HomeMy WebLinkAboutPermit Building 1997-08-11APRITTGFIELEt
COMMERCIAI,/ INDUSTRIAL PERMIT APPLICATION
CITY OF SPRINGFIELD I
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
Page 1
ilob Number: 97LOL4
225 North Fifth Street
Springfield, OR 97477
Location of Proposed Work: 152 28TH ST
Assessors Map #z L703364a
Office
Inspection Line
726 -37 59
726 -37 69
Tax Lot #: 00200
OTT OF SPruNGFIEID,
Owner: LEIGH CAIIPBELL
AddrESS: 358 BLAIR BLVD
DescripLion Of Work: DELI EQUIPMENT
Phone #: 342-5277
city/stare/zip: EUGENE, OREGON 97402
ADDITION Value:6,100.00
Plumbing:
Electrical
Contractor
DRAIN SAVER 0102888
Box 40325 Eugene OR 974040000
C&SELECTRIC OOO3849
PO Box 1-482 Springfield OR 97477000
Const.
Contract,or #Expires
1,0 /31,/ e7
oe/01,/e7
484-0803
7 41_-2236
No
7 Single Fixture
TOTAI, PERMIT
--- PLI'MBING ---
-- oFrrcE usE
LAND USE: 5300
Fee
$/Square Feet
Charge
70.00
70. 00
VaIue
5, 000 . 00
5, 000 . 00
QUAD AREA: 2CNW
Item
TNTERIOR REMODEL
TOTAL VALUE OF PROJECT
Plan Check Fee 32.83 Rec #: 26477 Date: 07/02/97 Rec By: LORNE PLEGER
BUTLDING
Surcharge/admin
MECHANICAL
Surcharge/Admin
PLUMBING
surcharge/admin
SDC FEES
SUBTOTAL PERMITS
50.50
4. 0s
0.00
0.00
70.00
5.60
295.22
425 .37
TOTAI, PERMIT FEES EXCLI'DING EI.ECTRICAIJ 425,37
Phone
SPFTXGFIELEl
Job Number: 97]0]-4
qTTOF a
Page 2
--- REQUTRED TNSPECTTONS ---
IL is the responsibility of the permit holder to see that all inspections are
made aL the proper tsime. To reguest an inspection, caLL 725-3769
(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 Ehe following work day.
Special InspecEions: In accordance with Section 306 of the SEate Specialty Code
a special inspector shall- be emptoyed by the Owner/Contractor during
construction of any following "*" work. A copy of the special testing reports
shall be furnished to Building Safety.
In addiLion to the inspections specified, the Building Officia1 may make or
reguire other inspections of any construction work to ensure compliance wiLh
the Building, CiEy or Development Code.
ROUGH PI.I,}TBING - PriOr TO CO1rET.
ROUGH ELECTRICAL - Prior to cover.
FINAL PLUIIBING - When all plumbing work is complete.
FINAL ELECTRICAL - When alf electrical work is compleEe.
FINAL FIRE - When all Fire Department requirements have been met.
been met.
FINAL BUITDING - When all required inspections have been approved and
the building is complete.
--- ADDITIONAL COMME}flTS ---
REVIEW OF IMTERIOR REMODEL FOR NEW DELI RESTAURANT
Plans Reviewed By: LORNE PLEGER
Building Site Reviewed By: LrSA HoPPER
Date: 08/07 /97
By signature, I staEe and agree, that I have carefully examined the completed
application and do hereby certify that alf information hereon is true and
correct, and I further certify t,hat 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 OCCUPANCY will be made of any structure without permission of the
Community Services Division, Building SafeLy. I further certify 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 al-L required inspections are reguested at the
proper time, Lhat project address is readable from the street, that the
permit card is l-ocaLed at the front of Lhe property, and the approved set
of ptans witl remain on the site at all times during construction.
)
)flft, /qz
ignature Date
oN ---
Receipt Number:
DaLe Paid:
Amount Received:
Received By
JOB N0. 47 t ot4
C ITY OF S PR-i NGF I ELf,T:iTilM,S0,,,,,-oPMENT CHARGE
WORKSHEET
NAME OR COMPANY 4 \oa)
LOCATICN I 5-L Zk ru /-t
DEVELOPMENT TYPT i? E*o.n cr Dal r
BUILDING SIZE OT SI Ft
1 SIORM DRAII1AGI
IMPERVIOUS SO. FT X $0.225 PER SQ FT. $
2. SAN ITARY SEi\rER -C ITY
NO. OF PFU'S X $.16.86 PER PFIJ $ z8l , tb
.)J
(See Reverse Side)
IRANSP0RTATi0N p/*
NO OF UNITS X TRIP RATE X COST PER TRIP
x
-
x $472.49 $
MI^JMC CREDIT IF APPLICABLE (SEE REVERSE)
x $472.49
x $472.49 $
X PER FEU + $10 I'II^IMC/ADM FEE q
TOTAL-MI^JI',|C SDC
SUBTOTAL (ADD ITEMS 1.2,3 & 4)
$
$
$ 28t.tG
,o6
X
X
$
4 SANITARY SE,^IER -Mu;MC
NO. OT FEU'S
5. ADl\,lINISTRAIIVE FEES
BASE CHARGI (SUBTOTAL ABOVE) X .05
SDC Coordi nator
Date:
TOTAL SDC $ 2?f,zu
flr\ I UnE UlVl I UALtsut.A I lLrlV r Ar)Ltr: Number oi New Fix' s X Unit Equivarent : Fixture.Units
(NOTE: For remodels, calculate on,
FIXTURE TYPE
Bathtub..............
Drinking Fountain
Floor Drain
lnterceptors For Grease/O illSolids,rEtc
lnterceplors For Sand/Auto WashiEtc..................
Laundry Tub/Clotheswasher.....
Clotheswasher - 3 Or More....
Mobile Home Park Trap (1 Per Trailer)
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial SinkiDishwasher/Etc..
Shower, Single Stall...
Shower, Gan9.........
Sink: Bar, Commercial, Residerrtial Kitchen....
e NET additional fixtures)
. NUMBER OF
NEW FIXTURES
/-
UNIT
EOUIVALENT
r:IXTURE
I.,'NITS
7
dlHea
2
1
2
3
6
2
6
6
1
3
2
l,
2
2
1
o
4
Urinal, Stall/Wall....
Wash Basinilavatory, Single......
Toiiet, Pubiic lnstallation.
Toiler, Private.......
Miscellaneous:
TOTAL FIXTURE UNITS
CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in rable,
calculate credits
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
x $_
(Rate X Assessed Value)
X$
(Rate X Assessed Value)
CREDIT TOTAL = $
Year
Annexed
Rate per S1,000
Assessed Value
Year
Annexed
Rate per $1,OOO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
1 986
$3.97
3.89
3.83
3.70
3.55
3.39
3.20
2.91
1 987
1 988
1 989
1 990
1 991
1 992
1 993
1 994
1 995
1 996
$2.56
2.17
1.73
1.31
o.92
o.74
0.61
o.45
o.31
o.17
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Only)
Hesidentiai... :....................... 0.4
Commerical ..... o.9
lndustrial...
Governmental............
o5
o.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
("
COM M ERCIAL/IN DUSTRIAL
PERMIT APPLICATION
225 Fitlh Street, Springfield, Oregon 97477
SPRINGFlELO
f)dZ ot336TAX LOT:
z4
JOB NUMBER
LOCATION OF PBOPOSED WORK:
ASSESSORS MAP:
PHON E
STATE:
(7 f 7-OWNER
ADDRESS:
CITY:
NEW
-
REMODEL ADDITION DEMOLISH ER VALUE
DESCRIPTION OF WORK:
NAME ADDRESS PHONE
ADDRESS EXPIRES PHONE
56(i
CONTRACTOR'S NAME
MECHANICAL:
ELECTBICAL:
CONST.
CONTBACTOR '
G EN ERA L:
PLUMBING
PLU MBING
NO.FEE CHARGE
Single Fixture
Relocated Bldg.
(new fix. addtl)
Water Service
ft
Sanitary Sewer
ft
Storm Sewer
ft
Backflow Device
I\lAtlrrrr tv a l\rl-r
TLIIQ Drne.,- A, ! -. .. . ,,v , Er rrvn r OfIALL
AllTlJAol:zrh ' ,^.^-.
tsAPIRE IFTHE WORI
vr rt_/El
colrrlrtrNntrn n 6 ,A
r tntu r bHMlrIS NO'
ANY 180 DAV Dcorrrr
"ur.ilYUL ,NtrU l-0R
TOTAL PERMIT
MECHAN ]EAL
NO EEtr 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
f rom
System apa(
AC or htg.
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT
- OFFICE USE _
LAND USE:
ZONING* OF UNITS:
HANDICAP ACCESS:
FLOOD PLAIN
LIGHTING POWER BUDGET:OCCY GROUP:
* OF STORIES:
QUAD AREA:
r OF BLDGS:
CONSTR. TYPEr
HEAT SOURCE:WATER HEATER:
SQ. FT.$/SQ. FT.VALUE
TOTAI \/Ariltr ntr DAnr
X
X
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
PLAN CHECK FEE RCPT#DATE BY
&?b 7r
BUILDING PERMIT PLUMBING DEMOLITION
5% State
Su rcharg e
5% State
Su rcharge
MECHANICAL 7 li,'- #0,FENCE
VALUE $
5% State
Su rcharoe " d+. qi SIDEWALK
FT.
SUBTOTAL
PERMITS
PAVING CURBCUT
FT.
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
INSPECTION LINE: 726-3769
OFFICE: 726-3759
SOHru t"DTflr:vt
4 ztPt 77 ?77
ARCHITECT:
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, 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 SpEC;AL INSpECTIONS: tn accordance
ELECTRICAL & and approved. Section 306 of the State Specialty Code
MECHANICAL: To be made a special inspector shal I be employed
before any work is covered. ATTIC DRAFT STOPS & by the Owner/ Contractor during
CURTAIN WALLS construction of the following work. A
FOOTINGS & FOUNDATIONS: copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are facing materials and before
erected, all steel in place, but framing inspection' srRUcruRAL CoNCRETE: ln
prior to placing 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 an insrab buirdins !n:l X.':R 3l'3:It",l,Xl:r" ilI:'"J"'X3^t,Y5tT',rrz o
service equipment, conduit, and vents are complete and
:g[3,i?".:,:;il!'; ii:*:'::J :H'fl::l"',]ffii:,1'iJ;[?:l: Bl?Xf],?E]*"T*,?l*IS?".in place but before any tightening operations. (306
concrete is placed. INSULATTON & 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.drainage lines. To be made board interior wall covering is
prior to covering or filling applied. S'EC'AL GRAD,NG,
t re nc hes.
,NDERFL..R: prumbins l:?:,s""="'f;m'J8[g]"' il:iut'iiiltll',5Jb'i],"1
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 Certificate by an approved
.lathingandgypsumboard,agency,furnishedtotheCity,s
posr & BEAM: To be made interior and exierior, is in ' Building Division before
prior to installation of floor place but before any beams are placed' (2501 u Bc'
insulation, decking or floor plastering is applied or before STDS' 25'1011)'
sheathing. gypsum board joints and
iasteners 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.
NAILING: Prior to installing
any roof covering.
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.
"ln addition to the inspec-
tions specifled, the Building
Official may make or require
other inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
By signature, I state and agree, that I have carefully 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 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.
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 remain on the site at all
Signature Date 2*zz -"(times durin g construction.
AMOU
RECEI
VALIDATION r
RECEIVED BY:
DATE PAID:D:
(l ({
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
F]NAL FIRE DEPARTMENT
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All project conditions such as
landscaping, parking Iot stri ping, etc. must be completed before
requesting this inspection.
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
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
a nnlTICrNA I COfvlN/FNTS
PLANS REVIEWED BY DATE
CITY OF SPB'NGFIELD, OREGO'V
SPRxC-.,ELl)
Dats
ELECTRICAL:'.YERITTT
rv\
Qltp1"
T,
THIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOH
33i,fi#lHl;:offi.sN Y StEPfY PERToD
INSPECTION RBQT EST : 726-3769
oFEIcE: 726-3759
City Job
3. COI{PI,ETE FEE SCMDULE BELOII
A Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Hanuf'd Home- or
Modular 'DvelIing
Sertice or Feeder
$ 8s.00
s 1s.00
s 40.00
B. Services or Feeders
Installation, Alterations
. or Relocation:
1 ,ON OP TNSTALI,ATTON
JOB DESCRIPTION
Electrical Contractor
Address
SumOO
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. COI{TRACTOR INSTALI..ATION ONIY
Phone ,I4l -AA3b
200 amps or less
201 amps to 400 amps
-
401 amps to 600 amps _
601 anps to 1000 amPs-
Over 1000 amps/volts
-
Reconnect OnlY
Circui ts
hfullaJ
One Circuit I
Bach Additional
Circuit or vith Service
or Feeder Permit 3
s
s
50.
60.
s
.00
.00
.00
'iBn a56JE
00
00
00
00
00
00
C $100
$130
$300
ci
Supervisor L se Number I brtS
Expiration Oate lO _-l - 9I
Constr Contr. Number a39
Exp iration Date q
Signature of Supervising Electrician
Owners Name
Address
Ci Phone 3 4!,- b^1'.l
INSTALI"ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
Orners Signature:
DATE:
c.Temporary Services or Feeders
Inslallation, Alteration or Relocation
40
-t -q1 200 amps''or less $
201 amps to 4OO amps
-
$
over 401 to 6oo amps
-
$
Over 600 amps or 1000T6lffs se
40
55
80
r€
D.
€lI I erat ion or Extension Per Panel
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utline Lighting
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
$
s
$
$
40
40
20
36
00
00
00
00
5
RECETVED
$ 3s.oo 35po
$ 2.oo b.oo
v5/ za/s7 tt? :44 1f503 726 36SS
roceirotl oF pnoposED woFtK:
ASSESSORS MAP:
so. Fr.
JOB NUMBER
tr.rSPeCftON LtNE: 22s.3269OFFIpE:72a.3tss
rAx Lcrn ru?@
SPI,'l)QER.tgoo2
aFitraoTtcLo
2 et
$rso FT.
SO. FTG MAIN
SO. FTG. ACOESS
SQ. FIG OTHEB
I
x
x
',
STATE:
ADDFESS:
OWNER:
PHONE
68ztP:
VALUE:$6.100.00
on : Class A)
OTHER
ecifica
Beaverton 97009
e
NAME
ADDRESS
OR
1 caOESCRIPTION OF WORK:
ARCHITECi
GENEHAI.:
PLI,JMEING:
MECHANICAL:
AELE TRICAI.:
ADDR is PHONE
CONST.
CONTRACTO
r5963) 643-1/11 /98 (s0
R'
,00925
EXPIRES PHONE
'' Na CHARflFFurnaoe/<im.@ & vent
& venlFurnacelbumbi
>100.000 EIUo
Floor furnace and vent
Euepe6dcd wall or lioor -. mountid unlt hcater.
Appllance Vent ..
separate
Statlonary evap.
cooler
Vent Fan/StnglC
duct
Vent
from
Mechtnlc.l cxhaucl-
hood and ducf
TOI:\L
Slngle Flxtqre
Water Servlco
fi.
Sanltary Sewsr
ft.
Storm Se*er
,r.
Backflow
TOTAL PERMIT
LAND USE:
, OF UNITSI
CONSTR. TYPE:
HEET SOUBCE
OCCY GROUP:
r OF STORIES:
QUAD AREA:
r OF BL.DGS:
HTINO POWER SUOGET
SHALL
0R
FOR
WATEB HEATEB:
PLAN CHECK FEE RCPT#DATE BY
BUILDING PERMIT O7,7o PLUMBING OEMOLITION
5%3,1Su ta 5,. /5% State
Surcharge
FENCE
VALUE $
5% State
Surcharoe
SIDEWALK
FT.
SUBTOTAL
PERMITS
PAVING CURBCUT
FT.
SYSTEMS
DEVELOPMENT
67s/TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
TOTAL VALUE OF PROJ
COMM
PERMIT
225 FtJth Street, Sprlngfleld, Oregon g.T 4?l
917'1 West Linn -
CONTRACTOB'e NAME
IEE.
,li
Permlt lsouance'
. OFFICE
VALUE.
-
REQUIRED INSPECTIONS
It ls the responsltslllty of the permlt holder to see that all lnspectlons are made at the proper time. To request an inspectlon, call
726.3769 (recorder), state your Clty deslgnated Job number, lob address, type of lnspection requested and when you will be ready
for lnspectlon. Requests recelved before 7:OO a.m. will be made the same working day, requests made after 7:00 a.m. wlll be made
the followlng work daY.
S|TE INSPECTION: To be ROUGH PLUMBING, PAVING: After gravel is ln
made after excavatlon, but ELECTRICAL & place but prior to placing
prlor to setup of forms. MECHANICAL: No work is to asphalt or concrete.
be covered untll these
UNDERSLAB PLUMBING, inspections have been made SPECIAL INSPECTIONS: ln accordance
ELECTRICAL & and approved. Sectlon 306 of the State Specialty Code
MECHANICAL: To be made a special 'lnspector shall be employed
before any work ls covered.- ATTIC DRAFT STOPS & by the owner/ contractor during
CURTAIN WALLS construction of the following work. A
FoorlNGS & FouNDATI6NS: ErDEor n ^F. ! copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are facing materials and before
erected, alt steel ln place, but f ramlng inspection' STRUCTURAL CONCRETE: ln
prlor to ptactng concrete" FRAMING: To be made after excess of 2500 PS'l' (306 a'1)
coNcRErE sLAB: ro be fl:Jn]:! i[J'B[',J13;'I[ ," srRUcruRAL wELDS:
made after all lnslab bulldlng place and a1 pipes, chimneys Performed on the lab' (2722 f)
servlce equlpment, conduit, and vents are complete and
piplng, accessories and other the rough electrical, ptumbing HIGH STRENGTH BOLTING:
anclllary equipment items are and meihanical are approved. Durl ng all bolt installation and
ln place but before any tightening operations. (306
concrete ls placed. INSULATTON & VApOR a.6)
BARRIER: To be made after all
UNDERGROUND: Plumblng, lnsulation and requlred vapor SPRAYED ON
electrical, gas, sanltary sewer, barrlers 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 interlor wall covering is
prlor to coverlng or fllllng applled. S'ECIAL GRAD,NG,
t re nc hes.
,NDERFL..R: prumbins [:::'S'"="?5X3[H]* il:iU1XllHii:'5Jb'i]'"1
electrlcal, mechanlcal. To be according to plans. chapter 29)
made prlor to lnstallation of
floor insulatlon, decklng or LATH AND/oR GYPSUM GLU'LAM BEAMS: lnspection
floor sheathlng. BOARD: To be made after all Certificate by an approved
lathlng and gypsum board, agency' furnlshed to the City's
posr & BEAM: To be made lnterlol and -exierlor, ls ln Bullding oivlslon before
prlor to lnstallaflon of floor place but before any beams are placeQ' (2501 U'BC'
lnsulailon, decklng or floor plasterlng ls applled or before STDS' 25'10'11)'
sheathlng.gypsumboard.|olntsand iasteners are taped and STRUCTURAL MASONRY: (306
FLooR TNSULATToN & flnlshed' a'7\
VAPOR BARRIERS: To be
made prior to lnstallatlon of
decklng or floor sheathlng.
MASONRY: Steel location,
bond beams groutlfig or
vertlcals ln accordance wlth
uBc 2415.
ROOF SHEATHING AND
NAILING: Prlor to lnstalllng
any roof coverlng.
SIDEWALK & DRIVEWAY:
Required for all concrete
pavlng withln street rlght 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 prlor to placlng
concrete.
.ln addition to the inspec-
tions specified, the Building
Of ficial may make or require
other inspections of any
construction work to ensure
compllance with the Building,
Clty or Development Code.
By slgnature, tstate and agree, that I have carefully examined the completed applicatlon and do hereby certify that all lnformatlon
hereln ls true and correct, and I f urther certify that any and all work performed shall be done in accordance with the Ordinances
of the Clty of Sprlngf ield, and the Laws of the State of Oregon pertalnlng to the work described hereln, and that NO OCCUPANCY
wlll be made of any structure wlthout permission of the Bulldlng Sa{ety Divlslon. I further certify that only contractors and employees
who are ln compllance wlth ORS 701.055 will be used on thls project.
I further agree to ensure that all required inspections are requested at the proper tlme, that proiect address is readable from the
the front of the property, and the approved set of plans wlll remain on the site at all
DateSignatu re
street, that the permlt card ls locat at
times durlng constructlon.
REcErpr -, ?-OZa 3
@,f,/VALIDATION AMOUKT HECEIVED:
RECEIVED BY:
DATE PAID
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
ADDITIO COMMENTS:
SITE PLAN REVIEW BOARD: Must be requested 2 days ln advance
of the date you wlsh lnspection. All proiect condltions such as
landscaping, parking lot stri ping, etc. must be completed before
requestlng this lnspection.
FINAL BUILDING: Bequested af ter the flnal plumbing, electrlcal,
rnechanlcal and Fire Department inspections are made and
. approved. No occupancy of the premises can be made until a
Certlficate of Occupancy has been issued by the Buildlng Division
and posted on the Premlses.
PLANS BEVIEWED BY DATE