HomeMy WebLinkAboutPermit Building 1995-8-28
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CO M M ERC IALII N 0 UST R IA L
PERMIT APPLICATION
SPRINGFIELD
ASSESSORS MAP:
JOB NUMBER 9 s /1(;, (,
INSPECTION LINE: 726-3769
OFFICE: 726-3759
R&tW
4l'~/ i n-?J
~~.Q. -~ 79 c
TAX LOT:
OWNER: ~ r ~
-/
ADDRESS: 1.-"3 9 5u~AJ~
C'ITY: -rz./4 _
J.A,/ LyAYA.J _~MAWoNE:
/)0 ~
STATE:
DESCRIPTION OF WORK: (4,) 7L -:Ll/ r:-y-~ (/t':.
NEW ~REMODEL ADDITION DEMOLISH
NAME
ADDRESS
ARCHITECT:
CONTRACTOR'S NAME
ADDRESS
GENERAL:
~h-~ r~rr
PLUMBING'
MECHANICAL:
ELECTRICAL:
i PLUMBING
I NO. FEE CHARGE
I /"2$ Single Fixture /~ ~ ..,.
I Relocated Bldg.j ]
(new fix. addtl) }
I Water Service : I
ft.
I Sanitary Sewe! ft. I
''!:,
Storm Sewer "\
ft.
Backflow Device
NO
72
/6
~.
ZIP: 5' 77~ l'
70 pr/ )
. J
OTHER
VALUE:
PHONE
CO NST.
CONTRACTOR II
l~\~
EXPIRES
\\\o-cn
PHONE
23s .3)11- .
MECHANICAL
FEE
CHARGE
/6
Furnace/burner & vent
. < 100,000 BTUs
Furnace/burner & vent
> 100,000 BTUs
Floor furnace and vent
Suspended wall or floor
mounted unit heater
Appliance Vent
separate~~
Stationaryevap.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or htg.
Mechanical exhaust
hood and duct
I
I
'9:'-' ~. ~I
I
3p-%.~1
I
1/.- tiP ./ -<'- ~ I
I
Permit Issuance
$10.00
':2~~
TOTAL PERMIT
~
TOTAL PERMIT
QUAD AREA:
~ R"\l.~
~~
~-/
- OFFICE USE -
LAND USE: \ \?:f\
\\p
CONSTR. TYPE: 5'--tY
HEAT SOURCE' &k/~~
1
HANDICAP ACCESS:#....,~..:4~ ~
FLOOD PLAIN: g;:# ..
ZONING: \v\..\')V' .
LIGHTING POWER BUDGET: #4-"
WATER HEATER: cL'~/ ~
Ii OF BLDGS:
II OF UNITS:
OCCY GROUP:
1/ OF STORIES:~
SQ. FT.
$/SQ. FT.
SQ. FTG MAIN I <:::""l '5 ~ X 31' <'-C
SQ.~ 2.~92 X 2.~.
SQ.ATG OTHER ~V~ X
;:/~~r WflL, '-'4!0- ~~ ~p-~~>--?
VALUE
(p 21' rGl"/
,
5/~f
~':2" y~ / S-8~ .u~".::<..
-'tP::?..... ~6? ., 7'
."" ., ~ (:~
TOTAL VALUE OF PROJECLJrl_,I'" _
PLAN CHECK FEE )71'), 2-~ RCPTIi ! ~~c>S DATE 7-/~ - '7L BY
/.:?66 ~
~Y'-~
"36'.Y40
?;-
I~~I~';~;IT I~. Sc!:>
15% State ~ 7/. .,S'=-
Surcharge ~-~ .2
I MECH~*~ I ~..~~
15% State ~I /~ . Be>
SurcharQe r'"5 c.. C/t!!!>
~;~~~~~'r'/ I' /~:!8. 7D
PLUMBING
5% State 1'2
Surcharge r~
FENCEiDa')"......~ I
VALUE$~~
SIDEWALK I
~? FT.
CURBCUT I
~? FT.
~
I
I
I
?6J.e>$' ~~~~~~~L 33?Y. ~3 I
,-. SYSTEMS I
~. e>;::> DEVELOPMENT "2o/~o/3. ? I
'. w;U1I"f'~/~'~1F 1/ ~'";?'4:. ~
I
DEMOLITION
TOTAL PERMIT FEES
EXCLUDING .ELECTRICAL .'
~~~~.~ y
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.
x
UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
x
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
seivice equipment, conduit,
piping, accessories and other
ancillary equi pment items are
In place but before any
concrete is placed.
x
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
d~cking or floor sheathing.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
.UB~ 2415.
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
REQUIRED INSPECTIONS
y
t
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 Owner! Contractor during
'construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
ATTIC DRAFT STOPS &
CURTAIN WALLS
FIREPLACE: Prior to placing
facing materials and before
framing inspection.
STRUCTURAL CONCRETE: In
excess of 2500 PS.1. (306 a.1)
;(
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.
HIGH STRENGTH BOLTING:
During all' bolt installation and
ti ghteni ng operations. (306
a.6)
STRUCTURAL WELDS:
Performed on the job. (2722 f)
x
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.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
SPRAYED ON
FIREPROOFING: U.B.C.
Standards 43-8.
x
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
{
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).
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-
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.
y
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
'.)( FiNAL PLUMBING
__0- __0_ ____ ___ ___ ___ _________ ___ __ __ _ __ _ _ _ _ __ _ __ _ __ _ _ _ __
FINAL BUILDING: Requested after the final plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be r,nade until a
'V' Certificate of Occupancy has been issued by the Building Division
...., FINAL FI~E DEPARTMENT _ " and,p6sted on the premises.
,A&~~~~'g~~b ~(\qTAl<A$ .LAu.' ....AJ ~ ,j)~.#9'1' \1 ~ -Z.~'"
~ "~lid-.o!\ \;\.\ ~~\l . ~J uA,rlJjAOr:f,)itJ> om cr'OQ M.;
~h 0, "\ \~ ~15 ~. r~
. pL~NS..R~VIEWED B~
t
.j '., FINAL ELECTRICAL
fi
FINAL MECHANICAL
.r 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.
,.1""
.~~i:F"'-' -z<::;>., ~S-
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify thfit 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 th_e Bulldll')g Safety Division. I further certify that only contractors and employe:es
who are in compliance with ORS 701.055 will ~e used on this pr<:>j~ct. . :. . .
I further agree to ensure that all re~uired inspections are requested atthe proper time, that profectaddress is readable from the
street, that the p It card Is located at the front of the property,' and the approved set of plans will remain. on the site at all
times during co str ctlon. (0- () ,.. . ^ .' ,. '.__
Signature _1.. _) / ~ .... Date 1<; -- ~B"-~ ~
," ;. " . ~... ...
,RECEIPT #:
AMOU~T RECEIVED: ~p~ 9S/s-/V
/5i:B evt./
DATE PAID:
VALIDATION:
~ -;?Ji?-"S-
RECEIVED BY: ~~~.,..
JOB NO. 9' S / / ~ b
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
LOCATION:
NAME OR COMPANY: eo ~ c. GRA"1 ,-:;-e. J L}jJ./1-/
. /
1"'3 i ~ ;.. 13>16 \'Q' / 13 i5 }
I I
(q\- 4- PLC:~('S
p crCIC~crt
131"7 '~e" sT-
DEVELOPMENT TYPE:
BUILDING SIZE: LOT SIZE SQ. Ft.
1. STORM DRAINAGf.
IMPERVIOUS SQ. FT. is, 350 X $0.21 PER SQ. FT. ~853€:)
J '- ,/
2. SANITARY SEWER-CITY
NO. OF PFU'S 25<0 X $43.43 PER PFU ~ ilBe€)
(See Reverse) '-..!. ..-"
3. TRANSPORTATION c.:.o€. 2Zl lo;..o.l e..~ f.p.v-~". a..-+
NO OF UNITS X TRIP RATE X COST PER TRIP
lto
X b.5e> X $437.93
(("q; O~3 ~
~ -'"
X
X $437.93
$
x
X $437.93
$
4. SANITARY SEWER-MWM(
NO. OF PFU' S Z5Co x $18.75 PER PFU + $10 MWMC ADMIN. FEE
(Use PFU Total From Item 2 Above)
0;)
$ if, Bib-
/
SUBTOTAL (ADD ITEMS 1.2,3 & 4)
$ 81 ~b
~_'12~..
'--.!: ~ .-:z
91
$Z3 755-
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL-MWMC SDC
5. ADMINISTATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
0'Bl~
11D'tJ ""',*LLl~T~rL
Troy McAllister
SDC Coordinator
Date:
7/7-S/c?s-
,
TOTAL SDC
1/"
$ 21./ 9'13'l-
,
FIXTURE UNIT CALCULATION TABLE: Number of New Fix+ -ClS X Unit Equivalent = Fixture Units.
. (NOTE: For remodels, calculate 0 he NET additional fixtures)
NUMBER OF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS
JI. Ita -: I~
Bathtub........ ...... ~... ............................ ............................
Drinking Fountain. ... ....... .......... .... ... ...... ............ ~.. ......
Floor Drain......................... ....:........................ ..,........ ::.
Interceptors For Grease/Oil/Solids/Etc..................
Interceptors For Sand/Auto Wash/Etc.................. .
Laundry Tub/CIOtheswasher................................~.. . \ .,. 1(., -::.lit,
Clotheswasher - 3 Or MorEl.....................................
Mobile Home Park Trap (1 Per Trailer)..................
Receptor For Refrigerator/Water Station/Etc........
Receptor For Commercial Sink/Dishwasher/Etc..
Shower, Single Stall.... ;.............................................
Shower, Gang........ ............ ......................:.. .................
Sink: Bar, Commercial, Residential Kitchen........................ x; 110 -=. iic
Urinal, Stall/Wall.......................................................
W h B . /L S' I 2 ;( V...- -:::32..
as aSln avatory, Ing e........................:.......... \D
Toilet, Public Installation................... .....................
Toilet., Private......................:.................:.............. "':z ,c \It;:= 3'~
Miscellaneous:
2
1
2
3
6
2
6
"6
1
3
2
1/Head
2
2
1
6
4
3Z
"3-z.,.
3"z..
32
tZ~
TOTAL FIXTURE UNITS
=
25~
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separates.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value.
1979 or before
1980
1981
1982
1983
1'984
1985
1986
$3.47
3.39
3.33
3.21
3.06
2.92
2.74
2.46
1987
1988
1989
1990
1991
1992
1993
1994
$2.13
1.76
1.35
0.95
0.58
0.41
0.29
O~ 14
Credit for Parcel or Land Only If Applicable
,/7
25"8'10 'X $ 3 -"
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
6 q lcb
Improvement (if after annexation date)
CREDIT TOTAL
= $
. bb
6~ --
Job. No. ~\ \ w\.o
SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAME: m\h~l\\\~\ \\\\{\ ~ PHONE: ro&8'lom
. (\- ~,\,- -- C "
ADDRESS: I~--.;i '~J~TATE:~ ZIP: l'1ff~
LOCATION OF PROPOSED BUlL NG SITE:
Street Address: \~\\o'\ \~\~ C\ I \3\~o\ \~\l . ~ ~ ~
, ,
\'Ii \OJ Tax Lot Number: \f\()?:V';52..~\<\CtJ
Plat Name:
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. .Sinale-Familv Detacheej
Single Family home
Manufactured home not in a park
NO. OF UNITS
X $1,000 per unit = $
B. .Sinale-Familv Attached,
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv Aoartment
NO. OF UNITS
\u> X $692 per unit = $ \ \,D\'L
D. Manufactured Home Park
$
$
\\U \L
r6
$ \ \)Dl2-
NO. OF UNITS
WILLAMALANE SDC
X $699 per unit =
2. SDC CREDIT (if applicable) SDC~payer must furnish proof of
Willamalane Credit approval, See SDC Credit Worksheet. $
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
. \k~t\ )
Develop-ment Servi
City of Springfield
~ I 79 / ~.!::>
Date