HomeMy WebLinkAboutPermit Building 1983-03-30..RESIoE-rtTIAL
2zs ltorth rrn r ron"aPPLicAT
r,N /PE,lttY
Spz.in4field, )regon 97477
Buildtng Diuision
7 26-37 53
SPFIINGFIEI.D
Date
-,e
5-5ffiJob Loccticn:
'", * \t\ CvL 3 i z4 t tSO) yc,z r,ot tAesessore
Subd.Ju.)sicn:
*;net:
Ad&ess:
Oru
Desct+be h'otk:
Vaiue
l-t )lqs
iate of App Liea!icn
lCditicn
RattoCeL
cereral L)lllf O .Atrt t Lt A 0-A)
I ElectrLccl
I q^^t-;-^t
I tt6Y.u,.Lc;b
, Plutttbinq
Dil.toLnr0!! 0R :icw)
Sanitary seser ccp?ed:t prcperz:; Li,ne
Septic totk pu:ped a,rd. filled aith graizi
Pinal - il4ren abcue itens ue ecr.toletei
anC uhen lenclittor- is :crwLe=e -cr st:-;:-
tuye naued aC cre:t:.)ses cleened ,ap.
Blocking otd. Sex-:tp
?Lunbing eonnect:icns -- sclto? al, utaler
Final - Aftet:crekes, skTrting, deci-s,
etc. @e ccnpleted.
Electr-,lccl Cmnec',ion - Blcckir4, set-ut
and plmbing conreeticns naist be qprcued
before requestin4 e! ec*-rical inspec'-ior:
Aceessot 3- Suiliin4
?qe1of2
I_2 ia lhe resgoncibility of tla petmit itod* to see -,hat aLL inspections, @e nade at )he proper t*n€, ir.at e-ch :C.lness is rea;a'c1.e
;'ron tiu stteet' anC titat the penrtt card. ie l,ocaled at the frcat of the atooetiat..3ui4ir4 )iviciot c1proz:eci plbt sitc,Ll yenain on the Buildnng S[* Zx eLL' t--nes-'
P!??EDaPg-104 litsPrnrcil.E:1\ES?;CALL726-3769 (recorCet) state yottz, City .Tesigra,ted job rum,ber, job aCitess, type of inspec=icnrequested atxi ahen ilou -uiLL be reatiy for inspection, cont?actcrs oi Amers r,cne Lrd. ptane nznbet. ,Pequesis rcceit:Zd b-efcne'7:00 c:t>iLL be nade the sane dcy, vequesta mc<ie aft* 7:00 olt viLL be raCe the neet -"nrking'dcg.
?\F3hT
Cons jllcJ2cdJeruie!_
c;aF ?rcri-ar^tr.
s;Aciary b"r
To be nad.e after
pricr tc set up of
Your CitA Desigra,ted Job Nwrber Is:
i tv* S ULAT ID N /v APO P ts AR R Ii R Ilt S?! C? IC N
To be nade aftez, aLL insulaticn ed.
requtred uqor bavie?s de itt olace
but before ag la.th, Wpsrn bcatC cr
ULL coueting is cpplied, cnd. beforeay insulation is eoncealeC.
DRYilALL iNSPgClrc!: Tc be nade
after aLL aryuall is in pl.ace,
but prior to any taVirq.
l,!AS1!lRI: Steel Location, bond
beans, grouting or uerticcls in
a,:cor<iotce,,nth A, ts. C, Secticn
2415.
After irxtaliation "Js
forms.
uitDgRSLt B :LL,!.B !:tC, ZLIC?RIC,|L IlttWna
tnrk i,s ccuerei.
PC)lIilG 1 ?AUilDAiiCil: ?o be r,aCe
aiter trencites a?e ezcanated at,l,
fcrns are etectei, but priat to
pouring ccnciete,
- u UDZRc?.a u:to ? tt;!tz_!4.2_Stgt2_!!r ! i,j
Lir4 cretches,
71 utwpvacl? ?iiJ:si:tG LylCllAtrCAL:tt@oi
fuoor insuk;ion o" Cecking.
A Pcsr *to uau: To be naCe prior lc, , ffiGr,Tci !-Loor trsu':,aziaz or
Ceckittg.
:ct.t1:: ?:iltE!:tG, !:i3:PICAL I ;.!!CX-
w:ttl ;kese ir"sceclioz:s hatse bo-et:.
naie ard :ccrcneZ.
i I FL:fPI;:li: Prtor )o :iccira ccctnoi I nc'2i;G and, befcre ir**i tnrpnb-
lion.
V .tzq::ilc: lktst be recuecteC cfler
iJ @aL cf rcugh pltr:,bing, electrt-
cal I nechanieal, ALI rooilr4
brac"-nq 2 chinmcys, etc, tr"tsc be
. cotryLeted. ,'lo ,;crk is to be con-
- cealed uncil this inspecicn l,a.s'been node enC aVotct;ed.
i,tocDS?c'n:ffina.
CUPB & .APPPCACII .A.?P.ON:
'*e ez'eeYeC but ot--or
Ai'tet fornsto pa,n )ng
co?1,2?ete.
SIDSilI.LZ & DRf;,TiAI: Fot, aLL cot't-
crete@-;l;E" s c?eet night-
of-tcy, tc be naCe a1'!zr all- exea-
ratina conolete & fotn ,,:ork 3 sub-
base rctetial in place.
I
rI
IIIIAL PLU:{BI:IG
FI;IAL :{EC1|AIICAL
?TIIAL ZLECIPICAL
!!NCE: Hhen conplate -- *cuiie
gates o" nouable aectians through
DIIU
- :
ALL projecx ca.iilions, suck cs the;-.nsrallaxicn cf street i?ees, 2aryleiion cf ;ne
required Landsccpirg, ctc., rilst be satt siied belcre ike eUiLDI;iG FI;'IAL :cn be requested.
|INAL W|LDII1C: (he Fincl Buildlr,q b.soecticn rast be requesteC eller the lizal Plunbitq
\_/ Ileccrical, cnc. :tecitar.iccl insTeccions h,auc been naCe ard tterouzc.
'ALL !4AIIHCLAS AllD CLEtttCUTS l!US? BE ACCESSISLE, .4DJUS7:!i:it lO 3E:.i^,DE !1.y !10:35? TC CI?y
M..-Bb*r\fi.dS
T
u
tr
tr
Tote:
tpt Sq. Ftg.
1 of Lct Cooerage
! of Storles
Total lleighx
?opography
"t
Stcte Swcianoe
s
Perw[t fesuotce
l4eciuniecl ?eomt
SOLAR -CESS REQ..
f n4 4w?
_ Interior
_ Cormer
_ Panitandle
Cul-de-sac
)-aa I
L-co d
tseitcons:
Reeeipt #:
Electricol Permit
l{het,e State La,t requiz,es tl.at the eleet*ical uork be done by an lleettical
Cont?eetor, the eleetrical portion of this permit shall rat be oaliC until
the Label lus been aigned by the Electz'tcal Cont"acta?.
Mechqnicol Permit
JOB NO
Lot laces -ineto,t Sources
leet
Cd?doe A.:eess.i/ata,! iacte"
ilor*-n ?an€e
llest
-- lees --
Mt.t Fvc :(VaLue Building Vtllue & Permit
This pern:-t is granted on the etp"ess condlticn tlwt the said-constzaciion
slall, in ail reseects, confcrn to the 3r4ittance cdoated. by the CitT cf
Spr'.ryfield, tnclding the ionir.g CtCinar.ce, r'egulctittg tke ccr.stt'.tct")cn
ctd use of bu:-Ldings, and ney be ;usperuieC oz, reuckei at cn-, t1-ne u?cn u't-c-
Lc.:icn cf zny prcuisions of saiC Crdirances.
?O!.11 VA.LUI
Zuild:,ng Per*t t
lotal Cl"anges
- I :..!C.Ai'ra Plumbing Permit
No perecn shtll constzuct, instal-!., a!,ter cr elwnge cng ned cr esistir,.g
plwnbin4 cr drainage systen in:,siale or in part, unless such person is tle
Legal possessot, of a ualid plwnber's License, eecept that a petson na"1 do
plrnbing aork to p?opert! ahich is otmed, Leased or operated by the c7pli-
cant.
!i.x;z*es
Resi-Centi.a.L ( 1 bcth)
Seuen
Plunbing Perrit
State Suteharge
I .'io. | .rtg
Res. So. ftc.
ll a,t /Extend, Circui ts
laflocvdPu Sezn)Lce
3t ).oo
oo
CiiARCE.:J
?.prace ?TU'S
Ezhast HooC
Vent lat
'rlcocisto:le
-- a:lcF.cAC:it5:t! --
Sectz-)tu Deccait"
Stotzoe
l4aintencrce
Petnrr|t
t. nc?,re3
u.3'.1
i?TAi t"\!1ul? DUE:.
P LC.L L-ianLvl,er
I HAW CAREFULLY lX,LAfilED the eompleted eopllcation for permit, cnti do
hetebg ceriiiy that aLL ,Lnfotnation het,eon ls t?ue and. correct, aml, f
fu":he! ce"tl7'r- ihat any ard aLL uork ieriortted slull be done in aceor-
dance vith the ordinanees of the cttg of Springfield, anl. ;he ict;s of the
State of 0regcn pertaining to tl".e wrk CescribeC herein, ctd. :itct N0 1CCU-
PAIICI '"raLL ba na.ie oI' dlA st"uctule aithout permission of the 3uilding Di-
uisian. i furthey, ::ertifg ths.t ottly ccntl'cetora and etplcgees t':'t"o ;r2 in
ccnplianee al.th CRS 701.055 uiLL be used on *.his prcieet
!,tobile llcne
s
Date
a
-TAie--
8 03
Cceuoancu Croup:!';oe/Cor.sc:
,r
?enee
t
INSPECIION I.INE
726-3769
CtTY OF SPRINGTIETD
:OMsINAIICN APPI.ICATION / PERMII
Addre
Dercription '3
Accerr.
ES
5q.
e
EN€RGY
Heo t
New-Add
-Aller
Other
n9e I Ure
Owner
Suilding Permit lnfo: De:cribe Work (i.e., Build Single
of Work:
Fomil
oo0,o9
dGoAddrerrcPhone
(^?
PhoneAddrer
(oddress)(lics. no.)DESIGN TEAM no mQ,
Pti {7 t
ttSlructurol
Ele<tricol
l(Mechonicol
CONTRACTORS (oddress) (lics. no.) (exPirer) (phone no.)(nomc)
tt
It
Ele ctri col
FEECHARGE
Me<honicol
MECHAN ICALPtUMEINCEIECIRICAt
CHARGENO.I lrlNO. r i rEE I CHARGE
furnoce/burner to
--ETU'T
l0,q ResidcDrs of
-sq. ft.le fixturc
w
!ta
Applionce vent
5epq ro te
Nlw circuits. olterqtions
or exten:ions
Relocoted building
(ncw fir. odditionol)
Slolionory evop.
cooler4A(*11 )'4\9asERVrcEs a&a.mp5.F. Reriden5e
(l both)
Vent fon with
single duct
I
Temporory ConslructionDuolex (l both) eo<h
Vent syslem oport from
heoting or A.C.
-+
Aciditionol both
Mechonicol exhourl
hood ond duct
Ampr.+
Woter tcrvice
Wood rtove/ heoterSewer
I
Heot PumpFEED ERSSbr-m Sewcr
Air hondler to
r0,000 cfMAmpr.
Air hondler over
10,000 cFM
tssu{NcE oF.P€RMIT
WHER.E SIAIE tAW REOUIRES rhor rhc Elactricol work bc donc by thc Elcrtricol Conlrscro?. thc clectricol portiorr oI lhir permil rholl not bc volid until o
lobal ho; bcrn rigned by on Etactricol Controctor ond oltoched to thc cleclricol ponel.
I HAVE CAREtULI,y EXAA{INED rho completed opplicotion for permit, ond do hereby cerrify thol qll informotion hereon is true qnd correci, ond I further
Gertify thot ony ond oll work performed sholl be done in ocordonce with lh
pcrtoining to thc work dcrcriixd herin, ond lhol NO OCCUPANCY will ba mo
ccaify rhtt my regirtrotion wilh lhc Euilder's Boord is in {ull force ond effect o
heron, ond thot only rvbonrqctors ond employees who ore in omplionce w
e Ordinonce: of the City of Springfield end the Lows of the Stute of Oregon
de of ony rtructure without the permirsion of the Building Divi:ion. I further
s required by ORS 701.055, thot if ex.empt the bosis for exemplion ic noted
irh oRs 701.055 will be usd on rhir pro[ecr.
TOTAT CHARGES/0.o9
SIGNA I TE
4r5tc'9 IOIAT CHARGESTOTAT CHARGES
Bosir for Builder'r Boord
NAA{E (plcorc print)
Frs.orhe,_iorl_ro.r#iifr ;rF@
Typc/ Conrr.
lood
--5q.
c,orp--P3--sq.Fir e Ftg. Acce::
ts 7r rfr Sq. Ftg. Moin
Flood Ploin
Zone x ----Volue
x Yolue
#67,*Syrremr Development
Choroe ( | .5?'o)
PIon Ck, Comm/lnd
65%/ Blclq Per Fee
Plon Ck. Rer
3o%/BIdq Per Fee
BlJItDING PERMIT
Chorger ond
Surcilorger
32::-t.?9
t
rtl>La.b..l reCFence 2ql, 75Totol Comb. PermitDemo
PLUMBING PERMIT
Chorges ond
Surchorgcr
/o,oA)
lla,3JSidewo ik
,d/C Pqvinq
ETECTRICAT PERlvllT
Chorger ond
Surchorges
r\ 0Y
,, \)v
4677Curb Cut
TOTAT
MECHANICAI PERMIT
Chorger ond
S ur <ho rge r
T. Cto ril l(rane e/r
Con*tuction tendct fi/t 0' A Q-
-
-
(e x pire: )(phone no.)
f)r, tt
NO.
"5,ry
FOR OFFICE USE ONIY
,1.@*ffi'E*a,
o
COMBINATION APPLICATION/PEx....r (CAP)
l. Appliconr to furnish
A- Job Address
B. Legol DescriptionI. exomple-tox lot I00, Lone County Mop Reference I7 03 43
2. exofr;E-Lot I. Block 3, 2nd Addition ro Springfield Estotes
C. Nome, etc. of owner ond construction lender
D. Energy Sources
'l . exomole-heot/electricol ceiling/or forced oir gos
2. er o-;;]E-w o t e r }6te rl?EIIri io I /or solor
E. Squore footoge or voluotion, etc.
t. 9ry!9-!150 rq. foot house, 500 sq. foot goroge
2. exomF'iE-iTEw proiect, check-new-if oddition, check
odd, etc.
F. Building permit informotion:
l. exomple-construct single fomily house with on ottoched
goroge
2. exomple-remodel existing goroge inlo fomily room
3. ex#FG-convert single fomily residence inlo
restouront (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construclion deloys, Building Division
Sloff mus, be oble to contoc, oppropriote persons regording
design informotion or iob site correclions, etc.
ll. Ab6ievioted Plumbing, Mechonicol & Electricol Schedules
A. Except where blcnk spoces occur in the description portion
of the Mechonicol ond Eleclricol Schedules, the opplicont
need fill-in only the No. Boxes odiocent to the oppropriote
. ilem(s) to be instolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Division
'1 . To conserve spoce on the permii form the schedules .:
hove been obbrevioted
2. lf the item(s) to be instolled ore not covered on the obbrevi-. oted schedules you should consult the full schedules
C. BUILDING OTVISION STAFF WILL FILL OUT ALL FEES.AND
CHARGES ON THE SCHEOUtES
lll. Applicont to sign ond dote
Whenever possible. the iniiiol opplicotion will be used os o
worksheet only. Where possible, Building Division Stoff will
prepore o lypewrilten copy ond return it to the opplicont ot
the time the octuol permit is issued for his signoture.
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the time of the opplicotion,
ond no plons will be processed until these fees ore poid. All
other fees ond chorges ore due ond poyoble when the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CCNDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit Clerk
PERMIT VALIDATION
I
Additionol Proiect lnformotion:
PLANS REVIEWED BY:
nome signolu6 a.," S-Zb'196t
INSPECTION IINE
72(..3769
F{CIIY OT SPRINGTIEID
COMsINAIICN APPI.ICAIION / PERMIT E-lil INfOTMAIION TINE
1264753
ES,
qf:
c
Lil?of Work:
Permit lnfo'
ence
AQ-
(lic. no.)aei
I
+-
OO
Phonec
Phone
(no.)(cxrers)
17
ooo
EN ERGY
--Demo-Chongef ure
Heot
leqol Dcrcriorion
dterr
Ow ner
Addrarr
8ui
Fo
Add rc rr
De:cribe Work ii.c., Build Single
Amoched
R
_., _Fence.
-6*.,
Sq. Ftg. Motn
Sq. F19. Olhct
-New-Add -Alter -ReP.
Pri
l(
(nqmc)no.)no,)s
CHARGE
II
MECHANICALETECTRICAT
t7ENO.
PlUr,{BING
FEE
Er FiE i CHAR CHARGE
€lecrricol
Machcnicol
iurnoce/burner ioReri&ace oi
-sq. ft'({)c)ctfixturc
w
Applionce vent
geporqle
...'lF.lt*lt"
sllerolioni
or exten5ign!Relocqtad bvilding
(ncw {ir. odcjitionol)d/\9 Slotionory evop.
ccoler^Ec{rx )-sERvrcEs a&4',w,ool
Vent fon with
sinqie duct
I
Temporory Contlruction
Vent sy:tem oport from
heoting or A.C.
Duolcr (l both) coch
Addilionol borh
S.f. Reridcnco
I bqrh)
Mechqnicol exhourl
hood ond duct
Ampr.
Wol.7 rGtvi(G
Wood slove/ heoler
Scwar
Heql PumpFEEDERSStcr.m Scwcr Air hondler ro
r0,000 cFAAmpr.
Air hondler over
10,000 cFM
ISSUANCE OFTPER,\AII
TOTAT CHARGESTOTAT CHARGESIOIAL CHARGES
SIGNATU
I E
rhirof rho nol volidbc nrilu oclcctricolrhcthecolElcrtriConlrocror,porlion pcrmilbaworkdoncEOUlhoIRESthcElcttricolbyEREWHAfl,LAWIE loolloched olertricol,hconc pcnel.<ol Conlloctotdn9qnE lc <rrihorlobolbybon!;9
CAR EfULLY
de of ony
s requireci
ond ond furtherollhereooinformolioniruecottecl,l5hereGerlithotforcoliononddobylyEXINrh?ED oppli parmit,H VEA compleied td lheond ofLows Stotethe oftheofof Oregonthewithrdino nce so City Springfietndoneocordonceshollbetndollorkthope rformedsnycGrtify rhe theof Bu Divirion.furiherwithoulttrucluroIdingpermirrionbewillmdNOtholOCCUPANCYherinndoCc:criixdthcworklornrngP"rto noted70roRsthoiifbothettfortrs.055,ax-empl exemptioneffestbylnondf ull forceEoordSuilder'rnrtroliorhrhc,hot m Y ac9le.lify .055701 ill usadbe no thisoRs proiect.irhorewholnndemplioncerb6ntrosiortioyaesemP
/0,09 g.rg
NA,\{E (plsorc print)
heron, ond thot only tu
Bo:ir for Euildc/r Soord ,
FOR OTFICE UsE ONtY
TOTAT VATUA
xFire
-f t'n sq. Fts. MoinType/ Conrl.
Ftg. Accesrccy Lood
5q. Ftg, Other
Zone
Flood Ploin
x
--Volue
x Yqlua
5y:tems DcveloPment
1.5
Plon Ck. Comm/lnd
I Per
3€,30"h1 Per Fee
Plon Ck. Rer
.tn
ID4aL
ITotolComb. PermilDemo
'-- o7',--
t \n,73ito2;, hi
SidewolkI /-'^, '.
L_-_' - --I r -.
PTUMEING PERA.{II
ICAT PERI1IT
BIJIIDING PERMII
Chorger ond
5urcl,orger
Chorger ond
Surchorger
ond
el
.17 .16. 'i
Curb Cul TOTAT
NICAT PERMII
ond
OESIGN IEAM
tt
No_
-BTU'T-+
v
f\0
COMEINATION APPLICATION/'
l. Appliconr ?o furnish
A. Job Address
PL.ANS REVIEWED BY:
&-
PEh. . .. r
/ Ire\ - PERMIT VALIDATION(cAP)
B. Legol DescriptionI. exomole-tox lot l00, Lone County Mop Reference l7 03 432. exfi;r.-Lor I. Block 3, 2nd Addition to springfierd EsroresC. N"If!il"f owner ond construction lender ^ tD. Energy sources
svrrJtl uLrrerr '' , L t T Y
l. exomole-heot,,electricol ceilinq/or forced oi t
Z. exo m o I e-wo re r heo ter,. electri co l,ior-T6lE7--
e. sqroE rilioge or rolrorio ' -' -:=- .I. exomole-1250 sq. foot house,500 sq. foot gr in,
2. exoEiiiE-iTlEw proieo, .t'".[ .,Ei-ii odditio
odd, erc.
oF SPRINGFIELD (
CirY Holl
Springfield, Oregon
o"oJ-"ir of Public works--brFtclAL REcEIPT
No. B 56s82
F. Building permit informotion:
I. exomole-construct single fomily house with o
goroge
2. exomple-remodel existing goroge inlo fomily3. eEtnoj-e-convert single fomily residence into
ffiTEnt (chonge of use)
G. Volue of work os defined in Secrion 303 (o) of th
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTCRS
To ovoid design or construciion cieloys, Building E,Stoff must be oble to contoct oppropriote p..ro.r,
design informction or iob site corrections, etc.
ll. Abbrevioted Plumbing, Mechonicol & Electricol Sched
A. Except where blcnk spoces occur in the description
of the Mechonicol ond Electricol Schedules, the op1
need fill-in only rhe No. Boxes odiccent to the opp
item(s) to be insrolled
B. Full Plumbing, Mechonicol, ond Electricol Scheduler
ore ovoiloble ot rhe Building Division'l . To conserve spoce on the permii form the schedr
hove been obbrevioted
2. lf the irem(s) to be instolled ore not covered on t
oted schedules you should consult ,he fuil schedu
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES /
CHARGES ON THE SCHEOULES
lll. Applicont to sign ond dote
Whenever possible, the iniriol opplicotion will be used oworksheet only. Where possible, Building Division Stoff
prepore o typewritten copy ond refurn it to the opplicon
the time the ocruol permi! is issued for his signotuie.
lV. Feer ond Chorges
Plon check fees ore due ond poyoble ot lhe lime of the oond no plons will be processed until these fees ore poid.
other fees ond chorges ore due ond poyoble when ihe pe
is issued. f-
V. FOR OFFICE USE ONIY
(
-L
9o,
)rti
I
5
o
Amou nt Rece,ived
Permit Clerk
(
(
BY
^UThORIZEO
SIGNATURE
EUGEI€ oi 97'Ol
(
?ROJECT CONDTTIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additionol Proiect lnformorion:
nome o signo dote - zb- lq 8t
(
(
I
t'
SXELlot'turi!uLL PirilERS'
I9n