HomeMy WebLinkAboutPermit Building 1994-9-22
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_.CITY OF SPRINGFIELD
225 North 5th Street
INSPECTIONS 726-3769
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BUSINESS 726-3753
BUILDING MOVING pERMtT/IlUJl.IJING DIVISION
OLD ADDRESS
0515~~ ~.
Legal Description
~1 CJ~ \~C(')
B21~g ~;(MtlAJ?-
Moving Firm Address
(/(d/f S;r{)1f' !vfL.d#G" ff()f;tre.! .
Des'cdption Of ,Intended Use "
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Address
Description of Route ~
~c(._~ _ ~
Description of BuildinR
.square Fo.otage/?~:t... Moving Length
Number Of Sections Being ~Ioved I
NEW ADDRESS (Furnishe
\~~f[ \~
Legal Description
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Phone
Lies 1/
Phone
Exp.
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?,/IY ff s 5
320)9
CITY IJESIGNATED .lOR ","'in""
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'(l Moving Width..-'t-- Height On Dolly
Type Of Construction t.nJd ~ALUATION
22./
NOTIFICATION OF MOVE: The Building llivision
will route copies of this application to all
appropriate divisions, departments and Agen-
cies. . HOt/EVEtt, the applicant mus I' contact
property owners if trees are involved in the
proposed move. IN ADDITION, the applicant
must secure the approval of all appropriate
municipal, county and state authorities
should the move originate or terminate out-
side the City of Springfield.
.
SEWER CAP: Buildings moved from \;ithin the
City limits shall have the sewer capped at
the property line and inspected one working
day prior to the move. If the inspection
indicates that the sewer has not been prop-
erly capped, the moving permit will be
revoked.
PLANS, FEES, AND CHARGES: Prior to recei v-
ing a permit to move a building to property
within the City, the applicant or his/her
authorized representative must:
1. Submit 2 copies of site or plot plan
for new site.
2. Submit 2 copies of foundation plan for
the relocated building.
3. Obtain a permit covering the new founda-
I' ion, as well as all plumbinglmechanical
and electrical work relating to the re-
located building.
4. Pay Systems Development Charge if appli-
cable.
SEPTIC TANK REQUIREMENTS: Prior to moving,
owner shall have all sludge from the septic
tank, seepage pit or cesspool removed by a
person holding a sewage dispoal servi,ce li-
cense, and shall fill same with clean:bar-
run gravel or other material approved by the
llirector or his authorized representative.
I CERTIFY THAT the above information is true and correct, that all required contacts have
been..ma;le and/lWthoriptions obtained, that the move will begin at -;' o'clock (aQ)lym
on <~:).::; fSUMcw. Jand will be completed by / o'clock am/<@1 on ~. 'T'r ,
and that no ~langes/ xn the route will be made without contacting the Buildi~~ Division. I
also certify that I have been informed that NO PERMIT WILL BE ISSUED BEFORE 5 WORKING DAYS
HAVE ELASpED. I further certify that my registration \;ith the Builder's Board is in full
force and effect as required by ORS 701.05.5 and 701.?6070' and that if exempt the basis is
noted hereon. Basis for Builder's Board Exemption: /;, 1
NAME Lk-.41J cXtrO.1o SIGNATURE (/> /'t) DATE fl-.JJ-fy
I I
,
FOR OFFICE USE ONLY V
20ne t.,j).r::f Flood Plain .-1/~ Type of Construction G"7f!1' Occupancy Group X-=?
Stories--.2 Living Units / Square Footage~~ VALUE ?~6-_c..-'
Application fee $18.00
Permit fee $60.00 -- Date
Number of Blocks over 6 @
Oate Paid 42'2 -"70/" Receipt Number
Paid &J~ 2'2-9"'/ Receiirt ~8'er
.60~ ,1...\ Amount \...\~. - 7iJ7;#L
;? ~~~.~
/2;'2.. '1'6
Sewer Cap $10.00 + 4~, State Surcharge -- Date Paid
-
_Police Department Willamalane Park and Recreation
Fire Department -Pacific Nil' Bell
-Northwest Gas. -Lane Transit District
OTHER -- specify
Rainbow Water / SUB
_Group II' Cable
_Lane County A & T
BUILDING MOVING PERMIT
I. Applicant to furnish (except as indicated)
A. Old add~ess for building
B. Legal Description
C. New address for building ,
(Building Div. will furnish)
D. Legal Description
E. Name, etc. of building owner
F. Name, etc. of moving firm
G. A description of intended use
H. A description of proposed route
I. A description of the building
II. Applicant to contact property owners if trees
involved, and secure authorizations from
other jurisdictions as necessary.
III. A site or plot plan, and foundation plan must
be submitted for the new site (2 sets)
IV. Plans must also be submitted for any other
work relating to the relocated building.
V. Fees & Charges:
A.. Application fee due and payable at time
of application
B. Moving permit fees due and payable upon
permit issuance \
C. FEES & CHARGES TO BE CALCULATED BY
BUILDING DIVISION STAFF
VI. FOR OFFICE USE ONLY
A. Plan check data collected
B. Copies of application to appropriate
divisions, departments and agencies
BUILDING DIVISION REPORT:
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PERMIT VALIDATION
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PERMIT CLERK~~
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TRAFFIC DIVISION REPORT:
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ENGINEERING DIVISION REPORT:
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