HomeMy WebLinkAboutPermit Building 1994-9-20
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CO M M ERCIALlI N DUSTRIAL
PERMIT APPLICATION
225 Fifth Street, Springfield, Oregon 97477
JOB NUMBER
cr-f/~/1
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK: q 2:-L.o~ \. A.f'\i1Qi:St:)j-\ ~(f.njL,
.A'ASSESSORS MAP: \,1 0 3 ~ ~ I \ (_~ · . TAX LOT:
PHO~~\..{ ~ ,.ll~ \ _/Q~\ ~ \~
OWNER' . -H~r;7 n,,"\ r ~~\ ~~~
ADDRESS: ~n' ~~\'" .~ 'l;t,~.:l
CITY: . -c. N""V\~-.c-
STATE: ~.~
LA\\2~1< /\ 'h~r\)
DESCR PTION OF WORK: \()O, I_m..~i:'
. NEW ~ REMODEL ADDITION
~.
DEMOLISH
. OTHER
ZIP: qlaqd-"
V\ ~lJi\~\~ S
VALUE:
NAME ADDRESS PHONE
ARCHITECT: \M:.\J\\:, \P{~ fZ-~v\Q"-('\'^~ HI;;::- \~"1h "((L ~ ~_ 'il~02- B-h~~l
1\.9) " CONST.
~ CONTRACTOR'S NAME '.i ADD RES CO~TRACTOR # EXPIRES PHONE
i,~\j\GENERAL: \-t...,n<~ rt1V\'6b. ~ ~ Ob -rl'0^~c- ~ qCA,\\ ~S q?,\.~\~
~J PLUMBING' ~c., f\U~~ ~,\"C} \ \otf\ <X 3'\~,~S 8;1~.~-.,
MECHANICAL: ~_7",O-r\. r ~'f"'Jeb~\OV\ qCA\ \' h.SqS CB\.31l1
~. ELECTRICAL: C .'<7'Ll A ," x-& r ~-b\() \s
I PLUMBING I MECHANICAL
I NO. FEE CHARGE I Nn 1=1=1= r.I-lAIH~1=
1~6 Si nglE;! Fixture ~6C) I Furnace/burner & vent
/P < 100,000 BTUs
I Relocated Bldg. I Furnace/burner & vent
. (new fix. addtl) . > 100,000 BTUs
1~L(6e Water Service o/~ I Floor furnace and vent
ft.
12~" ~anltary Sewer 'i3? I Suspended wall or floor
ft. mounted unit heater
I ~' Storm Sewer 'r'9~ I /p~' Appliance Vent ?-- ~/?
ft. separate
I ~ /tt/ I Stationaryevap. \ I
Backflow Device 2.t!!:> cooler
I I I~ Vent Fan/Single I~-I~
duct
I I I I Vent System apart I I
from AC or htg.
I I I I Mechanical exhaust I I
hood and duct
I I I I I I
I I I I, Permit Issuance I $10,00
I TOTAL PERMIT 17~~ I TOTAL PERMIT I ~/~
~UAD AREA:
\\{\\')tu
, ~-
~\
:J
- OFFICE U~7-
LAND USE: \\ ~of "".;;:.-:;
\r)() I
CONSTR. TYPE: ?~
HEAT SOURCE: ba::::r ~C:
# OF BLDGS:
# OF UNITS:
OCCY GROUP:
# OF STORIES:
HANDICAP ACCESS: ~~ .~~
FLOOD PLAIN: AkP
ZONING:\.A f\ ~ '
LIGHTING POWER BUDGET:
WATER HEATER: cc~c:;.7..
SO. FT. $/SO. FT. VALUE
SO. FTG MAIN _!Z/t:/r66::5"A1~5 X *'7 =
SO. FTG ACCESS ~l. /~~~ 5~S-<' q4/Jn9~€"x3$.Y&>~ ~~y~ Y~9r 8,,1;n~
SO. FTG OTHER ~~/~ 2fiil3?~~) ~ ~"2,~ 5 /H?~CJt)
~/~~'5cTd5"(~P;r.. ?~~/"$x/'~ /~~~~
/'U , . TOTAL VALUE OF PROJECT ~ 7-!?~9-:!>.9'S/
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Pl._.IlN CHECKJ~.E.E '79(;,;7 ? 0 ~ ac~]'#- J4172-'b
~1'MPC.O~,I!li; 7~ ~..,::z~......o
I BUILDING PERMIT ~~. ;"it' I PLUMBING
15% State r~ ;, 4::r. 3.P' 15% State .".~ ~
SurcharQe ~~ '7$/. "3 $ SurcharQe f-"3
I MECHANIQAL/~ I /IIP. -- I FENCE
r~at -9/~ ~ VALUE $
15% State .~ . q1h~ I SIDEWALK
SurcharQe j4~ ;z?. 95
I PAVING I ~S5: ;5'e> I CURBCUT
U:..... t...";"; 2--~-.,. ,_CJ'~ .'-
~~~~:r .'..,7;, ~~. /y',
DATE
7/2//~~ BY
/ I .
~~
(
'?7"~ . _e I DEMOLITION
~?&>.~ "
272.~- .
;f -5;~ ~k\:-~~b'" t'9t:~~
FT. I .ae;f A" 1-~~~~~i~L I /?~ I
I '11~~ ! ~~~Tc~~~MENT ~~,~~,
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~~1AL~bFNRGM~t~~;~ICAl ""~~? ""~' ..r': <trg ,
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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.
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,
PAVING: After gravel is in
place but prior to placing
asphalt or concrete.
ROUGH PLUMBING;
ELECTRICAL & .
MECHANICAL: No work is to
be covered until these
inspections have been made
and approved.
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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. -
UNDERSLAB PLUMBING,
, ELECTRICAL & -
MECHANICAL: To be made
before any work is covered.
ATTIC DRAFT STOPS &
CURTAIN WALLS
x
FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
FIREPLACE: Prior to placing
facing materials and before
"framl,ng Inspect1.on.
STRUCTURAL CONCRETE: In
excess of 2500 P.S.1. (306 a.1)
y
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.
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STRUCTURAL WELDS:
Performed on the job. (2722 f)
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
pi pi ng, ,accessories and other
ancillary equipment items are
in place but before any
concrete Is placed.
HIGH STREN'GTH BOLTING:
During all bolt installation and
ti ghteni ng operations. (306
a.6)
A'
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.
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'1=trte<& SEPARATION WALL:
Located and constructed
according to plans.
x
UNDERGROUND: Plumbing,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To 'be made
prior to covering or filling
trenches.
SPRAYED ON
FIREPROOFING: U.B.C.
Standards 43.8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork-. (306 a.11 &
Chapter 29)
x
x
UNDERFLOOR: Plumbing,
electrical, mechanical: To be
made prior to installation of
floor insulation, decking or
floor sheathing.
GLU.LAM BEAMS: Inspectton
Certificate by an approved
agency, furnished to the City's
Building Division before -.
beams are placed. (250l U.B.C.
STDS. 25-10,11).
x
LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
Interior and exterior, Is in-
plage but before any _
plastering Is applied or before'
gypsum board joints and
fasteners are taped and
finished.
~"
POST & BEAM: To be made
prior to installation of floor
Insulation, decking or floor
sheathing.
'~
STRUCTURAL MASONRY: (306
a.7)
/
FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing.
.:0
SIDEWALK & DRIVEWAY:
Required for all concrete .
paving within street rigtH'6f
way, to be made after all
excavating complete and form
work and sub-base material in
place.
MASONRY: Steel location,
bond beams grouting or
verticals in accordance with
UBC 2415.
*In addition to the Inspec-
tions specified, the Building
Official may make or require
CURB AND APPROACH other Inspections of any
ROOF SHEATHING AND APRONS: After forms are construction work to ensure
NAILING: Prior to installing erected but prior to placing compliance with the Building,
. any roof covering. concrete. ' City or Development Code.
--)(-FINAL~LUM~NG-----------~SITE~LAN~EVIEW~OA;D:Mus~~requeste;~ay~~adVanc~
of the date you wish inspection. All project conditions such as
;( FINAL ELECTRICAL 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
m wldJ and posted on the premises,
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,
FINAL MECHANICAL
')( FINAL FIRE DEPART~ENT
AD~lpNAL COMMENTS~ ~+T:
\ ~.J~ ~
'---
PLANS REVIEWED o/~ ,~~DATE 9-:<0 -"7 ~
Bysignature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information
heretn is true and correct, and I further certify that any and all work performed shall ,be done in p.ccordance .witl;l ire O~dil'lances
of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCC'UPANCY
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 inspectfons are requested at the proper time, that project address Is readable from'the
street, that the perm.lt.caf,~j.!s .Iocate9 .at, the (ront of the property, and the approved set of plans will remain on the site at all
::::t:~. :,~,o OO~ ~~~~" . . Date q /iIoAL'
~~ . \ '7~.-:::lq? ~cy--
AMOUNT RECEIVED: -5"'~ ~V'? S~,
/t./7~ Y ~/Y 7~
"
. -DATE pAl D:',. 9---<<::::)..~ 9'":. .,
""'REc.EI\iED;~'i'/ - .~ ~""..':~ .
'. .-/7-
VALIDATION:
RECEIPT #:
\...-' "
-..-----.....-.- .'--~
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ATTACHMENT B1
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.JOB NO. 17'///9
CITY OF SPRINGFIELD SYSTEMS' DEVELOPMENT CHARGE
'. WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: J-!~~'~
, (. /
LOCATION:' 9~(p ~ ~
DEVELOPMENT TYPE: /".? ~ ~
BUILDING SIZE: lOT SIZE SQ. Ft.
1b ~..~~~y I~ ~89.78 PelS,
X $0.209 PER SQ. FT. C.u-. Jif9.., ·
I~~ PP': ~~~.~~k
1. STORM ORA I N~
.
IMPERVIOUS SQ. FT. /24353 '
2. ' SANITARY SFWFR-CITY
NO. OF PFU'S Cj(Po
(See Reverse)
3. TRANSPORTATION
X $43.26 PER PFU
..- ~ .~
. ,,:/$'4(6~2r.~;
, ;
.\.~" .-c~
/,,,"'!r~,,. ~o
~[)E ~{
NO OF UNITS X TRIP RATE X COST PER TRIP'"
/0 () X ()"s"B X $436.19
X X $436.19
X
X $436.19
~s-, 29?;;Z\
~ ~__u_~."----- .
$
$
SUBTOTAL (ADD ITEMS 1. 2-. & 3)
$ ~ ....,..?:'.....
~... l,.,'......'I....,--
42~a/Jt y~
4. SANITARY SFWER-MWMC
NO. OF PFU I S 9C:,0 x $17.19 PER PFU + $10 MWMC ADMIN. FEE
(Use PFU Total From Item 2 Above)
;'
$ /~, SI2,~o
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL -MWMr. SOl.,
SUBTOTAL (ADD ITEMS 1,2;3 & 4)
$ fl ~.
(f /~>S-/2,~
$~B f., ~J~~Y~
7~ -;f1.?tD. iRes
5. ADMINISTATTVF FFES
BASE CHARGE (S JAl ABOVE) X .05
'~// '
~~ #M I
/ ~a~N'Ho"rni .E.
sO( Coordina or
~w
, Date: 9-/s-~9~
TOTAl sac
~'tSh'" :J~
-' ~"~?:?~
~ ... ~~~J5 0.--
. r ......
82 . SDC .
Ad ~""7 - .. "" _' 7).-,., ~ . 7";.- ~.
- .. r. a. ... ' ';'''~ ....,-c:=,;;- '-'
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FIXTURE UNIT CALCULA IN TABLE: Number of New Fixti...
(NOTE: For remodels, calculate only the I:iEI additional fixtures~
NUMBER OF
FIXTURE TYPE NEW FIXTURES
, X Unit Equivalent = Fixture Units
UNIT
EQUIVALENT
FIXTURE
UNITS
Ba thtub........:.............................................................
Drinking Fountain....::........................................ .......
Floor. Dr ain................................................................
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher .................. ......... ........
Clotheswasher - 3 ,Or More.....................................
Mobile Home Park Trap (1 Per Trailer).....;............
Receptor For Refrigerator/Water St'ation/Etc..,.....
Receptor For Commercial'Sink/Dishwasher/Etc..
Sqo~er ,..Single,Stall. ......~........:. ::'" .". .::--.. ;,....................
t.. .',..... "'!::. .....~... .... ..'; 6 . "'r~, ~ '-
Shower, Gang................................................ ~.........
Sink: ~ar, Commercial, Residential Kitchen........................
Urinal, StaIlIWall..:...... ::....:.....................:......;..........
Was.~ .B~JilI1/L.avator.y, Si.ngle. ~,.,.... ..... .....................
Toilet, Pu"blic Insta'ilation.......:.:..............................
Toilet, Private.............. ...................... ....................
Miscellaneous: ,TAHI TORS ,S.I",,~
/ 00
2
1
2
3
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
~
200
10
(,., 0
/0 0
.2.00
/00
/19 <'
/00
400
.':.': ..;~.~, ," ..'.--~',. ~<'#~--
.t. ....
. ~ , -J:\ 41 t: :,";.. ... ~ I.,,~ fl
TOTAL FIXTURE UNITS
=
9GO
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table,
calculate credits separ'!tes.
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
, Rate per $1,000
Assessed Value
1979 or before
,,' . J98.o.,
". '., 1981.,
", ,.-~. H38"t.: o.
1983
1984
1985
$3.46
3.38
3.32
3.21
3.06
2.92
2.73
1985
1986
1987
1988
1989
1990
1991
1993'
$2.46
2.14
1.77
1.37
0.97
0.61
0.44
0.15
. ~.~... ---
-....-.-..
. ", ,. .
.... t".') I;t .
:~~...~ ..;-
X $
(Rate X Assessed Value)
X $
(Rate X Assessed Value)
CREDIT TOTAL = $ ~
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~~~
=
Credit for Parc~1 or Land Only If Applicable
.". Improvement (i,f after annexation date)
=
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Job No. Cf4 \ \ \t
NAM&. "
ADDRESS:\..D.\\). .
SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
~ ~h ~ . PHON~: f)4~ ,c!U3
_' ~lO _ \Wl~ STATE:~ q~~
, )
LOCATION OF Jll~OPOSED BUIL~G SITE: _ \ ~ ~, '
, , Street Address If Known:, ~ ~ l...9'f\l\~
Platt Name:
'\\t), )
Tax Lot Number: '''()3~ 3( \ ('f!~{JL
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC Calculations and dwelling type
definitions are on the backJ
A. Sine:le Familv - Detached
Single Family home
Manufactured home not in a park
NO OF UNITS
X $400 PER UNIT _="
$
B. Sine:le Familv - Attached
NO OF UNITS
X $370 PER UNIT =
'$
C. Multi-Familv Aoiutment
NO OF UNITS \ ro X $277 PER UNIT =
~f"\If]tO
D. Manufactured Home Park
NO OF UNITS
X $280 PER UNIT =
$
WPRD SDC
$ <9..fl,fJlX)
$0
$~f\~W
2. SDC CREDIT (If applicable) SDC-payer must furnish proof of WPRD Credit
approval. See sac Credit.Worksheet.
3. TOTAL WPRD NET SDC ASSESSED (If SDC reduced for Credit)
~y~--
~ mmunifY Services Division
ity of Springfield
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