HomeMy WebLinkAboutPermit Building 1996-02-13CITY OF SPruNGFIELD,
SPFI]t.GFIELD
COMMERC IAI./ IIIDUSTRIAI, PERMI T APP IJI CAT I ON
CITY OF SPRINGFIELD
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
age 1
Job Nurnber: 96L477
225 North Fifth Street
Springfield, OR 97477
Locatsion of Proposed Work: 267 39TH ST 1-18
Assessors Map #: 170231-4L
Office:
Inspection Line:
726 -3759
726 -37 69
Tax Lot #: 011-00
Owner: RGR DEVELOPMENT INC
Address: PO BOX 193
Description Of Work: FND FOR 18 UNIT APT
Phone #: 998-3632
ciry/stare/zip: ELMIRA, OREGON 97437
NEW Value 3, 000.00
Generaf:
ContracUor
RGR DEVELOPMENT 0041,282
95239 Oaklea Dr .function City OR 97
Const.
Contractsor #Expiree
08 /2s / e6
Phone
998-3632
--- PLUIIBING ---
No.
L62
Fee Charge
1, 620 . 00
40.00
100.00
10.00
1,770 .00
Single Fixture
Sanitary Sewer
Water Service
BACKFLOW DEVTCE
TOTAL PERMIT
L20
546
ft
fr
No
--- DIECHAIITCAT, ---
Furnace/burner & vent < L000,000 BTUs
Mechanical exhaust hood and duct
Vent, Fan/Single Duct
Permit Issuance
TOTAL PERMIT
Fee Charge
108.00
81.00
r_08.00
10.00
351.00
36
HANDICAP ACCESS: Y
# OF BLDGS: 3
-- OFFICE USE --
QUAD AREA: 3RNW
# OF UNTTS: 18
LAND USE: 1134
ZONING CODE: HDR
Item
Sq. Ftg Main
TOTAL VAIJUE OF PROiIECT
Square Feet
]-5734
x $/Sguare Feet Vafue
500, 000 . 00
500, 000 . 00
Plan Check Fee:1-91-.75 Rec #: 23644 Date: LO/29/96 Rec By: LORNE PLEGER
BUILDING
Surcharge/admin
t,483
118
00
54
SPFI]t.GFIELD
h,
Job Number: 96L477 Page 2
MECHANICAL
surcharge/edmin
PAVING VALUE
PLT]MBING
Surcharge/edmin
SIDEWALK
CI'RBCUT
ELECTRICAL PERMIT FE
WILLAMALANE SDC
SUBTOTAL PERMITS
SYSTEMS DEVELOPMENT
TOTAL PERMIT FEES EXEI,I'DING ELECTRICAL
25 ,792 . OO
361.00
28.08
175.00
L,77O.OO
141.60
16.30
r.5.30
1, 858.40
L2 , 456 .00
t6,/95, ira
/u?a2,?1
L8 , 434 .32
Wn
k7t>*nEz?
E0 r 521 .9^ ,
7//?/?.e
--- REQUIRED INSPECTIONS ---
It is the responsibility of the permit hol-der to see that all inspections are
made at the proper time. To request, an inspection, cal-l 725-3759
(recorder), state your City designated job number, job address, type of
inspection requested and when you wilL be ready for inspection. RequesLs
received before 7:00 a.m. will be made the same working day, reguests made after
7:00 a.m will be made the following work day.
Special Inspections: In accordance wiEh Section 306 of the State Specialty Code
a special inspector shafL be employed by the owner/Contractor during
construction of any following "*rr work. A copy of the special testing reports
shall be furnished to Building Safety.
In addition to the inspections specified, the Building official may make or
reguire other inspections of any construction work to ensure compliance with
Lhe Building, CiEy or Development Code.
FOOTING - After Erenches are excavated.
SLAB - To be made after all inslab building service eguipmenL, conduit
pipj-ng, and other eguipment items are j-n place but prior to concrete
WATER LINE - Prior to filling trench.
SAIiIITARY SEWER LINE - Prior to filling trench.
STOR!{ SEWER LINE - Prj-or to filling trench.
I,NDERGROI,ND EI.ECTRICAI. - PriOT TO COVET.
ROUGH PLITMBING - Prior to cover.
ROUGH MECEAI{ICAL - Prior to cover.
ROUGH ELECTRICAL - Prior to cover.
ELECTRICAL SERVICE - Must be approved to obtain permanent power.
FR.NIING - Prior to cover.
INSULATION - Floor,' prior to decking wa11/Ceil-ing; Prior to cover
VAPOR BARRIER/INSULATION - To be made after insulation and required
vapor barriers are in p1ace, but prior to any wall covering.
DRYIIIALL - Prior to taping.
ROUGH GRADING - After gravel is in place but prior to placing concrete
FINAL PAVING - After paving is complete.
FINAL PTITMBING - when all plumbing work is complete.
FINAL IIECIIANfCAL - When a]I mechanical work is complete.
FfNAL ELECTRfCAL - When all electrical work is compleEe.
ffNAL FIRE - When all Fj-re Department requirements have been met.
been meE.
CURBCIIr - After forms are erected but prior to placement of concrete.
SIDEWALK - After excavation is complete, forms and sub-base material
in p1ace.
SPF!NGF!ELD
ilob Number: 96L477
SPilNGFIETD,OF
Page 3
FINAL SITE PLAI'I - After aII reguirements have been met for Minimum
Development Standards or from the DevelopmenE Agreement.
FINAL BUILDING - When all reguired inspecEions have been approwed and
the building is comPlete.
.-- ADDITIONAI. COMMENTS ---
SITE PLAN REVIEW JOURNAL NT]MBER 95-08-155, 'JILIA }ADJUK
SECOND PLAN CHECK FEE OF $953.95 PArD L-3-97
Plans Reviewed By: LORNE PLEGER
Building Site Reviewed By: LISA HOPPER
Date: oL/3t/97
By signature, I state and agree, that I have carefully examined the completed
application and do hereby certify that all- information hereon is true and
correct, and I further cerEify that any and all work performed shall be done
in accordance with Ehe Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described herein, and that
NO OCCUPANCY wifl be made of any structure without permission of the
Community Services Division, Building Safety. I further certify that only
contracLors and employees who are in comptiance wiLh ORs 701.055 will be
used on this project.
I further agree to ensure that atl reguired inspections are requesEed at the
proper time, that project address is readable from the street, Ehat the
permit card is located at the fron! of the property, and the approved set
of plans wilL remain on the site at all times during construcLion.
J-/3-?r
si ture DaLe
..- VALIDATION ---
ReceipE Number:
Date Paid:
2r'977
2
Amount Received 2
Received By:,4-r:->-,7/-
CITY OF SPilNGFIELT',
SPRINGFIELD
,Job Number: 96A47'7A Page 2
FIXTURE I'NIT CALCULATION TABLE
Number of
New Fixture
Unit
Equivalent
Fixture
UnitsFixture Type
Bathtub
Drinking Fountain
Fl-oor Drain
Interceptors For Grease/oi1/Solids/etc
Inteceptors For Sand/Auto Wash/Etc
Laundry tub/CLotheswasher
Clotheswasher - 3 Or More
Receptor For Refrigerator/water Station/etc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial, Residential Kitchen
Urinal, Stall/Wall
Wash Basin/LavaLory, Single
Water Closet, Public Installation
water CLoset, Private
Miscellaneous
18
0
18
0
35
0
35
0
36
0
36
0
L44
0
z
1
2
3
A
2
5
1
3
2
2
1
6
4
18
0
0
0
0
18
0
0
0
35
0
0
0
0
36
0
0
0
36
0
TOTAL FIXTURE UNITS =324
CREDIT CALCTLATION TABLE: Based on assessed value. If improvements occured
after dnnexation date, credits are calculated separately
(calculations are by $1000)
Year Annexed: 1969
Credit For Parcel Or Land OnIy If Applicable: 65,780 X 3.47 = 228.26
Improvement (if after annexation date): 0 X 3.47 = 0.00
CREDIT TOTAL = $i229.2G
(If land value is multiplied by 1- then the parcel/Iand credit is not accurate.)
PLAN CHECK F e@--RCPT#DATE BY
BUILDING PERMIT 3*-5o PLUMBING DEMOLITION
5% State
Surcharge /72 5% State
Su rcharqe
MECHANICAL FENCE
VALUE $
5% State
Su rcharqe
SIDEWALK
FT.
SUBTOTAL
PERMITS
PAVING CURBCUT
T t-
SYSTEMS
DEVELOPM ENT
q/,5?TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
..\. r-- i^t'L-97 (f8:.47A, rvlortaer Engirreering < =o,t ) 4=,4 - 6a'e
ri{qJRTIER
IlNGINEERING, P.C.
PO. BCX 139. 1245 PEARL STHEET
STRUCTURAL
BUILDING t)[3lCr-i o i li]L i:.i;i". ii--,i-,.;r"r
CODE CONSULTANT. PI,4N r*r iEr,'.j-,r..: -jr:r)NqTRUCTtOtrl I NtS pEC.T rON
l:l lri!f,lg r1Qtrl:nN a'/idn
Frlaiiil- t5! l, ac{-grau - r^x [5.tt, {6{-o6Jo
Harc:tr 11 , 1997
::Bsiign Studio
151 W- ?th, Suite 42O
?iugene, oR 97401
RE: 267 l.l. *39th. Sprinqfjeld
Llre {a[Ja f't.mhJfl l.L997. Durlnq
The roof sheathlng congigted of a 5/8 cDX prywood with Bd ring
sharrl< naile at 4t! on center panel edges and about 6tt on c$ntc=:.field. Approxlmately LOt of the faetenera -i{ere over*dr.i-veii.Thig roof dlaphraqrnr system is adeguate to rasist. air i1npc..;1;"lloads per the Oregon State Structural Specialty code asaclopted by the Clty of Springfield (see attached copy of AFA,*over-driven nail lnformation sheet),
T hope thls report
fhank you very much.
ie adeguate for your purpoaes at this time.
11,
l1
Owen Grover, P.E.
aIfi/Ye
dsgn3sth
milfl ..,I
,l
IJJ-.-'
EXPIfiES:6-30-
7z
Poat-lt'. brand lax transmiltal rnemo 7571 * oi pegeu r
{{-
1
I
- w. o. #9398-BRtrt
49 yQu requcEted, I grer furrlreu alt irrsPr=r-Licrrr aL
complexee on 39th St. in Sprinqfield on Dtarch ZB,that inepectlon I made the following observatlons:
k
hq'ffi t4glJoW 4rur/
07,1{'97 THL lJ:15 FA-I 5J 1J56
CALCULATIONS
STRIJcTUML
EUILDING DESIGN o Fin= pROTi:C1tJi.
CODE CONSULTA/VT . PUhl CHECKTNG
alo NSTRUCTTO N tNS PECTION
5 r, ('t rA,, i, lal t-6 t- P n f -TJ
zG ) N. J 4! st ALu r^; Ou O f.-r.
a? P,'uC FtL.Lo O<
I q16 () 56s (_
3 uO A Co\tc<Ma.ta*Ei ltt40
19 ltk t(11
lA0o2'0tt':.
cirErr -A-E5r6U 53 -A.a-t-c.
SHEET NO
CALCULATED BY RQr
CTItCKEC AY
o^r, 2./-J.-11-L--
\N'
\\\N
\
7
+r6
34
t o't
t"./ l7l-1 c.l #J t LA6 @ocz-ti, k" S tvCrllr, {FeArt(rat
T-s
,L
( s,t-6 L5uta
$
G
N
N"
\
\
R
Nir
a
N
\
\
N
\
$
t c s+/!+,* u*,
te
l"!'-t-iil
iiWeos
tl,'t
t{i
I
-FR-
i
I
I
I
I
i
'
I
In
'. tjtnr
EXP tilES: C-3Lr-
/ 1t-o
ItL k'D
Ftk)
\
f-,iLT ? r.S -fo
>"i I ,.; (:
L e U0 !,\rg
ttrt { wr.i, lit/t' f 6aorS
l-ltjc'i t
Z\ IL
716
anta
11r
Lu s 26._3
51r,1 1 5'/'. ll
To14L
l,lerGnt
t il,- 2,t
t
loRlJEtt
tt,
'f{iJ c i to
ln
I X
T
,
t\
t,L(\ ,; fi Rocrs
r lJ tz,, X,li,,A s6,'
fii a-fi uG
.,*i5arh,r:r.
?xe 4's€
T'I\l
<-- ?rirsgnl ->I
II(
,/:
/i
L t, >'i6 5
"7r 94 4 L tz r('oN.,e^lace)o{
(fl s,1€s,v,*
ET- t n)
4xl +
2X$ *,tY p 0*r1 ,l;
\t,/\tz
. , .1...
*xq t
>-{,1 l:'l Apf RdN-fi,oF i a-7 t/
,PBs 1+A 11 ''a.4,r.f,<''f411sStta-taw 7o rt'\*c, -rr/ r- t')'>l
[luceo
Vc.T zr 4
t^.r t-l sl /il
F, ,,q $ AilO R4 tt-
A.nr,irz{ a * -
...i ..
\
6t l'
.Ii s -Atp 6 (rr" (
av7
_v a
!? l-i
{
.\i
I
I
I
I
i
:
)
I
V
9r oe.5
...+-,- _--'...,.--I
l:':'
4'
7
,v
blo
t'l
I
_l
1
I
l
Treads & Risers: The greatest riser height and thegreatest tread rt.rl (depth) shatt not exceed the smattestby more than 3,/8 inch.
tlirriers: llinding treads are permitted, provided thedepth of the tread at a point not mone ttran'12( frorn theside rhere the treads are narro!.er is not tess than 9tt,the minimun depth is not less than 6,t aM the average
depth of any tread is not less than 9,,.
ilardrails &.Guardraits: Hardraits are required on atteast one side of stairs having three or more risers,
and shatl be continuous the fut( length of the stairs.
Ends shatt be returned to the ratI or shatI terminate in
neHeI posts or safety terminats. The handgrip portion ofthe hardraiL shatl not be more than !-J78ir'in cross-sectionaI dimension, or ol an equivatent gripping
surface. Open sides of stairs rith a totaI rise of-irrcrithan 30'r above the ftoor or grade betor shatt haveguardraits as retI as a handrait (see drasing).
3lz
MAX
Z?'I MIN,
BETWEEN
RoJEOTtoNsbTH
AND T4WOB+/L ARERqUtRm AfffiN =fr1175
tt
{\q
aq
s\
\i
\
\)
tlt
(
,It
$\l
\
t-l
tt
t)/zn
lyltN,
Hnttoru,tL
Rt PD aNE I
i
\
\9r(\
AIDE ONI-Y -J
" MtN,IR WID
7-a-?4t" - 24-qO
l" l"llN,
NostNG
I
I
t-
t-
It
I
I
E
I
L
F
I
I
F
I
RINGF1IELEI DATE:
CITY OF SPRINGFIELD
Developmenr Services Depr.
Building Salety Dlvision
225 N. 5th Street
Springtield, Oregon 9?4??
Stairways and Railings
I
I
,'9? THU lJ:lI FiI 511 _356 ld0ot,t,o:
I
$*$
Da4i4 /. O. Scrl*4*
27W 74La. Sru
*-, Oirq 9?%s8e-#l
TELEFAX TRANSMITTAL
FAX#: (511) 726-36seDATE: July 24, 1996
TO: Lorne Plcger
COMPANY: City of Springfield
JOB: Springfield Apanments @rojcct No. 96[a??)
FROII: David J.O. Bectrman
CC:
This Transmittal is 2 pages, including this cover sheel
X For your record and inforuution.
At your requcst.
Please respond by Thurk you.
Please confirm receipt to e[ (503)343-g694.
Description: Stair layout detail
Notes:
Here is the detailing for the building stair. If you have any questions please call. Thank you
C'TY OF
EI.,ECTRICAL PERHIT APPLICATION
Ci ty Job Nurnbe , ?0t '/ 7 7
I,ETE FEE SCEEDUIjE BELOV
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
I tems Cos t
$ 8s.001000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
s 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less -1-20L amps to 400 amps
40L amps to 600 amps
-601 amps to 1000 amps-
0ver 1000 amps/voIts
Reconnect Only
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000 voTt
VGFIELO
Circuit or vith Service
or Feeder Permit
6,;,{; -,lll'r::JXj i Uffl ,:;: j;:',Hffty',
Zoning IL
225 FIFTE STREET L)are
SPRINGFIELD,74
INSPECTION REQT'E a66Prre
OFFICE: 726-3759
1
1%'2 -7 A
B
C
E
DESCRTPTION
ldo Sum
JOB DESCRTPTION
A/t w Serua 12-5 CtLCq
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}ITRACTOR INSTALI.,ATION ONLY
Electrical contrac rcr f. n/ f E?a:Vc*
Address
City_ Phone
,h fu/ SU
* r'{qr'^
s s0.00
s 60.00
s100.00
$130.00
s300.00
s 40.00
-Each installation
Pump or irrigation _ $ 40.00
sign/outline Lighting- $ 40.00
Limited Energy/Res $ 20.00
SUBTOTAL OF ABOVE {8,0O
5Z State Surcharge
-Z:-,
a
32 Administrative Fee /. C YTOTAL __GW-
do
ee I'8, aEovil
$2 00
40.00
55.00
80.00S
Supervisor License Number
Expiration Dare /A*/ - Oel
Constr Contr. Number ')ffiBf
Expiration Date
of Supervising Electrician
Ovners Name Hrn
Address 38 5zf
ci
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
0vners Signature:
Temporary Services or Feeders
Installation, Alteration or Relocation
$
s
$ss
D. Branch Circuits
Nev, Alteration or Extension Per Panel
s 3s.00
Ar.1 Phone ?Y/- ? qf 1
One YCi rcui t
Each\ Additional
3 6
Miscellaneous (Service/feeder not included)
DATE:fiifRECETVED B
5
JFTALI,ATION
COM M ERCIAL/IN DUSTRIAL
PERM!T APPLICATION
225 Fitlh Street, Springfield, Oregon 97477
LOCATION OF PROPOSED WOFIK:
ASSESSOFIS MAP:
SPRINGFIELEl
qz
JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
TAX LOT:y'n ' '"1D
77439ZIP:STATE:
pHoNE: 7F4a - -i ' -Ql ,<oJZ-
CITY:
ADDRESS
OWNER:
DESCBIPTION OF WORK:
NEW
-
REMODEL ADDITION DEMOLISH OTHER VALUE
ARCHITECT
CONST.
CONTBACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES PHONE
ADDRESSNAME PHO}IE
MECHANICAL
ELECTRICAL:
G ENERA L:
PLUM BING
PLU MBIN G
NO.FEE CHARGE
Single Fixture
Belocated Bldg.
(new fix. addtl)
Water Service
ft.
Sanitary Sewer
ft.
Storm Sewer
ft.
Backflow Device
TOTAL PERMIT
Nr)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.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or htg.
Mechanical exhaust
hood and duct
&^r,,I -PtlL l-c^,t,- Ilqr^
Permit lssuance 0 $10.00
TOTAL PERMIT
'':'i'llT SHAI=t "lPlPE !F
OCCY GROUfit
* OF STORIES:
C e nveriEl - 8OO -332 -"3 4 4 ).Jl
$/SQ. FT.SQ. FT.
'
jF"Rl()i1
iOF
X
X
T9TAL VALUE OF PROJ
l.
SQ. FTG MAIN
SQ. FTG ACCE-Sb
SQ. FTG OTHER
RCPT#PLAN CHECK FEE DATE BY
BUILDING PERMIT $rlt.-PLUMBING drld -DEMOLITION
5% State
Surcharoe ll, & r tl.bs'5% State
Su rcharoe * r.as- {-.aaf
MECHANIOAL Acz. *to,-PENOE
VALUE $
5% State
Surcharoa t3,gs+ a.o
'
SIDEWALK
FT
SUBTOTAL
PERMITS
PAVING Sq:, so CURBCUT
FT.
SYSTEMS
+bbTOTAL PERMIT FEES
EXCLUDING ELECTRICAL
QUAD AREA:
* OF BLDGS:
REQUIRED INSPECTIONS
It is the rdsponslblllty of the permlt holder to see that all inspections are made at the proper time. To rgquest an inspection, call
726.3769 (recorder), state your Clty deslgnated job number, Job address, type of inspection requested and when you will be ready
for inspectlon. Requests received before 7:00 a.m. wlll be made the same worklng day, requests made after 7:00 a.m. will be made
the following work day. -\\ : ./
SITE TNSPECTION: To be ROUGH PLUMBING, -- - PAVING: After gravet is in
made after excavatlon, but ELECTRICAL & ./ - place but prior to placing
prlor to setup of forms. MECHANICAL: No work ls to asphalt or concrete.
be covered until these
UNDERSLABPLUMBING,inspectionshavebeenmadeSPECIALlNSPEcTloNS:lnaccordance
ELECTRICAL & and approved. Section 306 of the State Specialty Code
MECHANICAL: To be made a special inspector shall be employed
before any work ls covered. ATTIC DRAFT STOPS & by the Owner/ Contractor duringcuRTAlN WALLS cbnstruction of the following w6rk. A
FOOTINGS & FOUNDATTONS: copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Buildiig Division.
excavated and forms are ., facing materials and before
erected, .n "G"i in-b1""", out '. framing lnspectlon' srRUcruRAL CoNCRETE: tnprior to placlng concrete. FRAMING: To be made after excess of 2500 P.S.l. (306 a.1)
coNcRETE SLAB: To be the roof, all framlng, fire
made arter ar insrab buirdins 3l::5'::.':f; 3i'3:i:t"^",';l:r" EIXy,T".,f3"t,Y5tt3oi'rrrr, ,rservlce equipment, condult, and vents are complete andplplng, accessories and gther
iricrEry equipment items are m'fl::[.',]i"'jif.1' jJ;[?l?? Blf,:fI?:]?HgPflSi".in place but before any tighte-nlng operations. (306concrete ls placed. INSULATIoN & vApoR a.6)
BARRIER: To be made after all
UNDERGROUND: Plumblng, insulation and requlred vapor SpRAyED ONelectrlcal, gas, sanitary sewer, barriers are ln place but FIREpROOFING: U.BC.storm sewer, water and before any lath or gypsum Standards 43-8.dralnage llnes. To be made board interior wall covering isprior to covering or f iiling appried. spEcrAL GRADTNG,trenches.
,NDERFLo.R: p,umbing [ll:,]""="?Hi3[g]"' fii,iruiil-:ii',5Jh'i],""
electrlcal, mechanical. To be according to plans. chapter 29)
made prlor to installatlon of
floor lnsulatlon, decklng or
-
LATH ANO/OR 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 interiol and exierlor, is in Building Division before
prlor to lnstallatlon of floor place but before any beams are placed (2501 U B.C'
lnsulatlon, clecklng or floor plastering is applied or before STDS' 25-10'11)'
sheathlng. - Sypsum board joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR rNsuLATloN & finished' a'7)
VAPOR BARRIERS: To be
made prlor to installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
vertlcals ln accordance with
uBc 2415.
RooF sHEATHTNG AND iHRS^il?fJ'T"#!|'"
NAILING: Prlor to lnstalllng erected but prior to placing
any roof coverlng. 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
Official may make or require
other inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
7v''x-
,Y
-*
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
landscaplng, parking lot stri plng, etc. must be completed before
requesting thls lnspection.
FINAL BUILDING: Requested after the flnal plumbing, electricat,
mechanlcal 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
By signature, I state and agree, that I have carefully examined the completed applicatlon and do hereby certify that all information
hereln 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 pertainlng to the work described hereln, and that NO OCCUpANCy
will be made of any structure without permisslon of the Buildlng Safety Divlsion. I further certify that only contractors and employees
who are in compllance wlth ORS 701.055 will be used on this proiect.
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 permlt card ls located at the front of the property, and the approved set of plans wlll remain on the site at all
times durl constructlon.
Signature Date
VALIDATION AMOUNT RECEIVED Lt
RECEIPT *:3aL 0 1,
-)+
DATE PAID: ?_T1-- X 1
RECEIVED BY' q(J
CITY OF OREGON
S' GFIELI)
225 FIFTE
SPRINGTIELD,
Zoning l{ D r'r-
3-r1-q
Jl,il:,:#[%3:?T:iri11g:;:mHf ,J:!'fi ?rrr-irE,'
""'l1,ft_@np
city jSbc
L000 sq.ft. or less
Each additional 500
sq. ft or portion
APPLTCATION
t*1 1
s 8s.00
INSPECTI0N RfiQffif,,;o
OFPICE: 726-3759
1. LOCATTON OF INSTALLATIONStor 3q fr\- 3ht-c*
LEGAT DESCRTPTIONl? o\al brr f7)
JOB DESCRIPTIONl*l--
Expiration Date- lO:L: O_t
Constr Contr. Number 2o 8n ?
Expiration Date /L-?o^u>
Signature of Supervising Electrician
0vners Name (
0vners Signature:
DATE:
A. Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:Items Cost Sum
Address 3K 3a*5 \aSpr-r L-*.\lt{
Ci ty ("tX c{ <,L pn"." J\ 6-?\8 9
OVNER INSTALTATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
ee rrBrr a6ove
D. Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit I $ 3s.00 iL-Each Additional +
Circuit or vith Service
or Feeder Permit S 2.OO
200 amps''or less
201 amps to 400 amps
-Over 40L to 600 amps
-Over 600 amps or 1000-16-ITs
s
$
$
s
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation _ $ 40.00
sign/outline Lighting- $ 40.00 -
Liilited Energy/Res S 20.00 I
Limited nnerfy/Comm S 36.00 :
Temporary Services or FeedersInstallation, Alteration or Relocation
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
c
E.
40.00
55.00
80.00
5
RECEIVED
Arr,
I
-ADDRESS-267 39TH ST t_-]-B
-INFO-
NEW
RESIDENTIAL
113 4
001--060-coM/rND PLN cHEcK
OO2-OO5-PLUMBING
OO3-O]-s-STORM SEWER
OO4-OO3-TEMP ELECTRICAL
OO5-OO2_BUILDING PERMIT
006-060-coM/rND PLN CHECK
OO7-OO2-BUILDING PERMIT
OO8-OO6-MECHANICAL
O O 9_O 87_MECHANICAL I SSUAN
0L 0-0 0 8-PAVTNG/GRADTNG
O 1 1-O O 5-PLUMBING
012_O ]- 3-SIDEWALK
013_O]-2-CURBCUT
o L 4 - 07 4 -SDClWr LLAMALANE
0 L 5-0 7 0-sDC/STORM
oL6-07 1-SDC/SANTTARY
0L7 -07 2-SDCITRANSP
O1B-05s_REGIONAL SEWER
019-073-SDC/ADMTN
O2 O_O O4-ELECTRICAL
O2L_07 1-SDC/SANITARY
022_055_REGIONAL SEWER
BUILDING DIVISION JOB# 9F'477
-LEGAL-LOT BLOCK
DESCR!18 UNIT APARTMENT COMPLEX L7 023L4L01- 1- 0 0
_OWNER-
RGR DEVELOPMENT INC 998_3632
PO BOX 1-93
ELMTRA, OREGON 97437
961-031 / 97t007
-ENERGY- -STATS-HEATI- 2- 3 BLDG ZONE HDR
H2O- STORIES FLOODPLAIN
RANGE- BEDRM OCC GRPINSULATION 1.8 UNITSPATH- SQ FEET
CONST TYPE
_CONTRACTORS-
GENL-RGR DEVELOPMENT
CONTRACTOR PHONE-998_3 63 2
PLMB-
ELECT-
MECH-
DESGN-
-VALUE-
628792
ACTIVE
600, 0o
25,79
QUAD AREA 3RNW
sEQ-REQUTRED pERMTTS- -------FEE--SURCHARGE--DATE--RECPT--CAT-------VALUE
1-91
1-00
5
40
38
963
1, 483
351
L0
L75
L,770
L6
L6
456
959
000
7LL
485
532
730
499
48s
75
00
00
00
50
95
00
00
00
00
00
30
30
00
36
00
15
30
74
00
00
30
0.00
5.00
0.00
2 .00
1.93
0.00
74.15
L7 .55
96LO29 2
96LO3L 2
961-031- 2
96LL25 2
96L2L3 2
970L03 2
9702L3 2
9702L3 2
9702L3 2
9702L3 2
9702L3 2
9702L3 2
9702L3 2
9702L3 2
970306 2
9702L3 2
970306 2
9702L3 2
970306 29702t3 2
970306 2
9702L3 2
3644
3679
3679
3 901
4047
4208
4573
4573
4573
4573
4573
4573
4573
4573
47 87
4573
4787
4573
47 87
4573
4787
510
500
827
10s
520
906
5t-0
6t- 3
6L2
500
3, 00
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
04757
0.00
0.00
88.50
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
86. s0
0.00
0.00
L2
4
10
4
6
1
1
4
6
SEQ-MINIMUM INSPECTIONS + REQUTREMENTS-- --EXP DATE---ACT DATE-
OO1-027-STORM SEWER APPROX 467 FEET
OO2-O4O-TEMPORARY ELECTR BY OWNER
003-002-FooTrNG
OO4-OO3-FOUNDATION
005-002-FoorrNG
0 0 6-0 04-SLAB
OO7-024-WATER LINE
OO8-02 6-SANTTARY SEWER
OO9-027-STORM SEWER
O1O-041-UNDERGROUND ELEC
O1- 1-_02 3-ROUGH PLUMBING
O 1 2-O 3 1-ROUGH MECHANICAL
013-042-ROUGH ELECTRIC
014_044-ELECTRIC SERVICE
015_OO6-FRAMING
O].6-0Og_INSULATION FLOOR
017-018-VAPOR BARRIER
961- 101
96LL26
96L220
97 07 LL
97 07 30
97 07 L6
97 07 02
97 07 02
97 052L
97L007
97 07 L6
O1B-O]-]._DRYWALL
O ].9-1-OO-ROUGH GRADING
O2O-101-FINAL PAVING
O 2 1-O 2 g-FINAL PLUMBING
022-0 39-FINAL MECHANI CAL
023_049-FINAL ELECTRICAL
024_064_FINAL FIRE DEPT
0 2 5 - 0 9 0 -DRI VEWAY/CURBCUT
O 2 6-O 91-SIDEWALK
027_OBg_SITE PLAN FINAL PLANNER IS JULIA HAJDUK
O2B-01.g-FINAL BUILDING
970728
970815
SEQ--INSPECTTONS -COMMENTS------- -----DATE---RSLT--INSP
OO]--027-STORM SEWER LLz' 1 CB.
OO2-027-STORM SEWER 250'
003-040-TEMPORARY ELECTR SUB-CALLED PEND,RTSER WrRE
004-002-FoorrNG
005-002-FoorrNG
OO6-OO2-FOOTING BLDG 1# FOOTINGS ONLY
OO7-OO3-FOUNDATION
OO8-OO3_FOUNDATION
OOg-OO2-FOOTING BLDG 2
O1O-OO2-FOOTING SURVEYED LOT
011-004-SLAB
OL2_047_SPECIAL GROUND ROD
O]-3-04I-UNDERGROUND ELEC 3-SLABS&EUF'ER GRN.
014_OO6-FRAMING
015-108-ROOF SHEATHTNG/NAROOF NEEDS TO BE RENATLED/NO C/N
O]-6-02O-UNDERGROUND PLUM CWI LETTER ACCEPTED
OL7-LO4-SHEAR WALL NAILINBLDG 1# FIRST FL ONLY
0I_8-108-ROOF SHEATHTNG/NANEED LETTER FROM ENGr/BLDG 2#
O].9-1-04_SHEAR WALL NAILINLEFT CARD
O2O-1.04-SHEAR WALL NAILINBLDG 2#
O?I-TO4-SHEAR WALL NAILINBLDG 3#
022-L0 8-ROOF SHEATHTNG/NA
023-104-SHEAR WALL NAILIN
024-108-ROOF SHEATHTNG/NABLDG 3
025-OO6-FRAMING026-0O6-FRAMING FIREWALL PENETRATIONS
027-023-ROUGH PLUMBING BLDG 1
028-042-ROUGH ELECTRIC BUILDING#1.
029_027_STORM SEWER MINIMUM INSPECTION DONE 961101
O3O-OOg-INSULATION SLAB EDGE INSULATION O.K.
031-03]._ROUGH MECHANICAL NEED CHANGE ORDER FOR 1HR SYS.
032-014-SPECIAL
O3 3-03 ]--ROUGH MECHANICAL
034-042-ROUGH ELECTRIC HOLD FOR THURS.
035-042-ROUGH ELECTRIC
036-02 3-ROUGH PLUMBING
037 -023-ROUGH PLUMBING
038-031-ROUGH MECHANICAL
039-014-SPECIAL CKED SETBACK AND HOUSE TO NORTH
O4O-042-ROUGH ELECTRIC
041-OO6-FRAMING
042-042_ROUGH ELECTRIC ALREADYM INSULATED
043-03 1-ROUGH MECHANICAL
044-OO6-FRAMING
045-0 2 3-ROUGH PLUMBING
046-OO6-FRAMING
047-O 14-SPECIAL
O4B-OO6_FRAMING UPSTAIRS ONLY BLDG ]. AND 2
049-042_ROUGH ELECTRIC BLDG, #2 ROUGH-IN
050-031-ROUGH MECHANTCAL BLDG2, 2ND FL.
051-OO6-FRAMING BLDG L#/AT CHASE AREA DOWN/STATRS
052-023-ROUGH PLUMBTNG BLDG2,2ND FL.
9611-01 0K 28
96LLO4 OK 28
96LL26 0K 61
96L2]-6
96L2L7
96L220
970 L 06
97 oLO9
97 010 9
97 01-0 9
97 010 9
9701-09
97 0204
97 032L
97 0328
97 0328
97 040 8
97 041-4
97 042L
97 042L
97 042L
97 0507
97 0507
97 050 B
9705L5
97 0520
97 052L
97 052L
97 052L
97 052L
97 052L
9706r-0
97 06LL
97 06LL
97 06lL
97 06LL
97 06LL
97 06LL
97 06L2
97 06t2
97 0623
97 0623
97 0623
97 0625
97 0625
97 0625
97 0625
97 07 0L
97 07 02
97 07 02
97 07 02
97 07 02
ro 59
NR
OK
cwI
WIR
OK
OK
OK
OK
OK
IO
NOTOK
NAPP
OK
POK
UGE
OK
OK
NR
WIR
OK
IO
IO
OK
OK
WTR
POK
IO
IO
NOTOK
IRC
WIR
NOTOK
WIR
WIR
IO
NR
38
59
09
59
59
59
59
59
59
59
59
61
59
59
59
59
59
38
38
38
59
38
20
6L
20
92
59
59
61
59
61
28
38
28
38
59
3B
6L
28
59
28
59
28
61
61
28
28
28
IRC
CWI
NOTOK
IO
IO
ro
IO
POK
OK
OK
POK
OK
053-OO6-FRAMING
054-OO6-FRAMING
055-OO9-INSULATION
056-024-WATER LINE
057-OO6-FRAMING
O5B-012-FIREWALL
059-O]. ].-DRYWALL
O6O-04].-UNDERGROUND ELEC
O 61-02 3-ROUGH PLUMBTNG
062-OO6-FRAMING
063-01]--DRYWALL
064-OO6-FRAMING
065-011-DRYWALL
066-023-ROUGH PLUMBING
067-03 1-ROUGH MECHANICAL
068-024-WATER LINE
069-042_ROUGH ELECTRIC
O7O-O 2 3-ROUGH PLUMBING
071_03 I-ROUGH MECHANICAL
07 2-O 1 1-DRYWALL
073-O].2_FIREWALL
07 4_042_ROUGH ELECTRIC
075-O 3 ].-ROUGH MECHANICAL
076-OO6-FRAMING
077 _042-ROUGH ELECTRIC
O7B-O]-1--DRYWALL
07 9-O 2 3-ROUGH PLUMBING
O8O-OO6_FRAMING
OBl--042-ROUGH ELECTRIC
OB2_026-SANITARY SEWER
OB3-02 3-ROUGH PLUMBING
O 84-02 6-SANITARY SEWER
OB5_O 3 1-ROUGH MECHANICAL
OB6-03 1-ROUGH MECHANICAL
OB7-042-ROUGH ELECTRIC
OBB-042-ROUGH ELECTRIC
O 89-03 1--ROUGH MECHANICAL
O9O-042-ROUGH ELECTRIC
O9].-091-STDEWALK
092-011-DRWALL
093-OO6-FRAMING
094_OO6-FRAMING
095-OO6-FRAMING
096-0 -ELECTRIC SERVICE
097 -0A _ELECTRIC SERVICE
#g
2
2
BLD.
BLDG
BLDG
^T CHASE DOWNST/BLDG Z#
ASE AREA DOWNST/BLDG 3#
NEED TO CALL JOHN MC.
BLDG T# BOTTOM UNITS
AT FRONT ENTRY/BOTTOM BLDG t_#
BOTTOM UNIT BLDG Z#
BOT/UNIT gLOe Z#
PLENIUM WALLS ONLY
BLDG. #2
BLDG 3 SUB. MECH. AND ELECT.
BLDG 2
BLDG 3
BLDG 3 2ND FL ONLY
BLD#3
BLD, #3
BLDG 3 1ST FL.
PANEL WALLS
BUILDING 3
STAIR INFO
NEED WATER GRN TO 250_94
BLD L_2_3 ]-B UNITS SUB-CALLED
97 07 02
97 07 02
97 07 02
97 07 LL
97 07LL
97 07 LL
97 07 Lt
97 07 L6
97 07 L6
97 07 L6
97 07 L6
97 07 L6
97 07 L6
97 07 L7
97 07 L7
97 07 L8
97 07 L8
97 07 22
97 07 22
97 07 28
97 07 28
97 07 30
97 07 29
97 07 29
97 07 29
97 07 29
97 07 29
97 07 30
97 07 30
97 07 30
97 07 30
97 07 30
97 07 30
97 07 3L
97 07 3L
97 0804
97 0804
97 08L4
9708r-s
9708L5
97 0909
97 09LO
97 0 910
97 0925
97L007
POK
POK
IO
OK
IO
IO
IO
OK
IRC
OK
POK
OK
POK
OK
OK
WIR
POK
OK
OK
OK
OK
OK
NR
OK
IRC
NOTOK
OK
IRC
NR
OK
WIR
IRC
NOTOK
OK
NR
OK
OK
OK
OK
OK
IO
IRC
WIR
NOTOK
OK
59
59
59
28
59
59
59
6L
28
59
59
59
59
28
28
2B
6L
28
28
59
59
6l_
6t
61
28
61
66
38
38
38
28
38
61
38
28
38
6L
38
28
38
38
28
59
61
6l_
JFN--24-199? a7'247 Br-€
OBSERVATION REPORT
s413455343 P.At
January 24,1997
PAGES: 1
Balthitcr & llrblail taiiacctt
UECI{ANICAL. ELESIRICAL, CIVIL COIISULTAT.TTS
s75 LIiICOLN ST., EUGENE' OR 97'101
FO gOX 10347. EUGENE, ORS7.l40
iorrj se&saza ohone), (54r) 345€30s (rax) f obrS'rr<
To Rod Crawford 7'{4- e5?2
COIIPANY RGR DeveloPment, lnc'
PROJECf 39th $traet Apartmcnts (P'O' #9352)
DATE OF VlSlT January 23, 1997
C-- \\ '/h o'^.
o\r SS4^L/33L
VISITED BY BlllPrenties
Location:
PcrmltNumbrr:
Purpo*:
39th Street Apartmcnts
267 N. 39th $treet
Springfteld, OR
ffi1477
Obeerva thc undcrground qanitary drain and domeStic eold water rough-ln for code
1
2
3.
compliance.
Present:Rod Crilvford
RGR DetreloPment, lnc.
484-4099
Kurt Blachnik
Voss Plumhiqg
Joumeyman Ucense #4'683JP. exp' 4/97
0hocrvatione:
Ggne*l: The complex consistg of three apartment mmplexes. Oboervatione includes only piping
tocateO below the apartment floor slabs,
EemeElic.lt{steI:e. Pipe used: TYPe L softcoPPer
b. lffitalletion: No fittings or joints used:belottr grade-
SanitaqrXratn:;. Ptpe used: Sclredule 40 PVC-D\ A/. ASME F891'93a'
;. init"tt"t6nr All piping irrstallcd in trench with adequate slope aM installed on bedding'
c, Testing:i. Observed tcet performed by Kurt Blachnik in accordance with the Uniform Plumbing
Code, Section 712-2Water Test'
ii. Each sf the three complexes teated separately'
iii. No drop in water levelwas obeerved and the systems were tight at all points'
ttl/tlliam H. Prentise
-J
I
B\qCE.I*TIOAP ARTM. OBS TOTfl- P.61
)
,, na
"r1:l
SPRTNGFIELD, OREGON 97 477
INSPECIION REQUEST: 726-3769
OFFICE: 726-3759
h
D0-
ur4 --ET.ECTRICAL PERHIT APPLICATION
City Job Number /q77
3. COHPLETE FEE SCEEDIJI^E BELOIT
A Nev Residential-Single or
z'
Multi-FamilY
Service Incl
SPRII'iGFl€LO
d
1. LOCATION OF
I,EGAL DESSRIPTION
JOB DESCRIPTION
ION
per
uded:
velling unit.
I tems Cos t Sum
/52-e
Permits are non-transferable and expire
if vork is not started vithin 180 days
oi ittu"nce or if vork is suspended for
180 days.
2. CONTBACTOR INSTALI-A'TION ONLY
The installation is being made on
property I oun vhich is not intended
for sa1e, lease or rent.
0vners Signature:
1000 sq.ft. or less
ach additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home' or
Modular DvelIing
Service or Feeder
tg s 8s.00
s 1s.00
s 40.00
Erectrical contrac rct JB flkih'-T'/t'
Address tr.t&#tg(at s
Ci ty (,t Phone /o37'{77o
Supervisor License Number 38?A S
Expiration Date /o 7
Constr Contr. Number 2
Expi tion Date
Si of e ing Electrician
Ovner Name 226,4 f l "' '-
Address
Ci ty Phone ?3-?z-32-
OVNER INST
TemporarY Services or Feeders
Insiallaiion, Alteration or Relocation
Services or Feeders
Installation, Alterations
or Reloeation:
200 amps or less 2
201 amps to 400 amPs
-
401 amps to 600 amPs /
601 amps to 1000 amPs-
Over 1000 amPs/vo1ts
-
Reconnect OnlY
-Each installation
Pump or irrigation
-
Sign/0utIine Lighting-
Limited EnergY/Res
-
Limi ted EnergY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
B
C
s s0.00
s 50.00
s100.00
s130.00
s300.00s 40.00
-l@.'o
/ae.1-
O.
200 amps''or less
201 amps to 400 amPs
-
0ver 401 to 600 amPs
Over 600 amPs or fOOOETis
40.00
55. O0
80. oo
ee t'B* aSoTi
$
s
$
s
D. Branch Circuits
Neu, Alteration or Extension Per Panel
One Circui t
Each Additional
Circuit or vith Service
or Feeder Permit -
s 3s.00
s 2.00
E. Miscellaneous (Service/feeder not included)
s 40.00
s 40.00
s 20.00
s 36.00
DATE: 2 =D-2
DE'ETIrcTT D
.!
5
oa
I
ctw oF sPR
SPFIIN(iF IELI)
lj,i, I?, xt t8J:f r, ffi,:fJgr,#il,ff
225 FTTTE STREET
SPRINGFIELD, OREGON
INSPECTION REQUEST:
oFFICE: 726-3759
1. LOCATION OF
LEGAI DESCRIPTION
JOB DESCRIPTION
(-t -
ELECTRICAL PERHIT APPLICATION
Ci ty Job Numbe, 26/Y >?
SCMDULE BELOV
974
726a3dft9a
ON
v
l\/
3
A.
B
C
D
Nev Residential-Single or
Mul-ti-FamilY Per dvelling unit'
Service Incfuded:
I tems Cos t
Permits are non-transferable and expire
if vork is not started vithin 180 days
of l""u"nce or if vork is suspended for
180 days.
2. COMRACTOR INSTAII,ATION ONLY
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereo f
Each Manuf'd Home or
Modular DvelIing
Serti.ce or Feeder
Sum
$ 8s.00
s 1s.00
. s 40.00
40.00
55.00
80.00
s see rrBrr a6ove
Electrical Contractor
Ci tv Phone
Supervisor License Number
Expiration Date-
Constr Contr. Number
Expiration Date-
Signature of Supervising Electrician
0vners Name
Address a,
Vhone V8,'74,77
Services or Feeders
Ins tallation, Alterations
or Relocation:
200 amps or }ess
ZOr "*p. to 400 amPs
-401 amps to 600 amps
-
60L amps to 1000 amPs-
Over 1000 amPs/volts
-
Reconnect 0nIY
TemporarY Services or Feeders
inst"tt"iio.,, Alteration or Relocation
200 amps''or less /
201 amps to 400 amps
-
Over 401 to 600 amPs
-
0ver 600 amps or 1OO0 voTt
Branch Circuits
Nev, Alteration or Extension Per Panel
one circuit $ 35'
nach additional
Circuit or vith Service
or Feeder Permit
-
S 2'
Miscellaneous (Service/feeder not
s s0.00
s 60.00
$100.00
s130.00
$300.00s 40.00
$
s
$
7a
00
Ci ty
DATE:
OVNER
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent'
-Each installation
Pump or irrigation _-
Sign/Out1ine Lighting_-
Limited EnergY/Res
-
Limited EnergY/Comm
E
00
included )
Signature
$ 40.00
$ 40.00
$ 20.00
$ 36.00
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
q2-e___*Z-_a
RECEIVED
5
?o
CITY OF SPruNGETELD,
SPR!NGFIELD
Page 1
CITY OF SPRINGFIELD SYSTE}TS DEVEI.OPMETiIT CHARGE
(COMMERCIAL / INDUSTRIAL)
Name or Company: RGR DEVELOPMENT INC
Location| 267 39TH ST 1-18
Developement Tlpe: C Building Size:
Job No. : 961-477A
Lot Size: 39054 Sq Ft
1. STORM DRAINAGE
Impervious Sq Ft 1.0 X 22950
2. SNiIITARY SEWER - CITY
Number Of PFUs 1.0 X 324
(see Page 2)
X 0.21,6 Per Sq Ft =V$4 ,959 .36
X 44.75 Per PFU =$L4,499.oo
D OA|O,lJo Y'
-cs
Y Cost Per Trip
45L.26 $4, 711 . 15
$4 ,7LL .L5 L-
3. TRAI{SPORTATION
Number Of Units
l-.0 x l_8 x
Trip Ratse
0.580 x
Transportation Tot.al
4. SAI'IITARY SEWER - MI'MC
Number Of PFUs
324
5. ADMINTSTRATIVE FEES
Base Charge (Subtotal Above)
x
x
Per PFU +
20.690 +
MWMC Admin Fee
10.00
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SITBtOTAL - (Add Items 1, 2, 3 & 4)
$6, 713 . s5
$228.25
$5,485.30) x_
$30, 554 . 82
$1- , 532 .7 4x 0.50
TOTAL SDC 2,L87 .56
Reviewed By: TROY MCALLISTER DaLe: OL/06/97
$,r52,
€e
X $692 per unit $ tz, ?r€v. '*
NAME:
ADDRESS, .. ?,O. fu/' /?>
-
STATE: OZ ZtP: - ?2 f>2eL/v/ry-
LOCATION OF PROPOSED BUILDING SITE:
Street Address:a
Plat Name Tax Lot Number: /: ^-z /, A//e
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. Single-Family Detached
Single Family home Manufactured home not in a Park
NO. OF UNITS X $1,000 per uoit = $
B. Single-Family Attached
NO. OF UNITS X $924 per unit $
C. Multi-Family Apartment
NO. OF UNITS
D. Manufactured Home Park
NO. OF UNITS X $699 per unit
WILLAMALANE SDC
2. SDC CREDIT (if applicable) SDC-payer must fumish proot of
\Mllamalane Credit approval. See SDC Credit Worksheet.
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
ment Se
$
$
$
$
/ 12/ tq7Date ---
Ci f Springfield
.sa
Willamalane
Fair.-& R-ecreation District Job. No. ?6,/"77
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
,.?G;.7 71 * -:* PHONE: aa€2-%?z
REQU IRED 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 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 pLUMBING, inspections have been made SPECTAL TNSPECTIONS: tn 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
CURTAIN WALLS construction of the following work. A
( fOO, NGS & FOUNDATIONS: copy of the special testing reports shall--t'|- i.";.; ';;;'after trenches are FIREPLACE: Prior to placing be furnished to the Buitding Division.
excavated and forms are facing materials and before
erected, all steel in place, but f raming inspection' srRUcruRAL CoNCRETE: ln
prior to placing concrete. FRAMING: To be made after excess of 2500 P'S.|. (306 a.1)
coNcRETE SLAB: To be the roof' all framing' fire
made arter au insrab buirdins 3l:::'::.':l 3f:lt";,';;:r" BI,S'T"'f3,l.Y5f3o"',rrr, ,,
service equipment, conduit, and vents are complete and
5Hl,?;""",",:;:l:? ?['.:'::J *?'fl::[""]ffii:,X'iJ;[3:i: El?,:,T?E],?'i[,:?h1}i".in place but before any tightening 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.dralnage lines. To be made bOard interior wall covering isprior to covering or filling applied. SPECIAL GRADING,trenches.
,NDERFL..R: p,umbins il::,*'i"'.^i*'J3[Ul"' El:lUtiii-:ii:,5Jb'j],"t
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 Certif icate by an approved
lathing and gypsum board, agency, furnished to the city's
posr & BEAM: To be made interiol and exterior, is in Building Division before
prior to installation of floor place but before any beams are placed' (2501 u'8c'
insulation, decking or floor plastering is applied or before STDS' 25-10'11)'
sheathing. - Sypsum board joints and
fasteners are taped and STRUCTURAL 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 sHEATHTNG AND iHlS^H'^tti'T:i."!|,"
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 ln
place.
t 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.
that the
uring cons
By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information
herein is true and correct, and I further certify that any and allwork 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.
all required inspections are requested at the proper time, that project address is readable from the
ront of the property, and the approved set of plans will remain on the site at all
tim
DateSignature
lfu
at the
ensure t
itc oc
q,1 nVALIDATION
2
AMOUNT RECEIVED:
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 proiect conditions such as
landscaping, parki ng lot striping, etc. must be completed before
requesting this inspection,
FINAL BUILDING: Requested af ter the final plumbing, electrical,
mechanical 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.
ADDITIONAL COMMENTS
PLANS REVIEWED BY oere r/?'/7 ^?d
t aD-t D 0
INSPECTION LINE SEE INSPECTIONS ON BACK SIDE
APPLICATION DATEi /Z-V,/-%
rffi
DATE ISSUED:
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
oFFrcE TELEPHONE (503) 726-37s3 ENCROACHMENT PERMIT
NUMBER:
PERMIT NUMBER: 96t477
LOCATION OF WORK
STATE:
PHoNE:*-23
PHONE
oNE %3-%=>.
ztP: 22/2A,
EXPIRATION DATE: /A ^7>
ADDRESS
OWNEB
TAX LOT: z./ac>
TAX MAP
ADDRESS:
CITY
SUBDIVISION
CITY:STATE:
CONTRACTOR
SITE ADDRESS:
APPLICANT
PHoNE:
-4^71-2ztPt €2?7>
CONTRACTOR REGISTRATION NO
PROJECT SUPEBVISOR:
REOUESTED PERMITS ACCOUNT NO:INSPECTIONS REOUIREO: APPLICATION FEE / DEPOSIT
f erucnoncHMENT PERMIT No: ...tr E $20.00 /
VALIO FOR SIXTY (60I DAYS FROM DATE OF ISSUANCE
fl cur srnerr O BoRE D orHEn tr E$
I ousr coNTRoL {TypE oF coNTRoL)
Q corusrnucloN. sroRAGE, srAGlNG tr
tr
E$
Ds
E$
Q orxen
Q asnHalr DEpostr...........
TYPE OF SECURITY DEPOSIT
Q ar-arxer sunEry BoND E sunlry BoND Q casH / CHECK E$
E cune cur PERMTT No: .... FT tr_
CONCRETE.INSPECTION: CURE / APPROACH AFT€R FORMS ARE ERECTED 8UT PRIOR TO POURING
VALIO FOR I80 OAYS FROM DATE OF ISSUANCE.
fl secoNo oBtvEWAy (sEE sEnARATE AppLtcATtoN)
f, stoewaLK eERMtr No: ..........,......... FT.
VALIO FOR 180 OAYS FROM DATE OF ISSUANCE,E $10,00+ $.1S/FT.
I r.rew l] REMovE / REeAIR I eave eLANT srRtp
[] srraacr D cURBStDE ll lerucrH
INqPF'TION. SIOEWALK / DRIVEWAY FOR ALL CONCRETE PAVING WITHIN THE STREET RIGHT OF WAY, TO BE
MADE AFTER ALL EXCAVATTNG rs coMpLETE , AND FoRM woRX ANo suB.6AsE MATEFTAL rs rN pLAcE.
f sarvtraRy sEWER coNNECTtoN pERMtr:
VALID FOR SIXTY (60I OAYS FROM DATE OF ISSUANCE
I ro srua E MAIN L|NE (EASEMENT-R/W) O orHER
E $s,00 /
fr sronrvr sEWER coNNEcloN eERMrr ,fr $5.00 /raO
VALIO FOR SIXTY 160) DAYS FROM DATE OF ISSUANCE
,& carcx BAsrN / BUBBLER E sruB E MAINLINE
PROOF OF INSURANCE: $500,000 MtNtMUM
fl arracHeo E REoUIRED AMoUNT TOTAL DUE: $
TOTAL DUE WITH PERMIT $
DESCRIPTION OF PROJECT:
and work zone protectionto be in complianco with the Manual on Uniform Traffic Control Devices (MUTCD).
WORK SHALL COMPLY WITH CHAPTER X ARTICLE 5 OF THE CITY CODE. CONTRACTOR TO COMPLY
BACKFILL MATEBIAL:
Advance signing
WITH MUTCD
DESCRIPTION
BORE:
AREA: LENGTH WIDTH
EXISTING SURFACE MATERIAL:
BACKFILL MATERIAL TO BE UTILIZED
HEIGHT:
TYPE OF WORK: CUT:
OTHEB:
SURFACE REPLACEN4TNT MATERIALS TO BE UTILIZED
TYPE OF DUST CONTROL TO BE UTILIZED:
NAME OF OTHEB UTILITIES IF THIS IS A JOINT PROJECT
WARNING DEVICES TO BE UTILIZED:
TIME:
TIME:
FROM DATE:
TO DATE:
REV|S|ONS 8/24195 FORM ' 116
4.2/)Y>>
E $10.00+$.1s/FT.
DEPTH:
PERIOD OF USE OR TIME OF CONSTRUCTION:
tr PLANS (TWo SETS) ATTACHED
PLAN REVIEW COMMENTS /SPEP'-1 L INSTRUCTIONS :
BESTORATION WORK SHALLSTANDARD specrrtcarroruS alllt-QQttlrvBMANcE-w-lrH ExtsrtNc crry coDES AND tN covrplralrcE wtrH cuRRENr, EXCEPT AS NOTED BELOW.
001
002
003
004
00s
006
007
o08
009
010
o11
012
o13
014
015
016
017
018
019
020
021
o22
o23
o24
025
026
o21
028
029
030
031
032
033
343
Minurnum 4' cleararrce at any point, swing-away.
Concrete minimum 4" depth, 3,OOOpsi.
Trench to be "T" cut.
Needs State / County permit.
No above ground enclosings in sidewalk or handlcap ramps.
Diamond cut A.C./Concrete value boxes to grade.
Freslr Oil signs / Graded.
Comply with Americans with Disabilities Act.
Concrete slabs, 72hrs. curing time, a5OObsi.
Concrete slabs require joint seal material.
Driveway requires dowels every 18".
Submit traffic control plan prior to excavalion.
Notily Traf f ic Division bef ore excavatipn.
Core drill main line, insert tee, 2ok min, grade.
Must cornply with the provisions of ORS 757.541 to 757.571
6" Circular hole/H2O-Vac.
THE LANE
"ONE
YOU ARE REOUIRED TO CALL
uTtIfTlES COORDINATTNG COUNCTL'SCALL NUMBER" 1-800-3 32_2344 - -
48 HOURS BEFORE DIGGING
lNSPECTIONS:
CURB CUT AND SIDEWALK INSPECTIONS CALL 726-3769 (RECORDER) STATE YOUR DESIGINATED CITY JOBNUMBER/PERMIT NUMBER, JOB ADDRESS, TYPE OF INSPEdTION REOUESTED, AND WHEN YoU WILL BE READY FoRINSPECTION, CONTRACTOR'S OR OWNER'S NAME AND PHONE NUMBER. REoUESTS REcEtvEo BEFoRE 7:OO A.M. WtLL BEMADE THE SAME DAY, REOUESTS AFTER 7:OO A.M. WILL BE MADE THE NEXT WORKrrlrC OaV. INSpECTIONS ARE TO BECALLED lN AFTEB EXCAVATIONS ARE MADE AND FORM WoRK i5 tru place BUT pnloR To poURtNG CoNCRETE.
SANITARY SEWER, STORM SEWER, ENCROACHMENT PERMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT726-3761.tr
SIGNATURE
Py-:!gngtut", lstate and agree, that lhave carefully examined the comp.leted application and.do hereby certify that all informationherern ls true and correct, and lfurther certifv that.'any and iil worti pJit;fi;i"E;it"b;'j;;;in accordance with the ordinances of the3l1v;[si:pJisii''ulil'.'13!:'f;fi^'.1;:flzu{ini;Ij',r1"*r*i;yitds[1Jifi ffinii5: ;,ri#.ti",qtr;li:i.1E !315: .:,li['
project.
Ilt'?'';'Tixl?il's:'Jlfivs!:;ri3"i"i'rl?*'.qti:;i'#;flt'ffi$j,-,*1,"ffi[tr]rdi*qr:,i+ii:t-:fiii+i,$,i#
**ir,d?;*r*.
return the site'to a standaid-a;Cep-taulJ i;ih;'
d^ays (30) from the date of trre noiitito Jo-ii6tCity and the costs will be Uittea to tfre-peimiiiee.
lfurthor aoree to enstrre that all required insoections are requested at thg^q1qgc1firne, tlrat project address is readable frorn the street,and the ap-proved set of drans witiiemiin o"{t#';ii; ;i".iii1ilr'e.s.?tliis construcr,on.
Signature Date /0- 3 /- 7,(
5.ae
RECEIVED BY
DATE PAIDAMOUNT RECEIVED
RECEIPT NO:
VALIDAT!ON:
FOR SIDEWALK AND CURB CUT PERMITS PLACE A COPY (COMPLETED) IN PERMIT DRAWER.
AT TIME OF COMPLETION: DATE:
ELEVENTH MONTH:- DATE:
f, rnarrtc REVTEWED By:
WORK IN PROGRESS
DEPOSIT RETURNED DATE:
DATE:
DATE:
DATE:
DATE:
INSPECTION:
INSPECTION:
DATE
DATE
DATE
f, ernrrlttr ISSUED By:
f rrucrrueEntNc REVTEWED By
f naernreNANCE :
Comments:
Backfill with %" minus rock.
Compact every 18" loose depth.
Requires compaction with a steel rolller.
A.C. to match the greater of existing depth or 4.,.
All cuts sealed for final inspection.
Temporary patch may be used at the end of the day.
Signing and Zone protection to comply with MUTCD
Cut concrete only on score lines or cold joints.
Sidewalks and driveways min. 3,OOOpsi.
Curbing min 3,500psi / No patchwork less than 3,.
Meet min. requirements on curb cuts, Spfd. code.
Restore planted areas, Spfd. code 206.3.0S
Spec. to Bore / Jack / No A.C. cuts.
Mechanical compacting required.
No patchwork allowed.
Lateral cuts to have control density filt.
Cuts to be polymerized crack sealed for f inal inspection.
Mininum 2'' crushed rock %" minus.
tr
CO M M ERCIAL/ IN DUSTRIAL
PERMIT APPLICATION
225 Fitlh Street, Springf ield, Oregon 91477
LOCAIION OF PROPOSED WORK
SPrlINGFIELO
h,
JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
TAX LOT:
z
ASSESSORS MAP:/7 -a 7/t q,z
t^)lwe u
@(LSTATE:ZIP:YszqCITY:e tru tnA
O ssLtLt jJ 6COA-*cf
PHONGOWNER:
ADDRESS:
3(3a Bor< I
=;pc,
C6
D
DESCRIPTION OF WORK Ula UD/
REMODELruEw X s#r s
ADDITION DEMOLISH OTHER
NAME ADDRESS PHONE
AME EXPI RES PHON E6Ue
ADD RESS
MECHANICAL:
ELECTRICAL:
CONTBACTOR
ARCHITECT:
ELtt44+
o 6ox 11, s
PLUMBING:
G EN ERAL:
CONST.
CONTRACTOR #
PLUMBING
NO.FEE CHA RG E
Single Fixture
Relocated Bldg.
(new f ix. addtl)
Water Service
ft
Sanitary Sewer
ft.
Storm Sewer 427 rr./2d.'o
Backflow Device
TOTAL PERMIT
NO CHA RG F
Furnace/ burner & vent
< 100,000 BTUs
FFE
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended watl oilt,ror-
mounted unit heater
Appliance Vent
separate
Stat ionary evap.
cool er
Vent Fan/Single
duct
Vent
f rom
System apart
AC or htg.
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT
_ OFFICE USE _HANDICAP ACCESS
r OF UNITS:
OCCY GROUP:
I OF STORIES:
OUAD AREA:
I OF BLDGS:
CONSTFI. TYPE:
HEAT SOURCE:
SQ. FT.$/SQ. FT.VALUE
TOTAL VALUE OF PROJ
X
X
X
SO. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
PLAN CHECK FEE ;ATE,/A ^??-rE BYRCPTo ZVZ ././
BUILDING PERMIT PLUMBI NG /2A.*DEMOLITION
5% State
Surcharoe
5% State
Su rcharg e
f-, at2v.n-MECHANICAL FENCE
VALUE $
5% State
Su rcharoe
SIDEWALK
FT.
SUBTOTAL
PERM ITS
PAVI NG CUBBCUT
FT.
SYSTEMS
DEVELOPMENT
12A.*TOTAL PEBMIT FEES
EXCLUDING ELECTRICAL
o1:
FLOOD PLAIN:
ZONING:
LIGHTING POWER BUDGET:
WATER HEATER:
LAND USE:
REOUTRED INSPECTIONS
It is the responsibility of the permit holder to see that all inspections are made at the proper tirne. To request an inspection, call
226-3769 (recorder), state your City designated job number, iob 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,
--
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 of 'the state specialty code
MECHANICAL: To be made a special inspector shalll be employed
before any work is covered. ATTIC DRAFT sroPs & by the owner/ contractor during
CURTAIN WALLS construction of the following work. A
I
FOOTINGS & FOUNDATIONS:copy of the special testing reports shall
be furnished tb the Building Division'
STRUCTURAL CONCRETET ln
To be made after trenches are
excavated and forms are
erected, all sJeel 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.
X uNDERGRouND: Plumbing,
electrical , sanitary sewer,
ater and
rai nage nes.To be made
prior to covering or f illing
t re nc hes.
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
sheathi ng.
FLOOR INSULATION &
VAPOR BARRTERS: To be
made Prior to installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
FIREPLACE: Prior to Placing
facing materials and before
framing insPection.
FRAMING: To be made after
the roof, all f raming, fire
blocking and bracing are in
place and all PiPes, chimneYs
and vents are comPlete and
INSULATION & VAPOR
BARRIER: To be made after all
insulation and recuired 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 ls 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.
the rough electrical, Plumbing
and mechanical are aPProved.
STRUCTURAL WELDS:
Performed on the iob. (2722 t)
HIGH STBENGTH BOLTING:
buring all bolt installation and
tightening operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.BC.
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AN D FILLING:
Duri ng earthwork. (306 a.11 &
Chapter 29)
GLU.LAM BEAMS: lnspection
Certif icate by an approved
agency, f urnished to the CitY's
Building Division before
beams are placed. (2501 U.BC.
sTDS. 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
construction work to ensure
compliance with the Building,
City or Development Code.
ROOF SHEATHING ANO
NAILING: Prior to installing
any roof coverlng.
By signature, I state and agree, that I have carefuily examined the completed application and do hereby certify that all information
herein is true and correct,-and I further certify tnat any and all work performed shall be done in accordance with the ordinances
of the city of springfield, and the Laws of thsstate of oregon pertaining to the work described herein, and that No occuPANoY
will be made of any structure without permission of the Building Safety Division. I f urther certif y 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 located at the front of the property, and the approved set of plans will remai n on the site at all
ctiotimes during co
DateSignature
)/-
VALIDATION
>D
RECEIVED BY:
DATE PAIDAMOUNT HECEIVED
RECEIPT #
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
SITEPLANREVIEwBOARD:Mustberequested2dayslnadvance
of the date you wish inspection. All proiect conditions such as
landscaping,parkinglotstriping,etcmustbecompletedbefore
requesting this insPection.
FINAL BUILDING: Requested af ter the final plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
iertificate of Occupancy has been issued by the Bullding Division
and Posted on the Premises.
PLANS REVIEWED BY DATE /^7,/-21
ADDITIONAL COMMENTS:
,01)\,ar \A (
/D