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Home My WebLink AboutPermit 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 P i,II G H 4p () Qo -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 tl T tr I l( x u