HomeMy WebLinkAboutPermit Building 1984-11-20ffi
COI,IBI NATI ON APPL I CATION/P ERMIT -37
Job Address fs
Lesal Description\\ Oa ?\ \O ?qCO tjater Heater
Ranqe
EIIERGY SOURCES
Hea t
onn"')4s) J)r sr?t}t)fr8.s Du Va#iue of l,lork:
J5, aoo
Fto. tlain_
Sq. Ftg. Access._
Sq. Ftg. Other_
_l{ ew_Add_A I te r_Re p .
_Fence_Demo Change/Use
0ther
Address PhoneJn^, z Quilging Permit Info: Describe tlork(Farnily Residence llith Attached Garage
i'e., BuiId Single
I
4
I
/1 0 n-/^ a-,1Construction Lender ru/*(//,)
Addres s Phone 113
.laso
c)\r(X
DES I GN TEAI.,I name address I ics . no./exo i$es phone no.
Primary
Struc tura l
Electrical
l4ec han i ca I
c0NTRACT0RS n ame add res s lics- no.exo I res (phone no.
Ge
tr\, (c-zq l8{
tvA
4
-/Jetr n +
PLUIlB I NG
rl
ELECTR I CAL MECHAN I CAL
NO FEE CHARGF NN FFF NO FFF l^HA PG F
Z Each single fixture 5 \5p Residence of
FTsQ
furnace/burner to
BTU, s
Relocated buildinq
(new fix. additional)\
New circuits alts
or extensions S:s.ae
Floor furnace
and vent
S. F. Residence(l bath)SERV I CES Recessed wal I
Space heater and vent
Duplex (l bath) each
Additional bath Temporary Constructi on Apol iance vent
s eDa ra te
l.Jater serv ice Cha e in existing
res
ng
id ence
Stationary evap
coo I er
Sewer multifamily, conrn
I ndustri a l
or t\Vent fan with
sinole duct 5 \D@
Storm Sewer -amp s.0f Vent systenr apart from
heatino or A.C.
c0Ml.1./IND. FEEDERS Mechanical exhaust
hood and duct
I n sta I I /a I ter/ rel ocatedistrib. feeders !'Jood stove/heater
0f amp s.
ISSUANCF OF PFRIIIT
TOTAL CHARGES \Dso TOTAL CHARGES Gp-TOTAL CHARGES \L--
llAl"lE(ptease print)O 1.., A LD
I Gi,IATU R E,\
DATE )
permi
ffect
e fyLYthe comp apnl ication r Dermit, and do hereb.y certi t all information hereon is trueand correct, and I further ce rtify that any and ail workf the State of Oreqon oerta
performed shall be done in a ccordanc e with the 0rdinances of the City
nd that NC 0CCUPANCY wiil be madL
of Springfield and the Laws o ining to the work described herein, aof any structure without the ssion of the Buildi ng Division. I further certify
701.055, that if exempt the bai
t m,y registration with the Builder,sthaBoard is in full force and e as required by ORS 'ls for exemption is noted hereon, and thatonly subcontractors and ernpl oyees who are in comolia nce with 0l?S 70i.055 'I I be used o n this Droject.
WHERE STATE L.II.J REQUIRES thAtshall not be valiC unt.il the Iabe
het IE e 'I ndobectrcIarkw0nea E ecI rtt Ica e ItracContorthe ec ctri Ia rt on'I fo sthi rmt tp0peIhasbeenslEIanbygnedI
bytri ca Su vtr r50ecPe )uan urneret tod Buthe I1 'Id Di '|'IS 0nng
TOTAL V
x
x
Valu
Flood Plain- S
dSo
upl-B:2 sq
. Ftg. Acces
. Ftg. 0ther
Type,/Cons
Val
Uni
cy Loa
tories\ -t Gro
Val ue
Zone
Fi re drooms
t 63tto
ts So . Ftg. t,ta i n
Plan Ck. ConmTIn?I
651lB1dq Per Fee
Systenrs Deve
Charge (1.57 opmentBUILDING PERNIT
Charges and
5u rcha rges qg
Fee
Plan Ck. Res
30%/Bldg Per
FencePLUI4BING PERMIT
Charges and
Surcha rges .\o
co___\o
D6mo
Sidewal k
ELECTRICAL PERI1IT
Charges and
S u-rcha rges
\t
Tota'l Comb. PermitA/C Pavi ng
Curb Cut
I,IECHANICAL PERHIT
Charges and
Surc ha rges
___rL._=__
. \tv TOTAL 5L\ qb
I
auADnE
-6-
PERMIT VALIDATION
,l
Permit Clerk
il, 67x 7?
l*lra
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot l. Block 3, 2nd Addition to
SIFii-sField EstatesC. Name, etc. of owner and construction IenderD. Energy Sources1. example- heat/2. EIE66Ie- waterE. SquaiE-766:tase or
air gas
1. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check new - if addition,
ifiecE-add, etc.F. Building permit information:1. example - construct singie family house with an
attached garage
2. exampie - remodel existing garage into family room3. example - convert single family residence into
rEtaurant (change of use)G. Value of work as defined in Section 303 (a) of the
Structural Specia)ty CodeH. 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.
Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. 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 installedB. Ful'l Plumbing, Mechanical, and Electrical Schedules
are available at the Building Divisioni. 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 the
ful I schedul esC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. 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.
Applicant to sign and date
Whenever possible, the initial application will be. used as
a worksheet oniy. 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
s i gna ture.
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.
FOR OFFICE USE ONLY
II.
III.
IV.
V.
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
permit appljcant exempt from registration wjth the Builder's Board because:
Additional Proiect Information:
PLANS REVIEWED BY:
na -rqs i gnatu da te\\-\G
t /-tc ,l
SPltl,r'GFI€LT'
Job Address:
ignated
555
aa equired lnspec Jns..
IT IS THE RESPONSIBILITY OF IIIE PER]VIIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT TI{E PROPER TI}.TE,
IHAT EACII ADDR,ESS IS READABLE FROI{ T}iE. STREET, AND THAT TIIE PERI.IIT CARD IS LOCATED AT TI{E FRONT OF THE
PROPERTY. BUILDING DIVISION APPP.OVED PI.ANS MUST BE ON JOB SITE AT ALL TI}IES.
PROCEDURE FOR. REQUESTING IIISPECTIONS: CaI1 726-3769 (reccrder) srare CITY DESIGNATED JOB NU}EER,
Job address, type of inspection requested and vrhen yorr will be re edy
youfor the inspeccicn. ConEracEorso= orrners name and phone number. Requests received be fore 7:00 am will be nade the sarne day, requests i
received after 7:00 am will be nade the foLlors ing work day
Your City Des Job Number Is 7 (\0802
t\trur\ Sv
Ovrner:
Contractor:
SITE INSPECTION: To be nade
ffir exca\ratlon, but prior
setup cf forms.
T'NDERST"AB PLI,XIBING, ELECTRICAL
6 IIECHANIg\L: To be nade before
any trlork is covered.
CONCRETE SLAB INSPECTI0N: To be
nade after all inslab building
service equipment, conduit, piping,
accessories and other ancillary
equipnent items are in place but
before any concrete is poured.
FOOTINGS 6 FOUNDATI0NS: To be made
after trenches are excavated and
forms are erected, all steel in
place, but prior to pouring concrete
TNDERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer, Storm Sewer,
Waler anC Drainage lines. To be
nade prior to covering or filling
trenches.
TNDERFLOCR:, Plumbing, Electrical,
Mechanical. To be made prior to
installaticn of floor insulation,
decking or floor sheathing.
PoST 6 BEAM: To be made prior toinstallati.on of flocr insulation,
decking or floor sheating..
FLOOR INSULATION G VAPOR BARRIERS:
To bc made prior to installation
of decking or flcor sheating.
IIIASONRY: Steel locarion, bond beamsgrouting or verticals in acccrdance
tcith U.B.C. Section 2415.
SI.IEAfiING Prior
ATTIC DRAFT STOPS E CURTAIN WALLS.IAL INSPECTIONS:
on t lding Code a special
inspector shall be enployed by the Or"ner/
or during construction of thefcllowing work. A ccpy of the special
ting reports shall be furnisheC to the
Building Division.
STRUCTURAL CONCRETE: In excess of 30C.'
P.S. I. (306 a.1)
STRUCTUR{L IIELDS: Preformed on thejobJzru r)
HIGH STRENGTH BCLTING:During all -bolt installaticn and tighting
operations (306 a.5)
SPRAYED ON FIREPROOFING:
StanCarCs 43-8)
(u.B.c
SPECIAL GRADING, EXCAVATION ;\\D
FILLING: During earthuolk. (506 a.1l
6 Chapter 29)
GLU-LAI'{ BEA}IS Inspection Certificate,
FIREPLACE: Prior to placing facing
materials and before framing :
inspection.
INSUT-a.TION G VAPOR BARRIER: To be
nade after all insulation and
required vapor barriers are in place
but before any lath or gypsum boardinterior wall cover 'ing is applied.
NUG: To be nade 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
heating wires, pipes and ducts are
approved.
FIRE & SEPARATION IVALL: Located &
ccnstructec according to plans.
- LATH AND/OR 6YPSLI! BOARD INSPECTION
To be made after aII lathing and
g)?sum board, interior and exterior,
is in place but before any plasteri
is applied or before gypsum boardjoints and fasteners are taped and
finished.
WOODST0\tES: After installation is
conpl eted.
SIDEIVALK & DRIVEWAY: Required foral1 concrete paving within streetright-of-way, to be rnade after all
excavating ccnplete I form work 6sub-base material in place,
CURB .{ND APPROACH APRON: After forms
are erected but prior to pouring
concrete.
PARKING LOT:After gravel is in
place but prior to placing asphaltor concrete.
after the
ed
Oc cupancy by
by an approved agency,'the City's Building Di.
furnisheC to
vision before
I beams are placed. (2S01-U.B.C. STDS
25-10,11) .
* In addition to the inspections
specified hereon, the Building
Official nay :nake or require other
inspections of any construction
work to ascertain conpliance withthe Building, City or Zoning Codes.
final Plumbing, Electrical, llechanical anC Fire
No Occupancy of the premises can be mede untilthe Building Divisicn ar:d posted on the prenises
any roo
ROUGH PLU}'BING, ELECTRICAL 6
IIIECHANCIAL: No worl< is to be covereduntil these inspections have been
made and approved.
FIN.qL PLI,'M8ING
t
CITYTS SITE PLAN REVIEI{ B0ARD INSPECTION: ltust be requested 2 days j.n advance of the date yousuchaslandicaping,parkint1otstriPin8etc.nust
be compLeted befcre lequesting this inspection.
FINAL BUILDING: Must be requesteCCparfi;t-6+ections are made and
FINAL ELECTRICAL
FINAL I.IECHANICAL
FINAL FIRE DEPARTIIE}IT
a Certifi
S ICNA o
*eLL uq,lHoLrs.tND cLEANours IIUsr BE.tccESsIBLE, ADJUSTI\IENT To BE r,ldDE AT No cosr ro rHE clfi.
a
e
Ia