HomeMy WebLinkAboutPermit Plumbing 1994-10-24
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COMM ERCIALlI N DUSTRIAL
PERMIT APPLICATION
225 Fifth Street, Springfield, Oregon 97477
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JOB NUMBER
q 7"/6?2.....
INSPECTION LINE: 726.3769
OFFICE: 726,3759
LOCATION OF PROPOSED WORK: 17~ h'~./.A/
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ASSESSORS MAP: /~?-3~-..)"/
"'1"r?rl!EfF?: ~7"5 /2~/=?
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TAX LOT: d~E=::~
~~.., /'J 7-c...-" ~70/"~~. 4. ,. - ==PHONE:
ADDRESS: /? v-::> _~./ 7.?- . '
e:;; A L....r-:>
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D~PTIO.N_O'=-'@RK: ~t"~<.'"":'C'= --? Sl"~,.c:-~~,-...
~~ ~~~'C.-II';J_ /,/_' .~cS:::>.
'N W REMODEL ADDITION DEMOLISH OTHER
OWNER:
7~'c- So"~ yy
CITY'
STATE:
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ZIP: ....-s:>? c..~ ~
- ' -
,
r~/>< .1:..-' ~ .~'
... .. - - - ..
VALUE:
NAME
ARCHITECT'
CONTRACTOR'S NAME ADDRESS
GENERI ' .
PLUMBINC"
MECHANICAl'
ELECTRICA' .
PLUMBING I
NO. FEE CHARGE I
7 Single Fixture lIP ':;l? - I
Relocated Bldg, I
{new fix, addtl\
Water Service I
It,
Sanitary Sewer I
It,
Storm Sewer
It,
Backflow Device
ADDRESS
PHONE
CONST,
CO NT RACTO R .
EXPIRES
PHONE
A
~.
MEr.HANI(~AL
Nn
000
"'~AB.GE_J
Furnace/burner & vent
< 100.000 BTUs
Furnace/burner & vent
> 100.000 BTUs
2-
Floor furnace and vent
Suspended wall or floor
mounted unit healer
Appliance Vent
separate
Stallonaryevap.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or htg,
Mechanical exhaust
hood and duct
?
<::;;,-
Permit Issuance
I
$10,00 I
, /? /~. -I
.///~. I 0.7.
TOTAL PERMIT
,7..::;l,-
TOTAL PERMIT
,
QUAD AREA:~(' .A<\/ J
- OFFICE US~ -
LAND USE: \ \."2,'T
HANDICAP ACCESS:
. OF BLDGS'
. OF UNITF'
ZONING'
FLOOD PLAIN'
~
OCCY GROUP:
.
. OF STORIE!':'
CONSTR. TYpo.
HEAT SOURCF'
LIGHTING POWER BUDGET:
WATER HEATER:
SQ, FTG MAIN
SQ, FTG ACCESS
SQ. FTG OTHER
SQ, FT.
(/7.c
$/SQ, FT.
X ...J:$. S--o
VALUE
/8. 2>R. Yz:o
X
X
TOTAL VALUE OF ,PROJECT
PLAN CHECK F& B -::>. ~ RCPT'/~20 /
DATE
/&7-'< y.c;;.I"BY '~~~
...,.-/ ~ -
~ //
, DEMOLITION
,
I BUILDING PERMIT
,
I ?y. SO
ft:;>, 7 -;F
4.6'/
'6.-
2"'5':' -
--~
, PLUMBING
5% State
Surcharpe
I MECH~7
15% Stale '!~.
Surch'arae .,..~ '
I PAVING
5% State
Surcharoe
FENCE
VALUE $
SIDEWALK
~
?~.-
7'~=
=z ./.0
FT,
SUBTOTAL
PE RM ITS
SYSTEMS
, DEVELOPMENT
A <E':?CtG;.,"
$ 4/'1 ,-1F
CURBCUT
FT,
TOTAL PERMIT FEES I
EXCLUDING ELECTRICA'
bGG. S~
. R~aUIRED INSPECTIONS.
It Is the responsibility of the permit holder to see that all Inspections are made at the proper lime. To request an Inspecllon, 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.
--/-FINAL~U;BING-------------SITE~LAN~EVIEW~OA~D:Mus~~re;:ted~~~~~ad:::
of the date you wish Inspection, All project conditions such as
0/ landscaping, parking lot striping, etc, must be completed before
^ FINAL ELECTRICAL requesting this Inspection,
.A' FINAL MECHANICAL
)( FINAL FIRE DEPARTMENT
UNDERSLAB PLUMBING,
, ELECTRICAL &
MECHANICAL: To be made
before any work Is covered.
x
FOOTINGS & FOIJ'NDATlONS:
To be made after trenches are
excavated and forms are
~\erec!ed, all _steel.ln pla<?~I.~~t
, prlor,to placing concrete.
CONCRETE SLAB: To be
made alter alllnslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment Items are
In place but before any
concrete Is placed.
./
UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines, To be made
prior to covering or filling
trenches.
x
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to Installation of
floor Insulation, decking or
floor sheathing,
.x
POST & BEAM: To be made
prior to Installation of floor
, Insulation, decking or floor
sheathing.
x
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to Installation of
decking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
vertlcals In accordance with
UBC 2415,
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
ADDITIONAL COMMENTS'
;X
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.
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 following work. A
copy of the special testing reports shall
be furnished to the Building Division,
)(
ATTIC(@AFT STOPj 8:
CURTAIN WALL" .
A
FIREPLACE: Prior to placing
facing materials and before
framing Inspection,
. FRAMING: To' be made a'fter
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.
HIGH STRENGTH BOLTING:
During all bolt Installation and
tightening operations, (306
a.6)
STRUCTURAL CONCRETE: In
eX,cess of 2500 P.S.I, (306 a,l)
STRUCTURAL WELDS:
Performed on the job, (2722 f)
:-t.
INSULATION & VAPOR
BARRIER: To be made alter 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 cons tructed
according to plans,
SPECIAL GRADING, "
EXCAVATION AND FILLING:
During earthwork. (306 a,ll &
Chapter 29)
SPRAYED ON
FIREPROOFING: U.B,C,
Standards 43,6,
.A
,,(
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),
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,
STRUCTURAL MASONRY: (306
a,7)
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,
tlons specified, the Building
Official may make or require
other Inspections of ,any
construction work to 'ensure
compliance with the Building,
City or Development Code.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
x
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 Dlvl.slon
and posted on the premises,
,
PLANS REVIEWED BY ~~ ..:?'"~..........".. DAT~ /r8-"7?'
<'/7/' < :./
By signature, I state and agree, that I have carefUlly examined the completed application and do hereby certify that alllnformaUon
herein Is true and correct, and I further certtfy 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
times during construction, '
Signature zJ.-. ~J <) r 1.1r
r
Date
NOV, J, n lCl-
VALIDATION:
AMOUNT RECEIVEP' b6C,. "3"~
RECEIPT .' /'7> 'Y ~
DATE PAID'
RECEIVED BY:
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. ATTACHMENT Bl . NO. 9i'/~ 32
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ~-iu
LOCATION: /;t.( '1 }/fAIN 57. ~)2 ,; 13
,
DEVELOPMENT TYPE:, ~ I p..Y..-..:.I ~ 2 ~
BUILDING SIZE: lOT SI7F'
../.
__'. ~... :z
SQ. Ft.
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1. SJD~M nRATNAGE
"
IMPERVIOUS SQ. FT. No AL>.o L
X $0,209 PER SQ, FT,
$ ~A
/
2. S.AN TT ARY SFWFR -r TTY ....
','
NO. OF PFU'S '
(See Reverse)
3, TR4NSPORTATI0cr
NO OF UNITS X TRIP RATE X COST PER TRIP
s-
X 543,26 PER PFU
$(2IC..JD")
'-- ----
c;..oDF
)0/
/ ADDb o,-f< X $436.19
$ m 3..2,0")
'-- --
X
X
X 5436.19
X $436.19
$
$
SUBTOTAL (ADD ITEMS 1.2. & 3) $ 3 ';9,.$'0
4, SANTTARY SFWFR-MWMC
NO. OF PFU'S S x 517,19 PER PFU + $10 MWMC ADMIN,FEE $ "".Lf~
(Use PFU Total From Item 2 Above) iP~~dL)~~
MWMC CREDIT IF APPlICABLE (SEE REVERSE) $ 9s-,~~
IQIAI -MWMr sQC $ ~
SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ "$i'?'So
5, AnMTNTSTATTVF FFEs.
';;?1!r~VE) X ~::e.
;:~~nig. t7b
/ SDC Coordi nator
~9~8j
//- tF- c;>~
IQIAI snr
$ 919, ofIJ'
-
B2.SDC .
FIXTURE UNIT CALCULAION TABLE: Number of New Fi.S X Unit Equivalent = I'ixture Units
INOTE: For remodels, calculate only~ liEI additional fixtures)
NUMBER. OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub"".,.,.,.,.,..,."".""""'.".""""...,..,.""'.""'.,.... ,
Drinking Fountain,............, ..,.......'"...........,...., ,.", ,...
Floor Drain......... .............,.. ,..,.......................... ,.......,
Interceptors For Grease/Dil/Solids/Etc,.."..,.....,..,
Interceptors For Sand/Auto Wash/Etc..................
Laundry TublClotheswasher ,...., .... ........ ...,.....,.... ...
Clotheswasher. 3 Or More....,..........,.....................
Mobile Home Park Trap 11 Per Trailer)............,.....
Receptor For RefrigeratorNVater Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.,......,...,........,..,......;,................
Shower, Gang.. ....... ...... ,...,... .... ...,......... ........... .......
Sink: Bar, Commercial, Residential Kitchen........................
Urinal, StaIlNVall..:.... ,............,........., ....,..........".."".
Wash Basin/Lavatory, Single............,..,....,............,
Toilet, Public Installation...,..............,........"....,.."..
Toilet, Private............,..,...,..................."...."...."..
Miscellaneous: ,T....., r:J?'$ .s",.;.<-
2
1
2
3
6
2
6
6
1
3
lel ). I A)l/~ 2
1iHead
Ie/? 2
2
IU 7 I A/)/)'t. 1
6
leX .1 JA/W'I.. 4
.<
2.
<2>
4
TOTAL FIXTl.:i;;: UNITS
=
S'
CREDIT CALCULATION TABLE: Based on assessed value. If improvemems occurred after annexation date in table,
calculate credits separates.
'I Year Rate per $ 1,000 Year Rete per $ 1,000 1
Annexed Assessed Value Annexed P.ssessed Value II
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1979 or before $3.46 1985 $2.46
1980 3.38 1986 2.14
1981 3,32 iSS7 1,77
1982 3,21 1983 1,37
1983 3,06 1239 0,97
i984 2,92, 1990 0,61
, .
1985 2,73 1991 0.44
1993 0,15
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Credit for Parcel or Land Only If Applicable X $ =
IRate X Assessed Value)
Improvement (if after annexation date) X $ =
IRate X Assessed Value}
f:ENOOEL.
CREDIT TOTAL = $
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