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HomeMy WebLinkAboutPermit Backflow Test 1992-4-22 }<.EN: COMMERCIAL/lNDUSTRIAL. PERMIT APPLICATION .JOB NUMBER 9/077/ . ~ - ~ INSPECTION LINE: 726-3769 OFFICE: 726-3759 225 Fifth Street, Springfield, Oregon 97477 LOCATION OF PROPOSED WORK. ASSESSORS MAP' /703 <'P ~_ ~ _~ .-a...;;.. --, '2 2.. c:D..A;~ bA-4=~ c;:> 4:> TAX LOT. t? "/_ 1"'7 ) ~ ~ { ~ ~ t 6€N~ o::>"'~\'- / 'v""~n, rv\~__ ~~, '- :"YI~) 13 C'>>t'/"" ADDRESS: RJ 12.)(, ~~/ :<kP~ ~p Mew CITY: t;hr7TUANC> " / ~...e~r/~ ;TATF.~i"L /..{) -"""'~/_ -P -r '7' , ZIP: C;'L.::;-:-. :"Wi>CcJ PHONF. ~2'!5 ?"'ilc BP.f> ~Loo-J ~N~~"\ DESCRIPTION OF WORK: NEW'~ REMODEL ADDITION DEMOLISH OTHER VALUE: NAME '~~ON ~\~e-lZ- ARCHITECT' ~~, vaJ. i _, ~"..._TI ADDRESS PHONE CONST. CO NT RACTO R . CONTRACTOR'S NAME ADDRESS EXPIRES GENERA' ' ~t:)~"'(;L c.o....,~"- PLUMBING: IC;;~ '1"~>'I'\"""'N ?o ~'( \ \li'la1- "'d.:(JNI Q1WO ...t l'-'l. ~ ... , 5Co75 ro.\'k'I \qZ- MECHANICA' . ELECTRICAl' PLUMBING NO. FEE CHARGE Single Fixture Relocated Bldg. (new fix. addtl) Water Service It. Sanitary Sewer It. Storm Sewer It. Backflow Device /5.00 MECHANICAL NO 1=1=1= Furnacel burner & vent < 100,000 BTUs Furnacel burner & vent > 100,000 BTUs Floor furnace and vent Suspended wall or floor mounted unit healer Appliance Vent separate Stationary evap. cooler Vent Fan/Single duct Vent System apart from AC or htg. Mechanical exhaust hood and duel Permit Issuance TOTAL PERMIT IS.DO TOTAL PERMIT - OFFICE USE - HANDICAP ACCESS: QUAD AREA" LAND US.' FLOOD PLAIN: . OF BLDGS' . OF UNIT~' ZONING' OCCY GROUp. CONSTR. TYp.. LIGHTING POWER BUDGET: . OF STORIES. HEAT SOURCF. WATER HEATER' SQ. FT. $/SQ. FT. VALUE SQ. FTG MAIN x SQ. FTG ACCES~ x X SQ. FTG OTHER TOTAL VALUE OF PROJECT PLAN CHECK FEE RCPP DATF BY I BUILDING PERMIT 15% State SurchalJl.e I MECHANICAL 15% State SurcharGe I PAVI NG PLUMBING 15",0 .75" DEMOLITION 5% State Surcharge FENCE VALUE $ I SIDEWALK I CURBCUT FT. SUBTOTAL PERMITS SYSTEMS DEVELOPMENT FT. TOTAL PERMIT FEES I EXCLUDING ELECTRICAl 7~ -8", 'of -'1Q"~"~ PHONE (lI.~ ~\2"'n I ~HARGI I I I I I I I I I $10.00 I I /S.7S . 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. UNDERSLAB PLUMBING, ELECTRICAL & MECHANICAL: To be made before any work Is covered. FOOTINGS & FOUNDATIONS: To be made after trenches are excavated and forms are erected, all steel in place, but prior to placing concrete. CONCRETE SLAB: To be made after all lnslab 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. UNDERFLOOR: 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 AND NAILING: Prior to Installing any roof covering. FINAL PLUMBING FINAL ELECTRICAL FINAL MECHANICAL FINAL FIRE DEPARTMENT ADDITIONAL COMMENTS. ROUGH PLUMBING, ELECTRICAL & MECHANICAL: No work is to be covered until these inspections have been made and approved. ATTIC DRAFT STOPS & CURTAIN WALLS FIREPLACE: Prior to placing facing materials and before framing inspection. 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. 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. 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. 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. CURB AND APPROACH APRONS: After forms are erected but prior to placing concrete. PAVING: After gravel is in place but prior to placing as phal t or concrete. SPECIAL INSPECTIONS: In accordance Section 306 of the State Specialty Code a special inspector shall be employed by the Owner! Contractor during construction of the following work. A copy of the special testing reports shall be furnished to the Building Division. STRUCTURAL CONCRETE: In excess of 2500 P.S.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.Be. Standards 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). )( STRUCTURAL MASONRY: (306 a.1) ~~/~ j)EM/'Ip. , *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. 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. 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. PLANS REVIEWED BY 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 Bul/ding Safety Division. I further certify that only contractors and employees who are In compliance with ORS 01.0. will be used on this project. I further agree to ensure t t all ~u ep Inspections are requested at the proper time, that project address is readable from the street, that the pe~plltl rd Is I ca d at the front of the property, and the approved set of plans will remain on the site at all times during constru on. /" ,/ / 'signature / VALlDATIONI 71.11 I f// I l:1o~NT RECEIVED: V RECEIPT .. /5.7S -f'~/ -;;' DATF Date 3/ 'Z- 'i /~7 DATE PAID:_o/2.2-/5'2 RECEIVED BY: ~#~ . , . SPRI.IELD DEVELOPMENT SERV'CES PllULlC WORKS METROPOLITAN WASTEWATER MANAGEMENT :'25 nnN Sfr.'1I r :;fl/UNUnl:l.p. Oil' fh:lI/ (.r;03) i:"j; :Ii:d p.pril 23, 1992 Thompson Landscape Co. P.O. Box 11562 Eugene, OR 97440 Attention: Ken Subject: Backflow Permit Gentlemen: Enclosed is your receipt for the backflow permit for B85 Oakdale Street. Your copy of the approved application is also included for your records. I have also enclosed the original permit application your signature. Please sign the application on the back page by the red "x" mark, and return it to this office at your earliest convenience. please call our inspection request line (747-3769) for the required inspection once the device is installed, but before the trenches are covered. Thank you in advance for your attention to this request. P;;7f~ Donald 1100re construction Representative .... " .,. 2:1:1 Fillll SlrOI)I, Springfield, Oregol1 97477 ~ .m NUMBEIl -9 /Q_"Z7./ COMMERCIALIINDUSTRIAL . PERMIT APPLICATION INSPE.CnON LINE: 72G.:J769 OFfiCIO: 72G<I'I\i\1 IUt.:^,IUrl ut 1'llUI'u~.a:1J WOln,: $>'ii? ~ cQ~/C Drf-Lc /703> . __'A _2__.__.9_ .C> mx LOT: ___2.:'2- /"1 ^~::~jE::;~()ns r\'.1^r: ~~-,;;,~~';:., *Z~';;~~:';-t-~-_.._S?l-f'rl7U__8- ~-- PHONE _~_:7_':~__ <-';.-:/:1-2:. _. 77"~_:.8t; '..f ADunES,; \'t:'l?:,r'-_S_~ 1.~t..L __31fC2S_&:{Jf'~tf<-U.-Lu., - - - . --0/7,,/,77. __u_ CII Y ll,i(..\C..\N o. r _ .. . ~...er~,E I~ STATE: QR",___ . ZIP: C::iJ<::~-CC~<;SC~ DE;~cnIPTION OF WOnK: _\~~,,_~~"'" .:;-.,J-::-!~~""'-"--'~C)C~. NEW. /" _ IlEMODEL __ ADDITION DEMOLISH on-I Ell -- - VALUE: ___ NAME ':r~\(;.i~'"n<":I'-' '~-b\u~ 1'-t2- ARCHITECT: _ _~\""I.,.",:,_"2<<-LL_\"':'C-:\_0 :CL- ADDRESS PHONE W('c' . ... ,- __.I"".:l..:~>:i:,k)_ CONTRACTOR'S NAME ADDRESS CONST. CONTRACTOR" EXPIRES PHONE GENERAL: i.-\-,....\J..X.~\'I'="~ Lc,.....-;~L~\L.. PLUMBING:\(", N ~t~(\'i?'>C:I,,_~9_\.l,I,_\_\!?k~_~~0.~I~LS!\N0__ -U.:...--:.:..,:.:..._.. - 5&>75 I~'\".~ \," (,..'l( _ -',W'-, _ __\.11-_ ;.u. .I~__. w~. L_~",.JI.; MECHANICAl. ELEcrRICAL: __ 1-.--- .-.- --- _NQ.u .___ __~~UM~lNG __MEGt!ANJ.!::AL _ _F_"~_ _CHARGE _NO.__ _FEE _. _ .CltAI1GE_ GtlCkllow Device /5.!C>O Furnnce/blllllCr & vent ___ _ __,,-1QQ,QQ()~CY~ FUllwce/bulllcr & vent ___ _.?"JQQ~qQ_QXU~!_ _______ ___ Floor furnace anti vent Suspended wall or floor mounted unit heater Appliance Vent separate Statiollnry evap. cooter Vellt Fan/Sinole c1uet Vent Systelll np<lIl Irolll AC or llllJ. Mechanical eXll.:lUsl Ilood ami duel Sin!]le Fixture 1II1Iocatt~(\ BldU. \llt~W Iix._a~!d~JL_ _ Wale I Service II. . :,;;uliI ary. Sewer----. II. StUlIll Sewer --- II. Permit Issuance $10.00 TOTAL PERMIT /5.00, TOTAL PERMIT - OFFICE USE - HANDICAP ACCESS: FLOOD PLAIN: __ OUAD AREA: LAND USE: 11 or IILUC~~: 11 OF UNITS:_________ ZONING: __. _ OCCY Gr<oup: CONSTR. TYPE:_. LIGHTING POWER nUDGET: .. UI :;/UIIII":; ilEAl ';OUHCE: WAlEH IIEAn,H: SO. FT. $/50. FT. VALUE ~iO. FTC Mt,IN ___._.__ X so. FTG I\CCESS x SO. FIG OTHEH X _ ~ _u_ TOTAL VALUE OF PROJECT___ PLAN CHECK FEE RCPT" DATE BY 5% SlalC ~~rclwrg~.__ __ PAVING 51)/0 Slale Surcl1arqc FENCE VALUE $ ___ SIDEWALK --.- J500 DEMOLITION ~_ __f_ __ __ _. __. .._ __. .75 [lUILDING PEHMIT I PLUMBING 5% State ~~lfEJ.!!~9~ _ .__ MECHANICAL FT. SU IlTDrA I. l'Ef!~~TS SYST EM S DEVE LOPMr,-N-I..___ CURBCUT FT. TOTAL PERMIT FEES EXCLUDING ELECfRlCAL /5.7S ,. ,'--.- . REQUIRED INSPECTIONS. It is the Icspon:..,ihilily olll1e perlllit Iwlder 10 see t11R,t all inspections ilre made althe proper lime. To request nn inspection, call 726.3769 (recorder). sl<:llc YOlll Cily dc::;ionaIlJ<.! iob number, job addrcr.s, type of in:;peclion H)quc:,!r.HI and whfm YOll willi)!: n:ady for in~;J1el:ljon. n(l(llll.::;I:; Il)ccivnd helUln .!;()O :UFl. willllf~ IlHldl) 1I1f~ :";lI11C wlllldll!l d;IY, 1()(pll~:"I:; rrl;lflf~ :1111]1 '/:f)f) :l.Itl. willllf: 111:U": Illu fol1owilltj wurl\ <lilY. UNDERSLAB PLUMBING, ELECTRICAL & MECHANICAL: To be made before any work is covered. ROUGH PLUMBING, ELECTRICAL & MECHANICAL: No wl,)lk i~~ tu be covered until 010$1) inspections have been rllfldc and approved. PAVING: Afll)! W;lv,~1 i:.. in pl:ICf] but pdf)!' III pl:t1:in!1 :L:..pllall or CI.1l1Clr]II.:. SITE INSPECTION: Tu 1.l(.~ made afler excavation, bul prior tu ~:;etup 01 lorlll~;. FOOTINGS & FOUNDATIONS: To b(~ rnade alter trenches arc excavnted ;':lI1d forms arc erected, all ~;Ieet in place, but prior to placiny concrete. FIREPLACE: Prior to placino facing materials and befow (raming inspection. SPECIAL INSPECTIONS: In ::Jccofd;Hlce Section aOG of the State Specially Code a special inspeclor slli111 be crllployc(J by Ille Ownerl Conlraclor dllrin~l con:;lrllclion of tile followin~l work. ^ copy (If tile f,pecial lc~.tinfl nJp'_)rl~ :;l1al1 b'] furnished 10 the BlIildlno Divj~;ion. ATTIC DRAFT STOPS & CURTAIN WALLS CONCRETE SLAB: To be rl1:1d.! ~l(jcr nil insl;!\) huildin!J scrviGe equipment, r;omJuit, pipin{l, accessories and otllel ancillary equipment iterns are in place but hefore :Jny concrete is placed. FRAMING: To be 1l1;l(.J(~ aflCI Ihe roof, all (mming, file blocking and bracino are in placu amJ all pIpes, ctlilllllCYS and vents arc complete and lhe rouuh electrical. plumbing and mechanical are appt'Oved. STRUCTUflAL CONCflETE: In exces~. of 2500 p.z~.1. (306 a.l) STRUCTURAL WELDS: r"~tlr:'tnl,:d (.>/1 Ill.: i,.,I). I;:;'::: '1 UNDERGROUND: PlullllJinU, eleclrical, O:lS, sanitary sewer, stOlln sewer, w;1ter and tlrainage line~,. To be I1Hldc prior to covering or fillinU lrenches. INSULATION & VAPOfl BARRIER: To be ronde alter HII insulation and required vapor barriers ;.ue in place but before any lattl or gypsum board interior wnll covctin~l is apIJlied. HIGH STRENGTH 1.l0LTING: Ourin~l ;JII bolt insl;lll:lli(ln ;)n{l lightening oper:lliolls. (306 '1.6) SPRAYED ON FIREPROOFING: U.U.G. Standard~. 43-U. UNDERFLOOn: Plurnbinn, elechical, rnechnnical. To be made prior to insinUation of rloor insulation, decking or floor sheathing. FIRE & SEPAflATION WALL: Located and constructed according 10 plans. SPECIAL GRADtNG, EXCAVATION AND FILLING: Durinn enrll1worlc t:30G n.11 (, Chapler 2U) POST & f] EAM: 10 be made prior 10 installation of floor insulalion. decking or floor sheathin~J. LATH AND/OR GYPSUM BOARD: To be lIlade a(ler all lathing ami UYP~HlIll bO;lId, inlerior and cxtel'iOl, i~: in place bul bcfole any plastering is npplied or befol'C gypsum board ioints :lnd fasteners are t;!ped and finished. GLU-LAM lJEAMS: In~:peclioll Cerlificntc by ;1Il apProv,~(1 ;1\Jency, fl.lt'lll~;l1r.:d 10 II\~~ Cily':; BuildinO Oivi:;iul1 b.:lrlH~ Ilt~am:; ;Ill) placed. (:!~lOI U.UC STDS.25-10,ll). FLOOR INSULATION & VAPOR BARRIERS: To be made prior 10 installation of decking or floor !5heathing. SIDEWALK & DRIVEWAY: Required for all <";OIlClctc paving within street right o( way, to be made alter all exc<1vating complete and form work and sub-base material in place. STRUCTURAL MASONIIY: (:\OG n.7) X---~t'2_j)&d$ MASONRY: Sleol location, bond beams nroutlng or verticals in accordance with UBe 2415. ROOF SHEATHING AND NAILING: Prior to installing any roof covering, CURB AND APPROACH APRONS: Afler forms are eleclec! but prior to placing concrete. Oln addition to tile inspec- tions specified, tile Blllldin~l Official may Ilwlw or requite other inspcction~.; l)f any construction wod\ 10 cn~u'c compliance with Ihe Building, City or Devclol:1I11'JnI Code. ------------------------------------------------------- FINAL PLUMBING SITE PLAN REVIEW 130ARD: Must lJu rcquestcel 2 d.1Y~ in aelvanct.:' of the date you wish inspection. All project cotl(liliofls such as landscaping, parking lot slripino, etc. must be compleled I)I]IOH~ requesting this inspection. FINAL ELECTRICAL FINAL FIIlE DEPARTMENT FINAL BUILDING: Heque~~tctl ;lltcl' IlIe finClI pltlflllJin~1. ,]I'Jctllc~iI. mechnnical and Fire Deparllll/:nl inspccllon~3 are "we!l:: ;11111 approvud. No OCCUP;lIlcy III II,,: 11It:llli~.f~S. can !itJ 1l1;l{h~ 1111111 :1 CCltilicalc of OCf,:lIpal1cy 11:1:; IJ1J!:1l i:~:~lIed IJY till..: UlIilrlittU I.lIVl::it'll and posted on Il1e plellli~;u~;. _ _ _n FINAL MECHANICAL ADDITIONAL COMMENTS: __ PLANS REVIEWED BY DATE ___ By signature, I ~~tate and agree, that Illave carefully examined Ille completed application ilnd do llCteby certify Ihal all infot'fll<:llion herein is lrue and correct, and I further cellily tllat any and all work performed shall be dOlle in accordance willl llle Qrdin;1IlGCS of thc City of Sprinufielcl, and the Laws o( ttlC Stote of Oregon pertaining to tho work cle~r;rilJed herein, and that NO OCCUPANCY will be made of any structure without permission of tho BuUding Safety Division. I further cenily tllal only contractors (lnd Ur1llJloyer1S who are in compliance with OAS 701.055 will be used on this project. I (urther agree to ensure that all required inspections are requested at the proper time, Illat proiect address is rC<Jdal)le IrOfll IlIe street. that the permit card is located at the front of the property, and the npprovetJ set of plans will remain on the site al all limes during construction. Siunalure l);lte ___._ nEGEtPI" J/:_ - 75" J':;J' -1-6/3______ DAlE I"AID: _~~_~/7'~_ IlFCI.IV[IJ IW: "I~:Z::;:' I VALIDATION: AMOUNT RECEIVED: l