HomeMy WebLinkAboutPermit Demolition 1995-06-15RESIDENTIAL
PERI]iIIT APPLICAI'ON
lnspections: 726.3t69
Ottice:726.3759
LOCATION OF PROPOSED WOBK:
ASSESSOBS MAP:
LOT:
SPrlI NG FIELD
JOB NUMAER ?-;ez
225 Fi f th Street
Springfleld, Oregon 9Z 477
TAX LOT:OC DA
z
BLOCK:
ZIP:STATE:CITY:
ADDRESS:
OWNER:
DEMOLISH *<OTHER
DESCRIBE WORI(:
NEW
--
REMODEL ADDITION
ADDRESS EXPIRES PHONE
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTBACTOR #
G EN EBAL:
PLUMBING
- OFFICE USE -
# OF BDRMS
WATEB HEATER
LAND USE:QUAD AREA:
I OF BLDGS:
SECONDABY HEAT:
SOUARE FOOTAGE:FIANGF-:
OCCY GROUP:
* OF STORIES:
ZONING CODE:
FLOOD PLAIN:
CONSTR. TYPE:
HEAT SOURCE:
# OF UNITS:
To request an inspection, you must call 726-3769. Thlmade the safile working day, lnspections requested
s rs a 24 hour recordrng. Ail rnspections requested before 7:00 a,m, wiil beafter 7100 a,m. wlll be made the followlng work day.
REOUIRED INSPECTIONS
Temporary Electric Rough Mechanlcal - prlor tocover.Final Plumbing - When ailplumbing worl< ls complete.
Site lnspection - To be made
af ter excavation, but prior losettinO forrns.
Rough Electrical - prior to l--l rlnat Etectricat - When ail
-
electrical work ls complete.
cover.
Underslab Plumbing/ Electrical/
Mechanical - prior to cover.Electrlcal Servlce - Must beapproved to obtaln permanent
electrlcal power.
Flnal Mechanical - When allmechanical work ls complete.
Foollng - After trenches are
excavated.Final Building - When allrequired lnspecilons have beenapproved and buildlng iscompleted.Masonry - Steel locailon, bonclbeams, groutlng.
Flreplace - prior to faclng
materlals and framlng lnsI
Framlng - prlor to cgver.
Foundatlon - After forms areerected but prior to concreteplacemen t.
B Othsr
Wall/Colling lnsulatlon - prlor tocover.
[--l Unaerground plumbinq - priorLJ to fittlig trench I Drywall - Prior to taping.
fu-a FD
Underlloor plumbing/ Mechanlcal
- Prior to lnsulatlon or ctecklng.
Posl and Beany. - prlor to floorlnsulation or decklng,
MOBILE HOME INSPE TIONSWood Stovo - Aflor installatlon
[-l tnsert - Alter ftreptace approval
-
and installatlon of unlt.
l-_l Alocking and Set.Up - When alt
-
btocktng ls complete.
Floor lnsulation - prlor to
decki ng.Curbcut & Approach - Afterforms are erected but prior toplacemont of concrete.
Plumbing Connecllons - Whenhome has been connected towater and sewer.Sanitary Sewer - prior to tilling
trench,
Storm Sewer - prior to flllingtrench.
Water LIne - prior to fillingtrench.
Rough Plurnbing - prior to
cover.
Sidewalk & Drlveway - Afterexcavatlon ls completc, formsand sub.base material ln place.
Electrical Conneclion - When
P_lg!kilg, ser.up, and ptumbingInspoctions have been approvedand the home is connected tothe servlce panel.[-l Fence - When compteted.
[-l Stroet Trees - When ail required
-
trees are planted.
Final - After all requiredrnspections are approved andporc.hes, sklrting, decks, andvenilng have been lnstalled.
SUBDIVISION:
-_
%
?-t za
PHoNE: 74.-z -*E
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total helght
bac
P.L.HSE GAR Acc
N
S
E
IS THE PFIOPOSED WO
HISTORICAL DISTRICT'
THE HISTOBICAL REGI]
APPROVED
RK IN THE
OR ON
STER?
ll yes, thls application must be slgned
and aPProved bY the Historical
Coordinator prior to permit issuance'
VALUE
BUILDING PERMIT
SO. FT. X S/SQ. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the cxpress concjition that the Said
construction shall, in all respects, conform to the Ordinanceadopted by the City of Springfietd, including the
Development Code, regulating the construction and use ofbulldings, and may be suspended or revol<ed at any time
upon violation of any provisions of saicl ordinances.
Plans ReviewecJ 13y Date
Recelpt Numbe
Date Paid
Received By
Systems Development Charge is due on all undeveloped
properties within tl.re City limits which are being improved.
)Lo
FEE
*sh.tQQ c@.
2Jo
N0
Moblle Home
Resldentlal Bath(s)
Sanltary Sewer
Storm Sewer FT,
Water FT.
Plumblng Permlt
State Surcharge
Total Charge
,2ft,4t
(c)
PLUMBING PERMIT
ITEM
Fix tu res
ADDITIONAL COMMENTS
MECHANICAL PERMIT
Fu rnaco
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/Flreplace Unlt
Dryer Vent
(D)
Mechanical Permlt
lssuance
State Surcharge
Total Permlt
By slgnature, I state and agree, that I have carcf ully examlned
the completed application and do hereby certlfy that all
lnformation hereon ls true ancj correct, and I f urther certify
that any and all work performed shall be done in accordance
wlth the Ordinances of the City of Springfietd, and the Laws
of the Stato of Oregon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCy wiil be made of any
structure wlthout perrnission of the BulldinO Safety Dlvislon,
I further certlly that only contractors and employees who
are ln compliance with OBS 70i.0S5 wiil be used on thls
proiect.
I f urther agree to ensure that all requlred lnspections are
requested at the proper time, that each address ls readable
from the street, that the permit card ls located at the front
of the property, and the approved set of plans will remaln
Date
n the slte at times during construction.
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut '
f t
/yo fae'F> ZDa-
Total Mlscellaneous Permits (E)
Itlon
State Surcharge
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
/./ z-o1-/A2----
_<eDATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
RECEIPT NUMBER
Lot TYPe
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de-sac
rot^r ree t/a P. CftAtMf-2,*rrl)
Plan Check Fee: _
SYSTEMS DEVELO PM ENT CHARGE (SDC)
(B)
.FT
CITY OF OREGON
SPRIL.- ,ELD
FD- i5B
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726 3737
FAX (503) 726.2297
DEPARTMENT OF FIRE & L'FE SAFETY
OPERATIONS h,
TRAII\ING BIIRN AUTEORIZI\TION
L-
TO:City of Springfiel( a Municipal Corporation, acting by and through its Department of Fire
and Life Safety
You are hereby authorized and permitted to burn under zupervision and for education and instruction
purposes that certain house or building located on:
Taxlot #.:{OC - bOO ln Addition to Springfiel(
Oregon which is designated as .?-f{ S:,. q 7 Stoeet, Sprinef,el{ Oregon.
UWg expressly warant and represent to you that UWg the undersignd are the owner(s) of said property,
and that tlte same is free and clear of any and all liens, encumbrances, judgments, and any interest right,
title or claim in any other person other than the undersignd and that this consent is freely and
voluntarily given, and that we will save the City of Springfield harmless from any liability to any person
whomsoerrer by reason of any statement or warranty contained in this letter.
UWe, the undenigned, also agree to the following requirements imposed by the Department of Fire and
Life Safety to assure completion ofall regulations.
l. The property owner(s) shall remove all debris on the lot(s) involved in this burn
within sixty (60) days after completion date of the burn by the Department of Fire
and Life Safety.
2. The property owner(s) is to secure the required demolition and plumbing cap
p€rmits from the luilding Department when inside the City Limits.
3. Outside City Limits, County regulations apply.
4. The property owner(s) shall have the stnrcture inspected for a$estos. This
includes:
a. An internal and external inspection of the structue by an asbestos or
environmental consulting fi rm.
b. Removal of asbestos containing materials, as indicated by the inspecting
firm.
l. An Owner-occupant mayperform a$estos removal.
a. The Waste Shipment Record (ASN4) must be filled opt
b. Setup an appointment with Short Mountain Landfill -
6874120 - for disposal.
2. If not an oumer-occupant" a removal company must perform
asbestos removal and disposal.
c. The property owner(s) shall submit a copy of the original asbestos inspection as written
by the inspecting firm and a signed note asbestos has been removed.
ADDRESS
PHONE
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Bulk Sample Sheet
Magnum EnvironmenLal, Inc.
Client
Attention
Project Name
Project Address
Results To
Job Number
Date Sampled
Date Submitted
Marbrook 95-1097
Maxine Marlow 06-05-1995
Rental Scheduled For Demo (Buming)06{5-1995
255 S.47th Street - Spring{ield, Oregon 97478
Sample #Material Description Sample Location Condition
95420S-1 1'x 2' Ceiling Tile Throughout Downstiairs Fair
954210-1 Sheet Vinyl - Tan''llle Pattem Kitchen
9s-021 1-1 Sheet Vinyl - Creme Tile Pattem Utility Room & Bathroom
954212-1 Sheetrock Throughout
95-02 1 3- 1 Siding Roof Good
954214-1 Roofing (Petroleum Base)Fair
Quantity Sampleds Name Tum Around Analysis Requested
6 Jack R. Pierce Regular PLM - Bulk Analysis
Relinquished By Received By
Company Magnum Environnrental, lnc (Field)Company Magnum Environrnental, lnc. (Lab)
Signature (l^-t 2',t^ o--,Signature
Print Name (Jack R. Pierce Print Name Mark A. Losco
Comments
Maxine Marlow Format VerbaULetter Page -L of 3-
Bulk Analysis Report - Asbestos
Magnum Environ-cntal, lnc.
Client
Attention
Project Name
Project Address
Analyst's Signature
Job Number
Date Sampled
Date Submitted
Marbrook 95-1 097
Maxine Marlow 06-05-1 995
Rentai Scheduled For Demo (Buming)06-05-1995
255 S. 47th Street - Spring{ield, Oregon 97478
lrlole: Method ot Analyss (NlOSif 9202) diitiog a polarized lioht micBopy with d6peBion eaining oii All malsials anal/zed 6nt aning l% d rcc asbestos mus b€ teated as asbeslos
Sample lD Number 95-0209-1 954210-1 954211-1 954212-1
Sample Location Living Room Kitcfien Uliliy Room Aftic
Sampled By Jack R. Pierce Jack R. Pierce Jack R. Pierce Jack R. Pierce
Analyzed By Mark A. Losco Mark A. Losco Mark A. Losco Mark A. Losco
Material Description Ceiling Tile Vinyl - Tan Tile Pattem Vinyl - Crerne Sheetrock
Overall Appearance Friable Non-Friable Non-Friable Friable
Homogeneous Yes Yes Yes Yes
Layers No No No No
Fibrous Yes Yes Yes Yes
Color Tan & White Beige Beige Ofl-White
Sample Treatment Teased Teased Teased Crushed & Teased
Asbestos Content No No No No
I - Percent Chrysotile
2- Percent Amocate
3. Percont CrociJolite
4. Percent Ottpr
1.
2
3.
4.
0?o
o%
o%
Oo/o
1.
2.
3.
4.
o%
o%
ff/o
Oo/o
'1.
2.
3.
4.
0%
o%
V/o
tr/o
1
2.
3.
4.
0%
o%
o%
e/o
Total Pefcent Asbestos 0%ff/o V/o o%
Fibrous Content Yes Yes Yes Yes
l. Percent Cellulose
2- Percent Fiberglass
3. Percent Synthetic
4- Percent Ottrer
1.
2.
J.
4
6s%
o%
ooi
o%
1.
2
3
4.
151o
3OYo
Ooto
o%
1
2.
3.
4
1Oo/o
35%
a%
O7o
1.
2.
3.
4.
25?o
15%
o%
09o
Non-Fibrous Contenl Matrix Matrix Matrix Fermiculite
Sample Disposition DBL 30 DBL 30 DBL 30 DBL 30
Abbrwi.lhns: RTC 30 . Rstumed To Clbnt within 30 d:y6 tollowing analyis, DBL 30 = Oispoed 8y Lab 30 days iollming amtyss, HFA 306090 = Hold For AnalFis 30,60€0 days
Comments I
/t{,! {"1 Date 0646-95 Page 2 of.L
Phorc (5O3) 6t9-S62o lOT9 Highway fS North
Bulk Analysis Report - Asbestos
Magnum Environmental, Inc.
Client
Attention
Proiect Name
Project Address
Analyst's Signature
Job Number
Date Sampled
Date Submitted
95-1 097Marbrook
06-os-1995Maxine Madow
06{5-1995Rental Scheduled For Demo (Buming)
255 S. 47th Street - Springfieid, Oregon 97478
95-0213-1 954214-1Sample lD Number
RoofSample Location Exterior Siding
Jack R. Pierce Jack R. PierceSampled By
Mark A. Losco Mark A, LoscoAnalyzed By
RoofingMaterial Description Transite
Non-FriableOverall Appearance Non-Friable
Yes YesHomogeneous
No NoLayers
Yes YesFibrous
BIackColorG.aY
Crushed & TeasedSample Treatment Crushed & Teased
NoAsbestos Content Yes
1.
2.
3.
4.
35%
o%
o%
tr/o
1.
2.
J.
4.
o%
o%
o%
o%
l- Percent Chrysotile
2. Percent Arnosite
3. Fercot Grocittolite
4. Farcent Ofter
35%e/oTotal Pei'cent Asbestos
Fibrous Content No Yes
1.
2.
a
4.
o%
o%
o%
a%
1.
2.
3.
4.
o%
15%
OYo
ff/o
l- Percent Cellulose
2. Percent Fiberglass
3. Percent Synthetic
4. Percsrt Other
Fermiculite MakixNon-Fibrous Content
Sample Disposition DBL 30 DBL 30
ADtrdietim RTC 30 = Returcd To Clicnt wlthin 30 d.y6 fo{iling .aatylis, DBL 30 : D,lped By Leb 30 days folwng amty!i6, HFA 3016090 = l-told For Anslysb 3ry609o days
rr\ tComments
Date 06{6-95 Page,l of .f
Phom (5o3) 6t9-8620 fO79 Highway 99 North Eugcoc, Orcgoo 97{02 l-er (5O3) 689-8619