HomeMy WebLinkAboutPermit Building 1987-04-17IISP ECT I
?5-37 69
0il L IiiE -l{ Lr,riCOMBI iI RMIT 7?6-37'>a
1AR
APPL I CATI
i pti on 0 /300
S .1,.i
l-l
eI ;)
" Gen e
Phone a s
23A
Job Address
l-ega 1
0wner
ol
€qn
c"k
Sq. Ftq. ot1_". ---_l
_tlew_Add XAiter_-[Ep.
_Fence_Demo_C ha nge/ U se
0ther
F
nq
R
I o a e
llater Heater Gqs
n
L
u llo rk S ngiecl
I
Sq. Ftg. Access
Ftq. l.iain
Val ue of l,lork
e rnt
esid crt
EIIERGY SOURCES:Heat 4 t1 s
Ranqe
o: Desth Atta
Constructi on Lender nfl,r){ {rro', niua\tr ril s t?ern qs Por Seir,d./)
.\ddre s s Phone c-st5
name lt/t addres s I i6s. no
Pri ma
S t ructura I q€tq
El ectri cal
l'lec ha n i ca I
CONTRACTORS n ame address ){exoi res )(phone no.
Genera i e <.'-J L b
tri ca I
anical
PLUI1B I NG ELECTR I CAL MECHAN I CAL
Each single fixture Residence of
SQ. FT S
furnace/burner to
BTLI
Relocateo buildinq
(new fix. additjonal )ore sions
New ci rcui ts al ts Fl oor furnace
and vent
s i dences
SERV I C ES
Duplex () bath) each
Additional bath Temporary Construc ti ol Apol i ance vent
l,la ter Cha e in existing Stati onary evap
Sewer multifami)y, comm or I le
Vent f an l.ri th
Storm Sevrer 0f
hea
Vent systern apart from
c0r.$1./IND. FEEDERS i\lechan i ca exhaust
I nsta I I /a I ter/rel ocate !/ood stove/heater
-amps.0f
TOTAL CHARGES TOTAL CHARGES
-.,tb
.s>
i s oernri t
RI.IHE S AT ET RL1L.J ESR hatEQU tt he tr e ctr ac r{0 rk be don e na e tc r acE Co rant t0c r het e tec crl abnot rt no fp0auItneethabeenbehaedan
byrignEect ca s0rSby a rend rntu eduperv to Buthe d Di S 0nng
liAilE(piease print)
S IGIJATURE
e
DA
and
of
of
Boa
onI
fy
0reqo
he Bu
Y E het e dcomp a ca o npt)t for t an d doDerm he re rce tb.v t tha a f,fy n 0 Lrrna o ncorrt hereo n rtrnadfucthererthattndaaanytJorkerfo rme sd ha nedonbe ac rdc0 cean ht 0the rd nnaSorefid sce 0 f th endath CngeLaofr^/s tyStheLdfteonDCtarnntoethkworsrdescbedherendantnhatOCAI,s tr CUP IV',l beCYvtucwire ma deLthoutepermSonfot)
Dng s on fu r th r ec rtrd th tasnfy tras t onUreqirrty vri theth Bu derfo sanrcedLffecarequredORS01by055thtacxeemhetbaptsrfotEXCMD0nnUheotedonreandvbconfrorttha Landwhoernpoyeearec0mcnncawiehLDC07005EbesedUnthsectDTo.j
Buxs
x
X
-D
S
0
tns/LO ni ts Value
Flood Plain Stories
0ccy Load
c.y Grou
Access
TOTAL VALUATION
Value
Zone o. Fto. l,lain
l-so. Ftqp/-"itl4sq. Fts
Fire Zone Bedrooms I
VaI
an Ck. Comm/ln Svs
Cha
ve i opmen t
5z)rge 1.1
BUILDING PERI,lIT
Charges anC
5 u rc ha rges z,dz s
3 r F
Re
Pe
an Ck.
B]ls
Fence &.6a Demo
Sidewalk
PLUI4BING PERI4IT
Charges and r
ELECTRICP.L PERI:IT
Charges andSurcharges Y
2z_sa
A/C Pavi ng Total Cornb. lermit /a 7, /z
Curb Cut
IIECHANICAL PERI,tIT
Charges and
Surcharqes t.nt
/5=_
-@ r 0TAL /zz.zz
*-)
O
U'l
ISSUAI]CE OF PFRt,lIT
00<*v
Addre s s
exni rcs
,/2fi
Recessed wal l
Soace hpatpr ^nd vont
/u-,
7
TOTAL CHARGES
sha l ls
s
S
___S_o-fa I
-2-? ''
coMBINATI0N AppLTCATIoN/PERMIT (CAp)
I. APplicant to furnish
A. Job AddressB. Legal Description
1. example- Tax Lot 100, Lane County l'lap Reference
17 03 43
2. example- Lot 1. Block 3, 2nd Addition to
SE7-ingfield EstatesC. Name, etc. of owner and construction lenderD. Energy Sources
PERMIT VALIDATION
1. exampl e-2. examp I e-E. squaiE-T-otao
heat,/el ectrical iti ' forced air gas
solarwa te eater e or
e or val uation, e
II.
1. gll4ole- 1250. sq. foot house, 500 sq. foot garage2. Example-- jf-new project, check new - if aaOition,ElEck-i-dd, etc.F. Building permit information:1. example - construct singie famiiy house with anattached garage
2. glqmple - remodel existing garage into family room3. glqrnpf" - convert singie iaiily"resiAence intoiEsG-urant (change of"use)G. Value of rvork as defined in Sect.ion 303 (a) of theStructural Specialty CodeH. DESIGN TEAI,I AND CONTRACTORS
To avoid design or construction delays, Bu.ildingDivision Staff must be able to contact appropriitepers0ns regarding design information or job sitecorrections, etc.
Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Lxcept Hhere blank sDaces occur in the descriptionportion of the Mechanical and Electrical Schedules,the applicant need fill-in only the No. Boxes aOjaientto the appropriate item(s) to be instal ledB. Full Plumbing, I'lechanical, and Electrical Schedulesare available at the Buildinq Division1. To conserve space on the permit form the schedules
have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you shou.ld consult thefull schedulesC. EUILDING DIVISION STAFF I^JILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must
electrica l contractor for signaturesupervisor. The general contractorto sign the electrical label.Applicant to sign and date
be delivered to the
by hi s e1 ectri ca )is not authorized
I1I.
IV
lJhenever possible, the initiaj application will be used asa.worksheet only. Where possible, Bui lding Division Staffwili preoare a type written copy and return it to theapplicant at the time the actual permit is issuecj for h.issignature.
Fees and Charges
Plan check fees are due and payable at the time of the
appl ication, and no pians wi l l be processed unt.i l thesefees are paid. All other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONLY Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
Additional Project information :
PLANS REVIEWED BY:
name sig na tu re date f,-,/?-€2
Permit applicant exempt from registration with the Builder's Board because:
IiJ
7?6
Oil L L
c0rlBI ilA
UI
APPL I CAT I ERMIT
IAT
/(d-Jl),
I,lECHAN I CAL
Vent systenr apart from
ISSUAIICE OF PFRIIIT
TOTAL CHARGES
-li Li ri
--)
../-,|
I(_3 -b L
.5?
Job Address 1,36 l.),/ a'1 S, {'.|)SOURCES
6'As
'later Peater lt?j
EIIERGY
Hea t
Ranoe
a3a 0 /300l-ega1 Descripti on
'-6.n. G"kowner {)r l 3 .l,uiL T,rc-Val ue of l.lork
#Saaa
5q. Ftg. Access._
5q. Ftq. 0ther
_l{erv_Add l?l ter 1",0.
_Fence_Demo_Cha nge/ U se
0ther
So, Ftg. l.iarn
Addrc s s PhoneO I (*)a I e 'I
Fani
(l
I e
nlli dS ng etacdGa
rnr I
id scrr be l,lork
;2<,yl L uo"r(a e a oL{<
Construct'i on Lender
.?stlDof 6to
.\ddres s Phone F,ts
DESiGN TEAIJ name /t addres s (li6s. no.
add res s ll i cs. no.l-exp i res )
Plumbin
PLUIlB I NG EL ECTR I CAL
Each single fixture Residence of
SQ. FT s
furnace/burner to
BTLI
ocated building
new fix. additionai )or ext ions
New ci rcui ts al ts Fl oor furnace
and vent
I
S. F. Fles i ence
SERVICES Recessed wal I
Duplex (l bath) each
Additional bath Temporary Constructi oI Apol iance vent
l,la ter Chanoe .i n exi sti ng Stati onary evap
I r
Sewer multifami ly, comm. or (jVent f an r.r'i th
Storm Seyrer 0f s
COI4I.!./IND. FEEDERS exhau sti'lechan ca
Instal l,/a l ter/rel ocate llood stove/heater
amp s.0f
TOTAL CHARGES TOTAL CHARGES -..rbI,IHERE STATE LlN REQUIRES Ihat tshall not be valil until the label
Ire Electrical work be done by
has been signed by an Electri
' an Electrical Contractor, the electr.ical portion ofca1 Supervisor and returned to the Bu.ilding Division
'i s oerni t
IlAilE(pl ease pri nt)?S S IGIIATURE TEt-.
fy
any
rd
ORS
YL theN eted ccompap ti f,on r rmD a dond heDCt re rt hat atbv n rmao t hon nereo t ruesnac0rdandfurec t rrthe tcer ttha a nda afyny work oerfo rmed ash dobe ne an rdcco an ce ht eth rd0 n can oes tf CheoDSnr]f tyedndaILtheoawsthfSeteta0reoofonDEartnthetorwokrnqdeschbedrenantdhtOCCCYUPAIItJ1bemadetofrucurethotuthermipeSSoofnD,,the d DiI on fu herrt cert athv tr t o n t hrn.y reg th Bue ed roaBsnfufoercndafectefsaureclred0NS70505b.y tha t f texemot bahe fo r exemD t no teno d her n'eo a thnd taonsubcovranttocndarsoernpwhoyee s rea n comD a nce t h 701 055 be u de no th DTs ec to,l
OFF I
Fire Zone Bedrooms 0ccy Load _ Sq
Flood Plain Stories / }ccy e"oup/"Zi,t/ysq
TOTAL VALUATIONB urrq
S o. Ftq . l,la i n .x Va lue
Value <ZA:>->Ftg .0ther.
tsson/C t
. Ft!. Access
Zone
x Val ue
an ndk. c
1. 5z
eS ys tens
Cha rqe
opnrenBUILDII,IG PERTIIT
Charges anC
Su rc ha rges
___50-f,a_
2,d Pl an Res
Per
Fence i{ c6o
t{ a>
z r_-__.__
' 4;D Demo
Sidewalk
PLUI4BING PERMIT
Charges and
Surc ha rges
ELECTRICAL PENIIIT
Charqes and
Surcha rges
2z-s>
Total Cornb. Permit /a 7. /zA/C Paving
Curb Cut
I,IECHAN I CAL PEPI.l IT
Charges and
Surc harqe s
/-r=_
-@ TOTAL /zz.zz
Prima
Structura I
Electrical
l''lec ha n i ca l
Genera'l
hani cal
?
,/)zor -{rr,;,".f./)
N AMP Dhonp nn
FFF aHAD/:F Nn EFF aunDnr ilo r FFE asAonr
,/?ft
Snacp hp:ton:n/ riont
seoa rat p
.DD,N /e4- 5fr,e ?
distrih foodorc
t
s'I
:
I
I
COMBINATION APPLICATION/PERHIT (CAP)
I. Applicant to furnishA. Job AddressB. Legal Description
l. example- Tax Lot 100, Lane County Map ReferenceI7T3-,132. example- Lot l. Block 3, Znd Addition toSETlfgTietd Estatesq. Name, etc. of owner and construction lenderD. Energy Sources
.-CITY OF SPRINGFIELD
Cily Hall
Springfield, Oregon
D.parlm.nt ol Publlc WorkroFFrcrALiil:'B
6s26:
From jz ,
Address
E. Squa
examo I e-
examo I e-
,iE-T6o:otag
examo I e-
hea t,/e I
wa ter ter
1250 s,
lT-i-ew
, etc
2
e or va'l uati ohr e
ca or solar Received For:r
,/2e
rt ca cei I in or forced air qas
(-t
(;
(r
(-r
rh,r
(F
e
c
examp j e-
aEEaI-add
q. foot house, 500 sq. foot garageproJect, check new _ if addit.ion,-o'z
3..tp
F Bui lding permi t information:1. examo.le - construct single family house with anattached qaraqe
Z. ggry-]C --remodel existing garage into famiiy roomJ. examote - convert single family residence into
.. - restaurant (change of-use)Value of work as defined in Section 303 (a) of theStructural Specialty Code
DESIGN TEAI.I AND CONTRACTORS
To avoid design or construct.ion delays, BuildingDivision Staff must be abje to contait'appropriatepersons.regarding design informat.ion or job sitecorrections, etc.
fUUrgvll-t9a Plunb.ing,. Mechanical, & Electrical SchedulesA. Lxcept r{here blank spaces occur in the description -
portion of the Mecnanical and Electrical Scheduiei,the appiicant need fill_in only the No. Boxes aojiient
^ Io.gh9-aOpropr.iate item(s) to -be instal.l edo. rul I ptumbrng, Ilechanical, and E.lectrical Schedulesare available at the Building Division1. To conserve space on the permit form the scheduleshave been abbreviated ...2. If the item(s) to be installed are not covered onthe abbreviated schedules you shou)d consuit thefull schedulesC. BUILDING DIVISION STAFF I.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 electricaisupervisor. The generai contractor ii not authorizedto sign the electiical labelApplicant to sign ancj date
Hhenever oossib)e, the .init.ial application will be used asa.worksheet only. Hhere possibie, Building Division Staiiwill.preoare a type wr.itten copy and returi it to theapplicant at the time the actuai permit is issueci io" niss i gna ture.
Fees and Charges
Pian cneck fees are due and payable at the time of theapplication, and no pians wiil-be processed unti.l theserees are patd. All other fees and charges are due andpayable when the permit is issued.
FOR OFFICE USE ONLY
L
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-22
BY
F
(F
z.trh+
Z Z ,7'2Amount
Permit Clerk
SIGNA
fuEf ausrtess FoRMs, lNc. (5o3tI2.8r4g
I
III
IV
V
PROJECT CONDITiONS TO BE SATISFIED BEFORE OCCUPAIICY:
rmit appljcant exempt from registration with the Builder,s Board becausePe
Add jtional Project Informat.ion:
PLANS REVIEWED BY
name si da te <- ^-a2Ina tu re
4l !!! PR2PER TrrrE.AT TITE .FRON? OF THE
PRocEDtIRE FoR REQUESTING IIISPECTIoNs: Cal1 726-3769 (recorrler) state you CITy DEST6NATED JoB N{IMBER,job address' tyPe.of inspection reouested and ort"" yo,i will be reedy-t6i tne inspecticn, contractorsor olrners name and phone number. Itequests received'u"t.r"-zldo-Ii-iriii'be nade the same day, requescsreceived after 7:00-am will be nade the fofiowing-roi[ a"y.
Your City Designared Job Number *, 3?22*
Job Address: /b rD
owner, ry< 51€/z> //--< . Phone'-
-contractor:
.,*(t're' f,.vrq) 18'€/€2
SITE INSPECTION:ffiffi-n
made and aPProved.
FINAL PLWBING
u#i
FINAL ELECTR.ICAL
iri
FINAL TG,CHNICAL
To be rnade
, but prior
ING
e inspectio;rs have been
ATTIC DRAFT E CURTAIN WALLS
FIREPI-ACE: Prior to placing facing
materials and before framing
inspection.
INSULP.TION & VAPOR BARRIER: TO bCffind
required vapor barriers are in place
but before any lath or gyPsun board
interior wal1 coveting is applied.
FRAMING: To be nade after the roof,
Ef1-6ming, fire blocki.ng and
bracing are in place and all PiPes,
chimneys and vents are conplete and
the rough electrical, plurnbing and
heating wires, pipes and ducts are
approved.
FIRE & SEPARATION WALL: LOCAtCd &
STRUCTURAL CONCRETE:ffiri. lsIZ alll-
STRUCTUR{L I1IELDS
'il]-:-O7rrT-HIGH STRENGTH BOLTING
bolt installation and
operations (506 a'5)
: In accordance u'ith
ding Code a special
In excess of 3000
Preformed on the
During all -tighting
o
to setup cf fcrms.
T,NDERSLAB PLM.{BING, EIECTRIC.U
G MECHANICAL: To be nade before
any rrroil-l-s-covered.
CONCRETE SLAB INSPECTION: To be
ffirdlng
service .equipment, conduit, piping,
accessories and other ancillarY
equipment items are in Place but l -before any concrete is poured. Y)
F00TINGS & FOpNDATI0NS: To be made
after trEnches are excavated and
forms are erected, all steel in
place, but prior to pouring concrete
INDERGROUND: Plumbing, Electrical,
Gi-Sanltaly sewer, storm sewer,
Water anC Drainage lines. To be
made prior to covering or filling.,.
trenches. \L'
UNDERFLOCR:, Plunbing, Electrical,
friiEfianicai. To be made Prior to
installaticn of floor insulation,
decking or floor sheathing'
iosr E srPJ''l: To be nade Prior to
ffiGirlrlo; of flocr insulation,
decking or floor sheating' '
FL0CR INSULATION E V4POR BARRJERS:
6=SaTia6Efor to instal lation
of decking or flcor sheating'
I'IASoNRY: Steel location, bond beans
;il"ttins or verticals in acccrdance
ii.ttr u.s.c. Secticn 2415'
H'i;Siiiii*;"S'#li*Ii'
inspector sha11 be employed by the onner/
ntractor during construction of the
fcllowing work. A ccpy of the special
reports shal1 be furnished to the
Building Division.
I
w
tr
w
ccistructeEacco-fiing to Plans.
IATH AND/OR CYPSIJM BOARD INSPECTION
6-6;ea;-;Eter-a1 I lathing and
SPRAYED ON FIREPROOFING I
StanCards 43-8)
SPECIAL GRADING. EXCAVATION .{ND
FTLLttlc: 0'uring earthwork. (306
FcII!-ter zs;
DATE
(u.B.c
a.11
is in place
is applied ,
joints and
finished.
WOODSTOVES
c.-pleGal
g)?sum board, interior and exterior,
but before anY Plast GLU-LAM BEAI'IS: Inspection Certificate,
5y an approva agency, furnished to
tire Cityls Building Divi'sion before
beans are placed. (2501-U'B'C' STDS'
2s-10,11) .
* In addition to the insPections
specified hereon, the Building
olfi"i"t naY make or lequire other
insPections of anY construction
,"tl a" ascertain conPliance with
itt" s"ifai"g, CitY or Zoning Codes
or before gYPsun board
fasteners are taPed and
After installation is
SIDEWALK E DRIVEWAY: Required for
.ailf-Errcrete Paving within street
right-of-waY, to be made after all
exlavating tornPlete & form work &
sub-base material in Place'
cuRB .{ND APPRoACH +PRoN' tl:::^fo"';re erecied but Prior to Pourlng
concTete.Prior
PARKING LOT: After grave lisintr)-,Il place but prior to Placing
to be covered or concrete
IS S PLAN BOARD
w1 Sh on.
be completed befcre request ing this insPection'
r1
asphal t
Must be reque sted 2 daYs in advance of the date You
ect t ions such as landscaP ing, Parking 1ot striPing etc. must
B:*i?r#iiq#"#::'o:':"8::: liiilil#i "il:'
atertificateofoccupai;;h"beenilluedbvthe
Plumbing, Electrical' tvlechanical and Fire
OccuDancy of the premises can be T"d" :i::t^
H'li[;;;'ci,ititn' and postcd on the Premrses
""")
*Yil,. ,r*u DEPARTMEITT S
*111 1'6NHOLES AND CLEANOUTS MIJST BE ACCESSIBLE, ADJUSTI.IENT TO BE I,TADE AT NO.COST TO THE CITY
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