HomeMy WebLinkAboutPermit Building 1995-4-11
CO M M ERCIALlI N DUSTRIAte
PERMIT APPLICATION
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JOB NUMBER
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SPRINGFIELD
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225 Fifth Street, Springfield, Oregon 97477
INSPECTION LINE: 726.3769
OFFICE: 726.3759
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LOCATION OF PROPOSED WORK' (9 f N IV
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OWNER' .::To ,^..J '1<. '1J.e '(5TU e/1
ADDRES?,-. .:3.~ m.' ul
CITY' ~ lJO ~~-€- STAT'"
DESCRIPTION OF WORK:1,(~ IIY1 '0 leA. eJ ""
NEW REMODEL --* ADDITION
NAME
~SSESSORS MAP:
ARCHITEcT:
CONTRACTOR'S NAME /.1'1
GENERA" ...J O~~
1
PLUMBING:
MECHANICA' .
ELECTRICAl'
_~YV> P
PLUMBING
NO,
Single Fixture
Relocated Bldg.
(new fix. addtll
Water Service
Sanitary Sewer
Storm Sewer
Backflow Device
TOTAL PERMIT
QUAD AREAAlr Sll ")
I
'A '2.
. OF BLOGS:
OCCY GROUP'
. OF STORIES'
/
SQ. FTG MAIN.
SQ. FTG ACCES"
sa. FT.
~/
sa: FTG OTfjER
PLAN CHECK FEf
19.vf~
1 BUILOING PERMIT '~:;;o
15% State , -.J' 0/7
, Surcharoe3? +Z'-r C;, Tf
1 MECHANICAL I.
15% State 1
Surcharae
I PAVING I
_... I "':'.
"
c:;: p .(tel, .
TAX LOT ffi.RI1)
PHONE 71../(1l COlsz....
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CA..J.:.
DEMOLISH 'k.
,
OTHER
VALUE:
ADDRESS
PHONE
AOORESS -+-
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CONST.
CONTRACTOR'
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It.
I MECHANICAL I'~ARG~
FEE CHARGE I .." """
1 Furnace/burner & vent
< 100.000 BTUs
1 Furnace/burner & vent I
> 100.000 BTUs
I Floor furnace and vent 1
I Suspended wall or floor I
mounted unit heater
I' Appliance Vent I
separate
I Stationary evap. I
cooler
1 Vent Fan/Single 1
duct
1 Vent System apart I
from AC or htg.
I Mechanical exhaust I
hood and duct
I I
I Permit Issuance $10.00 j
I TOTAL PERMIT I
It.
It.
- OFFICE USE "'"
LANOUSE:~ J
· OF UNITf'
HANOICAP ACCESS:
FLOOD PLAIN: I'rt, _
lONING: \'j(/
CONSTR. TYPE:
\/-^'
LIGHTING POWER BUOGET:
WATER HEATER'
HEAT SOURCE:
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.,
-x
. X
SISO. FT.
//-,.,1D
VALUE
<;2,129'.
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X
RCPP /r;,9/'Y
OATEJ/II/'1..r
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r
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,
TOTAL VALUE OF PROJECT
BY
, PLUMBING
. OEMOLlTlON
5% State
SurcharQe
I FENCE
VALUE S
I SIOEWALK
I CU RBCUT
FT.
SUBTOTAL
PERMITS
SYSTEMS
, DEVELOPMENT
,~~'1~
FT.
TOTAL PERMIT FEES I.
EXCLUOING ELECTRICAl
'3g,~.7()
.
REQUIRED INSPECTIONS
.
It Is the responsibility of the permit holder to see that alllnspecUons 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 I
prior to setu p of forms.
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 Inspectlon.
X FINAL BUILOING: 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.
( LAV^,d."J L,c"-E~/_)
UNOERSLAB PLUMBING,
" ELECTRICAL &
MECHANICAL: To be made
before any work 15 ,covered.
,~
FOOTINGS & FOUNOATIONS:
To be made after trenches are
excavated and forms are
erected, all steel In place, but
prior to placing concrete.
x
CONCRETE SLAB: To be
made after all Inslab building
service equl pment, conduit,
piping, accessories and other
ancillary equipment items are
In place but before any
concrete Is placed.
UNOERGROUNO: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
d ral nage II nes. To be made
prior to covering or filling
trenches.
x
UNOERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to Installation of
floor Insulation, decking or
floor sheathing.
, ,
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.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
ROOF SHEATHING ANO
NAiliNG: Prior to Installing
any roof covering.
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
'>t( FINAL FIRE OEPARTMENT
AODITIONAL COMMENTS:
/YJ~'5
ROUGH PLUMBING,
ELECTRICAL 8< ..
MECHANICAL: No work Is to
be covered until these
Inspections have been made
and approved., .l
ATTIC ORAFT STOPS &
CURTAIN WALLS
FIREPLACE: Prior to placing
facing materials and before
framln"glnspectlon.
FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are In
place and all pipes, chimneys
and vents Bre complete and
the rough electrical, plumbing
and mechanical are approved.
INSULATION B<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.
'X
LATH ANO/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
II nl shed (f/;eewJ.4./..L)
SIOEWALK & 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.
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 rhe following work. A
copy of the special testing reports shall
be furnished to the Building Division.
STRUCTURAL CONCRETE: In
excess of 2500 PS.I. (306 a.1)
STRUCTURAL WE LOS:
Performed on the job. (2722 f)
HIGH STRENGTH BOLTING:
During all bolt Installation and
tightening operations. (306
a.6)
, ,
SPRAYED ON
FIREPROOFING: U.B.C.
Standards 43.8.
SPECIAL GRAOING,
EXCAVATION ANO FILLING:
Ouring 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.
STOS. 25-10,11).
STRUCTURAL MASONRY: (306
a.7)
'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.
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PLANS REVIEWED BY .../,"( ~""""l DATE
'-1:.
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 pe It card I Vthe front of the property, and the approved set of plans will remain on the site at ali"
times during nstr ctlon /~
Sign re .A ~
VALiDATI7V . .
AMOUNT RECEiVEO.
RECEI PT ..
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
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Date
f/'/r}-
~Q:-
OATE PAID:
RECEIVED BY:
. .
.
.OB NO. Q504-104-
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: ::\I">I-\N. "Dt::-f'"lU~(....'T
LOCATION: '2-009 f\f\I><tt-J 'S-r. I fO? ~(",4'1- - o4">.'Joo
DEVELOPMENT TYPE: c.c '. vJke.E:..f4-0uSE. /~TD2-A-(....~
I
BUILDING SIZE: LOT SIZE SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ. FT. <?l~ X $0.209 PER SQ: FT. ~ OBZ;)
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2. SANITARY SEWER-CITY
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NO. OF PFU'S X $43.26 PER PFU
(See Reverse) .~
3. TRANSPORTATION
0>'I>t:. \';'0 - WAtLt!-\oU9k1G, " 0.74- jib SF
NO OF UNITS X TRIP RATE X COST PER TRIP
X
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $17.19 PER PFU + $10 MWMC ADM FEE
(Use PFU Total From Item 2 Above)
X $436.19
0~1~
$
$
O.'?l!;', X 0.74- X $436.19
X X $436.19
$ -e-
TOTAL-MWMC SDC
$
~
'- .--
$ 1.15~
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
SUBTOTAL (ADD ITEMS 1,2,3 & 4)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
o :.. ts- - j.~ck- Date: 4:-(U/"1t;
.~' Kip Burdic~ { TOTAL SDC
SDC Coordinator
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