HomeMy WebLinkAboutPermit Plumbing 1991-10-21CO M M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATION
225 Fifth Street, Springfield, Oregon 97477
er (
SPRINGFIELO
TAX LOT:
<1,
DLOCATION OF PROPO
ASSESSORS MAP:
JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
OWNER
ADDRESS:
CITY:STATE:ztP
E:
DEMO OTH ER VALUE
DESCRIPTION OF WORK:
NEW
-
REMODEL ADDITIO
ARCHITECT
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOB # EXPIRES PHONE
MECHANICAL:
ELECTRICAL:
I
NAME ADDRESS PHONE
PLUM BI
G ENE
PLUMBING
NO.FEE CHARGE
r7 Single Fixture tlo,cu
Relocated Bldg.
(new f ix. addtl)
Water Service
ft.
Sanitary Sewer
ft.
Storm Sewer
ft.
Backf low Device
TOTAL PERMIT
MECHANICAL
NO trtrtr (]HA RN tr
Furnace/burner & vent
< 100,000 BTUs
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent
f rom
System apart
AC or htg.
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT
_ OFFICE USE -
ZONING
LAND USE
HANDICAP ACCESS:
FLOOD PLAIN
LIGHTING POWER BUDGET:
WATER HEATER:
* OF UNITS:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
SQ. FT.$/SQ. FT,VALUE
TOTAL VALUE OF PROJECT-=---
X
X
SQ. FTG MAIN
SQ. FTG ACCESS
SO. FTG OTHER
RCPT#PLAN CHECK FEE DATE BY
'&\5gq
BUILDING PERMIT PLUMBING ryo@ DEMOLITION
5% State
Surcharoe
5% State
Su rc haroe NSfl
MECHANICAL FENCE
VALUE $
5% State
Surcharge
SIDEWALK
FT,
SUBTOTAL
PE RM ITS
PAVING CURBCUT
FT.
SYSTEMS
DEVELOPMENT "l)()9.3('\
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
- REQUIRED INSPECTIONS V
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-g769 (recorder), state your City designated job number, lob address, type of inspection requested and when you will be ready
for inspection. Requests received before 7:O0 a.m. will be made the same working day, requests made after 7:OO a.m. will be made
the following work daY.
SITE TNSPECTTON: 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 SPECIAL INSPECTIONS: ln accordance
ELECTRICAL & and approved- section 306 0f 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 during
CURTAIN WALLS construction of the following work. A
FOOTINGS & FOUNDATIONS: F'hEh, ^^E.. copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are facing materials and before
erected, ail steet in ptace, but framing inspection' STRUCTURAL CONCRETE: ln
prior to placing concrete. FRAMING: To be made after excess of 2500 PS.l. (306 a.1)
coNcRETE SLAB: To be the roof' all framing' fire
made arter al insrab buirding 3i::5::.']fl 3,'3:It"ri';;:r" il*i'TJX3"t,Y5tT',rrr, ,,
service equipment, conduit, and vents are'complete and
:#1,?;""",",:;:{:? ?i:i:'::J ffi'fl'":1.",1i9ffi,1'JJ;[3:?: El?Xf],?E]?T*,?,o,"'IHX"oin place but before any tightening operations. (306
concrete is placed. TNSULATION & 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.C.storm sewer, water and before any lath or gypsum Standards 43-8.drainage lines. To be made board interior wall covering is
P-t]:t^l::""rins or filling applied' spEcrAL GRADTNG,rrencnes.
,NDERFL..R: p,umbins llx:,S'.="'fm'Jfl[Hf "' il:iJt'i[i-tii,?,5Jb'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: lnspection
floor sheathing. BOARD: To be made after all Certif icate by an approved
lathing and gypsum board, agency, furnished to the city's
posT & BEAM: To be made interior and exierior, is in Building Division before
prior to installation of floor place but before any beams are placed (2501 u'Bc'
insulation, decking or floor plastering is applied or before STDS' 25-10'11)'
sheathing. gypsum board joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR TNSULATToN & finished' a'7\
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.
RooF sHEATHTNG AND iHXS^H?fJ'",:'of""l'"
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.
"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.
FINAL PLUMBING
FINAL ELECTRICAL
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All project conditions such as
landscaping, parking lot stri ping, etc. must be completed before
requesting this inspection.
FINAL BUILDING: Requested after the final plumbing, etectrical,
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.
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
PLANS REVIEWED BY DATE
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 allwork 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
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
'z/,/aDateSignature
times during st ru ct ion
VALIDATI AMOUNT RECEI
RECEIPT #RECEIVED BY:
DATE PAID
ADDITIONAL COMMENTS:
-
s1'tUNGFtEL()
?fr,
STREETPITTH225
1
Perrnits are non-transferable and explrelf work is not started withln 180 daysof issuance or lf vork ls suspended for
180 days.
2. COI\ITRACTOR INSTALI,ATION ONLY
BLBCTRICAL PBRHIT APPLICATION
City Job Number
rBE SCEEDUI,E BELOY
Dtrev Residential-Single or
Multi-Family per dwelling unit.
Service Included:Items Cost
1000, sq.ft. or }ess
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvel).lng
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations or
Relocation:
Sum
B
Electrical Contractor \rs-s:S E\-€C-
Address \n-\O N -}€}\*
citv?)Ppc, Pho'qliSftS$
sup ervisor ticense Ndmber 3\O\5
Expiration Date
Constr Contr. Number
Expiration Date I
ture of lng Electrician
Owners
Address
Ci ty Phone
OTINER ALI,ATION
The installation is being made on
property I ovn vhlch ls not intended
for sale, Iease or rent.
Ovners Signature:
DATB:
RBCBIPT
C. Temporary Services or Feeders
Installatlon, Alteration or Relocation
above
Circul ts
ew, Alteratlon or Extension Per P anel
E
One Circuit $ 35.00
Each Additional
:l';:il":'rxl,ll,'""'gl $ 2: eo lB%
Miscellaneous (Service/feeder not included)
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
STETOTAL OF ABOVE
5Z State Surcharge
TOTAL
$ s0.00
$ 60.00
$100.00
$130.00
200 amps or }ess $ 40.00
201 amps to 400 amps _ $ 55.00
0ver 401 to 600 amps _ $ 80.00
Over 600 amps or 1000 volts see rrBrl
40.00
40.00
20.00
36.00
$300.00
$ 40.00
I
-Bach installation
Pump or irrigation $
Sign/0utIine Lighting_ $
Limited Energy/Res _ $
Limited Energy/Comm $
RECEIVBD BY:
5
INSPBCTION RBQTIBST:
0FPICE: 726-3759
qt old)
@
COM M ERCIAL/ I N DUSTRIAL
PERMIT APPLICATION
225 Fifth Street, Springfield, Oregon 97477
SPRINGFIELD
JOB NUMBER
INSPECTION LINE: 726-3769
OFFICE: 726-3759
6
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:/2AV*=')>,'-+=s TAX LOT:GO?A
PHONE:
ztPt qVlA7STATE:CITY:
ADDRESS
OWNER:
NEW
-
REMODEL ADDITION DEMOLISH OTHER VALUE:
DESCRIPTION OF WORK
a ar\1. t-rtrr\-r.
CONST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR # EXPIRES PHONE
MECHANICAL:
ELECTRICAL:
NAME ADDRESS PHONE
PLUMBING:
PLUMBING
NO.FEE CHARGE
"/Single Fixture /2 ?e-n
Relocated Bldg.
(new fix. addtl)
Water Service
ft.
Sanitary Sewer
ft.
Storm Sewer
t(.
Backflow Device
TOTAL PERMIT
MECHANICAL
NO FFF EHA RGF
Furnace/burner & vent
< 100,000 BTUs
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Single
duct
Vent
f rom
System apart
AC or htg.
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT
_ OFFICE USE -
ZONING
LAND USE
HANDICAP ACCESS:
FLOOD PLAIN
LIGHTING POWER BUDGET
* OF UNITS:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
SQ. FT.$/SQ. FT,VALUE
TOTAL VALUE OF PROJ
X
Y
SO. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER
RCPT#PLAN CHECK FEE DATE BY
/2-&
BUILDING PERMIT PLUIMBING 40-*DEMOLITION
5% State
Su rch arq e
5% State
Surcharoe ?-4
MECHANICAL FENCE
VALUE $
5% State
Su rcharq e
SIDEWALK
FT,
SUBTOTAL
PERMITS
PAVING CURBCUT
FT,
SYSTEMS
DEVELOPMENT
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
Fa4-aA
?4?<-/a,r''
GENERAL:
WATER HEATER:
,\ REQUIRED INSPECTIONS .v
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. Flequests received before 7:OO a.m. will be made the same working day, requests made after 7:O0 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 SPECIAL INSPECTIONS: ln accordance
ELECTRTCAL & and approved' section 306 0f 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 during
CURTAIN WALLS construction of the following work. A
FOOTTNGS & FOUNDATIONS: copy of the special testing reports shall
To be made after trenches are FIREPLACE: Prior to placing be furnished to the Building Division.
excavated and forms are facing materials and before
erected, ail steet in ptace, but f raming inspection' STRUCTURAL CONCRETE: ln
prior to placing concrete. FRAMING: To be made after excess of 2500 P.S.l. (306 a.1)
coNcRETE sLAB: To be the roof' all framing' fire
made after an insrab buirdins Bl::5::.':fi 3;';ilt"r,;,1:r" ;lI3,"JJJ3l,Y5tT',rrr, ,,
service equipment, conduit, and vents are'complete ancl
:i?fr,?;".",",:;:{:? ?$:'::i :H';::lf;ti;;#'iJ;[3:?: El?Xf],ffi]?T*,".3,"'IH?".in place but before any tighteiing operations. (306concrete is placed. INSULATION & 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.C.storm sewer, water and before any lath or gypsum Standards 43_8.drainage lines. To be made board interior wall covering is
P,ti::L:-""*ring or filling applied. SpEctAL GRADING,
,NDERFL..R: prumbins l:::.*..t"'f;m'J3[,Yft* il;iut'jil-:li.',5J!tj]""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: lnspection
floor sheathing. BOARD: To be made after all certificate by an approved
lathing and gypsum board, agency, furnished to the City,s
posT & BEAMr To be made interior and exierior, is in Building Division before
prior to installation of floor place but before any beams are placed' (2501 U'B.C'
insulation, decking or floor plastering is applied or before STDS' 25'10J1)'
sheathing. " Sypsum board joints and
fasteners are taped and STRUCTURAL MASONRY: (306
FLooR TNSULATToN & finished' a'7)
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.
RooF sHEATHTNG AND iHRS^H'^ttJ"t::f""X,.
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.
* 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.
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
SITE PLAN REVIEW BOARD: Must be requested 2 days in advance
of the date you wish inspection. All project conditions such as
landscaping, parking lot stri ping, etc. must be completed before
requesting this inspection.
FINAL BUILDING: Requested after the final plumbing, etectrical,
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.
ADDITIONAL COMMENTS
PLANS REVIEWED BY DATE
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 Springf ield, 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 f urther 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
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
Signat Date
times during construction
4z--VALIDATI AMOUNT RECEIVED
RECEIPT *:RECEIVED BY:
DATE PAID
?/rt,4./
:;r.rilNGl:trir-L,
225 I'ITTII STNBEf,
SPRINGFTBLI), oRgcoN 97477
INSPE6II0N RBQIIE$I: 726-3769
oPPTCE: 726-3759
1 TOCATTON OT TNSTALIJ\TION
IJGAL DBSCRIPTION
JOB DBSCRIPTION
constr contr. Number
BLESTRICAL PBRHIT APPLICATION
CityJobNrber%
3. COTIPI,BTB FBB SCTIEDUI.B BBLOU
A. Nev Residential-Slngle or
Multl-Pamily per dvelling unit.
Service Included:
Items Cost
1000 sq.ft. or less
Each additlonal 500
sq. ft or portlon
thareof
Each Manuf'd llome or
Hodular Dwelling
Service or Feeder
$ 85.00
$ 1s.00
$ 40.00
B. Services or Feeders
Installation, Alteratlons or
Relocat ion:
Permlts are non-transferable and explrelf vork ls not started vlthln 180 daysof lssuance or lf vork ls suspended for
180 days.
2. CONITACTOR INSTALIATION ONLY
BIec t r i cal Con t rac torN\-eS( E_ss-c-
Address \q\b \\ -b*ei\
cityq=pFs Phone-\\-\\S\3
Supervisor License Number -b.\O\t5
Bxpiration Date to\r\
Sum
200 amps or less /
201 amps to /r00 amps
401 amps to 600 amps
-601 amps to 1000 amps
over 1000 amps/volts
-Reconnect Only
$ s0.00
$ 60.00
$100.00
$r30.00
$300.00
$ 40.00
%,'>ts
cq_Temporary Services or FeedersInstallatlon, Alteratlon or Relocation
Bxpiration Date
Slgna ture of Supervlslng Blectrlclan
Owners Name
Address
cl ty Phone
OIINER INSTALIdTION
The lnstallatlon ls belng made onproperty I own r.rhlch ls not intendedfor sale, Lease or rent.
Ovners Signature:
DATB:
D. Branch Clrcults
New, Alteratlon or Extenslon per panel
One circuit $ 35.00
Each Addltional
Clrcuit or r.lith Servlce
or Feeder Permi t /, $ 2.,00 ,/Z
HlscelLaneous (Servlce/feeder not lnclucle<l)
-Each installation
200 amps or less $ 40.00
20L amps to 400 amps
-
$ 55.00
over 401 to 600 amps
-
S B0.OO
0ver 600 amps or 1000 voms see ,Bu affi
Pump or irrigation $Sign/0utIine Lighting- SLimi ted Energy/Res
-
$Limi ted Energy/Comm .--
$
r
40.00
40.00
20.00
36.00
2 SUBTOTAL OP ANOVB
5Z State Surcharge
TOTAL
/-> aae --
1. ,/e+a!-/4NECBIVBDBY:
5
//zr 5rz tq* *.
^ ?'2^-&z ?
C'TY OF
SI'TIINGFIELE,
?ie
1
225 FIFTE STRBET
SPRINGFIELD, oREGON 97477
INSPBGIION REQIIBSTz 726-3769
OPPICE: 726-3759
OF
Permi ts non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
Constr Contr. Number 'b:o-=>3(-
Expiration Date r.c\t.\*a
Signa of Supervi Electrician
BLB TRICAL PERilIT APPLICATION
City Job Nunber
3. COI{PLETE TEE SCEEDUI,B BELOS
A. Nev Residential-Single or
c
MuIti-FamiIy per dvelling unit.
Service fncluded:
Items Cost
1000 sq.ft. or less $ 85.00
gach additional 500
sq. ft or portion
thereof $ 15.00
Each Hanuf'd Home or
Modular Dvelling
Service or Feeder $ 40.00
Temporary Services or Feeders
Installation, Alteration or Relocation
2. C0NIRACIOR INSTALLATION 0NLY B. Services or Feeders
Installationr Alterations or
EIec t r i cal Con t rac t o r }t\_s=S:3( Es_-qI Fr:r(_ Relo ca t i on :
Address \nto \s.'>Ss 200 amps or less
201 amps to 400 amps 1il
401 amps to 600 amps _
601 amps to 1000 amps_
0ver 1000 amps/vo1ts /
Reconnect Only
Ci tytt eiSg=* rsr-SPtrone\\:bl$
Supe rvisor License Ndmber 3\D\:
Expiration Date ro\r.\r*
$ s0.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
Sum
rcd
oO
o*
above
not included)
40.00
40. o0
20.00
-@
200 amps or less I $ 40.00
201 amps to 400 amps _ $ 55.00
Over 401 to 600 amps _ $ 80.00
0ver 600 amps or 1000 volts see f'Brl
Ovners Name
Add
Ci ty hone 5
O}INER ALI.ATION
The installation is being made on
property I or,rn vhich is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
RECEIPT
D. Branch Circuits
Nev, Alteration or Extension Per Pane1
One Circui t
Each Additional
$ 3s.00((
E
Circuit or with Service
or Feeder Permit 8)s 2.00 lLe'o
Hiscellaneous (Service/feeder
-Each installation
Pump or irrigation $
Sign/OutIine Lighting_ $
Limited Energy/Res _ $
Limi ted Energy/Comm $
SIIBTOTAL OF ABOVB
5Z State Sureharge
TOTAL
(
RECEIVED BY:
5 CC)
COM M ERCIAL/I N DUSTRIAL
PERMIT APPLICATION
225 Fiftn Street, Springfield, Oregon 97477
SPRINGFIELO JoB NUMBE " ?/aaao
INSPECTION LINE: 726-3769
OFFICE: 726-3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:/7 3d V IAX LOI:?oe-,
4tf-PHONE:
Ezlqdz/e ztPo.z
'T-
e24 (STATE:CITY:
ADDRESS:
OWNER 'o/r'7 a)
Fls.n ,?ro"r-t)-s
NEW X REMoDEL ADDlrloN DEMoLISH orHER VALUE: fu U:?
DESCRIPTION OF WORK:
pLUMBTNG: .Z*teu ' ' ' *et/ 30*6Rtl /U.r- /7t/
Z**1 -l
EXPI RES PHONE
7/4 -/42-/
Jo --6c-7/?- z2-/3ELECTRICAL:
o
7?MECHANICAL:4lzdr tz * ,?<te
Ja/7e
4/6LT */e.%:
ADDRESS
,///<tARCHITECT:
ADDRESSCONTRACTOR'S NAME
G EN ERA L:
PHONE
&t;atz- z/7-76ao
CONST.
CONTRACTOR #
NAME
l/*a*a .4crL
H-L a
PLU MBIN G
NO.FEE CHARGE
2A Single Fixture /d.-ze.a
Relocated Bld
(new fix. addtl s
)
Ita'Water Service
ft.2<6
1So'Sanitary Sewer
fr.-z<- -i
/88 Storm Sewer
ft.^r<-
/Backflow Device /2-"./2-ao
TOTAL PERMIT 7/5-*
MECHANICAL
NO trFF (:HA NGF
L/Furnace/burner & vent
< 100,000 BTUs Z 7/*
Furnace/burner & vent
>100,000 BTUs
Floor furnace and vent
Suspended wall or f loor
mounted unit heater
Appliance Vent
separate
Stationary evap.
cooler
/a Vent Fan/Slngle
duct 7*?-2'
3 Vent Sys
from AC
tem apart
or htg.1tu /2.-*
Mechanical exhaust
hood and duct
Permit lssuance $10.00
TOTAL PERMIT 77.€a
-o EU
f2 7'/Y
z*s
QUAD AREA: ]P Nrr-)
* OF BLDGS:
LIGHTING POWER BUDGET:
WATER HEATER:
HANDICAP ACCESS:
FLOOD PLAIN
ZONING* OF UNITS:
LAND USE
CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
* OF STORIES:
VALUE$/so. FT.SQ. FT.dTaa ,,/am^^aX
x
x 72 soa
SQ. FTG MAIN
SQ. FTG ACCESS
SQ. FTG OTHER -- 7
TOTAL VALUE OF PROJECT <4+4OO
€ afi.aa<<*
7 -/6 -2/47.
BYP
753' U/
BUILDING PERMIT // sq,79 PLUMBING ?q*DEMOLITION
5% State
Su rcharqe s7,q?5% State
Su rc harge /€.7,ADrrrro--oz 2 ,rt* -Zge
MECHANICAL 77P FENCE
VALUE $<.-o /#-"72/
5% State
Surcharqe 3.gb SIDEWALK
FT.
SUBTOTAL
PEBMITS 220 /. a7
PAVING /)62.4 CURBCUT
FT.
SYSTEMS
DEVELOPMENT 75tuoo
TOTAL PERMIT FEES
EXCLUDING ELECTRICAL
/*,yhz
\7 REQUIRED INSPECTIONS V
It is the responsibi lity of the permit holder to see that all inspections are made at the proper time. To reguest 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 7:0O 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
made after excavation, but
prior to setup of forms.
V UNDERSLAB PLUMBING,
ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
/ FoorrNGS & FouNDATToNS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
in place but before any
concrete is placed.
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing.
POST & BEAM: To be made
prior to installation of floor
insulation, decking or floor
sheathing.
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.
ROOF SHEATHING AND
NAILING: Prior to installing
any roof covering.
ROUGH PLUMBING,
ELECTRICAL &
MECHANICAL: No work is to
be covered until these
inspections have been made
and approved.
ATTIC DRAFT STOPS &
CURTAIN WALLS
FIREPLACE: Prior to placing
facing materials and before
framing inspection.
FRAMING: To be made 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 mechanical are approved.
V___A- INSULATION & VAPOR
BARRIER: To be made after all
insulation and required vapor
barriers are in place but
before any lath or gypsum
board interior wall covering is
applied.
FIRE & SEPARATION WALL:
Located and constructed
according to plans.
LATH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
interior and exterior, is in
place but before any
plastering is applied or before
gypsum board joints and
fasteners are taped and
f inished.
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.
CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
v
^
PAVING: After gravel is in
place but prior to placing
asphalt or concrete.
SPECIAL INSPECTIONS: ln accordance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Owner/ Contractor during
construction of the following work. A
copy of the special testing reports shall
be furnished to the Building Division.
A STRUCTURAL CONCRETE: In
excess of 2500 P.S.l. (306 a.1)
9
STRUcTURAL WELDS:
Performed on the job. (2722 I)
X HIGH STRENGTH BoLTING:. During all bolt installation and
tightening operations. (306
a.6)
SPRAYED ON
FIREPROOFING: U.BC.
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork. (306 a.11 &
Chapter 29)
cLU-LAM BEAMS: tnspection
Certif icate by an approved
agency, furnished to the City,s
Building Division before
beams are placed. (2501 U.B.C.
STDS. 25-10,1'1).
STRUCTURAL MASONRy: (306
a.7)
*ln addition to the inspec-
tions specified, the BuildingOfficial may make or require
other inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
FINAL PLUMBING
FINAL ELECTRICAL
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
SITE PLAN REVIEW BOARD: Must be requested 2 days in advanceof the date you wish inspection. All project conditions such aslandscaping, parking lot striping, etc. must be completed beforerequesting this inspection.
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 aCertificate of Occupancy has been issued by the Building Divisionand posted on the premises.
ADDITIONAL COMMENTS
PLANS REVIEWED BY DATE 2 -2-
By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all informationherein is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinancesof the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCYwill be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employeeswho are in compliance with ORS 701.055 will be used on this project.
Signature Date
1 4r d -2.
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VALIDATION AMOUNT RECEI
RECEIPT *:RECEIVED BY:
DATE PAID: