HomeMy WebLinkAboutPermit Building 1988-12-15
'.
tilt CITY OF SPRINGFIELD
Cor1BINATION APPLICATION/PERMIT
.
INFDR/1ATION liNt I
726-3753
Sq. Ftq. 1.lain //~ 9~;:;;:
~q. Ftg. Access.R""9~
Sq. Ftq. Other
New Add Alter Rep.
--Fence Demo Change/Use
Other- -
~
~
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O~
',INSPECT'iON LINE
: 726-3769
{name)
Phone
(address 1
EIIERGY SOURCES:
Heat
Hater Heater
Ran!'le
Valu€ of Hark:
'5"6' </. q""9a d.
Bulldinli Permit Info: DescrIbe Work(i-.e.. Build Single
Familv ~esidence With Attached r,araQe)
h4 ~'" . b5';'_riA-'7?~7 C:r-Q<-<7""'~ I
-,. ,_,...... ~ 1.,- r_1 ~
'1TF/"Z ~ .h'7Er-.#c. J?~F 2J~~i_
:S-E'~.s ~ /-;;U,::;e: .z:-
111C5. no.) {exniresl
Job Address =ta"?o '/::'A-?'EI-V"9-Y 57".
Legal De'cription/70~_Z.?___O .c)':iC/c>9sT"Z.:<=
Owner ~"q;,;~A-C 6;"0 C--rA/ C>~ ~/,7::-
Address /.,=/ J/~N'Tu7-?A- &V7:Y~J~~h<,,-'<1~<<'?
Eh',c/A/&>, 44. 9/.y~
Construction lender
- ;;O;;-.&'-Y?b?
~~"""7' /~::>";
Address
OE~I{iN 1l:.A1~
(ohone no. I
Primary
Structura 1 0L~",~ At %/M~ ~7*: ~ 2.~~e :;-i.".!:!;;. ~Z~ ;;~;r- -=:: ::>e>8
(:<'<'\G ') ~ ::$ -C;/:3 5'"7
Electrical
Hechilnical
CONTRACTORS (namel
Genera 1 t<;,$/YEP4L 6#'-"_7.# eo~ <::2l.
(address) (lies. no.)
/ ,~"7" /(k/.r:?/"'J'"bR -::W7''/.:
(exnire~)
(ohone no.'
7~'- 7''/a7
Plumbina
PLUI1BING
'\' ~ '\
~"yJ
C;J, 00
Electrical
71<;,'-% 5 2/ '
fleeR1P;t:al /T/..aC'~ ~r~/J"~7/~~~
ELECTRICAL
MECHANtCAL
ND.I
-----lEach single fixture
Relocated building
(new fix. additional)
FEf
CHARr.f
Nn
""-- J:JiARli[ IIn
'J'.LJ:JiARli[
SQ. FT.
furnace/burner to
BTU's
Residence of
Sewer
INew circuits alts.
or extensions
I SERVICES
I
ITemporary Construction
IChange in existing
fpc;ide.ncp
ImultifamilY, COIlT!1. or
Innustriil1
IOf amps,
I C0I11'1. II ND. FEEDERS
I Install/alter/relocate
.di<:trih. fpeder,
IOf amps.
I
I
I
Floor furnace
and vent
S.F. Residence
(] bath)
IDuPlex (1 bath) each
IAdditional bath
~Ia ter serv; ce
Recessed wall
Soacp hp~tpr and vent
Storm Sewer
Appliance vent
seoarate
Stationary evap.
cooler
Vent fan with
sinole duct
Vent system apart from
heatinQ or A.C.
I Mechanical exhaust
hood and duct
I Hood stove/heater
I
I
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ISSUANCF nF PFRtllT
TOTAL CHARGES
WIIERE STATE L\I~ REQUIRES
shall not be valiJ until the
TOTAL CHARGES
TOTAL CHARGES
that the Electrical work be done by an Electrical Contractor, the electrical rortion of this perlilit
label has been signed by an Electrical Supervisor and returned to the Building Division
Flood Plain
I HAVE CAREFULLY EXAMINED the completed apr1ication for permit, and do hereby certify that all information hereon is true
and correct. and I further certify that any and all work nerformed shall be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Ore~lOn pertaining to the work described herein d that fW OCCUPAfKY will be made
of any structure without the permission of the euilding Division. I further certify th my gistration with the Builder's
Board is in full force and effect as required by Or-S 701.0~5. that if exempt the basi for ex ption is noted hereon, and that
only subcontractors and e~lAoY~~S who la(re~nl :p,lsiance with OP.S ml.05S \'Iill be uSI on thi~r07.t.._____
IWIE(please print) I~ 7 'I K. SIr.rlATURF. / Y DATE /).. -/),41'
FOP. orFICE USE orlLY / F t
Tyoe/Const.-:<'.-Y. :f~?\Jnits So. Ft~. 11ainV //,,~>q<vg ~ Value
Bedrooms Occy Load Sq. ft9. Access SZZ.<./'j'h x_",~-"" Value
, '
Occ,Y Group..8-< Sq. Ftg. Other x Value
r'\' 'd. , "'" ",,-, TOTAL VALUATIDlI~~99,t?, #",
\j t;;""..,,, _~/"rc.PTP/"2s:a: /
CO,Il1iilI,nd I /~/: Isyste~s Development....;k "'~.L'"'
Ppr Fpp 9":>.9. ~"? 7~ Charqe (1. 5~) . ~ '/79: .--.;,,;>
Res I I
Per Fee
I I
I I
I I
I
I
I
Cl":
Zone
Fi re Zone
Stories
/
BUILDING PWIIT
Charges an'::
Surcharges
d-
__I..'iJ:!..~,-~q_
7/.53
PI an Ck.
65%/Bldu
Plan Ck.
30UBldo
PLU'1BING PERMIT
Charges and
Surcharges
Fence
ELECTR I CAL PERI:IT
Charges and
Surcharges
O~mo
I'Sidewalk
I A/C Paving,
I Curb Cut
I
hotal
I
I TOTAL
I
I
I 9976.88
Comb. Permi t
I~02.(/3
MECHANICAL PERMIT
Charges and
Surcharges
.
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
1. Applicant to furnish
A. Job Address
B. legal Description
1. example- Tax Lot 100, lane 'County Map Reference
II 03 43
2. examp]e- Lot 1. Block 3. 2nd Addition to
sprlngtield Est~tes
C. Name, etc. of owner and construction lender
D. ,Energy Sources
1. exam~le- heat/electrical ceil;nqjor forced air oas
2. examyle- waterheater/electrlcal/or solar
E. Square footage or ~valuat;on. etc. -
1. examole- 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. example - construct single family house with an
attached garllge
2. example - remodel existing garage into family foom
3. examole - convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (aJ of the
Structural Specialty Code
H. DESIGN TEM~ 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. 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. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
O. As noted on the CAP. the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is.nQl authorized
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 will be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
\1/\5
V. FOR OFFICE USE ONLY
Permit Clerk
eV
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
]
PLANS REVIEWED BY:
name'LoA'.N.,c- h~ F?f
.
signature /2___.....-:..~---.->'?
r/ . p"
I
date /2-/":?-fr8
. p
.-~
.. R.uired
Inspecti.s ..
,
.
IT IS THE
THAT EACII
PROPERTY.
RESPONSIBILITY OF THF. PER!iIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TUlE,
ADDRESS IS READABLE FROM TilE STREET, AND THAT TilE PF.Rl'iIT CARD IS LOCATED AT THE FRONT OF THE
IIUILDING DIVISION APPROVED PLANS MUST liE ON JOII SITE AT ALL TUlES.
PROCEDURE FOR REqUESTING INSPECTInNS, Call 726-3769 (recorder) state you CITY DESIGNATED JOB ,NUMBER,
job .:lddrcs~, type of inspection rcC]uested and ",hen you will be re<::dy for the inspection. Contractors
or owners name and phone number. Requests received before 7:00 am:will be reade the same day, requests
received after 7:00 am will be ~de the followinh work day.
Your City Desip,nated Job Number Is, ~~/'~~
Jeb Addres", -::3/? ''''5~ ~A.;r~I/V'A'-4- ~/-?'C=--~7'"
Owner'~~ERA/ <3"'c>Ir~77<-' ~"'.= ~L/J-:: Phone,_ ~6':'-~?c?
Contractor:
o
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SIT~ INSPECTION: To be made
after excavation, hut prior
to setup cf forms.
UNOERSI.AB rl,ll~mrNr.l El.r:CTRIC,\I.
r. ~1r:CII^NIC^L: To be madc bererc
any \~ork is covered.
CQNcm,TE SI.^Jl INSPECTION: To he
:nade after all inslah building
service equipment, conduit, piping,
accessories and other nnci llary
equipment items arc in place hut ~
before any concrete is poured. 1)(1
FO~NG.s ~:OIlNnATIONS: To be made
after trenches are excavated and
forms ~re erected, all steel in
pInee, hut prior to pouring concrete.
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tJ~or:RGRnUNn: Plumbing, Electrical,
C..IS, S:mitl1l'Y Sewer, Storm Sewer,
1\':lter and \)r:1 in:tge 1 ines. To be
made prior to covering or fi 11 ing
trenches.
D
UNnERrLOCn: , Plumbing, Electrical,
Mechanical. To he made prior to
installation of floor insulation,
decking or floor sheathing.
POST r. REAM: To be mnde prior to
installatioa of floor ir:sulation.
decking or floor sheating...
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FI.OOR INSlIl.^TION r. V^POR Jl^RRIERS,
To be mnde prior to install:J.tion
of decking or floor sheat ing.
MASONHY: Steel location, hand beams
grouting or verticals in accord.mce
\~ith U.B.C. Sectioll 2-115,
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ROOF S!lE^11IH!r. ANn NJ".II.INr.: Prior
to inst;111 ing any roofing.
ROUr.1I PWMRTNr.. EU:CTRTC^L f,
MEClIANCIAI.: No l\'Ork is t.o be co\'ered
until these inspections have been
made and approved.
o FINAL PJ.lIMBING
o FINAl. ELECTRICAL
o FINAl. ~mCIIANICAL
o rINAL FinE nEPARnmNT
o
Phone:
^1iIC ORAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prier to placing facin~
materials and he fore framing
inspection.
INSUI.ATION & vAPOn BARRIER: To he
made after all insulation and
required vapor harriers arc in place
but he fore any lath or gypsum hoard
interior wall covering is applied.
FMMING: To be made after the roof.
all framing, fire blocking <lnd
bracing are in place and all pipes,
chimneys and \'ents are complete and
the rough electrical, plumbing and
heating ",ires, pipes and ducts arc
approved.
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1.A11' ANn/OR r.YPSlI~l BOARD INSPECTION: ::J
To he mude after all lathing and
gypsum hoard, interior and exterior,
is in place but he fore nny Plastering::J
is appl ied or hefore gypsum hOtlrd
joints and fasteners arc taped and
finished.
SPECIAl. INSPECTIONS: In accordance dth
Section 306 of the Building Code a special
inspector shall be employed by the Owner/
Contractor during construction of the
following work. A cepy of the special
testing reports shall be furnished to the
Building Division.
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STRUC11JRAL CONCRETE: In excess of 30(11)
P.S.!. (3060.1)
rIRE & SEPARATION IMLt.: Located f,
constructed according to plans.
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WOOOSTOVES: After installation is
completed.
SIDEW'A'.K r. DRIVEWAY: Required for
all concrete paving within street
right-of-way, to be made after all
excavating complete r. form work r.
suh-base material in place.
CURR ANn APPROACH APRON: After forms
arc erected but prior to pouring
concrete.
STRUCTUR\L WE1.nS: Preformed on the
job. (2722 f)
IllGH STRENGTII ROLTING: During all
holt installation and tighting
operations (306 a.S)
SPR^YED ON FIREPROOFING,
Standards 43~8)
SPECI^1. GR^DING. EXC^V^TION
FII.I.ING: During earthwork.
f, Chapter 29)
(lI.n.c.
AND
(3060.11
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PARKING I.CIT: After gravel
place hut prior to placing
or concrete.
is in
asphalt
Kl
r.LlJ-LAM BEMIS: Inspection Certificate,
by an approved agency, furnished to
the City's Building Division before
beams arc placed. (2501-U.B.C. STDS.
25-10,11) .
?/(./.-1I'V'S
* In .Iddition to the inspections
specified hereon, the Building
Official ~ay make or require other
inspections of any construction
work to ascertain compl innce wi th
the Building, City or Zoning Codes.
CITY'S SITE PI~N REVIEW BOARD INSPECTION: Must be requested 2 days in advance of the date you
wish inspection. All project con~itions such as landscaping, parkin/; lot striping etc. must
be ::om~leted hefore requesting: this inspection.
o
FINAl. BtIItOING: Must he requested after the final Plumbing, EIectric<ll. ~lechanical and rire
Department inspections arc made and approved. No Occupancy of the premises can be made until
:.1 Certificate of Occupancy has been issued by the Building Division and posted on the premises
SICN^TURE
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