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HomeMy WebLinkAboutPermit Building 1991-1-18 . I -. CITY OF SPRINGFIELD - INSPECTIONS 726-3769 225 North 5th Street BUSINESS 726-3753 BUILDING MOVING PER~MIT/BUILDING DIVISION OLD ADDRESS 3\0'5.9 (1(ll\'\ Q ~ ~ m , R ClCI_~ Legal Description Building Owner \ J:\\t\,\(\ ,-\(\~NJQ, ~ioving Firm , ft'f\\'f\ f\ WJ \\\\\11 ~ ,r > Des-citPt\~(\ Of Intenaed Use tJ '-f t:]J')(1 p f)~ G Description of Route 'l:RJ ~ ~ Address Address (r \rk.. V'L~ W-lJI\ Description of Buildin~ ,Square FootageJ3fY)O Moving Length Number Of Section~ Being ~Ioved 4 (;iJ)Y( a-+ qlV C<;ru. J Colo~~ NEW ADDRES~~Oni[~eo by Legal Description - Building Div.) Phone Lics # Exp. '}- ~'-I Phone ",)l./ '-I ~ ~:$ ) S).os<1, . CITY DESIGNATED JOB NUMBER q [) 14:,J~ &01.11(., V\l/'\JJL. OV'-. ~f- 0...... 1 (;!., / I}\ I ..jJOJI S (1/1/ o Moving Width ~ P Height On DollY-DLrL- Type Of Construction V /\) VALUATION I CERTIFY TK~T the above information is true and correct, that all re~ired cont been made ~d a~horizations obtained, that the mov~ will begin~ L1 o'clo on l~ ('r"J-Loj and "ill be completed by () o'clock am pm on - and that no changis in the route "ill be made w~out contacti the Building Dlvision. I also certify that I have been informed that NO PE~4IT WILL BE ISSUED BEFORE 5 WORKING DAYS HAVE ELASPED. I further certify that my registration with the Builder's Board is in full force and effect as required by ORS 701.055 and 701.070, and that if exempt the basis is noted hereon. Basis for Builder's Board Exemption: NAME~S 0:--I{61/? lJvMJltfJ6~ SIGNATUREij~ NOTIFICATION OF ~IOVE: The Building Division will route copies of this application to all appropriate divisions, departments and Agen- cies. HOWEVER, the applicant must 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 within the City limits shall have tbe 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 receiv- ing a permit to move a building to property "ithin the City, the applicant or his/her authorized representative must: 1. Submit 2 copies of site or plot plan for new si te. 2. Submit'2 copies of foundation plan for the relocated building. 3. Obtain a permit covering the ne" founda- tion, as well as all plumbing/mechanical and electrical "ork relating to the re- located building. 4. Pay Systems Development Charge if appli- cable. " SEPTIC TANK REQUIREMENTS: Prior to moving, owner sball bave all sludge from tbe septic tank, seepage pit or cesspool removed by a person holding a sewage dispoal service li- cense, and shall fill same with clean bar- run gravel or other material approved by the Di~ector or his authorized representative. /, " ,/ ~ \I - DATE '.2- sl.'?J Flood Plain FOR OFFICE USE ONLY Type of Construction \J 0 Occupancy Group'Q~* ~ \ I Square Footage Paid \t\. Q\ ,ctO l.Q( ) au Zone U') R Stories ~ Li ving Uni ts Application fee $18.00 Date Permit fee $60.00 -- Date Paid Number of Blocks over ~0~erWE? Cap $10.00 + 4~o ~olice Department ~ ire Department Northwest Gas OTHER -- specify 6 @ .60~ l~~{) VALUE Receipt Number Receipt Number \ q()n() \4 \ r1 ) Amount State Surcharge -- Date Paid Willamalane Park and Recreation -Pacific NW Bell - ~ane Transit District ~~ \~I~JL\I _Rainbow Water / SUB _Group W Cable _Lane County A. & T r~ BE R-,f'.s~~S 18LL FdL.- A't.-L 7724-PAc $II'€. /hvo f21tPtJff ~ ~(! ~. BvA.Je~ Date 1//@!9/ / BUILDING MOVING ttMIT I. Applicant to furnish (except as indicated) A. Old address 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 relatin~ 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 ~:~I~ u[)O w TRAFFIC DIVISION REPORT: C()1VT{<Ayf~ SH1l LA- (?O. ~/;e,f) (_ A-T ~Ot/,,,-C P~!3Lr/'"J'S <!:JfL ST~fCT ENGINEERING DIVISION REPORT: en.....rrlL~cr... SLY.::::LL 411JERM~T VALIDATION /-Ig-q/ /q/od PERMIT CLER B, \ ~1f..1" J -lr8 I C?- l2.C-,=f-~ <:;.) e:,LE:. \2a- ~ '1 ~1l::...Cbr-.J -co co (U3, <(\ G"C)\' BL <it ':;. l H.sct:-"1 S,az.l)c....1'LJ~ I ADDITIONAL PROJECT INFORMATION: ~ By'D.Q f2~ Date 1-\"O~91 By . Date