HomeMy WebLinkAboutPermit Building 1993-9-16
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CON1M B1CIAL/lN DUSTRIAL
PERMIT APPLICATION
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225 Fifth Street, Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: ..r; 78/
ASSESSORS MAP' /7-L/::i-"3':s-~/
JOB NUMBER
9~?6'.2
INSPECTION LINE: 726-3769
OFFICE: 726.3759
TAX LOT:
c:::;~~~
7'7;ee~~-'R'S~ ~.l_er~E"c<.~~' PHONE r7~:::>) ~~~-~.c>L
ADDRESS: ~4'~S< .# 'Zr~~
CITY' r-:=::-U~~~ STATF' c:;;;r. ZIP: '9."..-:>~/
4/KA" .,/ ~~AI?EZ:> ..;;V~ ~,_' '_
. . . r - - - - 'rgz:~ ::i"B~
DEMOLISH OTHER VALUE: ~ ~~.
PHON~~
~ 4"V -40- .:..-....<::".
DESCRIPTION OF WORK: $<w~,...
NEW X' REMODEL ADDITION
NAME . AD~).~
ARCHITECT:.Qtr -f" .~/...vh.C~ ~~'1?:i....~q~~
CONST.
CONTRACTOR'S NAME 1.:1 ADDRESS CONTRACTOR' EXPIRES PHONE
GENERAL: L:..E!:~~_ ,~~~~O .6"5">//'. /f,,"5~ _.7~:;>.6::S?
, ~ / , ,
PLUMBING' WL.j'Y?/u,1Fft?
MECHANICAL: l?k..1?""'.7.v~...","~~ 5
ELECTRICA" '5<:.~;!R:.;:::>
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1::2
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I TOTAL PERMIT
PLUMBING
Single Fixture
Relocaled Bldg.
(new fix. addU)
___ ~ Water Service
. "9 'I It
.,..... - Sanitary Sewer
?h It
~ - Storm Sewer
/7t!>f1.
Backflow Device
QUAD AREA:. 3f-"sr ./
I
15 - -z..
. OF BLDG~'
OCCY GROUP-
. OF STORIES:
I
SQ. FTG MAIN
SQ. FT.
~41 /<:7
SQ. FTG ACCES"
SQ. FTG OTHER fj-5:z:f
I
FEE CHARGE I
/t? ~.-4
S"b. -
7~-1
~~-f
/t? 20. ....1
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~.-I
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Iz.
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I TOTAL PERMIT
\~:ftl
~'1r
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MECHANICAL r
I_EEE_!_CHARGE-,--
Furnace/burner & vent
/" , ~."""
< 100.000 BTUs ~ f ..c;.
Furnace/burner & vent I
> 100.000 BTUs
Floor furnace and venl
Suspended wall or rloor
mounted unit heater
Appliance Vent
separate
Stat ionary evap.
cooler
Vent FanfSingle
duct
Vent System apart
from AC or hlg.
Mechanical exhaust
hood and duct
~ r:;,~~
PermIt Issuance
- OFFICE USE - 7'\
LAND USE: ,t::)8 Dr )
. OF UNITS'
CONSTR. TYPE:
HEAT SOURO"
$/5Q. FT.
X
X
~-A/
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b.~1
~s-ol
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::z ~....,.. I
$10.00 I
12 'T. 5'01
HANDICAP ACCESS:
, DEMOLITION
-=3"b~.--
/$.-
ZONING'
FLOOD PLAIN:
(1[' ../
LIGHTING POWER BUDGET:
WATER HEATER:
VALUE
= 2~ D<1>C>
- - '/ -- -----
~..../~ X /.S-C>,.~~ = ~ (')~
~/re ~~;.... .;....,,;;'5. '/I --'
TOTAL VALUE OF PROJEC~~~ O~
_ D /
~~f~E~K~ ~~:a..~~ ...J1~1tJ DATEO. 17~ BV'tJ')f/)C(
I BUILDING PERMIT , $Y2.?,o I PLUMBING
15%1 State ~2 j;? "'% State
Surcharge ....urcharae
I MECHANI~ /.-t> ."""" FENCE
'7 v. ~&> VALUE $
15% State' /. -2~ SIDEWALK
Surcharoe FT.
I PAVING -:z Y7' D 0 CURBCUT
FT.
~/~)~.N"~~'
~"3?7!~--r - I/.:?~ I
m~~i~L / ~9~-:%
~m~~~MENT # 577-3 I'i I{f>
TOTAL PERMIT FEES I
EXCLUDING ELECTRIC/'
7';?~6-7S
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It ,; the r~5ponsjbillty of the permit holder to see that"alllnspectlons 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
prlo~-to set,up of forms.
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REQUIRED INSPECTIONS
K.
ROUGH PLUMBING,
ELECTRICAL &. .
MECHANICAL: No work is to
be covered until these .
inspections have been made
and approved. ~
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PAVING: After gravel Is in
place but prior to placing
asphalt or concrete.
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UNDERSLAB PLUMBING,
ELECCRICAL'&. .
MECHANICAL: To be made
before any work Is covered.
ATTIC DRAFT STOPS.&' ..~
CURTAIN WALLS .
FIREPLACE: Prior to placing
facing materials and before
. fra,!,lng InspectloQ.
... '-." ~;" 4
IX' - FRAMING: To be m~de after
the roof, all framing, fire
blocking and bracing are in
place and all pipes, chimneys
,... . ~and vents.are complete and
.,,~'.. . the rougti-electrical,:plurnbing
and mechanical are approved.
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INSULATION & YAPOR
BARRIER: TO:be'made after ali
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.
SPECIAL INSPECTIONS: In accordance
Section 306 of the St'!te Specialty Code
a special Inspector shall be employed
. . ':by the 'OV!nerl Contractor dunng
construction of Hie following work. A
copy of the.special testing reports shall
be furnished to the Building Division.
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STRUCTURAL CONCRETE: In
excess of 2500 P.S.I. (306 a.1)
y
FOOTINGS & FOUNDATIONS:
To he made after trenches are
excavated and forms are
.:,,::er~q.t~dj all steel.ln_ place, but
~rl<;>r.1o. placing concrete.
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LATH AND/OR GYPSUM
BOARD: To b,f 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. '
STRUCTURAL WELDS:
Performed on the job. (2722 f)
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HIGH STRENGTH BOLTING:
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During all bolt installation and
lightening operations. (306
a.6)
CONCRETE SLAB: To be
made after all Inslab building
. service equipment, CO!,dult,.\
piping, acce~sorles and ottier
ancillary equipment items are
In place but before any
concrete is placed.
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UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
.......
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.
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CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
SPRAYED ON
FIREPROOFING: U.BC
Standards 43-8.
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SPECIAL GRADING,
'EXCAVATlON 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.BC.
STDS, 25.10,11).
STRUCTURAL MASONRY: (306
a.7r'
-In addition to the Inspec-
tions specltled, the Buliding
Official may make or require
other inspections of any
construction work to ensure
compliance with the Bulldln!;,
City or Development Code.
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.
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-r 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
y' Certificate of Occupancy has been issued by the Building Division
',:~~:~:i~~~~oC\0~~~"C8;'J)lon~or. (;1l1~r[;~
(, ~~\ ~(~ "'II \tV.~ ,\(;p
~ fr.r--. ~~7 ,~~:,..,.~- ~ ,..~\J\'/'\;~V 0...\
. .':\ . 'PLANS'REVIEWED BY . /L_ -...-z%: ::'" , DA~~'?-2~":?
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UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to Installation of
floor Insulation, decking or
floor sheathtng.
POST & BEAM: To be made
prior to Installation of floor
Insulation, decking or floor
sheathing.
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to Installation of
decking or floor sheathing.
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MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
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. ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
f
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 lri.acco'rdance 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 GAS 701.055 will be usedJon this project. "', .~~..~.
1 further agree to ensure that all required Inspections are requested at the proper ttme, 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 pla";s will remain on the site at all
times ~In~ construction. 1 n L . . I
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Signature _ ~- Go-. Date --L <-<> I .,
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AMO~NT REC'1IVED: ~ 7~: ~O\.o ,r Q(
RECEIPT': -\ O:l,~ 1'1:1'_1 O?::J.+:;
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'FINAL PLUMBING
A'
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FINAL ELECTRICAL
FINAL MECHANICAL
VALIDATION:
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DATE PAID: -d / f'\C;:~
RECEIVED Bt~A )
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.JOB NO. Q?OQtp2
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(PROFESSIONAL OFFICES & INDUSTRIAL)
NAME OR COMPANY: 7iiURS/O/J FAN1IL-Y PRAL -rIG€; CLINIC
LOCATION: 5n { mAIN Sr.
/7a2?34/ -()??Soo
DEVELOPMENT TYPE: Cc: 1Y1601CAL. CLINIC
BUILDING SIZE:
3'-1 (q S09-. PI.
LOT SIZE
SQ. Ft.
I. STORM DRAINAGE
IMPERVIOUS SQ. FT. 0.5 x
/??q~
X $0.203 PER SQ.
FT4I?5"17l)
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2. SANITARY SEWER-CITY
NO. OF PFU'S 0.5 X
(See Reverse)
3.' . TRANSPORTATION
DJpt:. 7'2D fYlE;PICAL oFFIC-E ::. -!-.Dfs!r6Sf
NO OF UNITS X TRIP RATE X COST PER TRIP
If>
7'5~7 X $42.08 PER PFU
( T78~
x
X $424.31
~'Zq5'i ~
'--- -----
$
$
0.5 X
0.5 X
X '-1.08 X $424.31
X X $424.31
0.5 X 3.<t{Q
4. SANITARY SEWER-MWMC
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NO. OF PFU'S ?1!J"?7x $15.125 PER PFU + $10 MWMC ADMIN. FEE $ 5",q~
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
Llf2~ ,,!i .
TOTAL-MWMC SDC Go ~
, I 1..1
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ 5..,'1 & -
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
( 1-7-+~
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. ~p Burdick
SDC Coordinator
7 /")./~i'~
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TOTAL SDC
$ 57''?!:!:..
FIXTURE UNIT,CALCULAaN TABLE: Numbcr of Ncw Fixtures.t Equivalcnt = Fix1ure Units (NOTE:
For remodels, calculate only the NETWitional fix1ures) .--:: .
. . NUMBER OF UNIT FIXTURE" -.
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub.............................. ................. ... ........... ........
Drinking Fountain.....................................................
Roor Drain........................................ .......... .... ..........
Interceptors For Grease/Oil/Sollds/Etc...........:.....
Interceptors For Sand/Auto Wash/Etc..................
Uiundry TubjOotheswasher................................... .
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.Stall.................................................
Shower, Gang............................................. ..............
Sink, Bar, COmmerciaL..m......................................
Urinal, StalljWaIL..........m..m..................................
Wash BasinjUivatory, Single..................................
Water Ooset, Public Installation.............................
Water Ooset, Private...............................................
Miscellaneous:
1.
2
1
2
3
6
.2 .
6
6
1
3
2
I/Head
2
2
1
6
4
/4-
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TOTAL FIXTURE UNITS
1l
,...,.
/9.
/13
;5?:>7
Based on assessed value. If improvements occurred after. annexation date in table,
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
CREDIT' CALCULAT10N TABLE:
calculate credits separates.
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1979 or before
1980
1981
1982
1983
1984
1985
$3.21
3.13
3.08
2.96
2-82
2.68
2.51
1986
1987
1988
1989
1990
1991
1992
Rate per $1,000 ~
Assessed Value
$ 2.24
1.93
1.57
1.18
0.79
0.44
0.28
I.
3.1-1 X $ 52.54 -Lt,8~
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ j b f( ~
Credit for Parcel or Land Only If Applicable
Improvement (If after annexation date)
. . RUNOFF COEFFICIENTS FOR STORM DRAINAGE
ResidentiaL..................................................... 0.4
Commercial...................................................... 0.9
IndustriaL...................................:.:...:..........:..... 0.45 .
GovernmentaL.................................;.............. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
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SP~'ELO
The following projocl as subm.mc~;r"'!~~~ ~c
zoninG, and .joes- not (squIrt: ",Pc..'V1 ~c
225 FIFTH STREET approv,!. ELECTRICAL PERMIT APPLICATION
SPRINGFIELD. OREGON 97477 Zoning ~. r,
INSPECTION REQUEST: 726-3769 Ci ty Job Number '1 3()q 10 7 "
OFFICE: 726-3759 Date Ci, 1.-L:.q'.2.. ~^",,-_, '
. . d S' natur. ~V" cunPLETE VF.F. o::r.nEDULE BELOII
1; LOCATION OF INSTALLATIONAuthonze 19 .
h r'J'X I 1!'VvJ tin Sf- A. New Residential-Single or
-- Hulti-Family per dwelling unit.
LEGAL DESCRIPTION Service Included:
170 7"::>;-::>.,d \ n?'AYJ
Supervisin
~_J1.
r::,,....' t1 . 11
N9:me T v~<, /t(;yyJ 1'I!f/--nM
fn /"1 LJ ,,--Y'
~ut Ie- 0--" Ph:ne 7717 L/l/ c;.. ?&tJ /
JOB DESCRIPTION
+€'AM?
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.' CONTRACTOR INSTALLATION ONLY
Elee'trieal Contraetor..:::J KG, E (,N'r-
Address '2\67
City '-.~
Vh V\ S+-
Phone (L\ 6 ~l-/b&
(3)48s
IO~/.q6
Supervisor License Number
Expiration Date
Constr Contr. Number i{~IZ-'1
Expiration Date
'-I - ZJ.f -q J
'iI
Owners
Address
City
011NER INSTALLATION
The installation is being made on
property I ovn vhieh is not intended
for sale, lease or rent.
OVnersSignature:
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DATE: ~~-i~~1~-~----------------
~"r..ln I:' I DdP&J
RECEIvED BY: 1\ ,\~
Items Cost
1000 sq,ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less $ 50.00
201 amps to 400 amps $ 60.00
,401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
C. Temporary Services or'Feeders
Installation, Alteration or Relocation
200 amps or less
201 amps to 400 amps
Over 401 to 600 amps
Over 600 amps or 1000
S 40.00
$ 55.00
$ 80.00
see "Dn
volts
'-- D. Branch Cireui ts
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
M,".,
~
Stim
LfOl5(j
above
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40,00
Limited Energy/Res $ 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE 40. 0lJ
5% State Surcharge L'{)D.
TOTAL L) 7 .60