HomeMy WebLinkAboutPermit Building 1993-11-10COM M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATION
225 Frtln Street, Springfield, Oregon 97477
SPFIIi.GFTELO
JOB NUMBER 2>L68/
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK LS 3 So**t /S 4
ASSESSORS MAP:/'/ 03 jb ?Z TAX LOT:o /ooa
ry*6-7/ ?{PHONE:4d
D?STATE:ZIP:?ry'rry
3
/ r,voa 1 //ovo l/e&e
S?rrnCFtCITY:
ADDRESS:
OWNER:
o,r/€ 6n/ R\AP l4inr lOL'rJ./x DEMOLISH OTHER uorur,u o00
DESCRIPTION OF WORK
NEW
-
REMODEL ADDITION
PHON El l.tttl
ADDRESS
3o 1/7-trr3-&-
3o4
PHONEEXPI RES
MECHANICAL:
ELECTRICAL:
ADDRESS
t l/talt
NAME
CONTRACTOR'S NAME
ARCHITECT:
PLUM BI N G:
GENERAL:
CONST.
CONTRACTOR #
PLU MBING
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
MECHANICAL
NN FFF CHARGF
Furnace/burner & vent
< 100,000 BTUs
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cool er
Vent Fan/Single
duct
Vent
from
System apart
AC or htg.
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT
_ OFFICE USE :b3C()ofZONING* OF UNITS:
LAND USE
HANDICAP ACCESS:
FLOOD PLAIN
LIGHTING POWER BUDGET:
WATER HEATER:
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
SQ. FT.$/SQ. FT.VALUE
*1@
TOTAL VALUE OF PROJ
X
X
X
SQ, FTG MAIN
SQ. FTG ACCESS
SO. FTG OTHER
acer" /427 ^q*.DATE BYPLAN CHECK FEE z3
520,?z
BUILDING PERMIT %-*PLUMBI NG DEMOLITION
5olo State
Surcharqe ?-fr 5% State
Surcharqe
MECHANICAL FENCE
VALUE $
5% State
Su rcharqe
SIDEWALK
FT.
SUBTOTAL
PERM ITS ?d-a7
PAVING CURBCUT
FT.
SYSTEMS
DEVELOPMENT fr quoo3 X
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
/?
-REQUIRED INSPECTIONS
It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call
726-3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready
for inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made
the following work day.
SITE INSPECTION: To be 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 SpEC;AL INSpECTIONS: ln accordance
ELECTRICAL & and approved. Section 306 of the State Specialty Code
MECHANICAL: To be made
before any work is covered.
FOOTINGS & FOUN DATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
concrete is placed.
UN DERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or f illing
trenches.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing.
POST & BEAM: To be made
prior to installation of floor
insulation, decking or floor
sheath i ng.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
uBc 2415.
ROOF SHEATHING AND
NAILING: Prior to installing
any roof covering.
ATTIC DRAFT STOPS &
CURTAIN WALLS
FIREPLACE: Prior to placing
facing materials and before
framing inspection.
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are in
place and all pipes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanical are approved.
INSULATION & VAPOR
BARRIER: To be made after all
insulation and required vapor
barriers are in place but
before any lath or gypsum
board interior wall covering is
applied.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
interior and exterior, is in
place but before any
plastering is applied or before
gypsum board joints and
fasteners are taped and
f inished.
SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material in
place.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
a special inspector shall be employed
by the Owner/ Contractor duri ng
construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
K STRUCTURAL CoNCRETE: In
excess of 2500 P.S.l. (306 a.1)
v
X
STRUCTURAL WELDS:
Performed on the job. (2722 t)
HIGH STRENGTH BOLTING:
During all bolt installation and
ti ghteni ng operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.B.C.
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AN D FILLING:
During earthwork. (306 a.1'1 &
Chapter 29)
GLU-LAM BEAMS: lnspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed. (2501 U.B.C.
STDS. 25-10,11).
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.
\,\-l\{
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 all work performed shall be done in accordance with the Ordinances
of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUpANCywill be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employeeswho are in compliance with ORS 701.055 will be used on this project.
Date //-,/a -73S ig natu re
CNSUo thatre al re U dre areons uested atq he th a roreqproperme,add Sre S readSp,ject leab mfro ethatthheSreetocatedf ron ofperm he nda heprorty,pe Sroved oet San atppplrem n no eth it EmesudnflconSs
VALIDATION:^a /?z9a1AMOUNT RECEIVED:
RECEIPT S:RECEIVED BY:
DATE PAID:
FINAL PLUMB!NG
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL F!RE DEPARTMENT
ADDITIONAL COMM
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All project conditions such as
landscaping, parking lot stri ping, etc. must be completed before
requesting this inspection.
x FINAL BUILDING: Requested after the final ptumbing, etectrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
PLANS REVIEWED BY DATE /A?4 >
d
I further agree
,! ! r..!gt lELg
1
225 FIFTE SIRBBf, ]: ]
SPRTNGFTBLD, oRBGoN 97 477
INSPBCIION REOIIBST: 726-3769
0FPICE: 726-3159
Perml ts re non-transfelf vork ls not started th
The,.rtlowing project as submitted h* the lollowing
zoning, and does not requiro specific land use
ELSCf,RTCAL PERHIT APPTICATION
Date ?-ur-q\Ctty Job Nuuber
t. . N.,eL._C_gIf.l,EJE--rj_E SCEEDULE BEtOs
[{,t.
q+
Nev Resldenttal-Slngle or
Hultl-Famtly per dvelllng unlt.
Servlce Included:Items Cost
1000 sq.ft. or less
Each addltlonal 500
SQ. ft or portlon
thereof
Each Hanuf'd Home or
. Modular Dvelllng
Servlce or Feeder
$ 85.00
$ 15.00
$ 40.00
of lssuance or lf vork ls suspended for
180 days.
2. COITTRASTOR INSTALI.ATION ONLY
EIect rlcal contracto, L.R. BRABHAI4, INC.
Address 68 l,l. "Q" ST.,
Ct ty SPFLD Phone 747-6638
Supervlsor Llcense Ntimber I 473S
Expl ratlon Date 10./1/95
Constr Contr. Number 08699
ExP iratlon Date I 2/18/94
Slgna ture of Supervlslng Blectrlclan
Ovners
address4% 50
Cl ty 1 7ab'qn+Phone
OIINER INSTATI,ATION
The lnstallatlon ls belng made on
property I ovn whlch ls not lntended
for sale, lease or rent.
Omers Slgnature:
DATB:
RECEIPT
a
Sum
e and explreln 180 days
B. Servlces or Feeders
Installatlonr Alteratlons or
Relocat lon:
c.
D.
200 amps or less $ 50.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $f30.00
0ver 1000 amps/volts $300.00
Temporary Servlces or Feeders
Installatlon, Alteratton or Relocation
200 amps or less $ 40.00
201 amps to 400 amps
-
$ 55.00 ,
0ver 401 to 600 amps $ 80.00
Over 600 amps or 1000 volts see I'8" above
Branch Circuits
Nev, Alteratlon or Extenslon Per Panel/sil
One Clrcult i
Each Additional
Circuit or vith Servlce-
or Feeder Permi I 5
zr r1A$ 35.00 ri::
$2.oo /0.00
B
5. STIBTOTAL OT ABOVB
5Z State Surcharge
TOTAL
Hiscellaneous ( Servlce/feeder
-Each lnstallatlon
Pump or irrlgation S
Sign/Outline Lighting- S
t,iili ted Energy/[es --
$
not included)
40.00
40.00
20.00
36.00
OREGOCITY OF SPN
RECEIVBD
4 5,lo
q3tr col
JOB N0. nbr o
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
T.IORKSHEET
PR0FESSIoNAL oFFICES & INDUSTRIAL)(
NAME OR COMPANY:
L0CATION: Zh%6ou rA l51l Sr .l,-l o 12 bbbz - o.?ooo
DEVELOPMENT TYPE
BUILDING SIZE:
1. STORM D RAINAGE /
IMPERVI0US SQ. FT. 0.5 x \126
NO. OF PFU'S 0.5 X
(See Reverse)
tNct-oEE UVE,
x $0.203 PER SQ. FT
$
X $42.08 PER PFU
3 TRANSPORTATION
rrltlrroE*otoplNo . o 1r? / tg S f
NO OF UNITS X TRIP RATE X COST PER TRIP
0.5 x
0.s x
0.5 x
4. SANITARY SEWER-MWMC
NO. OF PFU'S
t,412 x o,1b x$424.31
x _ x $424.31
x x $424.31
(Use PFU Total From Item 2 Above)
Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE)
ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .05
p Burdick
Coordinator
$
$I5.125 PER PFU + $10 Mt,lMC ADMIN. FEE $
TOTAL-MWMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)s 'tol bJ
Y
5
2"A23
?4 ?
TOTAL SDC $ qbo"3
L-
SIZE SQ Ft.
2. SANITARY SEt,lER-CITY
FIXTURE UN,IT CALCUI-AT.-N TABLE: ruumuer of New Fixrures X.- Equivalent = Fixture Units (NoTE:
For remodels, calculAie only the l'ilEJ additional fixtures)
NUI4BER OF UNIT FIXTURE
FIXTURETYPENEWFIXTURESEOUIVALENTUNITS
Bathtub.......
Drinking Fountain......
Floor Drain--
tnterceptors For Grease/Oil/Sol lds/Etc.......-... --....
lnterceptors For Sand/Auto Wash/Elc...-......:.......
Laundry Tub/Clotheswasher.....-.-
Clothes-waqher - 3 Or More........--.
Mobile Hdnie Park Trap (1 Per Trailer)......-....----.:.
Beceptor For RefrigeratorAVater Station/Etc.-......
Receptor For Commerclal Sink/Dishwasher/Etc--
Shower. Single'Stall. ..........-..---..--....--.-
Shower, Gang...........
Sink, Bar, Commercial
U rinal, Stall7YVall....
Wash Basin/t-avatory, Single.......-.
Water Closet, Public lnstallation....
Water Closet, Private.
Miscellaneous:
TOTAL FITTURE UNITS
CREDIT CALCULATION TABLE: Based on assessed valUe. lf improVements occurred after annexation date in table,
calculate credits
2
1
2
6
2
6
6
1
3
2
1
2
2
1
6
4
ead/H
Credit for Parcd or land Only lf Apflicable
lmprwement fif after annexatlon date)
x $-
(Rate X Assessed Vatue)x 9-
(Rate X Assessed Value)
CREDIT TOTAL $
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1985
't987
1988
1989
1990
1991
1992
$ 2.24
1.93
1.57
't.18
0.79
0.44
0.28
1979 or before
1980
1981
1982
1g€Xl
1984
1985
$3.21
3.13
3.08
2.96
2.82
2.68
2.51
RUNOFF COEFFTCIENTS FOR STORM DRAINA'GE
Besidential.
Commercial.....--............
lndustrial....
Govemmental................
0.4
0.9
o.45
0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT