HomeMy WebLinkAboutPermit Building 1997-07-24CO M M ERCIAL/I N D USTRIAL
PERM!T APPLICAT!ON
225 Fitlh Street, Springfield, Oregon 97477
LOCATIOT.] OF PROPOSED WORK:
ASSESSORS MAP:
SPFINGFIELO JOB NUMBER
2fr,
7
TAX
#
d-3
PHONE:
STATE:ZIP:.?zrzz
726 - //OWNER:
ADDRESS:
CITY:
VALUE:DEMOLISH OTHERNEW
-
REMODEL I./ ADDITION
|/-
DESCRIPTION OF WORK:
NAME ADDRESS PHONE
CONST.
CONTRA TOR #NA Grrtt<-0
Z
2 r
-2,
EXPIRES PHONE
MECHANICAL:
ELECTRICAL:
ARCHITECT:
PLUMBING
G E N ERAL:
CON S ADDRESS
NO.FEE CHABGE
Slngle Fixture
Relocated Bldg
(new flx. addtl)
Water Service
ft.
Sanitary Sewer
ft
Storm Sewer
ft
Backf low Device
ila],r{u,o 1" bo
,'h c{,,ll.J - r"un*ul *1
eW,;1 t t42,
U
TOTAL PERMIT @
NN FFtr CHA RGF
Furnace/burner a vent
<100,009 BTUs
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f looT
mounted unit heater
Appllance Vent
separate
Stationary evap.
cool er
Vent Fan/Single
duct
Vent System apart
from AC or htg.
Mechanical exhaust
hood and ductW -2//t),
Permit lssuance $10.00
TOTAL PERMIT /6?o
ZONING:
LIGHTING POWEB BUDGET:
WATER HEATER:
- OFFICE USE -
LAND USE FLOOD PLAIN
OCCY GROUP:
I OF STORIES:
QUAD AREA:
I OF BLDGS:
HANDICAP ACCESS: _
CONSTR. TYPE:
HEAT SOURCE:
I OF UNITS:
$/SQ. FT.VALUE
TOTAL VALUE OF,PROJ
PLAN CHECK FEE RCPT'DATE BY3L2_A
x
X
X
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
BUILDING PERMIT /<Lr^PLUMBING DEMOLITION
3'l.i',',!'.Zf 3+ 4l g /L?(5% State
Surch
MECHANICALlTJdatre /5:,la-Oo FENCE
VALUE $
3Y;"if,i". ,?f+.4 r /,La SIDEWALK
FT.
SUBTOIAL
PERMITSINGCUBBCUT
FT,
SYSTEMS
OEVELOPMENT
ZTOP+TOTAL PEBMIT FEES
EXCLUDING ELECTRICAL
INSPECTION LINE: 726.3769
OFFICE: 726.3759
77//-/
claos
O,^
SQ. FT.
It ls the res ponslblil ty of the permt t holder to see that all I
REQUIRED INSPECT
nspecilons
toNS726.3769 (recorder),state your Cl ty dest gnated
a.m. wlll be
Job numbe
made the
r, Job add ress, type of inspec
same worklng day, refu
tion
for lns pecilon Req uests rece before 7:00
are made at the prop er tlme. To request an i nspection, catrequested and whenests made after 7:00
UNDERSLA
ELECTRICA B PLuMBtNc,
the followlng work day.
lved
SITE IN sPEC-t:'lON: To bemadeafterexcavatlon, butprior to setup of forms.
excavated and fo rms areerected,
prlor to placlng c
all steel In place, butoncrete.
ROOF SH EATHTNG ANDNAtLtNG:Prlor to lnstalll n0any roof coverlng.
you will be read.
a.m. wlli oe maOi
PAVING: After gravel is ino work ls to place but prlor to. placing
u ntll these asphalt or conc rete.lnspecflons have been made SpECtAL ECTTONS: I n accordanceINSPSection306 of the State S pecialt Y Codea speclal ln spector shallby the Own erl Contractor be emp
durin
loyed
sconstruction of the follo wing work. A
MECHAN ICAL: To be made and approved
before a ny work ls covered.Arrtc DRAFT STOPS &
FOOTINGS & FOUN DATIONS:
CU RTAIN WAL LS
To be made after tre
iafflHf:ij:"w t:?:i:'
blockl ng and bracln g are lnplaceand all pl pes, chlm neysandvents are com plete andtheioughelectrl
:i,','."?i, ff 1 i,""
r, ",
lcal, plumblno
are approved]
coPY of the speclal tesil ng reports shallbe furnis hed to the Buit ding Divis ion.
STRUCTURAL coN CRETE: tnexcess of 2500 PS.l. (306 a.1)
STRUCTU RAL WELO S:Performe d on the jo b. (2722 t)
HIGH STR ENGTH B OLTING:
CONCR-ETE SLAB: To bemade after ail tnstlO-OuttOtng
iiJ^,',#j ;"x1 sff i:: :.^*;l I ";
ff ii{ii .",Trets?3'J;;;; ; ;;
concrete ls placed.
FRAMIN
the roo t,
and mec hanlcal
INSULATI ON&VA PORBARRIER: To be made after all a.6)
Durl ng all bolt lnst allation andilghtening operati ons. (306
-
SPRAYED ONFIREPROOFTNG:u.B.C.Standa rds 43-8.
'ln add Itlon to the lns pec.uons speclfled , the BulldlngOf flctat may make or re qulreother I ns p€cil on I ofa nyconStrugtlon work to engure
storm sewdralnage ttn6s. ro o6.riaaeprlor to coverrnslilliii;;"trenches.
-
y,:",;:5:1?$5llgf ,
?:, ^-made prtor to lnst;l;;to; ;iftoor lnsulatf on, Oec'fif ni,oI,floor sheathlng.
POST & BEAM: To be madeprlor to rnstarr"tron?.ii3lIlnsutauon, oe"r.rnJ ;; ;i#;sheathlng.
.MoR tNsuLArtoN &VAPOR eaRRrEiS: io bemade prtor to tnstailait;; ofdecklng or floor "n""ii,irsl,
MASONRY: Steel tocaflon.bond beams grouitn;;i",
ve_rtlcals ln aclordan"cJ wlthuBc 2415.
lnsu latlo n and re qulred vaporbarrlersare ln place butbeforeany lath or gypsum
applled.
board I nte rlor wall coverlng ls
FIRE & SEPARATION WALL:Located and constructedaccordlng to plans.
,Y -
SPECIAL GRADING.
EXCAVATTON aN'dir r_r_rru c,During earthwork. (ao6; riaChapter 29)
_ GLU.LAM BEAMS: lnspectlonceruftcate uy an appiJv-"-j,",,
P!!'?iI;'B!?t
s treo iJ i [e"6r tv s
3ie3:;T#aceo' asdi u ac
_ STRUCTURAL MASONRY: (006a,Z)
,i1i$&:t,[fuH:,.{f,,"',
ptace but before anvprss_terlng ls applle6 or beforegypsum board Jolnts and
;ili:,ffi: are ta'ed and
:LoElvA![ & DRTVEWAY:F{equlred for all concrete
.?.1yl1S_ wlthtn street rlsht ofway, to !e made after lllexcavailng complete and formwort( and sub.base materfa'i'inplace,
i H 13 ^il i fi,',:,o#"" :,"
:11"^t:q,but prtor to ptactnsconcrete.com pll ance wlth
By slgnature' I state and agre€, that I have caref ully examlned the completed appllcailon and do nereoy cerilfy thFt all lnrormatlonhereln ls true and correct, and I further certlfy that any 8nd all wori pbrformeb'shail bo dons ln ecoordanco wlth tha ordlnlnoosof the Clty of Sprlngfleld, and the Laws of the State of Oregon portal;lno to the work Jescrloeo hereln, and that No occupANcywlll be made of any structure wlthout permlsslon of the Bulldlng safety olvtston, I further ""rtii/tn"iohiv "",itiir'","rs and emptoyeeswho are ln compllance wlth ORS 701.0SS wlll be used on thls prolect,
I further agree to ensure that all requlred lnspectlons are requested at the proper tlme, that prolect address ls readable trom thestreet, that the permlt card ls located at the front of the property, and the approved set of plans wlll remaln on the slte at alltimes durlng constructlon.
2-Sig n ature Date
VALIDATION ECEIVED
2/e
"-.3
2RECEIPT g:
AMOUNT
RECEIVED BY:
DATE PAID:
Clty or Developm the Bullcilng,€nt Code.FINAL PLUMBlNGx
z\
*
SITE PLAN REV]EWof the date you wlshlandscaplng, parklng
requesilng thls lnspe
?_Ol!?.r, Mus.t..be requested 2 days tn advancernspecilon. All project condltloni sr;;;; ,
tot strtpins, etc. must Ue co.pie-t#'O!rli",ctlon.
FINAL ELECTRTCAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
ADDITIONAL COMMENTS:
).
PLANS REVIEWED BY
FINAL BUILOING: Requested af ter the flnat plumblng, etectrlcal,mechantcat and Ftre cjepaiimeni-i";;;;ii;"" ars made andapproved. No occuoancy of the pr"-T"Ji'iln be made unilr a!-e1tt]t-c-1te.of occu'pancv nas oeln isorJo-iv the Burdrng Drvrsronancl posted on the premises.
DATE
stlR,.--.1FtELC)
,H/S
4Ut*,
w
97 477
726-37 69
Zoni (ct
I
225 FIFTH STREET
SPRINGFIELD, ORECON
INSPECIION REQUEST:
0FFICE: 726-3159
1 ION IN]*4 JA T
PERHIT APPLICATIONhbql ilZl
Permits are non-transferabl-e and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days
Job Number
FEE SCEEDIILE BELOV
Nev Residential-Single or
MuIti-Family per dvelling unit.
Service Included:
I tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Modular Dvelling
Service or Feeder
s 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
')
A
Ygz o4 Sum
OB ON
i yuCt
,
EIec
Addr
Ci ty
Supe
Expiration Date
Constr Contr. N
Expiration Date
CONTRACTOR IN
trical Contrac
ess
Pli
rvisor Lic e Number
ON ONLY B.
C.
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0n1y
s s0.00
s 60.00
s100.00
s130.00
s300.00s 40.00
umber
Temporary Services or Feeders
InstalIation, Alteration or Relocation
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amps
-Over 600 amps or 1"000-voITs
Signat of-Supervising EIec ician
0vn s Name
Add ress
$4$s$e
see
0.00
5.00
0.00
"9" 3[[iE-
D. Branch Circui ts
b Nev, Alteration or Extension Per Pane1
Ci ty
O\INER I ALt,ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Orrners Signature:
Phone 72h L/07'/ s 3s.oo ,{One Ci rcu i t
Each Addi tionaf
Circuit or vith Service,
or Feeder Permi t -Z-
Miscellaneous (Service/feeder
-Each ins tall-ation
Pump or irrigation S
Sign/Outline Lighting- $
Linri ted Energy/Res
-
$
Limi ted Energy/Comm S
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
$ 2.00
.11 not
40.
40.
20.
36.
included )
00
00
00
00
135 m
DATE:
/. /7R.ECE PT
1H7-
q2./L