HomeMy WebLinkAboutPermit Building 1989-6-13
L11 Y IJI' 5I'HIII(;F I ELl!
CO/mIllATlON MPLlC^TION/PEIlM/T
k lil5PECflOll Uil[
It 726-3769
Job Mdress
n__ ________.
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3'2 ~ /~h/ ~~N/~ &Y2:> .
I.egal Description \ '\ D ~~ L~Lio LCD
/Ht-.nVN ~/ -p,p<, P. 5c~ l .
'Owner 5;Z>;:~D. ~~PS7#/?"
E!IEIlr;y SOUIlCES:
Ilea t
l'/a ter Ilea ter
Ranr)C
ValUE of Hork:
'I'~ $2:>...:s _ .--e
Bui lCinq "crmi t Info:
Fa~ily Residence Hith
;?;::~~ .~_H~ C c.::::. '/?7"~~~ I
J3'7 ~~~~ .. ,~~L..< /d=t--~5~1
r;.y-~~;;/~ $/S 6~~
(Iics. no.) , (exnires) - (nhone no.)
Address
Phone
Construction Lender
,\ddress
DESIGII TEN!
(name)
Phone
(address)
Primary
Structural
Electrical
~- ,
!1echanical
CONTRACTORS (n<lme) (address)
General J5E//#Y~~/c::-"", ~~_ ~5't:P~(.E7-~.
PlumbinQ
Electrical
/lechanical
PLUllfI !rlG ELECTR J CAL
i:u.1 _---ElL..1 CIIARGE jlL
Each single fixture
Residence of
sq. FT.
Relocated building
(new fix. additional)
New circuits alts.
or extensions
, '
l'
IS.F. P.esidence
(I b,lth)
IDuPlex (I bath)
IAdditional bath
I ~!a ter serv i ce
IS~wer
IStorm SeHer
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;ISERVICES
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ITemporary Construction'
IChanqe in existing I
residence
Imultifamily. conlm. or 'j
Industrial
'IOf
-ICOf11-1./IND. FEEDERS
-11 ns tall la 1 tet"/reloca te
distrib_ fppders
, Of _ amps.1
-,
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each
amps./
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TOTAL CHARGES J TOTAL CHARGES
\-IIIEP.E STATE L\\I REQUI/{[S that tile Electrical \~ork be done by an
,Shall not be Villi-] until the label has been signed by iln Electrical
IlfO/lllAT..:1 LL,C
77.6-375J
So. Ftq. nai'n
~<:1. !'"tg. Access.
SQ. Ftq. Other
rle\~ Add {t,l ter ~eD.
--Fence Demo Change/Use
-Other -- --
I~
.~
~
lle s c r i be \-10 rk ( i . e.. till i IdS i ng I e
f\,t tilchcd r.araoe)
(I i cs. no.l
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7517~ ;>/S.Q; I
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(exoiresl
(lJhone no.l
~l[CIIAN I CAL
JELIJ:llARGL..J1!l.....:1
'.Hl....JUJAlllil.
furnace/burner to
[JTlI's
Floor furnace
and vent'
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, I Recessed wall
Soace heiltpr and
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I ApDl iance vent
seoa ra te
I Stationary evap.
cooler
'/ Vent fan \~i th
sinole duct
I Ven t sys tem apa rt from I
heating or A.C.
I rlechan i ca I exhaus t
hood and duct
I \-Jood s tove/ hea ter
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I SSUANCr OF PFfU11T
TOTAL CIIARGES '
Electrical Contractor, the electrical rortion of this perr.lit
Supervisor and, retl/rned to the Building Division
1 IIAVE CAI?[fULLY EX/vlllIEIi 'ihe'co/llpleted apnlication for fJer/llit. and do hereby certify that all infOI"mation hereon is true
and correct. and I further certi fy that any and all \~ork oerfor/lled shall ,be done in accordance wi lh the Ordinances of the City
of Soringfield and the Laws of the St<lte of Oreoon oertaininC) to the work described hel"ein, and that /10 OCCl'PMICY \~i 11 be made
of any structure without the rermission of the Ill/ildinrl Division. I further cer,tify that IllY re'listration ~lith the [Juilder's
[Joard is in full force and effect as required by OI!S 701.055, that if exemlJt the basis for exemntion 'is noted hereon. and that
only subcontractors and emflloyees\~ho arc in coin:Jliance with or!S 701.055 \','ill be used on this project.
IIA:IE(please rrint) ~"r v is. il~ r I.c..(
SIr.rlATl!RE ~
OFFICE lISE OilLY
FO~
dAY
Dfl.TE/J J-:"" f'9
x
,Value
Value
Value
Zone
Fire lone
,1 Flood Plain
Tyoe/Const.,
[Jedrooms
S tori es
Units
Oecy Load
~ Occy, Group,
,So. F t!J. rlil in
SQ, FtQ. Access
Sq. Ftg. Other'
[JUILDIIlG PERr,l1T
Charges an>::
Surcharges
, "'2 ~ 'Plan Ck. Convn/lnd
- - -- _~h:"__ -= _~5%1[JldCJ....!'gr Fee
Plan Ck. Hes
JO%/[Jldq Per Fee
17'./ S-
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PLUI1[J ING PER~llT
C:Ja rges and
Surcharges
Fence
Dtlmo
,CLCCTRI(f.,L PERI:IT
CharQes and
Surci1a rges
___________-' Sidewalk
'I AlC Pavine]
, I Curb.eu t'"
------------1-
11EClfANICAL PEP,111T
Charges and', ",
SurcharC)es
f ,
x
x
TOTAL VALUATIOtI
Systems Oevelopment
ChilrQe (1.5'1.)
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/Total Comb. Permit
I TOTAL 2."'77. ~
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COMBINATION APPLICATION/PERMIT (CAP)
1.
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Applicant to furnish
'A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Refc
17 03 43
2. example- Lot I. Block 3, 2nd Addition to
Springfield Estates
C. Name, etc. of owner and construction lender
D. Energy Sources
1. eXillTlp,le- heat/electrical ceil iM/or forced
2, examoJe- waterheater/electrical/or solar
E. Square rootage or valuation, etc.
1. examole- 1250 sq. foot house, 500 sq. foot
2. examp]e- if new project, checknew _ if add
check add, etc.
F. Bui Jding permi t inforrna t ion:
1. examnle - construct sinyle family house wit
attached garllge
2. examole - remodel existing garage into fami
3. exallllJle - convert single family residence il
restaurant (change of use)
G. Value of \~ork as defined in Section 303 (a) of t
Structural Specialty Code
If. DESIGN TEAI-I AND CONTRACTORS
To avoid design or construction delays, Uuildiny
Division Staff must be able to contact appropria
persons regarding design information or jOb site
corrections, etc.
Abbreviated Plumbing, Mechanical, ,I: Electrical Schedl
A. Except where blank spaces Occur in the descriptic
portion of the Mechanical and Electrical Schedule
the applicant need fill-in only the No. Boxes adj
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical ScheduJ
are available at the Building Division
1. To conserve space on the permi t form the sche,
have been abbreviated
2. If the item(s) to be installed are not Covere<
the abbreviated schedules you should consult t
fu 11 schedu 1 es
C. BUILDING OIVISION STAFF Will FILL OUT All FEES ANC
CBARGES ON TIlE SCHEDULES
D. As noted on the CAP, the label must
electrical contractor for signature
supervisor. The general contractor
to sign the electrical label.
Applicant to sign and date
Whenever possible, the initial application will be used as
a worksheet only. Where possible, Building Division Staff
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
signature.
Fees and Charges
Plan check fees are due and payable at the time of the
application, and no plans will be processed until these
fees are oa id. All other fees and charges are due and
payable when the permit is issued.
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be delivered t
by his electri
is ~ authori.
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IV.
V.
FOR OFFICE USE ONLY
;,
! '-0,
r --rv OF SPRINGFIELD
City Hall
'SprIngfield, Oregon
Office of Community and Economic Development
OFFICIAL RECEIPT
~
14125
Date rhl'/G I~
~e..,.h cJ l:r~" ~ Cc.>--
Rec'd From 7./A. -If I . r ; ~......:..
... ~ <""'7 -'Y -..
Address e<.-::::= ~.. ~?SI'../?
"
I ---=~ ~---."., / 4-Av11
Received For~T/~~t
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPM1CY:
roc
~f
he
198"7
11 7?-
..~
-.2o(!:?3- -'"
;: C/.~
~
i ..'
~97./S
~/'77//
Amount Received .2 ~7. /1i""
~~
0?~"'G~ -
Fruntler BUSINESS FORMS, INC.
(SOJ}342.8149
'5B7'
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Perm it Cl erk
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Permit applicant exempt from registration with the Guilder's Goard because:
Additional Project Information:
. . . ".,.;......, ~ .~~. ...,. I..
..... .. .... ." . ....... .'. - ,.,... - ....~
PLANS REVIEWED BY:
~,;, .u.
A
name
i.?8~
?l L-.-:r- ~
Signatu4-:;~
-,,, ..... -., ~.......... --" ,,,.,....~,, " .... ,
d(lte L'/?~5
. .. .~.,.....""... ...",1
lilSPEer 10(/ L lilE'
726-37ti9 '
Lll y 1)1' Si'RII/GF I ElU
cO/m If/A Tl ON APPL/ CA Tl ON/ PERM IT
II/FOIUIAT: .:/ ll,,~
726-3753
50. I' tQ. 1,1a i n
~<1. H'J. Access.
SQ. ftq. Other
r/e\~ Add JI,lter [leD.
--fence Demo Change/Use
-Other - --
Phone
i~
~
~
,
Descrihe Work(i.e., Bui Id Single I
/lttached r;araQe)
.?F~v.--= .~;B~ Cc('~'A~~~~ J
I?~ ~~~~.. ,~~~_< ~...2.s~
bv~~~ $/5 ~~~I
' (lies. no.) r (exnires) '(nhone no.,!
E!lERGY SOURCES:
Ilea t
1'1a tr-r Ilea ter
Job Address
3'2 ~ LEA?/ L.--...crN/~ ~.cv2:> .
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l.e'Jal De~cription
!/&-nUN ,~/P~<'v 5C~t .
Owner 57>F~,D. ~~ P~7#/?'
Ranqe
,\<ld ress
ValuE of Work:
L/q S2=>.::::s. ~
(Jui 1;1nQ Permi t Info:
Fa~i1y Residence With
Construction lender
/A<ldrcss
DESIGrl TEAr1
(name)
Phone
(address)
Primary
Structural
Electrical
!1echanica 1
CONTRACTORS (name) (address)
General ~~ffrJ)4'f$/e-, ~-;..~ ~5"GP~!"'".:.:.<!'.<'ET~
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77'7~ ~S..Q;!
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(lics. no.~(expiresl
(Ilhon!' no.)
P1umbinQ
Electrical
~'echanica1
Each single fixture
PLUfHlIrIG ELECTR I CAL
FEE I_C/lARGE JLL'
Residence of
MECHANICAL
i:U.1
:-ITLJ.u!LiRu[ rlo. I
1..1> > njARGI.
furnace/burner to
SQ. FT. IlTll's
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
IS. F. Res idence
(1 bath)
IDuPlex (1 bath)
IAdditional bath
~!a ter serv i ce
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Sel'/er__ '...._,. ..__I
each
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/SERVICES
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Temporary Construct iQn
ChanQe in existing
residence
I mu I t i f am i 1 y, c onlm. 0 r
Industrial
lOf
/cor1iI./IND. fEEOERS
I Insta 11/al ter/relocate
distrih, feeders
Of amps.1
am[)s.I,
I Recessed wa 11 I
Soace heater ann vent
I I
, Apol iance vent I
separate
I Stat ionary evap. "
cooler '
I Vent fan \~ith ,I
s ino1e duct'
I Ven t sys teP.1 apa rt from I' ,
heating or A.C.
/ rtechan i ca 1 exhaus t I
hood and duct
I Wood s tove/hea ter I
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I TOTAL CHARGES
that the Electrical I~ork be done by an
label has been signed by an Electrical
Electrical
Supervisor
I I SSIMNCr OF PFfUlIT
~ CHARGES
Contractor, the electrical portion of this per~it
and returned to the Bui1din~ Division
TOTAL CHARGES
I-JHEr.E STATE L'\II REQUIRES
shall not be vill i-J unti I the
1 /lAVE CMErULLY EXNWIEI) t~le completed apnlication for lJermit, and do herebv certify that all information hereon is true
and correct, and I further certify that any anda11 \~ork nerformed shall be done' in accordance with the Ordinances of the City
of Soringfield and the Laws of the State of Orenorioertaining to the work described het'ein, and that 110 OCCl!PAIICY will be made
of any structure without the rermission of the /luildin'l Division. I (ut'ther certify that r~'y re'listration ~lith the Builder's
Iloard is in full force and effect as required by OI~S 701.055, that if exemflt the basis for exemntion is noted hereon. and that
only subcontractors and e~plo'yeeswho are in cO~D1iance with O~S 701.055 w~ll be used on this rroject.
Zone
Fire Zone
Flood Plain
FO~
S If~UATl!RE ~
OfFICE lISE OIlLY
ddH
DATE/J J~ PC;
IIA:1E(p1ease "rint) G-Cir v is. iltttrje..(
Tyoe/Cons Lr
Bedrooms
Stories
Units
Occy load
Occ.y Group
So. Ftc]. l1a i n
Sq. Ftc). Access
SI]. Ftg. Other
x
Value
Value
Value
x
x
TOTAL VALUATION
lJUILDIIlG PERr'llT
Cha rges an~
Surcharges
.-.., eo- Plan Ck. COIIVll/! nd
- - _~_i:?~___-:.. _ ...Q5:UIl1dQ_Per Fee
Plan Ck. Hes
30%/01dq Per Fee
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Sys ter.ls Development
Char'll' (1.5'Y.)
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IT9ta1 COMb. termi t I
I TOTAl 2:77. rs-
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PLUf11llNG PERMIT
C~a rges and
SurCha rges
,ElECTRIC/!.L rEfH~IT
Cha rqes and
Surcharges
I1ECIlANICAL PEfHllT
Charges and
SurcharQes
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.a. .~.. .....o.. ,"1101. . 1 . I I~.. .. .... 1.1
COMBINATION APPLICATION/PERMIT (CAP)
I
I. Applicant to furnish
,A. Job Address,
B. Legal Description ,~
1. example- Tax Lot 100, can'e County Map Reference
17 03 4]
2. example- Lot I. Block ], 2nd Addition to
SprIngfield Estates
t. Name, etc. of owner' Mid constr'uction"'lender
D. Energy Sources ,
.1. ,examp.le- heat/electrical"cei I inq/or ,forced air qas
, 2. exampJe- w~terheater/electrlcal/or solar
". '-'[." Square footage o'r valua'tion, etc.
. ~, 1. examole- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, checknew - if addition,
check add, etc.
F. Building permit information:
1. example - construct single family house with an
attached gar~ge ,
2. example - remodel existing garage into family room
3. example - convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section ]03 (a) of the
Structural Specialty Code
H. DESIGN TEAt-I AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job site
corrections, etc.
II. Abbreviated Plumbing, Mechariical, & Electrical Sch~dules
A; Except where blank spaces OCcur in the description
portion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacent
to the appropriate item(s) to be installed
B. Full Plumbing, Nechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the permit form the schedules
have been abbreviated
2. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
1'ul I schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must,be
electrical contractor for signature by
supervisor. The general contractor is
to sign the electrical label.
Ill. Applicant to sign and date
Whenever possible, the initial application will be used as
a worksheet only. Where possible, Building Division Staff
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
signature. '
IV. Fees and Charges
Plan check fees are due and payable at the time of the
application, and no plans Ivill be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
"
delivered to the
his electrical
~ authori zed
V. FOR OFFICE USE ONLY
. ..... ......1........_..... ""1 .
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAnCY:
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PERMIT VALIDATION
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Permit Clerk
Permit applicant e~e~pt from registration with ,the Builder's Board because:
Additional Project Information:
. - -...,~....... --....;.......... ..... -........~ -""" ,.
.." .. .-... ~. ... ......oIl......1
I............." "...
...,"""...:...101..... .,""'..Q.,....~. 1i..:i.14.
!
PLANS REVIEWED GY:
, .
name [PH~ ~..::..;:.~,
signatu~~ ~~ date L7f-.p::;>
'r-~~
.... .,.,.."..................~I......-.. ~'; .,.......-...... _.'..,.".~... ..'1..1.".... l.........~..... .....,".'...1
'._~,]
.
HaMI,~ 1-1.:(,J/c. Scl.,~ I :e, /.1'1'1 !?c/lov..f,'M.-
BE.QWREI1ENTS AND SPECIFICATIONS
5UOI'"t:.I~DED CEILINGI,
1. Related Mark specified in other section.. Light fixtures - Electrical
division.
2. Submittals. Shop drawing showing grid layout, components, and abutment
details. Coordinate layout with electrical lighting plan.
3. Codes and Standard.. Comply with applicable portions of U.B.C. and A.S.T.M.
standards.
4. Tolerances; Suspension system components fully loaded, maximum deflection
1/360 of span in accordance with A.S.T.M. C-635. Finish surfaces level and
true within lIS inch per foot.
~. Handling and Storage; Deliver in unopened protective package., protect against
damage and discoloration.
6. Coordination; Coordinate with other trades .ffecting or affected by work in
this section.
7. PRODUCTS I
A. Hanging System.
Suspended exposed steel tee grid system wi th tee cUps. Law sheen
satin calor, white.
B. Acoustical Panelsl
5/S inch mineral fiber acoustical 24" x 4S" with washable vinyl
finish. Flame spread rating 0 to 25. NRC .50 - .60. Pattern to be
fissured Ilke Armstrong Fire Guard ...;' "r
C. Furring Channelc
1 1/2" Cold rolled steel.
D. Wall Molding:
Wall molding secured to wall with factory formed corners.
E. Accessoriesa
Il.
~Gauge galvanized wire hangers, panel clips to hold panels in place,
trim, angle closures, attachment devices, and ather acces~ri.. a.
may be required.
Page 6
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REQUIREMENTS AND SPECIFICATIONS
B. EXECUTION:
A. General I
Install acoustical treatment as shown, specified, and required for
complete installation.
B. Installation:
Install susPended ceiling system as per A.S. T .M. C-b36 unless
otherwise speclfied herein. Suspension system to be firmly ,anchored
to structural meabers above,do not suspend from gypsum board
finishes. Install all materlals in strict accordance with
manufacturers recommendations.
Finished Surfaces Shall have straight and level lines and corners.
Make close fit at all vertical surfaces. Make cuts neatly, tight to
openings and equipment. Keep exposed acoustic finish materials
clean. Raplacedemaged Dr dirty material at contractors expense.
Borders of suspended ceiling'systems shaUbe factory finished; wall
moldings secured to wall with factary farmed corners.
Where mechanical and electrical work interferes with regular spacing
of hangers, provide additional hangers and channels and make
necessary adjustment in ceiling construction. '
C. Cleaning and Repairingl
Upon completion, clean soiled and discolored surfaces. Leave free
fro. defects. Remove and replace units which. are damaged or
improperly applied. Clean, repair, Dr replace when directed,
products which have been discolored or damaged by work in this
section.