00
40
40
20
36
STIBTOTAL OP ABOI'E
5Z State SurchargerorAl fvTo
RECETVED
5 A^L
Aaar"="
Phone nga-0q0q
t
CO M M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATTON
225 Fitlh Street, Springfield, Oregon gl4Tl
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
SPRINGFlELD
JoB NUMBER 7/d7/Z
INSPECTTON LtNE: 726-3769
OFFICE: 726-3259
d
TAX LOT
PHoNE: /eG, -F-2/a
CITY:
ZIP:STATE:
OWNER:
ADDRESS:
I
NEW
-
REMODEL ADDITION DEMOLISH OTHER VALUE:
DESCRIPTION OF WOBK
NAME ADORESS PHONE
ADDRESS EXPIRES PHONE
ELECTRICAL:
CONTRACTOR'S NAME
ARCHITECT:
GENERAL:
MECHANICAL:
PLUM BI NG:
CONST.
CONTRACTOR #
NO FEE CHARGE
Single Fixture
Relocated Bldg.
(new f ix. addtl)
Water Service
ft.
Sanitary Sewer
ft
Storm Sewer
ft
Backf low Device
TOTAL PERMIT
NN FFF CHA FIGtr
I Furnace/burner & vent
<100,000 BTUs ,a <rzJ
IE
Furnace/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 7-
Vent
from
System apart
AC or htg.
Mechanical exhaus[
hood and duct
Permit lssuance $10.00
TOTAL PERMIT ,/4lg e-/.;
- OFFICE USE -
LAND USE
HANDICAP ACCESS
FLOOD PLAIN
LIGHTING POWER BUDGET:
WATER HEATER:
r OF UNITS:
OCCY GROUP:
S OF STORIES:
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
SO. FT.$/so. FT.VALUE
TOTAL VALUE OF PROJ
X
X
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
RCPT#PLAN CHECK FEE DATE BY
BUILDING PERMIT PLUMBI NG DEMOLITION
5% State
Surcharqe
5% State
Surcharoe
M u"'oYAgL"/A_-e'/+ d{FENCE
VALUE $
5% Stale
Su rcharoe
lf*3 -3rE SIDEWALK
FT.
SUBTOTAL
PEBMITS
PAVING CU RBCUT
FT.
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL Z4-26
ZONING:
REOUIRED INSPECTIONS
It is the responsiblllty of the permit holder to see that all lnspectlons are made at the proper time' To request an inspection' call
726-376g(recorder), state your city designat"Jioo nr.oer, rob address, type of inspection requested and when you will be ready
for inspection. Requests ieceived before 7:oo a.m. will be made the same working day, requests made after 7:00 a'm' will be made
the following work daY.
slTE INSPECTIoN: To be - u
19].91.P^L^YMBING', PAVING: After sravel is in
made after excavation, but ELECTRICAL & place but prior to placing
prior to setup of forms. fvf-gtHllf f CAL: No work is to asphalt or concrete'
be covered untll these
UNDERSLAB PLUMBING, ,";pectlons have been made sPEclAL lNsPEcTloNS: ln accordance
ELECTRICAL & andipbroveo. Section 306 of the State Specialty Code
MECHANICAL: TO be made ^.-,.. .roor, " special inspector shall be employed
berore "ny
*oit i" covered. tl,tJ?^',fttiJ,-sroPs
&
Sljl?,:Jl:'ii,?:'!X:l;;,0"U'$3,n. o
copY of the special testing reports shall
FOOTINGS & FOUNDATIONS: FIREpLACE: Prior to placing be f urnished to the Building Division.
To be made after trenches are i""ing ,.t"rials and before
excavated and forms are framing lnspectlon. STRUCTURAL CONCRETE: ln
erected, all steel in place, but excess of 2500 P.S.l. (306 a'1)
Prior to Placlng concrete'
CONCRETE SLI\B: To be
made after all inslab buildlng
service equiPment, conduit'
PiPing, accessories and other
ancillarY equiPment items are
ln Place but before anY
concrete ls Placed'
UNDERGROUN D: Plumbing'
electrical, gas, sanitary sewer,
storm sewer, water and
dralnage llnes. To be made
Prlor to covering or filling
trenches.
UNDERFLOOR: Plumbing'.
electrical, mechanical' To be
made Prior to installation of
floor insulatlon, decklng or
floor sheathing'
POST & BEAM: To be made
Prlor to lnstallatlon of floor
insulation, decklng or floor
sheathlng.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made Prlor to lnstallation of
decking or floor sheathlng'
MASONRY Steel location,
bond beams groutlng or
vertlcals ln accordance wlth
UBC 2415.
ROOF SHEATHING AND
NAILING: Prior to lnstalllng
any roof coverlng.
FRAMING: To be made after
the roof' all framlng, fire
blocking and bracing are in
Place and all PiPes,.chimneYS
and vents are complete and
the rough electrical, Plumbing
and meLhanical are aPProved'
INSULATION & VAPOR
BARRIER: To be made after all
insulation and required vaPor
barrlers are ln Place but
before anY lath or gypsum
board lnterior wall coverlng is
aPPlied.
FIRE & SEPARATION WALL:
Located and constructed
according to Plans'
LATH AND'OR GYPSUM
BOARD: To be made after all
lathlng and gypsum board'
interlor and exterlor, ls in
Place but before anY
|rlasterlng ls aPPlled or before
gypsum board Jolnts and
fasteners are taPed and
f inlshed.
STDEWALK & DRIVEWAY:
Required ior all concrete
Paving within 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 Prior to Placing
concrete.
STRUCTURAL WELDS:
Performed on the iob' (2722 l)
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening oPerations' (306
a.6)
SPRAYED ON
FIREPROOFING: U'BC.
Standards 43-8.
SPECIAL GRADING,
EXCAVAT]ON AND FlLLING:
During earthwork' (306 a'11 &
Chapter 29)
GLU.LAM BEAMS: lnsPection
Certificate bY an aPProved
agency, furnished to the City's
Bullding Division before
beams are Placed. (2501 U'BC'
srDS. 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
constructlon work to ensure
compliance with the Building,
Clty or Development Code.
FINAL PLUMBING
FINAL ELECTRICAL
f FINAL MEcHANTcAL
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
landscaplng, parklng lot striping, etc. must be completed before
requestlng thls lnsPection.
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
Certlflcate of Occupancy has been issued by the Bullding Dlvislon
and posted on the premises.
ADDITIONAL COMMENTS:
*PLANS REVIEWED BY DATE
By slgnature, I state and agree, that I have carefully examlned the completed applicatlon and do hereby certlfy that all information
herein ls true and correct, and lfurther certify that any and all work performed shall be done in accordance with the Ordinances
of the City of Sprlngfield, and the Laws of the State of Oregon pertalnlng to the work described herein, and that NO OCCUPANCY
will be made of any structure wlthout permlssion of the Bulldlng Safety Dlvlslon. I further certify that only contractors and employees
who are in compllance with ORS 701.055 will be used on this project.
I further agree to ensure that all requlred inspections are requested at the proper time, that project address ls readable from the
street, that the permlt card ls located at the front of the property, and the approved set of plans will remaln on the site at all
Signature Date
lontimes durlng
VALIDATION */L/2-8q/?=AMOUNT RECEIVED:
RECEIPT *:RECEIVED BY:
DATE PAID:
q+
(,
\l
SPRIII|GFIELE'
225 FIFTE STREET
zoning, and does not require epeclfic land u8€
apProvsl.
tl EI,ESTR.ICAL PERUIT APPLICATION
ty Job Nunber
3. COHPLETE FEE SCMDIITE BELOIJ
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
L000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or- Modular DveJ.ling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
200 amps or
201 amps
40L amps
601 amps
c
40.00
55.00
80.00
ii$[[Il3il*3ffi33\o2ffii*P1,t'( ci
OFFICE: 726-3759 Authorized siignatutc n nA
1 LOCA
i
TION OFlat(, I
INSTALLATTON...,\ nAfv- A;f
Permi ts are on-transferable and exPir
if vork is not started vithin 180 days
of issuance or if vork is suspended fo
1B0 days.
CONTRACTOR INSTALI,,ATION ONLY
EIec t cal Contractor
Address
Ci ty
Supervisor Lice r
Expiration Date
Constr Contr.
Expiratio
Addres
Ci ty
OIINER IN
The installation is being made on
property I ovn which is not intended
for sa1e, lease or rent.
s
Over 1000 amps/vo1ts
Reconnect 0n1y
Temporary Services or Feeders
Installation, Alteration or Relocation
2oo amps or less -1-201 amps to 400 amps -
0ver 401 to 600 amps
Over 600 amps or 1000 vol-[
l_
4
6
1
to
to
to
$ s0.00
s 60.00
s1o0.0o
$130.00
s300. 00
s 40.00
amps
ess
00
00
000
amps _amps_
Sum
ee rrBrr aEove
$
$
$
SS
Ii D. Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0ut1ine Ligh t ing-
Limited Energy/Res
E
5
$ 40.00
$ 40.00
$ 20.00
s 36.00
CITY OF SPR OFEGOTV
Phone
Num
of Supervising Electri
ber
te
RECETVED
o
qr5
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
?/ ovlz
cITY 0F >r'RINGFIELD sysTEHS DEVEL0pmEt{T cltAIrGE
,,0,,,0H?l[t#5[1,, n..,
(r-NAl.rt 0R c0t'tPAt,tY:
L0CATI0l{: /6/b N.n ,4
DEVELOPI.ITNI TYPE:
BUILDING SIZE:oT siz
I. STORI'I DRAII{AGE
Il'lPERvloUs sQ. FT. f,lo6 x 50.203 prR sQ. FT.
SANITARY SEWER-CITY
F sQ. Fr
2
3
NO. OF PFU'S
(See Reverse)
g X $42.08 PER PFU
TRANSPORTAT IO''|.
NO OF UNITS X TRIP RATT X COST PER TRIP
X ]5,75 x s424.3i
x s424.31
x s424.31
x
x
4. SANITARY SEK'ER-I,iI{I.1C
N0.0F PFU'S 8 x $l5.l25 pER pFU + StO HHI4C ADl,t FEE(Use PFU Total-From-lG 2 Above)
HI\'I4C CREDTT rF AppLTCABLE (SEE REVERSE)
TOTAL.Hh'HC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
5. ADI'iINISTRATIVE FEES
BASE RGE BT L ABoVE) X .os
6-
s
s
I oo
3/2, A I
ToTAL SDC S gS2z.l9
3s6.6
6 e82.78
Coordi n or
a
I l/\a valq v,.r..
For rerrrcr.{cis. c:rlctriS!e grrly tlrc l{E{ ;rtl.lilitrrrlrl lir.lrrrl'1')
F]XTUNE N'PE
Brtlrlub.......
Drinking Fcrtttr!.rirt......
g;e91 prain.
lnl etceptors For Grease/Oil/Solids/Etc........'........
lnl erceplors For Sand//.ut o \t'a strr/El c'..-.'............
La undry Tub/Ootlresrva shcr.......
Clothest'aqher - 3 Or l'4ore.....
llobile Hdnie Park frap (1 Per Traiter).......' Recep!or F6r RekigeraloiAVater Station/Etc........
Beceptor For Commerclal S ink/D ishrt'a sher/Etc..
Shorver, Single'Statl
Shower. Gang......-......'..-.
' Urinal, StallnYall.......-..-
Wash Baiin/Lavatory, Single.---....--........;-.........-....
\t,ater Close! Public lnstallation.
t{[rt.166,, L]l:
t,lE\i' t:t.\l uiiE 5
I
TOT/..L FI}3'UAE Ui{ITS
L'i{lr
l:OLri\'/'.1 [ I JT
I
')
3
6)
6
6
2
2
1
6
1
3
2
t
r Ii:T UNE
U: JI TS
Z
7
/Head
I ---4
Il'/ater Closet, Prh'al e..........i...-..-.-..--...
l,{iscellaneous: o" /uA-'R f EPAPATaR
cREDIT CALCULA,TION TABLE: BaseJ on assessed value. lf improvemenis occurred afier annexation date in t-a'ble,
cajculatb cred::s es.
C{edit for Parcd or tand Only tf Applicable
lmprovement (rf after annexation date)
xs 7/.2to -3/2,d/
(Rate X Assessed Value)xs
(Rate X Assessed Value)
CREDIT TOTAL = $3/2,4
3,2/
Year
Annexed
Eate per 51,O0O
Assessaj Vaiue
Year
Annexed
Fale per 51.O0O
AssesseJ Value
1995
1 937
1993
19e3
,ro]1
r93I
.r oo2
s 2.?1
1.93
1.57
1.18
0.79
0.44
0.28
1979 or before
1g3C
1 931
1932
1993
1934'1S5
s3.21
3.13
3.09
2.$
2.82
2.6S
2.51
RUNOFF COEFFICTENTS FOR STOBTT'l DBAINAGE
IhIPERVIOUS AREA = TOTAL LOT SIZE X RUI{OFF COEFFICIENT
I
II