HomeMy WebLinkAboutPermit Building 1984-03-06N LINE m
COI1BI i{ATI ON APPL I CATION/PERMIT
Job Address
l-egal Description
EIIERGY SOURCES
Hea t
l^Jater Heater
Ranoe
n
Sq. Ftg. Access.=-._.-_-
Sq . Ftq. 0ther__
_l{ ew_Ad d_A i t e r_P.e p .
_Fence_Demo Change/Use
-other-
"0.t-o
9)0
Owner 5zzr.
Va l ue of l,Jork:4/dl
Sf enone(f5-/.s4 Bui I cr'i h
Farni I y
q Pernit Info: Describe [,Jork('
Residence tiith Attached caraqe 'e., Build Single
a// rtsa// * t/, &,/l
Construct ion Lender l//z tt <._
Addres s Phone
DES I GN TEAI.{name address exot res ohone no.
Pri mary
Structura I
El ectri ca I
Mechanical
name addres s "lics- no-)I pxn rpq ohone no.
Genera I fi * Bnout-z
Pl umbi nq
E I ectri ca I
l'lechani cal
PLUIIB I NG ELECTRICAL MECHAN I CAL
FFF CHARGE NN FFF CHARGF I'i0 FFF CHARGF
Each single fixture Residence of
SQ FT
furnace/burner to
BTLI' S
Relocated building
(new fix. additjonal)\
New circuits alts
or extensions \S:\y Floor furnace
and vent
S. F. Residence
( I bath)SERV I CES
Recessed wal I
SDace heat-er and vent
Duplex (l bath) each
Additional bath Temporary Constructi on Apol iance vent
seDaratF
[.later servi ce Change in existing
rps i dpncp
Stationary evap
coo l er
Sewer multifamily, comnn. or
Tndrrctria l
Vent fan with
sinole duct
Storm Sewer 0f amps.Vent system apart from
heatino or A.C.
\\\t$(EPCTCSFf 5.-s.@ coMr.,!./IND. FEEDERS
Mechanical exhaust
hood and duct
\U\rt0Nrr:ex t-5.@ Instal I /al ter/re1 ocatedistrib. feeders I'lood stove/heater
\\tlr,\Etz U€\TE2 S_6,@ 0f amps"EtocX\E\\EH-I 17S t)P
ISSUANCE OF PFRI,IJT
TOTAL CHARGES \SCD TOTAL CHARGES \5.co TOTAL CHARGES \).cD
WHERE STATE LIN REQUIRES that the E'lectrical workshall not be valiC until the label has been signed by
be done by an Electrical Contractor, the electrical portion of this perr,lit
an Electrical Supervisor and returned to the Building Division
I HAVE CAREFULLY EXAI1INED the completed apolicatjon for permit, and do hereb.y certify that all 'information hereon is true
and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the Cityof Springfield and the Laws of the State of 0reoon oertaining to the work described herein, and that NC OCCUPANCY will be madeof any structure without the permission of
Board is in full force and effect as requir
the Building Division. I further certify that m.y reqistration with the Builder's
ed by ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
n comcliance w'ith 0l?S 701.055 will be used on this project.only subcontrac ernpl oyees r,rho
I,lAtlE(please print I GNATI]RE
t:\ll \\T units Ftt:
Ftg
Ftg
l'la i n
Acce
x Val ue
Fire Zone Bedrooms 0c cy Load Val
rlooo PIain
-I1,o..,",I 0c c,y Grou 0ther x Val ue
TOTAL VALUATI
r, ti etl t altl t
ON
BUILDING PERI'IIT
Charges and
Su rc harges
'\L--Plan Ck. Comm/Ind
65%/B1d'o Ppr Fpe
a)-rlgr vgla,
lg.7-o ck D[,D Systerns Deve
Charqe (1.5c opment
Plan Ck. Res
30%/81dq Per Fee
PLUi4BING PERMIT
Charges and
Su rc ha rges
5. oo
.ca--\
Fence
Demo
ELECTRICAL PERI,:IT
Charges and
Surcha rges eb--
\Sidewal k
A/C Paving Total Comb. Permit
14ECHAIIICAL PERMIT
Charges and
Surc ha rge s :qc-Curb Cut
TOTAL =70-!.2
Address
:TORS
\ ).r
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
17 03 43
2. example- Lot 1. Block 3, 2nd Addition to
SpTrffiield Estates
C. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
a)535
3-6-s/
1. exampl e- heat2. example- wate
E. Square footage or
cal 1 or forced air gas
r or solai
valuation, e
II
1. example- 1250 sq. foot house, 500 sq. foot garage
?. example- if new project, check new - if addit'ion,
check adci, etc.F. Building permit information:1. example - construct single family house with an
attached garage
2. example - remodel exist'ing garage into family room3. example - convert single family residence into
restaurant (change of use)G. Value of work as defined in Section 303 (a) of the
Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS
To avo'id design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job site
corrections, etc.
Abbreviated P)umbing, Mechanical, & Electrica'l SchedulesA. Except where blank spaces occur in the descriptionportion of the Mechanical and Electrical Schedules,
the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanicai, and Electrical Schedules
are available at the Building Division!' 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'l schedul esC. BUILDING DIVISION STAFF t^IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electricalsupervisor. The genera) contractor is not authorizedto 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 Staffwili prepare a Wpe written copy and return it to theapplicant at the time the actual permit is issued for his
s i gna ture.
Fees and Charges
P'lan check fees are due and payable at the time of theapplication, 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.
I1I.
IV
o )
V. FOR OFFICE USE ONLY Permit Clerk
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 s'l gnature a,ut"ZZ\-(q
B6i**ed lnspectlsns..
Mem be r E ug e ne - SP r I ngll eld
MuttlPte Llstlng Servlco
JIM BROWN' G.R'I.
Broker
1385 oAK sr.
EUGENE, OREGON
97401
OFFICE: 485-1506
HOME: 686-2941
- - -rour Urty Designated Job Number Is:q
Jcb ACdress:\4\\
Owner:?
Contractor, \\t\)\)
SITE INSPECTION: To be made;fter;xcavar6n, but priorto setup cf fcrms.
I,DER TO SEE THAT AL*L INSPECTIONS AR"E }!ADE AT TI{E PROPER TIIIE[.nct,AND THAT TI:E PER}IIT CARD IS L OCATED AT TIIE FRONT OF THNS }.,1UST BE ON JOB SITE AT ALL TIIIES
L 726-3759 (reccrder) srate CITY DESIGNATED JOB NUI-IBERand v.,hen yorr will be reedy the inspecticn. Contractor
BROS. & ASSOCIATES
FlEALTOF|S
you
for srecei',,red befcre 7 :00 am will b e eade the sane day, requesEsllorring work day
O\?-R
Phone:
Phone :
,B PL'JIIBITiG C.\L
C.\L e befcre
any nork s covered.
DERCROUND Plumbing, Electrical,
ATTIC DR FT STOPS 6 CURTAIN IT'ALLS
FIREPLACE: Pricr to placing facingmaterials and before framing :
insoect ion.
INSULI.TION 6 VAPOR BARRIER To be
the Building Code a special
be emplol'ed by the Onner,/
ng construction of thefcllowing work. A ccpy of the specialtesting reports shall be furnished to theBuilding Division.
ct ion 06
inspector shall
Ccntractor duli
IONS: In anCe tr'i
In excess of 300.1
CONCRETE SLAB INSPECTION: Tc be
made af ter -1 t-Ti! liE-Eii rding
service equipment, conduit, piping,
accessories and other ar:cillary
equipment items are in place butbefore any ccncrete is poured.
F0CTIT-GS E F0UN!i\TICNS: To bc made
aft er trenchE!-ZiE-EiJavated and
forms are erected, all steel inplace, but prior to pouring concrete.
maaeffind
required vapor barriers are in place
but before any lath or gyAsun boardinterior wall covering is applied.
FRAI|IING: To be made after the roof,
aJ.l framing, fire blocking and
bracing are in place and all pipes,
chimneys and vents are complete andthe rough electrical, plunbing and
heating wires, pipes and ducts are
approved.
FIRE 6 SEPARATION I\,ALL: Located E
@oplans.
STRUCTUR{L COICRETE
F.S:T.1306 a .ll--
STR.UCTUR\L IVELDS1;; (r?7r-il-Preformed on the
HIGH STRENGTH BCLT.ING: During all
EolT--ins rall at 1cn ;a ti ght i.n!operaticns (306 a.5)
Gas, Sanitary Sewer, Storm Sewer,
Wrter and Drainage lincs. To be
made prior to covering or filling
trenches.
UNDERFLooR:, Plunbing, Electrical,
!{echanical. To be made prior toinstallaticn of floor insulation,
dccking or floor sheathing.
POST 6 BEA-l't: To be made prior toinstallatio;r of flocr insulation,
decking or floor sheating,.
FLOCR INSULATION 6 VAPOR BARRIERS:Tobcmade@
tN
FI}i.\L PLUi\IB ING
FINAL SLECTRICAL
FINAL I\IECtI,\\I CAL
FII.IAL FIRE DEPARTTIE}IT
BCUCfi Pt.UilBING, ELECTP.ICAL 6 .
llEcll,\\CIAL: No worl< is to bc covereuntil these inspectio:rs have been
nade and approved.
is applied or before gfpsum boardjcints and fasteners are taped and
finished.
I,JoODSToVES: After installation is
conp I eted .
SIDEI\IALK f, DRI\IEI{IAY Required forall concrete paving within streetright-of-way, to be made after all
excavating ccmplete Q form r*ork 6
sub-base material in place.
CURB AND APPRoACH APRON: After forms
are erected but prior to pouring
concrete.
PAR(ING LOT: After gravel is in
place but prior to placing asphaltor concrcte.
SPR\YED ON FIREPROOFING@
SPECIAL GR{DI EXCAVATIOIV .IU\D
earthwork 6 a.11
GLU-LAll BEA.IS: Inspection Certificate,by an approved agency, furnisheC to.the City's Building Division before
beams are placed. (2S01-U.B.C. STDS.
25-r0,11)
(u. B.C
To be
CYPSIJ]I INSPECTI FI LLI
-mm
er all lat lng a
g)?sum board, interior and exterior,Etlapt-ter zsl
is in place but before any plast
of decking or floor sheating.
I'IASONRY: Steel location, bond beamsgroutinr or verticals in acccrdanccHith U.b,C. Sertion 2415.
TIlIllG /t\lD Nf.ING: Prioro installing any g
d
CITY'S SITE PLAI{E\IIEI,I BO.\RD I\SP
wish inspect At1 pt'o] cct c ons 5u
be conirleted befcre requesting this inspect
- Ftx,tr SllI LDING: trtust be steC after the final PIumbing, Electiical, llechanical anC Firereque
Dcpartment inspections are mad e and approved. No Occupancy of the premises can be made untila Ccrt te of 0ccupancy s been issucd by thc Building Divisicn ar:,d postcd on the premises
t
l*tust be requested 2 days in advance of the date you
ch as landscapi::g, parking lot striping etc. must
ion.
DATESICNA
rt FlNollTs \rllqT FF lraFqCTnI E AnIltqTtrF\.'T ?n trE rrlnE tT \.^ .^.T TA .ilr -,h
IAL
e
+.U L rt-\\ilol FS
t\qtu (
tr
e-
tr
rl
*In addition to the inspections
specified hereon, the BuildingOfficial may nake or require other
inspections of an1. construction
uork to ascertain conplience withthe Building, City or Zoning Codes.
Z tr