HomeMy WebLinkAboutPermit Mechanical 1986-2-14
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I INSPECTION liNE
726-3769
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legal Description 1'7-63' ::l"?- /eJ CJ~.€. ~
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CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
EIIERGY SOURCES:
Heat
Ilater Heater
Owner '~AI IIv&KA?J> /" er"'~-4 r~
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Address ? ~~X 78"~7
Aq.~e~~.
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Range
ValuE of Hark:
INFOR/lATlON LINE
726-3753
Sq. Ftg. Hain
~q. Ftg'- Access.
Sq. Ftg. Other
New Add Alter Rep.
--Fence Demo Change/Use
Other- -
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Job Address
Phone
Builriina Penmit Info: Descrlbe Work(i~e., Build Single
Familv nesidence With Attach~d GaraQe)
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Construction lender
Address
Ut~il.iN I ~Ar1
lnamel
Phone
(address)
nics. no.)
rexnires\
(ohone no.\
l
Primary
<<
,
Structural
Electrical
Mechanical
CONTRACTORS
(name)
(addres~ 1
l1ir:~. nn.1
(pxnirp~l
(nhonp no
Genera 1
Plumbina
Electrical
~Iechanic'al A'-"/'#'Y t?)v~6., ~S'" A66.i:!r.-r~y.~6,~
PlUrlBING ELECTRICAL I
NO, I FFF rNIlJlGL.JJn ~FF r'iARU( Nn
7~~. /~ =l /
MECHANICAL
SQ. FT.
furnace/burner to
BTU's
t't't' 1...cHAB!iE.
Each single fixture
Residence of
Relocated building
(new fix. additional)
S.F. Residence
11 bath)
, Duplex (1 bath) each
, Additional bath
New circuits alts.
or extensions
Floor furnace
and ven t
SERVICES
"2
~"'P~SPd wa 11
. ..
-, r)~r:". "~"'r~~ Innri ~"'nt .
6, - /:1.-
Water service
Temporary Construction
Change.in existing
, I"P~jtjPJlf'P
Imultifamily, comm. or
Tnf'hJ.,c:trit11
IOf amps,
ICO~1,/IND. FEEDERS
I Install/alter/relocate
rlic:trih. fpprlprc:
10f amp..1
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1
I
Appliance vent
~.~oaratp .
Stationary evap.
cooler
Vent fan wi th
sinale duct
Vent system apart from I
heatino or A.C.
Mechanical exhaust
hond and durt
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1
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12,-
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1
Sewer
Storm Sewer
Wood stove/heater
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ISSUANCf nF PFRlIlT
TOTAL CHARGES
WHERE STATE l~W REQUIRES
shall not be valid until the
TOTAL CHARGES TOTAL CHARGES h?//Y. /fi:-Z>
that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this permit
label has been signed by an Electrical Supervisor and retur~ed to the Building Division
Zone M~
Fire Zone
Flood Plain
I HAVE CAREFUllY EXAMINED the completed application for permit. and do hereby certify that all information hereon is true
and correct, and I further certify that any and all work perfonmed 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 the permission of the Building Division. I further certify that my registration with the Builderls
Board is in full force and effect as required by ons 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who are in compliance with ORS 7Ql.055 will be used on this project.
1lAf.1E(~lease print)J!:F",r~ S~U<\.o:a..C.lC.. ..._SIf,r~:[~ M '~._. N~
FOP. OFFICE ,~--_.~,
Sq. Ftg. riain
Sq. Ftg. Access
'%1-/ S F 0 h
#L L q. tg, t er
DATEl4 ntl,86
Type/Canst. ~ N
Bedrooms
Stories1r ~~:;;l
Units
Occy load
Occy Group
.
Value
Value
Value
TOTAL V AlUA Tl ON
x
.
BUilDING PER/oIIT
Charges an~
Surcharges
Plan Ck. Comm/lnd
____________ ...ill/R1do P.rr Fpp
Plan Ck. Res
30~/Bldo Per Fee
Fence
Systems Development
CharQe [J.5~) ,
PlU!~BING PERMIT
Charges and
Surcharges
DeA10
'Sidewalk
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ELECTRICAL PERIHT
Charges and.
SurCharges
A/C Pavi ng
L~-I '
. Curb Cut
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!Total Comb. Permit
I
I TOTAL
IS. ~.o
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MECHANICAL PERMIT
Charges and
Surchal"'ges
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COMBINATION APPLICATION/PERMIT (CAP) ,
I. Applicant to furnish
A. Job Address
B. legal Description
I. example- Tax Lot 100. Lane County Map Reference
17 03 43
2. examole- Lot I. Block 3, 2nd Addition to
, Springfield ~states, . . ,. ,'. \
C. ~ame, etc. of owner and construction lender \
O. Energy Sources' ' ,,"
'1. exam~le- heat/electrical ceil ing/or 'forced air Qa~
2. examole- waterheater/electrical/or solar
E. Square footage or valuation, etc. ------
I. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check new.- if addition;
check add, etc.
F. Building permit information:
1. examole - construct single family house with an
attached garage
2. examole - remodel existing garage into family roorr
3. examele. convert Single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. DESIGN TEAM 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. I Abbreviated Plumbing, Mechanical, & Electrical Schedules.
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, Mechanical, 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
'", ' full schedules
" . :C. BUIlOING DIVISION STAFF WILL Fill OUT ALL FEES AND'
CHARGES ON THE SCHEOULES
',0. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is.not authorized
to sign the electrical label. ---
III. 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 will be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
V. FOR OFFICE USE ONLY
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.ITV OF SPRINGFIELD
, City Hili ,
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Sprlngfteld. Oregon
Department 01 Public Work.
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OFFICIAL RECEIPT
No. B
Data1?ts7!!J /~ 19 ~
Rec'dF,om _~ ,,,!' ~~~.
Address '2~~ #r' ,".r".... lJ,/'~.
5.
65966
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.60
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Amount Received
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Pennit Clerk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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..Permit applicant exempt from reg'istration with the Builder's Board because:
Additional Project Infonnation:
PLANS REVIEWED BY:
.J" .'
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name
Signature~~ _ ~~
-7.j~te 279-8b
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.. tlquired
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:~':;lT IS THE RESPONSIBILITY OF THE PERllIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE
.... THAT EACH ADDRESS IS READABLE FROM TIlE STRF.ET, AND THAT TIlE PF.Rl'UT CARD IS LOCATED AT THE
, PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES.
Inspec.e.,s ..
PROPER TUlE,
FRONT OF THE
.: PROCEDURE FOR REQUF.STING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
. ""job address, type of inspection requested and when YOll will be ready for the inspection. Contractors
. :~~ or owners name and phone number. Requests received before 7:00 amlwill be ~~de the same day, requests
received after 7:00 am will be ~de the followin~ work day.
.. 'y~'ur City Designated Job Number Is: g~~S'$ &/
.Job Address: / ~o/J 4:PV-RAJ ~T .
:."Owner:d!!H~ /fr/~T.
, ~con.::actor: ~~ ., jP)'j'/CF_
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D, 'SITE INSPECTION: To be made
o after excav3tion. but prior
:-")':~:1:~..~o setup of forms.
n' UNDERSLAB PLUMBING, ELECTRICAL
L.:.J 9 MECHANICAL: To be made before
~;j:::-;'J-~~Y vork is covered. .: - _;.
D ..CONCRETE SLAB INSPECTION: To be
.~; ':' made after all inslab building
.: ':~;..;~~)~s,ervice equipment, conduit. piping.
~~~~~~:~~cessories and other ancillary
~~~;equipment items are in place but
.,~:~.~~~:~o~~ any ~oncret~. is ..~.~ured. " 0
O FOOTINGS & FOUNDATIONS: To be made
after trenches are excavated and
"~ :;forms are erected. all steel in
:'~~\1:,:~~lace, bu~ prior ~o pouring concre~e.
O UNDERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer, Storm Sewer, D
',; ..... '.>.4: ,Water and Drainage lines. To be
, ';''''-':-':'made prior to covering or filling
. ;"~,, trenches. D
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UNDERFLOCR:; Plumbing. Electrical,
Mechanical. To be made prior to
installation of floor insulation,
decking or floor sheathing.
,-'POST 6 BEAM: To be made prior to
installation of floor insulation.
.decking or floor sheating.'.
FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to installation
of decking or floor sheating.
MASONRY: Steel location, bond beams
grouting or verticals in accordance
with U.B.C. Section 2415.
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ROOF SHEATHI~G AND NAILING: Prior
to installing any roofing.
ROUGH PLlJ1ofBING. ELECTRICAL &
MECHANCIAL: No ~ork is to be covered
until these inspections have been
made and approved.
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FINAL PLUMBING
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CITY'S SITE PLAN REVIEW BOARD INSPECTION: 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 com~leted before requesting this inspection.
FINAL ELECTRICAL
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Phone:
?I ~~- 6/6-e>
7V~' /67./
Phone:
ATIIC DRAFT STOPS 6 CURTAIN WALLS.
FIREPLACE: Prior to placing
materials and before framing
inspection. '
facing
SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building 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.
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In excess of 3000
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INSUUlTION 6 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.
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
hea~ing wires, pipes and duc~s are
. approved.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
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LATH ANn/OR GYPSUM BOARD INSPECTION: ---,
To be made after all lathing and ~
g)~sum board, interior and exterior.
is in place but before any plasteriTl8--,
is applied or before gypsum board ~
joints and fasteners are taped and
finished.
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After installation is
WOODSTOVES:
completed.
SIDEWALK F, DRIVEWAY: Required for
all concrete paving within street
right-of-way. to be made after all
excavating complete & form work &
sub-base material in plac~.
CURB AND APPROACH APRON: 'After forms
are erected but prior to pouring
. concrete.
STRUCTURAL CONCRETE:
P.S.I. (306 ..1)
STRUCTUR~L WELDS:' Prefc;mDed on the
job. (2722 f) ,
HIGH STRENGTH BOLTING: During all :.
bolt in~t311ation and tighting
oper3~ions (306 a.S)
SPRAYED ON FIREPROOFING:
Standards 43~8)
SPECIAL GRADING. EXCAVATION AND
FILLING: During earthwork. (306
& Chapter 29)
(U,B,C,
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PARKING LOT: After gravel
place but prior to placing
or concrete.
is in
asphalt
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GLU-LAM BEN1S: Inspection Certificate,
by an approved agency, furnished to
the City's Building Division before
beams are placed. (250l-U.B.C. STDS.
25-10,11) .
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* In addition to the inspections
specified hereon, the Building
Offic~al may make or require other
inspections of any construction
work to ascertain co~pliance with
the Building, City or Zoning Codes.
YINAL BUILDING: Must be requested after the finai Plumbing. Electrical, Mech~nical and Fire
Department inspections are made ond approved. No Occupancy of the premises cah be made until
a Certificate of Occupancy has been issued by the Building Division and posted on the premises
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FINAL "EOIANI CAL
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FINAL FIRE DEPARTMENT
DATE
/4 Fg.a.
8~
* ALL.. "ANHOLES AND CLEANOUTS MUST BE .\CCESSIBLE. ADJUS'lloIENT TO BE IolADE AT NO COST TO TIlE CITY.