HomeMy WebLinkAboutPermit Building 1986-01-26ECTION LI
37 69
CITY OF SPRINGFIELD
COMBI I{ATI ON APPL ICATION/PERMIT 726-37s3
oLegal Descri ption
Job Address
liater Heater
Range
EIIERGY SOURCES:
Hea t
Owne r
Value of l.lork:
/D. ooo,'a
Sq. Ftg. Access._
Sq. Ftg. Other_
_t'l ew_Ad d-A I te r_Re p .
_Fence_Demo Change/Use
0ther
Ftg n_
Address /// <l-r) STH,#-2?fl Phone QuiT(ing Permit Info: Describe l^lork(i,e., Build Single
Fami l y Residence l,li th Attached Garaqe)
Tel\.a-nt D^arn, Dn rt t / /i,4r'1
Constructi on Lender
Addres s Phone
&oC
q)
q
DES I GN TEAI.I name addre s s I ics . no.exot rPs phone no.
Primary Da .4r>tu-rua-&sa<.. Zaa' 5, .t?tt<( 9t7,. SP/t<2.
"?Z.gz=fStructura l
77 7
El ectri cal
l''lec ha n i ca I
CONTRACTORS n ame add res s 'I i cs. no.'exni res )ohone no.
-/Genera I 6L-
o-3Jb sy's-=crs/zri cal ,bc-4
I'lec ha n i
PLUIlB I NG ELECTR I CAL MECHAN I CAL
I
FEE CHARGF NN FFF I^HA PAF NO FFF CHARG F
3 Each single fixture zto ?z.,&
Res idence of
FTSQ
furnace/burner to
BTU' S
Relocated bui1ding
(new fix. additional )
New ci rcui ts al ts.
"2";..H'o)*oae zz3
Fl oor furnace
and vent
S . F. R.es i dence(l uatn)SERV I CES Recessed wal I
Soace heater and vpnt
Duplex (l bath) each
Additional bath Tempora ry Constructi on Apol iance vent
separate
[,later servi ce Change i n exi sti ng
resi dence
Stationary evap
cool er
//o't Sewer fu.-Jndustrial
multifamily, comm. or I Vent fan with
sinole duct ?. o'
Storm Sewer 0f Vent systern apart from
heatino or A.C.
c0t4t1./IND. FEEDERS Mechanical exhaust
hood and duct-
Instal I /al ter/rel ocatedistrih- feeders [,Jood stove/heater
/0f aa s.
"".6
,
ISSUANCF OF PFRI1IT
work be done by an Electrical contractor, the electrical portion of this permit
ed by an Ejectrical Supervisor and returned to the Buildjng Division
l,lAl'lE(please print)S IGiIA
I
WHERE STATE LAl,l REQUIRES that the Electr.icalshall not be valij until the label has been sign
oermi t
rfo rmed
f exempt
.055 wi l
L aeted I c'I ta I ncompp l-)an d do he rtce I t tha Ia 'II forman 'IL nreb.y Ireon ts ru.icorre a Ind fu hert certr 'I t ha t nda Ia WOI krfyany DE s Iha 'I I nedonbe a cco anrd wlce theth I0rd na snce o cthe 'I tyrtIfIdandtheoLawsthfSeLdDngte0reofn'I n'Iqon to th kwor 'Idescr bedDe rta q he 'Ire n dan hat t,tct CUPAHCY0c Iwl beI made5rUtuctwlrehottheutrmrs1peSofnButheII'Id 'I I cfurther 'IDIson'I rte ,l t tra Ingrn.y on thvn Buthe II der sreqny
d s'I n'I Ifu I force nda aeffect 5 red SOR 'Irequi070155 the 1t 'Ion nforbyexemps heoted 0nre a tnd thastrubcontoacarsndIempawho'Ire n 'Iioyees cean thwlcomD I be s'I tecproj
TOTAL CHARGES TOTAL CHARGES -eTOTAL CHARGES
and
ofS
ofa
Boar
only
TOTAL VALUATION
other,/d-raopA_x .9t ccvutue ,/ar&.a
Del Cons t .frrY SrKu.
Acces s Val ue
Fire Zone Bedrooms
Zone )U
Load Sq. Ft!
eroup E'Z sq. Fts
x Value
Flood Plain Stories
its So. Ftg. t,lai
4.93 ,Qrel t"-aiualPlan Ck. Conrn/Ind
65%/B1dq Per Fee
f2.572aet';!ysteris Deveharqe ( i.5q opment /v./.BUILDING PERI'IIT
Charges and
Surcharges
__,9_a&__
zz Fee
Plan Ck. Res
30%/Bldq Per
FencePLUI4BING PERMIT
Charges and
Surc ha rges --Sz=€o--2.o Dgmo
Sidewal k
ELECTRICAL PERI,:IT
Charges and
Surcha rges
a@
b A/C Paving Total Comb. Permit
Curb Cut
I,IECHANICAL PERMIT
Charges and
Surc harges ---/'f-?---'6o TOTAL Z&-72
t
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Description
1. exampie- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot 1. Block 3, Znd Addition to
Springfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
L example-2. examp.l e-E. Square foota
air gas
s
2
example- 1250 sq. foot house, 500 sq. foot g
example- if new project, check new - if addi
check add, etc.
arage
ti on,
F. Building permit information:1. example - construct single family house with an
attached garage
2. example - remodel existing 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
Structura l SH. DESIGN TEAM
pecialty Cocie
AND CONTRACTORS
II
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 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, Mechanical, and Electrical Schedules
are avai lable 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 thefull schedulesC. BUiLDING OIVISION STAFF t^llLL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de'livered to theelectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical label
Applicant to sign and date
Whenever possibie, 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
appiicant at the time the actual permit is issued for his
s i gna tu re.
Fees and Charges
Plan check fees are due and payable at the time of the
appi ication, 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.
III,
IV.
V. FOR OFFICE USE ONLY
PERMIT VALIDATION
tfr
^t\f
Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Permit applicant exempt from registrat'ion with the Builder's Board because:
Additional Project Information :
PLANS REVIEI^IED BY :
name s i gnatu da te / -" r*G
(d
,((p
(
Sg. Ftg. Access._
Sq. Ftg. Othef_
_llew__lAdd_Al ter_Rep.
_Fence Demo_Change/Use
-other-
COHBI
ts
726-37
D
l/\
eOwner
Hea
Ftg.
ICAI
EIIERGY SOURCES:
ilater HeaLegal Description
Job Address
Va'lue of Hork:;i cr?
Address ,,a <, Z .fiu /io z >j Phone
s i dence
:De .€., Build Single
(4 4t4 c<6.\
Construction Lender
Address Phone
N
&
q
Ut5I GN TEAT.I name (address'lics. no-exot res Dhone no.
Primary
Structura I
El ectri ca l
Hechani cal
S name ( addre 'I ics. no-exo I res ohone no-
{ln^n ELECTR ICAL MECHAN I CAL
Each single fixture Res idence of
FTsQ I furnace/burner to,ioGtq Bru's /*b.Relocated bui ldino
(new fix. additioial)New circuits alts.or extensions Floor furnace
and vent
S.F. Residence
( l bath)SERV ICES Recessed wal I
Duplex (l bath) each
Additional bath Temporary Constructi on ance ventApp
llater service Change in existing
res i dence
Stationar-v evap.
coo l er
Sewer multifamily, corm. orfldustria I
Vent fan with
sinole duct
Storm Sewer Vent systern apart from
heating or A.C,
COMI.I./IND. FEEDERS Mechanicai exhaust
hood and duct
I nsta I I /a I ter/rel ocatedistrib. feeders $lood stove/heater
0f S 6r^Prtr^ --
ISSUANCE OF PFRI,IIT
CHARGETOTAL S LTOTA CHARGES 6bCHARGESTOTAL
sT,I,JHERE TE Ll\r,r RESIREQU ttha Ethe I ectr ca'|workI dobe ne a E ectrit Ica Con tractor the e ecI ctri Ia rt 0 f '|thhaS'II p0 s tbenot,|va ct permi'Iunt I the aI Ibe has been s 'I
bytrianEIec Ica sorgnedbySupervi and returned to Buthe II di v'lDi onslng
r_22-(Jl.lAl.1E(please pri
Ci ty
made
0regon
the Bui
of Spriof any
Board i the permi
nd effect
Y het e ted ca fo roncompapp t nda do rtceby atha t t onand hereon s truetcorrecandrtherfucertithataandfyworknysharmeddonebeaccWIordanceththena0rdiofthencesandefidLawsofthengthetaSoftertathetoworkpeningdesbedcr'l nherei ands ttha NCtwlructure OCCUPANCY wl behoLutssofdDnngs0Ihefurtcertirtha+fy tratis onfulmyreg l.r'l theth Bu raforcede sasredrequ i 0Rs 70t thatby055 f theexempt sba s for on svrssubcontractoexempti noted hereon andand thatwhoaempioyeesrenanWIcecomp0r?sth 7A 05 5 wl onused thi s ectproj
its Ftg
Ftg
Ftg
Y
an
an
1
0c lue
Fi re x
lue
c.y Group Sq
Const.
Load
. l'lai
Flood Plain Stories
ToTAL VALUATI0N_
,ve
5/,
opment
BUILDING PERI.IIT
Charges and
Surcharges
. Access
. 0ther
FencePLUI.IEING PERMIT
Charges and
Surcha rges Demo
Sldewal k
ELECTRICAL PERIIIT
Charges and
Surcharges A/C Paving tal Comb. Permit
Curb Cut
I,IECHANICAL PERHIT
Charges and
Surcharges
d-\4tf?2a,
TOTAL /f €a
ot
Snarp hpatan enr{ rran}
seoa ra tp
gp amps
PER}4IT VALIDATION
Permi t Cl erk L?
:6r-
prL\1 3
7'72'
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Description
l. example- Tax Lot 100, Lane County Map Reference
17 03 432. example- Lot l. Block 3, 2nd Addition to
SIiingfield Estates
C. Name, etc. of owner and construction lenderD. Energy Sources
l. example- heat/electrical ceiling/or forced air gas
2.
-examp
I e- wa te rheaTeF/e-fE trJZITor s oli r-
E. Square footage or valuation, etc.1. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check new.- if addition,
check add, etc.F. Builciing permit information:
1. example - construct single family house with an
attached garage
2. example - remodel existing garage into fam'i1y room
3. example - convert singie 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 avoid design or construction deiays, 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 E'lectrical Schedules
are available at the Building Division
1. 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
full schedulesC. BUILDING DIVISION STAFF I.IILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The generai contractor is.no'! authorized
to sign the electrical iabel.III. Applicant to sign and date
llhenever possible, the initial application wilI 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 gnature.
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
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY:
Permit applicant exempt from registration with the Builder's Boa rd because:
Additionat Proiect Informat'ion :
PLANS REVIEWED BY:
rc7->?4fnames't gnatur
IT IS THE RESPONSIBILITY OF THE PERIVTIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT TIIE PROPER TDfE'
THAT EACII ADDRESS IS READABLE FRO},I TIIE STREET, A\ID THAT T}IE PER}{IT CARD IS LOCATED AT TIIE FRONT OF TI{E
PROPRRTY. BUILDING DIVISION APPROVED PI.ANS MUST BE ON JOB SITE AT ALL TI}{ES.
PROCEDSRE FOR REQUESTINc IIISPECTIONS: Cal1 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
job address, type of inspection requested and trhen you_will be,ready for the insp_ection. -Contractors6r orrners name-ind phone number. Iiequests received before 7:00 am will be r.F.ade the same day, requests
received after 7:00- am will be nade the following work day.
Your City Designated Job Number Is:
Job ACdress:
Orrner Phone
Contractor:Phone:
SITE INSPECTION: To be made INSP In accordance witEEter-excavat , but prior
to setup of forns.
I,'NDERSI..AB PLI.NBING, ELECTRICAL
E ICCHANICII: To be nade before
any work is covered.
CONCRETE SLAB INSPECTION: To be
Building Code a special
inspector shall be employed by the Ouner/
ractor during construction of the
following work. A ccpy of the special
sting reports shall be furnished to the
ding Division
nade after all inslab building
service equipnent, conduit, piping,
accessories and other ancillary
equipnent items are in place but
before any concrete is poured.
)ob. (2722 t)
FOOTINGS & FOUNDATICNS: To be nade
.P']'I''ILD
aa
after trenches are excavated and
forns are erected, all steel in
place, but prior to pouri.ng concrete
TNDERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer, Storm Sewer,
Weter and Drainage lines. To be
nade prior to covering or filling
trenches.
IJNDERFL0CR:, Plunbing, Electrical,
Mechanical.. To be made prior to
installation of floor insulation,
decking or floor sheathing.
POST E BEAM: To be made prior to
installation of flocr insulation,
decking or floor sheating.
FLOOR INSULATION 6 VAPOR BARRIERS
To be nade prior to installation
of decking or floor sheating.
I,!ASoNRY: Steel location, bond beams
groutfig or verticals in accordance
with U.B.C. Section 2415.
ROOF SHEATIIIIJG A\D NAILING: Priorffi
ROUGH PLM,IBING, ELECTRICAL GI
@cove,until these inspections have been
made and approved.
FINAL PLI.,[MBING
FINAL ELECTRICAL
FINAL I\{ECHANICAL
FINAL FIRE DEPARTME}IT
I quired ln spec t, ft s ..
o
FIREPLACE: Prior to placing facing
naterials and before franing
inspection.
INSUI.A.TION 6 VAPOR BARRIER: To be
nade after all insulation and
required vapor barriers are in place
but before any lath or gypsum board
interior wal1 covering is applied.
FRAMING: To be nade after the roof,
EITEi,ning, fire blocking and
bracing are in place and all pipes,
chimneys and vents are complete and
the rough electrical, plunbing and
heating wires, pipes and ducts are
approved.
FIRE G SEPARATION WALL: Located G
ccnstructeC according to plans,
LAITI AND/OR CYPSUM BOARD INSPECTION
To be rnade after all lathing and
g)?sun board, interior and exterior,
is in place but before any plas
is applied or before gypsum boardjcints and fasteners are taped and
finished.
WOODSToVES: After installation is
STRUCTUR{L htELDS: Preformed on the
STRUCTURAL CONCRETEF:3i-l3o6;ll--
HIGH STRENGTH BOLTING:
EoiT-fi;tall?tio;-ana
In excess of 3000
During all -tighting
conp 1 et ed .
SIDEWALK 6 DRIVEWAY:Required for
all concrete paving within street
right-of-way, to be made after all
excavating conplete $ forn work &
sub-base material in place.
CURB .qND .{PPROACH APRON: After forrns
are erected but prior to pouring
concrete.
ed
WIN_!9Ir After gravel is in
place but prior to placing asphalt
or concrete.
CITYTS SITE PLAN RE\IIEI'J BOARD INSPECTI0N: Must be requested 2 days in advance of the date you
suchas1andscaping,p..iing1otstripingetc.IDuSt
be completed befcre requestihg'this inspection.
FINAL BUILDING: Must be requesteC after the final Plumbing, Electrical, Mechanical and Fire
Departnent inspections are nade and approved. No Occupancy of the prenises can be made untila Certifica Occupancy has been is by the Building Divisicn and posted on the premises
operations (306 a.5)
SPRAYED ON FIREPROOFING@ (u.B.c
SPECIAL GRADING, EXCAVATION .{ND
FILLINC: During earthwork. (306
6 Chapter 29)
a.11
GLU-LAM BEA}.,IS Inspection Certificate,
by an approved agency, furnished to
the Cityrs Building Division before
beans are placed. (2501-U.B.C. STDS.
25-r0,11) .
* In addition to the inspections
specified hereon, the Building
Official :nay make or require other
inspections of any construction
-lrork to ascertain conpliance with
the Building, City or Zoning Codes
W
J-*r'-€DATE
W
*ALL MANHOLES AND CLEANOUTS I''UST BE ACCESsIBLE, ADJUSTMENT To BE MADE AT No cosT To THE CITY
ATTIC DRAFT STOPS & CURTAIN WALLS