HomeMy WebLinkAboutPermit Building 1994-6-24
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JOB NUMBER
9'4'/),/ ~2
I 0"'
COMMERCIAL/INDUSTRIAL
PERMIT APPLICATION
225 Fifth Street, Springfield, Oregon 97477
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INSPECTION LINE: 7
OFFICE: 726.3759
LOCATION OF PROPOSED W{l~' A .'2...D7 '3
ASSESSORS MAP' II)()\""'D.~~_
~L'-I)'I.-tPI<-
:z. ,.>0 'rLGe>R-,
TAX LOT:.../) \ \(J)
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OWNER' E, A-t-:> l<=-- or '~~L,,\
0[6> jVtc:t.~'t1r-G- <---..:.;,. :c..~I..,...'"""\t.o..D
ADORe"". ~<;53~n ,?,,:>{F; ~..e..DJE, <:lCD. '
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CITY:
'E c5<<.,.ep~
DESCRIPTION OF WORK.A;r-,~ ~~ o;pAc:..:<=;,-<.
NEW
REMODEL ')C
ADDITION
DEMOLISH
ARCHITECT:
NAME
Z I "'^ "'" ~ -&.:>....,~"''-,. +="eA,.;c-,,",
CONTRACTOR'S NAME
GENERAl' M C!..:I--=rr 'I C"':r=-
PLUMBING' &~-;;'c>woSt-c..
MECHANICA" ~~E-Jll.'
ELECTRICAL: r'):? ~~'
ADDRESS
<iI"'"..
:!'
I
I NO,
I
I
I
I
I
I Backflow Device
I ,(lA"T/""",!-:?L ,7?c.,.::;P~ S;f~..-\?--
I ~ ~&-"I"'~ c15P
IV' r
I
I
I TOTAL PERMIT
PLUMBING
FE;
CHARGF
Single Fixture
Relocated Bldg.
Inew fix. addtl)
Water Service
ft.
Sanitary Sewer
fl.
Storm Sewer
It.
PHONE: (o~7- Z.91...{ I . 15/L.L.
-.,.c....-..P<...
STATF'
DQ..
ZIP: 9' 7'-1 B<
OTHER
VALUE:
PHONE
2Z-<-t,.-'SB<:oo
ADDRESS
j',JAr::> ~8...l-L1..""'"
i CONST.
CONTRACTOR'
o 3.:,"SD
\of')\M4
A Id"$-~
'''''~ '2...0-ls;-S<3....~.S.ctth5"'
EXPIRES
L e>/9 'f
~.\Y4,~
PHONE
(cB7-2.8'~1
345 -'05"~
'-I B'f~ Z3e")'
S '-e'r 72..'77
I
I Mn
I
I
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
from AC or htg.
I Mechanical exhaust
hood and duct
~[/~1"/?<- L~/'? ~ r.~'"
I ' ,---,~ '/n~-z.;- -
Permit Issuance '. S10.00 I
I TOTAL PERMIT I.
MECHANIC41
~~~
f'"1-Il\.cn:s:
Furnace/burner & vent
< 100.000 BTUs
Furnace/burner & vent
> 100.000 BTUs
0--,-
OUAD AREAr!)r Jl)u)
, - OFFICE USE -
LAND USF' ~3ro
HANDICAP ACCES~'
FLOOD PLAIN'
ZONING" (\ ~
. OF BLDG~'
OCCY GROUP:
-tJ~2.
. OF UNIT~'
CONSTR. TYPE: -:z -/ #;7?
HEAT SOURCE:
LIGHTING POWER BUDGET:
WA1ER HEATER'
. OF STORIES:
SQ FT.
slsa. FT.
sa. FTG MAIN
sa. FTG ACCESS
sa. FTG OTHER ~ ...;.n.;c.-c.
X
X
~."
.'
PLAN CHECK FEi: /2 '2.4"J
RCPTM / '5(",/9 ?
I BUILDING PERMIT I
15'10 State l' Y..,.
SurcharQe ?'"~--
I MECHANICAL
15'10 State
Surcharoe
I PAVING
/$~. S'.4>
1-:~
/~PLUMBING
5% State
Surcharae
FENCE
VALUE S
SIDEWALK
CURBCUT
VALUE
TOTAL VALUE OF.PROJECT.2..8~ seD
,
DATEJ-, '& -)~ BY ~~
, DEMOLITION
j
I
I
~3'.~ I
, I
. . ,.2...2.. 0 ,--'9 :!.::...J
':;~f.:;1
FT.
FT.
SUBTOTAL
PERMITS '-
SYSTEMS
. DEVELOPMENT
TOTAL PERMIT FEES I
EXCLUDING ELECTRICA'
.
. . REQUIRED INSPECTIONS
It Is the responsibility of the permit holder to see that alllnspecllons are made at the proper time. To request an Inspection, call
726.3769 (recor~~r), state your City designated job number,lob address,type of Inspection requested and when you will be ready
(or,l!,spectl6ii! Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made
tlie following wor~ day.
SITE IIi1SPECTION: To be
_ made-eJter 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 Inslab 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 8< BEAM: To be made
prior' to Installation of floor
Insulallon, 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.
y
FINAL PLUMBING
y
X
FINAL ELECTRICAL
FINAL MECHANICAL
y
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.
x
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.
y
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
asphalt 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.BC.
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.7)
"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.
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 fhiIl'.~spectlon.
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.
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PLANS REVIEWED BY 0-.;# ~
"//'
"' -
'~.....-;?
./
DATE
?-:;>?-~Y
< -
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 1 further certify that any and all work performed shall be done In accordance with the Ordlna~s:es
of the City of Springfield, and the Laws of the State of Oregon pertaining to the work 'descrlbed 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 m4..:- q!:~.~
.-, ,.
VALIDATION:
AMOUNT RECEIVED' ~2<:/... 9-
RECEIPT" / y~ >~
Date
9-/-?j~
DATE PAID: <:::::)'-':2~9 y
RECEIVED BY: ~~~'!ll r_
-~--
. JOB NO. Q"/Or'f2.
. ,(GVlseo F~
1-/$'-'1->1
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIOENTIAl)
NANE OR COMPANY: . 8AA'r ~r AMeRICA
LOCATION: 2.0 7_?' ()~"lh1.P1C (2~rLoc"e)
DEVELOPMENT TYPE:.REMOl>EA RJR NEW TENANT
BUILDING SIZE:
I.' STORM DRAINAGE
IMPERVIOUS SQ. FT. ;Yo Af)lJ"J. jJ1lPERII. x SO. 203 PER SQ. FT.
LOT S!ZF
SQ. Ft.
~..0)
'----/ ---
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See R.everse)
5
X S42.08 PER PFU
('"2./0, ~:)
'- -------
3. TRANSPORTATIOll
NO OF UNITS X TRIP RATE X COST PER TRIP
HO c./{AI'(G- F
1. '$/' X OP TRIP X S424.31
I<ArG.
X
X
X $424.31
X $424.31
co
s
s
4. SANITARY SEWER-MWMC
NO. OF PFU'S S" x S15.125 PER PFU + SIO MWMC ADM FEE S rg-S.':3
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
S 8'5-."3 KEldol>EL
TOTAL-MWMC SDC ~
SUBTOTAL (ADD ITEMS 1,2,3 & 4) S ;vo..fO
5. ADMIN~TRATIVE FEES
, \
BA~~~GE (:YYOTArOVE) X .05
~ /-f.~ 9'-/-9'~
/ \t6r C~~~~;~~tV
(/0.s0
TOTAL SDC S ;..,zo. 9~
FlxiuREU'NIT,CALCU.J..Q.T(O~ TA:BLE: NlJmt'N 01 New FiXI. Unit Equi":I!cnt = Fix1Ule Unils (NOTE:,
For remodels. c..1lcul~te only the. .1lkl,I,\)n,lJ fI\IUll"')
I-iLi/.mEn OF L':~lr FIXTURE
FIXTURE n-PE ' NEW FIXTURES EOLlI\'/\LE1JT UNITS
l3a.lht~b..............;;,;,..;.).................. ..'.'......................
Drln.klng .FounI31l1......................... ...........................
Floor Drain.................. ............ .,......... .... ......... ..... .....
Interceptors For Grease/Oil/Solids/Etc.................
Inlerceplors For Sand/',uto Wash/Etc..................
Laundry Tub/Clotheswasher...................................
Clotheswa~her - 3 Or More.....................................
"". I'
MobOe Hdme Park Trap (1 Per Trailer)..................
Recep!or F9r RefrigeratorjWaler Station/Etc........
Receplor For Commercial Sink/Dishwasher/Etc..
Shower, Single.Stall.................................................
Shower, Gang..........................................................
Sink, Bar, Commercial.,..KL.r.?f.(.4i:~................:......
. Urinal, SIaIl{WaJL.....................................................
Wash Basin/Lavatory, Single...v.l~.t..,?...€1.41.'1...
Waler Closet, Public Inslallation.............................
Water Closet. Prr-'ate...............................................
Miscellaneous:
.,
:?
3
G
2
G'
G
1
3
2
l/Head
2 2
2
~ 1 3
6
~
TOTAL FIXTURE UNITS
=
S"
CREDIT CALCULATION TABLE:
calculate credits separates.
r
Based on assessed value. If improvements occurred after annexation date in Iable,
Year Rate per $1,000 'I
Annexed Assessed Value
1986 $ 2.24 I
1987 1.93
1988 1.57 I
1989 1.18
1990 0.79 j
1991 0.44
1992 0.28
--.. . .
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
1984
'1985
$3.21
3.13
3.08
2.96
2.82
2.68
2.51
..
Credit for Parcel or Land Only If Applicable
Improvement (If after annexation date)
X $ a
(Rate X Assessed Value)
X $ a
(Rate X Assessed Value)
CREDIT TOTAL = $ REMDDEL
..
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RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Resid enlial..... ................................................... 0.4
Commercial...................................................... 0.9
I nd ustrial.. ....... ................... ...................... ......... 0.45
GovernmentaL................................................. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT