HomeMy WebLinkAboutPermit Miscellaneous 1993-9-7
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JOBNUMBER~[J
INSPECTION LINE: 726-3769
OFFICE: 726-3759
COMM ERCIALlIN DUSTRIAL
PERMIT APPLICATION
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@5.PlfAI..- (~i6}HONE:
225 Fifth Slreet, Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:
22..bD (flllll-U,(".F!
1- $ .J4.fr(J
ASSESSORS MAP'
11 0",
OWNER:
ADDRESS:
CITY:
? 1I{JL(c (1 I-l ~ u- - &f.UctAlt.-
pO 'O'X /blfo 5
EU(1'6~
UJ
?f"lLINo-l='lf:;LO
qtJO
01-
TAX LOT'
STATE: -1J./t-
L""-f.f' ~
ZIP: q7 iflfo
1.
DESCRIPTION OF WORK'
NEW J REMODEL
C,Iil': IMf''fLO/J/:;VVlI;,.,rr-/ tvJ6Dut.-/UL" BL-Ot.:r srm..Je.
I
ADDITION DEMOLISH OTHER VALUE:
170. DOt>
.
c.
NAME
ARCHITECT'
B~~ "
AIU.-H I r ~Lr7
CONTRACTOR'S NAME . b l:l/!.Av~DDRESS
'5/, '" pGL:rA ~/l1oJP. 'f-
GENERAL: po 2J\1A" (1tN41'/lU.JLrJt>1J
PLUMBING: Pt:-lfA 1AN P .( C::rEAu1::.l..-
MECHANICAl'
ELECTRICA' .
I PLUMBING i
I NO. FEE CHARGE 1
I Single Fixture I
I Relocated Bldg. 1
(new fix. addl n
I V' Water Service '7,",,- I
"2trl It.
I yo' Sanitary Sewer /~.- I
~ fl.
.1 ,/ Storm Sewer ~.-I
. ~O It.
I .,/ Backflow Device /.&! - I
I
I
TOTAL PERMIT
1
I
1
~/t'...o 1
ADDRESS
PHONE
"1() wlt.J..,~me1'Te f!:Uf!(f/...k OR.... 'I'd5Jn..
CONST.
CONTRACTOR' EXPIRES PHONE
I " MEeHANICAL I
I Mn coo eH~
I Furnace/burner & vent
< 100.000 BTUs
In Furnace/burner & vent. I
> 100.000 BTUs
I Floor furnace and vent
I Suspended wall or floor
mounted unit heater
I Appliance Vent
separate
I Stationary evap.
cooler
I Vent Fan/Single
duct
I Vent System apart
Irom AC or htg.
I Mechanical ~xhaust
hood and duct
I
I Permit Issuance S10.00
I TOTAL PERMIT
HANDICAP ACCESS:_"
QUAD AREA:)J~.)nJLJ
- OFFICE USE -
LAND USE: ,-r=s...~n.
FLOOD PLAIN'
(~(1 ~
SQ. FT. SI SQ. FT.
SO.FTGMAIN X VY'\flrlHP"vJl^^;-I,:
SQ. FTG ACCESS )(?#PPI.~ i5~~ ~~ =
SO. FTG OTHER "D):~ k~I./~;P~f>'). =
. OF BLDG~'
. OF UNIT~'
OCCY GROUP:
CONSTR. TYpo,
. OF STORIES:
HEAT SOURCE:
f7<P<? "11: -2..2.-n tVII:P~/
PL~~K FEE~~~ RCPT# /=-/~
I BUILD.ING PERMIT
5% State
Surcharge
MECHANICAL
PLUM!3IN,:;
II/; . 'fX>
7.o?$
15% Slate
SurcharQe
I PAVING
5% State
SurcharQe
FENCE
VALUF S __'
SIDEVIALK
__.__ _ ___ _?2J1~ FT.
511'>: ?e:::> CURBCU\t~ FT.
....."',
ZONING'
LIGHTING POWER BUDGET:
WATER HEATER'
VALUE
-1>>
::2&1__ e
,
/-2:>_... _.....;.
,
TOTAL VALUE OF PROJECT_/2?~
DATE ~~:.t~
BY ~--?
-/
? ~ _ ~1.Ii3L1'letl /#~ R/-.:s"...- "I
/< _ ..~J.-,.~ //.)~..,"9
15",S~l~.......-<(~~ .~~.-.:::- I
~..n:,.,? 9~.- I
SUBTOTAL // J
67.1"&> "PERMITS 9:J.5~
I" SYSTEMS .I! a ~'Z-
/6.?t:> . DEVELOPMENT I W - \ \ 02.. -
. .. //'IYa~r/~A7/b~~" 5"lf).- .
TOiAL'?ER~;~ FEES I ;;?c>M/. 7~
EXCLUDING ~LECTRIC~L .____
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 inspeciio~ requested and when you will be ready
for Inspectlon. Requests received before 7:00 a.m. will be ;nade 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.
, I
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
ruqu13stlng this inspection. i
X FINAL BUILDING: Requested after Ihe finai plumbing, electrical,
mechanical and Fire Department inspections arc made and
approved. No occupancy of the premises can be made untit a
Certlflcate of Occupancy l1as':.'becn issued by the ~D1Jion
and posted on the premises,. TJ '" f//\
~Of)ir;- ~~~.;~ ~ 1hA.~ i ~e.(\# Q';',ffi l\S /p'~/~,f,.
\;Q\~ r\ \)).J.,~ to 'i. \q'\iS
\. <:;&'-0>\-\:' 'f\-\ I'\C\() . - . ~ ""'-..!
\ PLANS REVIEWED BY ~~,/ ~.. DAT~ "'/..:P ~:Pl;;:'
\ ~/' 7':
By signature, I state and agree, that I ;,ave carefully examined the completed ;J.pplication and do hereby certify that all information
herein is tru~ arid eorrelct, and I further certify that ~ny and all work performed shall be done. in accordance with the Ordinanc"es
of the City of Springfield, and the Laws of the Siate of Oregon pertaining to the work des'cribed herein, and "that NO OCCUPANCY
will be made of any stru'c'ture without permission of the Bulld!ng Safety Division. I further certify that only contractors and employees
~ho are In",compliance ,~ith GRS 7q1.055 will be used on this project.
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REQUIRED INSPECTIONS
UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To tie made
before any work Is covered.
ROUGH PLUMBING.
EL"CTRICAL & ' _
MECHANICAL: No work is to
be covered until these -.
inspections have bee;1 made
arId appr~)Ved.
ATTIC DRAFT STOPS &
CURTAIN WALLS
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.
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y
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are In
place and all pi pes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanical are approved.
. ,
CONCRETE SLAB: To be
made after all Inslab building
service equipment, conduit,
piping, accessories and other
ancillary eq'uipment items are
in place but before any
concrete Is placed.
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.
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UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
d ral nage II nes. To be made
prior to covering or filling
trenches.
UNDERFLOOR: Piumbing,
electrical, mechar.:cal. To be
made prior to installation of
floor insulation, decking or
floor sheathing.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
POST & BEAM: To be made
prior to instaHatlon of floor
insulation, decking or floor
sheathing.
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 appl'ied or before
gypsum board Joints and
fasteners are taped and
finished.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
A
SIDEWALK & DRIVEWAY:
Required for all concret~
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material in
place.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
x
CURB AND APPROACH
APRONS: After forms arc
erected but prior to placing
con.crete.
ROOF SHEATHING AND
NAILING: Prior to installing
any roof covering.
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FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
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PAVING: After gravel is in
place but prior to placing
asphal.t or concrete.
SpECIAL INSPECTIONS: In accordance
Section 306 of the State Specialty Code
3 special inspeeto{ Sllijll be employed
by.:the Owner I Contractor during
construction of the following work. A
co'py of the special testing reports shall
be; furnished to the Buitding Division.
I
STRUCTURAL CONCRETE: In
excess of 2500 PS.1. (306 a.1)
STRUCTURAL WELDS:
Performed on the Job. (2722 f)
HIGH STRENGTH BOLTING:
During all bolt installation and
tightening operations. (306
.. a.6)
SPRAYED ON
FIREPROOFING: U.B.G.
Standard~ 43-8.
SPECIAL GRADING.
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
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).
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STRUCTURAL MASONRY: (306
a.7)
.M~~.z!? "''-L5#>
I,
"!:
.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.
I further agree to ensure that all requ'ired Inspections are requested at the proper time, that project address Is readable from the
street, that the.permlfcard is located at the front of the property. and the approved set of plans will remain on the site at all
times during construction.. '
Signature
~f1~
IF
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AMOUNT RECEIVED: 70.J!!l R LZ..,</
/ ,()"3 :::r.2...
VALIDATION:
RECEIPT N'
Date~'t~
-'\.)
DATE PAID: '9-~7-'9::!J
RECEIVED BY' 46':; S - ~
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. "JOB NO. CJ?>J'37D
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(PROFESSIONAL OFFICES & INDUSTRIAL)
NAME OR COMPANY: '5t:t(./Z./E.O drE:A-~1 Ge/J€.tI..A-L tlOSh-rA-L
LOCATION: -Z Z- ,,"0 tVJA-ttLHA 'f<.p
DEVELOPMENT TYPE: C!G: IIl/E.O/CPrL t<;p:p./ce /,M"OtJLA-~ f.3L/:>6 .
BUILDING SIZE: ?'72-0 F,"l LOT SIZE SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. 0.5 x
'S1"Z,"'t""L
X $0.203 PER SQ.
FT~9,I?I~
'-- ....-/
2. SANITARY SEWER-CITY
NO. OF PFU'S 0.5 X
(See Reverse)
"Zz.
X $42.08 PER PFU
((' L/ '" -Z i!)
-.......... ....-/
, 0.5 X "'2. .""2- X "".0$ X $424.31 ((''2-1 ~I~
.J '- ./
0.5 X X X $424.31 $
0.5 X X X $424.31 $
4. SANITARY SEWER-MWMC
3. TRANSPORTATION
c:..:>oe. "7~ . 1II1e.I>.CAL. OFFI~'=- 4.o~ i..-rlr$F
NO OF UNITS X TRIP RATE X COST PER TRIP
NO. OF PFU'S 'Z'}.. x $15.125 PER PFU + $10 MWMC ADMIN. FEE $ "2:J'-I-?.'Z
(Use PFU Total From Item 2 Above)
TOTAL-MWMC SDC
$ /3? IS
~
"--- ....-/
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
e~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ BG:,b&-
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
c-Lf~?~
\~'. ~ J
Kib Burdick
SDC 'Coordinator
'_~ '\ /., 11?1
, I
TOTAL SDC
$ '4\OZ.~.3-
FIXTURE Ut:HT,;CALCU LA. TABLE: Number of New Fixtures X .iqUivalent ~ Fixture Units (NOT~:- "
For remodels. calculate only the NET additional flXlures) .
NUMBER OF : UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
,.
Bathtub.... ............. ................................................. ....
Drinking Fountain.. ...................................................
Roor Drain................................................................
Interceptors For Grease/O.i1/Sbllds/Etc,..........:::...:.
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Ootheswasher...................................
Ootheswa~er . 3 Or More.....................................
Mobile Hdme Park Trap {1 Per Trailer).:.:....:...:...::.
Receptor F9r RefrigeratorjWater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single .StaIL................... .... .................... .....
Shower, Gang...........................................................
Sink, Bar, CommerciaL............................................
Urinal, StalijWall::.....................................................
Wash Basin/Lavatory, Single..................................
Water Ooset, Public Installation.............................
Water Ooset, Private...............................................
Miscellaneous:
. .
2
1
2
,.,' 3
6
.2
6
6
1
f 3
.,
2
I/Head
2
2
1 10
6 1"2-
4
Iv
'2-
TOTAL FIXTURE UNITS
~
'l-z,
CREDIT CALCULA nON TABLE: Based on assessed value. If improvelTle.nts occurre<j a~er annexation date in table,
,calculate credits separates.
-
\...
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed '
Rate per $1,000
Assessed Value
$3.21
3.13
3.08
2.96
2.82
2.68
2.51
1986
1987
1988
1989 .
1990
1991
1992
S 2.24
1.93
1.57
1.18
0.79
0.44
0.28
1979 or before
1980
1981
1982
1983
.1984
"i985
.'
~....I X $ '-II,'-I-~
(Rate X Assessed Value)'
X $
(Rate X Assessed Value)
CREDIT TOTAL
~
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credit for Parcel or Land Only If Applicable
'. ,. Improvement (If after annexation date)
=
= $ 1?,?'1.
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential....................:................................... 0.4
Commercial...................................................... 0.9
Industrial........................:...............:.....:............ 0.45
Govemmental.........................~...........:..........:.: 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT