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Home My WebLink AboutPermit Demolition 1987-01-12CO M M ERCIAL/ I N DUSTRIAL PERMIT APPLICATION 225 Fitlh Street, Springfield, Oregon 97477 SPFlI't.GF'ELO JOB NUMBER INSPECTION LINE: 726-3769 OFFICE: 726-3759 LOCATION OF PROPOSED WORK: ASSESSoRS M^P: / 7€ >-z '- V? rAX Lor: PHON E: ADDRESS: OWNER: NEW - REMODEL ADDITION DEMOLISH OTHER VALUE: DESCBIPTION OF WORK: ELECTRICAL: NAME ADDRESS PHONE EXPIRES PHONE?.CONTRACTOR'S NAME ARCHITECT; MECHANICAL: CONST. CONTRACTOR # G EN EFIAL: PLUMBING PLUMBING NO.FEE CHARGE Single Fixture Relocated Bld (new fix. addtl s ) Water Service ft. Sanitary Sewer ft. Storm Sewer ft. Backf low Device TOTAL PERMIT MECHANICAL NO FEF CHA RG F Furnace/burner & vent < 100,000 BTUs Furnace/burner & vent >100,000 BTUs FIoor furnace and vent Suspended wall or f loor mounted unit heater Appliance Vent separate Stationary evap. cooler Vent Fan/Single d uct Vent from System apart AC or htg. Mechanical exhaust hood and duct Permit lssuance $10.00 TOTAL PERMIT _ OFFICE USE _ ZONING HANDICAP ACCESS: FLOOD PLAIN: LIGHTING POWER BUDGET: WATER HEATER CONSTR. TYPE: HEAT SOURCE: LAND USE: # OF UNITS OCCY GROUP: * OF STORIES: QUAD AREA: * OF BLDGS: SQ. FT.$i SQ. FT.VALUE TOTAL VALUE OF PROJ X X SQ. FTG MAIN SQ. FTG ACCESS SO. FTG OTHER PLAN CHECK FEE RCPT#DATE BY /e4a BUILDING PERMIT PLUMBI NG DEMOLITION oe 5% State Surcharge 5% State Su rcharqe **a 1a MECHANICAL FENCE VALUE $ 5% State Su rcharge SIDEWALK FT. SUBTOTAL PERM ITS PAVI NG CUBBCUT FT. SYSTEMS DEVELOPMENT TOTAL PERMIT FEES EXCLUDING ELECTRICAL aFaFS= lZlaa crcv, @7€ srArE: / ,7 ztP: % r//2 Ve-k 2qq1 > \g REOUIRED 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 ROUGH PLUMBING, PAVING: After gravel is in made after excavation, but ELECTRICAL & place but prior to placing prior to setup of forms. MECHANICAL: No work is to asphalt or concrete. be covered until these UNDERSLAB pLUMBING, inspections have been made SpEC;AL INSpECTIONS: ln accordance ELECTRICAL & and approved. Section 306 of the State Specialty code MECHANICAL: To be made a special inspector shall be employed before any work is covered. ATTIC DRAFT STOPS & by the Owner/ Contractor duringCURTAIN WALLS construction of the following w6rk. A FOOTTNGS & FOUNDATTONS: copy of the special testing reports shall To be made after trenches are FIREPLACE: Prior to placing be furnished io the Building Division. excavated and forms are facing materials and before erected, ail steet in ptace, but framing inspection' srRUcruRAL CoNCRETE: ln prior to placing concrete. FRAMING: To be made after excess of 250O P.S.l. (306 a.1) coNcRETE SLAB: To be the roof' all framing' fire made after au insrab buirdins 3i::5 :N.":fl 3;'3:It",l,;l:r" Bln8,"Jyfl"t,Y5tT',rrr, ,, service equipment, conduit, and vents are complete andpiping, accessories and other anciliry equipment items are :i? H::[i]iiii:,1'i,$[l::: Blf,lf],?E]uol,l",?l"tl]X"oin place but before any tighte;ing operations. (306concrete is placed. INSULATTON & VApOR a.6) BARRIER: To be made after all UNDERGROUND: Plumbing, insulation and required vapor SpRAyED ONelectrical, gas, sanitary sewer, barriers are in place but FIREpROOFING: U.B.6.storm sewer, water and before any lath or gypsum Standards 43_8.drainage lines. To be made board interior wall covering isprior to covering or filling applied. SPECIAL GRADING,trenches. ,NDERFL..R: prumbins [:::,I'"'"',f;m'J3[H]"' il;tYt'iiil#ll',5Jh'j],"i, electrical, mechanical. To be according to plans. Chapter 29) made prior to installation of floor insulation, decking or LATH AND/oR GYPSUM GLU'LAM BEAMS: Inspection floor sheathing. BOARD: To be made after all Certificate by an approved lathing and gypsum board, agency, furnished to the city's poST & BEAM: To be made interiol and exierior, is in Building Division before prior to installation of floor place but before any beams are placed' (2501 U'B.c' insulation, clecking or floor plastering is applied or before STDS' 25-1OJ1)' sheathing. " gypsum board joints and fasteners are taped and STRUCTURAL MASONRY: (306 FLOOR INSULATION & VAPOR BARRIERS: To be made prior to installation of decking or floor sheathing. MASONRY: Steel location, bond beams grouting or verticals in accordance with uBc 2415. f inished RooF sHEATHTNG AND iH[3^H'^tti'"t:'of"":'" NAILING: Prior to installing erected but prior to placing any roof covering. concrete. SIDEWALK & DRIVEWAY: Required for all concrete paving within street right of way, to be made after all excavating complete and form work and sub-base material in place. a.7) .ln addition to the inspec- tions specified, the Building Official may make or require other inspections of any construction work to ensure compliance with the Building, City or Development Code. x By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information herein is true and correct, and I further certify that any and all work performed 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 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 inspections are requested at the proper time, that project address is readable from the ocated at the front of the property, and the approved set of plans will remain on the site at all DateSignature the permit St street, that times durin ?<'d:-2 t/18.?eVALI RECEIVED BY: DATE PAID:AMOUNT RECEIVED: RECEIPT *: FINAL PLUMBING FINAL ELECTRICAL FINAL MECHANICAL FINAL FIRE DEPARTMENT ADDIT AL COMMENTS: SITE PLAN REVIEW BOARD: Must be requested 2 days in advance of the date you wish inspection. AII project conditions such as landscaping, parking lot stri pi ng, etc. must be completed before requesting this i nspection. 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 and posted on the premises. PLANS REVIEWED BY DATE /2122 \c-Job Address \0\l l-egal Description EIIERGY SOURCES: Hea t l,later Heater Ranqe t ll.aspl L:,." 0wne r l Value of l.lork rF- Sq . Ftg . l.iai n_ Sq. Ftg. Access.-- So. Ftq. 0ther.-_ _l{ew_Add_A i ter_Pep. _Fence_Demo_C ha n ge/ U se 0ther Addres s e .e., Euild Single Farn i n t be lllork i dence I'li th Attached Gara7q-w Constructi on Lender ,\on1,4') Addre s s Phone DESIGN TEAI1 name address lics. no.exoi res )phone no n ame n PLUIlB I NG ELECTRICAL il0 FFF CHARGE NO FFF CHARGF NO FFF l Each singAB fixtlre hioLl{,..,r (tAhca 560 Residence of SQ. FT s furnace/burner to BTU Relocated buildinq (new fix. additional )) New ci rcui ts al ts. or extensions Floor furnace and vent S . F. Res i dence(l bath)SERV I CES Recessed wal I Soaae heatpr and vpnf Duplex (l bath) each Addi ti onal bath Temporary Constructi on Apol iance vent sepa rate l,later servi ce Change i n exi sti ng res i dence Stationary evap cool er Sewer Industrial muitifami1y, comm. or Vent fan with sinole duct Storm Sewer 0f amps.Vent systern apart from heatinq or A.C. coMl.!./lND. FEEDERS Mechani cal exhaust hood and duct Instai I /ai ter/re1 ocate di stri b. feeders l'lood stove/heater 0f .amps. ISSUANCE OF PFRI1IT TOTAL CHARGES 150c TOTAL CHARGES IOTAL CHARGES l,lAtlE(please print) S I GIIA and I HAVE CAREFULLY EXAI1INED completed apnl ication for Dermit, and do hereb.y cert.ify that al I inforrnation hereon is trueand correct, and I further certifvof Soringfield and the Laws of the that any and all rvork oerformed shali be done in accordance wi th the Ordinances of the CityState of 0regon oertaining to the work described herein that ll0 OCCUPANCY rvill be madeof any structure without t he permission of the Buil dinq Divi sion. I further cert.i 1"y that m.y registration vrith the Builder,sBoard is in full force and effect as required b.y ORS 70i.055, that if exempt i i ance wi th 0l?S 7ni .055 wi I I the basis for exemntion is noted hereon, and thatonly subcontractors and ernp loyees rvho are in comc be used on this oro,j ect 2- Zone 'i ts ToTAL VALUATT0N_ e/Const Loa d s Ftg. Acces s Group Val ue x Val ue Fire Zone Bedrooms Flood Plain Stories Fto. l,lain x Value q. Ftg.Other Corm/ I nd Per Fee Plan Ck. 65i/. / 81 dq Systems Deve Charqe (1.5c opmentBUILDING PERI,IIT Charges and Su rcharges Plan Ck. Res 30%/Bldq Per Fee FencePLUi4BING PERMIT Charges and Surc ha rges Demo Sidewal k ELECTRICAL PERIlIT Charges and Surcha rges A/C Paving Total Comb. Permit Curb Cut I,IECHAN I CAL PERM IT Charges and Su rc ha rqe s TOTAL bo INSPECTION LIIIE 726-37 69 Pri ma St ructura l Electrical l''lechani cal lt L COIlBI ON RMIT 7 -37 Oo El e rt I,JHERE STATE LAI,/ REQUIRES thAt thE EIEshall not be vaii.l until the label has be I'4ECHAN I CAL ctrical work be done en signed by an Elect byri ca1 Supervisor and returned to the Buildin an Electricai Contractor, the electrical portion of this perriit g Division ut .l 60 I COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to SEIfn-g-fieta Estates C. Name, etc. of owner and construction lenderD. Energy Sources 1. example- heat/electrical ceiling/o2. example- waterheater/electiicai/or E, Square footage or valuation, etc. r forced air gas sol ar 1. example- 1250 sq. foot house, 500 sq. foot ga2, example- if new project, check new - if addit check add, etc. rage ion, II F. Bu i I d'i ng permi t i nforma ti on :l. example - construct singie family house with an attached garage 2. examole - remodel existing garage into family room3. exampTe - convert singie iamily-residence inio restaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAI,1 AND CONTRACTORS To avoid design or construction delays, Build.ing Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, etc, Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechan'ical and Electrical Schedules, the appl icant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be instaliedB. Full Plumbing, Mechanical, and Electrical Schedules are available at the Building Division1. To conserve space on the permit form the schedules have been abbreviated2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult theful I scheduiesC. BUILDING DIVISION STAFF l,IILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. As noted on the CAP, the labei must be delivered to theelectrical contractor for signature by his electrical supervisor. The general contractor is not authorizedto sign the electrical labelIII. App)icant to sign and date Hhenever possible, the initial application will be used as a worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to the applicant at the time the actual permit is issued for his s i gna tu re.IV. Fees and Charges Plan check fees are due and payable at the time of the appiication, and no plans will be processed untii these fees are paid. All other fees and charges are due and payable when the permit is issued. V. FOR OFFICE USE ONLY PERMIT VALIDATION *wb?b Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Addi ti onal Proiect Informat'ion : PLANS REVIEWED BY: name s'l g na tu re date