HomeMy WebLinkAboutPermit Miscellaneous 1993-4-27
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CO M M ERCIALlI N DUSTRIAL
PERMIT APPLICATION
,
225 Fifth Street, Springfield, Oregon 97477
.
JOB NUMBER 9~~~
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, INSPECTION LINE: 726,3769
OFFICE: 726,3759
rikJ AJ~ F/Et.JJ
LOCATION OF PROPOSED WORK: / S-3:? )/(lfliEf ,( r
/ 7/J? .'ZJ:.::e
OWNER:~ri;.1f; ~~rf)/jW,~@...e.L/)J PH~O, <'
ADDRESS:_/ :.:z, 1A~4tf'--(1. d#L~OJt.. .
CITY' ~ <: /J~'...~ 1./ STATE: /J/2LAHr2..' \IP:~ "174-7 7
I J,/ " --r/ - < '
DESCRIPTION OF WORK' j?... :d2e.# ~ ~L~u iJ~ - yI- ~, J
NEW REMODEL V' ADDITION (EMOLlSH OTHER C~LUE:~~.~O
7fH? U~q U~~
NAME , ...--r' ADDRESS ~d/!,r:S 4<- PHONE '/ .
ARCHITECT:\. )e.IJI)('t"J,i Md'k1~tl/~tlJ ~D 'vV, ,~~~ (' JIf?.ef '7r1--?21d
f V' CONST, !/
CONTRACTOR'S NAME ADDRESS 'D CONTRACTOR · EXPIRES PHONE
I ~~ ~,,)1.I't" ~~/<
GENERAL: ~,.o;"C44l~~--/'~ .&:;;'u~~~-;. 6]J'~ /-,/~-~ 6~A?~"
ASSESSORS MAP'
PLUMBIN'"
MECHANICA' '
ELECTRICA' '
I
I NO,
/3
I
1
1
PLUMBING
FEE
Single Fixture
Relocated Bldg,
(new fix, addtl)
Water Service
Jt? q?
ft.
Sanitary Sewer
ft.
Storm Sewer
It.
Backflow Device
TOTAL PERMIT
QUAD AREA'
ACJ\)cu
. OF BLDGS:
OCCY GROUP:
. OF STORIEF'
SQ, FT,
SQ, FTG MAl N
SQ, FTG ACCES~
SQ, FTG OTHER J/tr~J~.e. ..l?=a.?4II'PeL
I
CHARGE I
~4
1
1
1
1
1
1
1
1
I
1
J~..,..c>1
TAX LOT-
MECHANICAL
Nn
.z
6
Furnace/burner & vent
< 100,000 BTUs
Furnace/burner & vent
> 100,000 BTUs
Floor furnace and vent
Suspended wall or floor
mounted unit heater
I Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or htg.
Mechanical exhaust
hood and duct
., c;...?:. <::7t:J :r,-~ r~
Permit Issuance
TOTAL PERMIT
LAND US"
- OFFICE USE -
HANDICAP ACCESS:
. OF UNITS'
CONSTR, TYP"
HEAT SOURC"
$/SQ, FT,
X
X
PLAN CHE~Ej~X'$"'~RC';.T:', -f.~~ /
I BUILDING PERMIT
15% State
SurcharQe
1 MEC~~~~
15% State
Surcharoe
1 PAVING
I J::l 1:><7. ::l ~I PLUMBING
./ ~/ 15% State
fPI!:>..,.dro Surcharge
,,~.""" 1 FENCE
hY".SC::> VALUE $
SIDEWALK
"3. 2.3
CURBCUT
OR
f "t/40o
I
""" r"ABG~
~,- /7,~
zSa 7"";; -I
l
I
'? ~"" 1
1
1
I
I
.~'" 7"- S'~ I
$10,00 1
, ~ '7. -.QJ 1
FLOOD PLAIN:
ZONING: r f\R .J'
LIGHTING POWER BUDGET:
WATER HEATER'
VALUE
l./VI/, V//~
r
TOTAL VALUE OF PROJECT
DATE ~~-93 BY ~~..#_
1
~ &~i,'i..-,~~
~p- .... ~.~
SUBTOTAL I
PERMITS /~83.9'7"
SYSTEMS ,J.
DEVELOPMENT -e-- m."
,.
J3l'?. ~
6, ;5"&>
I DEMOLITION
FT,
FT,
TOTAL PERMIT FEES I
EXCLUDING ELECTRICA'
/'t~? :e;"O
· 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
made after excavation, but
prior to setup of forms.
\
\
)(
ROUGH PLUMBING,
ELECTRICAL &
MECHANICAL: No work is to
be covered until these
inspections have been made
and approved.
PAVING: After gravel is in
place but prior to placing
asphalt or concrete.
x
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
FIREPLACE: Prior to placing
facing materials and before
framing inspection.
SPECIAL INSPECTIONS: In accordance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Ownerl Contractor during
construction of the followi ng work. A
copy of the special testing reports shall
be furnished to the Building Division.
UNDERSLAB PLUMBING,
, ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
ATTIC DRAFT STOPS &
CURTAIN WALLS
y
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.
STRUCTURAL CONCRETE: In
excess of 2500 P,S,I. (306 a,1)
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.
STRUCTURAL WELDS:
Performed on the job, (2722 f)
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing.
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.
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations. (306
a,6)
y
, UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
<.2!,amage IIne~To be made
prior HJ l.VVt;Hlng or filling
trenches.
SPRAYED ON
FIREPROOFING: U,B,C,
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork, (306 a,11 &
Chapter 29)
.Y
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
finished,
GLU,LAM BEAMS: Inspection
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed, (2501 U.B,C,
STDS, 25-10,11),
POST & BEAM: To be made
prior to Installation of floor
Insulation, decking or floor
sheathing,
STRUCTURAL MASONRY: (306
a,7)
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to Installation of
decking or floor sheathing,
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.
"In 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.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415,
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete:
-------------------------------------------------------
y
FINAL PLUMBING
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 striping, etc. must be completed before
requesting this Inspection.
y
}I
FINAL ELECTRICAL
FINAL MECHANICAL
y
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.
FINAL FIRE DEPARTMENT
ADDITIONAL COMMENT'"
x
PLANS REVIEWED BY /' ~...::.L /r DATE...~ //-'9"3
///- .'
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 Bulldl.ng Safety Dlvl~on. 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 loca ed at the front of the property, and the approved set of plans will remain on the site at all
times ~urlng construction. ~ L
Signatu~ ......... =-A, Date _~~ ~'9S
I '
IlllCP,
I~
RECEIPT #:
.$ IY 0:2, C;O
iO/7'2,
DATE PAID:
VAll DATION:
AMO NT RECEIVED:
RECEIVED BY:
" "
. . JOB NO. Q30552-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: CnRJ', ~r 1fH:; fkl?:51l?/Nc" 15/51-/01"' OF' (ft€, C O~ LP5
LOCATION: 15?? /YJftR.t<e, ST. / 7() ~Z15~? - '5,/00
DEVELOPMENT TYPE: CG: 'R&Yl(;l>~L
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIOUS SQ. FT. N. Apl?C-P Af2.IEIt X $0.192 PER SQ. FT,
LOT SIZE
SQ. Ft.
c -)
--- ---
2, SANITARY SEWER-CITY
NO, OF PFU' S No A:DD€:b /Fd's X $39,78 PER PFU
(See Reverse)
C"-)
--- ---
3, TRANSPORTATION
f./c f+ppr;.p ~
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X $401.05
c-)
........ .......
X
X $401.05
X $401.05
$
X
$
--
SU8TOTAL (ADD ITEMS 1,2, & 3) $
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
((-)
--- .......
TOTAL -C ITY SDC $ -t:)-
5. SANITARY SEWER-MWMC
NO. OF PFU'S x $13.62 PER PFU + $10 MWMC ADMIN, FEE $
(Use PFU Total From Item 2 Above)
~~~
'U Kip Burdick
SDC Coordinator
'-/ 1~7 /<;7
$
TOTAL-MWMC SDC~ ~ ~
-- .......
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL SDC $ ~