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Home My WebLink AboutPermit Building 1988-02-10t I ON LINE scr COHBI 7?6-4, n t n WoPhone Hea Va u€I Ranqe llater HeaterLegal Description Job Address Address Owner Sq. Ftg. Access._ I CAT EIIERGY SOURCES Sq. Fto. Sa.z- 2-1, Construction Lender Addres s Phone N .$ name Structura l Hechan i ca I El ectri ca I PLUt{B I NG ELECTRI CAL HECHANICAL Each single fixture Mrn./5^Residence of FTSQ furnace/burner to - BTU's la tia Relocated buildinq (new fix. additioiat)(/'l{ew circuits alts.or extensions2 aB,.hoBE Floor furnace and vent S.F. Residence(l bath)SERV I CES Recessed wal I Soace heater and vent Duplex (l bath) each t/ Additional bath Temporary Constructi on ance ventApp tlater service Change in existing res i dence Stationary evap cool er Sewer multifamily, corm. or I ndustri a I Vent fan with sinole duct Storm Sewer 0f Vent systern apart from heatinq or A.C. c0Ml'1./lND. FEEDERS Mechanical exhaust hood and ductInstal I /al ter/rei ocatedistrib. feeders l'lood stove/heater ISSUANCE OF PFRTIIT WHERE STATE LI\I.J REQUIRESshall not be valiC until the done by El ectri, tha EI cectri Ithet rkw0 be a E e1 cactri I ethe 1Contractor ectri Ica 'I ofon Sthi tportperm iIIbehabeensslna'|ca I sorbygnedSuperv and rnedretu tto Buihe d'I 'I v1Di Ings 0n Ga,TOTAL CHARGES e>TOTAL CHARGES IOTAL CHARGES l{A!'lE (p lease pri nt ) oermi t rformed C ity made ngfi e struc're permi effect f exempt .055 wi'l Y het comp c at onapr)an d do rtcereb.y n tforma onatfy re0n S truendtc0rrecandcerrtherfutthatfyndaworkashaDCbedoneaccordannWIcetth0rdihenasncetheofofanddSprtheofLawsStheteta any of nloerta to th work0regonng descri hebed re n dan ttha NC OCCU wtPANCY befotuwlretthouthssoofBuithedsnoDrfurthecertthattraontifyreg imy thV'I Buthe der s any rdBoa s n fu force and ulas red ORS ng 701reqby tha t055 ba s forsthe t on notexemp ed hereon and tha tbcsuvanontractorsdarewhoempoyeesnancomcwlceORSth07besedunthsp roj ec re Zone Bedrooms 0ccy Load Sg. ood Plain Stories3 tFa, Z.,Z. Occ.y GroupJE:z,__ ,Sq. Ftg Ftg Ftg TOTAL VALUATIOII . }th""4urr€ 2 tl u^tue,/#,/D Fi FI I lue Zo n e / /4R._r y o e / co ns t.fr/lR :qlJni t s Acces s . t'lai Plan Ck. eormmd- 65%/B1dq Per Fee Z4Z Systenrs Develoonrmt Charqe (1.52)237,19BUILDING PERIIIT Charges and Surcharges -l/-a-f,o an Ck FencePLUI,IBING PERMIT Charges and Surcha rges __/3_::__ Desro SldewalkELECTRICAL PERIIIT Charges and Surcha rges --?:59-_- A/C Paving Total Comb. Permit / 7?. {6 Curb Cut HECHANICAL PERHIT Charges and Surcharges 4> 2u TOTAL 4zo.v4 . Ftg.0ther dArEn a7? Ex7st2l)(sC71.yz3.R^? seDa ra te 91 amps r CITY OF SPRINGFIELD CllY Hdl SPrlngicld' Orcaon Otlice ol Community and Economic Developmenl OFFIC!AL RECEIPT 10923 ( COMBINATION APPLICATION/PERI'IIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. example- Tax Lot 100, Lane County Map Reference 17 03 432. example- Lot 1. Block 3, 2nd Addition to SpFngTield EstatesC. Name, etc. of owner and construction IenderD. Energ! Sources (, Cr 2 /, i) i.) r) (.) o () o o (! d From Address Recerved For: P-n o-D DX 7867 97 6 //c. ua 6a 2?.51,e_ O6-7f, 1. example- heat/2. exEfrEfE- waterE, Square footage or el ectri ca I r e valuat on, etc. forced air gas or solar l. example- 1250 sq. foot house, 500 sq. foot garage2. example- if new project, check new - if addition, check add, etc. f. Building permit information:1. example - construct single family house with an attached garage ?. example - remodel existing garage into family room3. example - convert single family residence intorestaurant (change of use)G. Value of work as defined in Section 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be abie to contact appropr.iite persons regarding design information or job sitecorrections, 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 Djvision1. 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 should consult theful I schedulesC. EUILDING DIVISION STAFF hIILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULES0. As.noted on the CAP, the label must be delivered to theeiectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto sign the electrical iabel. Applicant to sign and date l,Jhenever possibie, the initial application wilI be used asa worksheet oniy. tJhere possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i gna ture. Fees and Charges P'lan check fees. are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY Amount Received /?a.3q II. III. ? ffiEr gusrl:ss FoRMS. lNc ls)92-8r'9 IV v Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAIICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information PLANS REVIEWED BY: date /-27-8Anames't gn ature =t NEL CITY OF SPRINGFIELD COMBI NATION APPLICATION/PERMIT 3753 Job Address R E!,IERGY SOURCES: Hea llater Heater . Ftq. I'lain Sq. Ftg. Access.-. Sq. Fto. 0the I'lew Add A r IGT-[Ep. e , Change/Use N .$ Legal Description lan eZ /7 4'./Y B<aa.-.€- *4a,+*t.z :,.D - >Value of l,lork:/{Azo)wner A"?-rf .h-aF€5*at+zz< 6zoaP Address Phone Buildinq Pernlit Info: DescribE l.^loi[[i.e_Family Residence liith Attached Garaqe) -Build Single 42ry7.Er€ 2*<e -fa.rs 2-X, Construction Lender Addre s s Phone n ss Pri ma Structura l El ectrical o Mechan i ca I name address exoi rpq )ohone no. I umbi n El ectrical I PLUtlB I NG ELECTRICAL MECHANICAL FEE CHARGF NN FFF (.I.,IA PAF Il0 FFF CHARGF Each single fixture Mtn /5^Residence of sQ FT furnace/burner to BTLI ' s Relocated buiidino (new fix. additional)(/liew circuits aits. or extensions2 aR,haBE a.,fc Fioor furnace and vent 5. F. Residence(l bath)SERV I CES Recessed wal I Space heater and vent Duplex (l bath) each r//4 Additional bath Temporary Constructi on Apol iance vent seDarate tnlater servi ce Change in existing res i dence Stati onar.v evap. cool er Sewer multifamily, comm. or I ndu stri a I Vent fan with sinole duct Storm Sewer Vent systenr apart from heatino or A.C. c0Mr'1./IND. FEEDERS i[echanical exhaust hood and duct- Insta'l i /al ter/rel ocate di stri b- feeders I'Jood stove/heater 0f S. iSSUANCF OF PFRI/IIT TOTAL CHARGES cA TOTAL CHARGES TOTAL CHARGES q> WHERE STATE LIII.I shall not be valiC u REQUIRES that the Electrical work be done by an Electrical Conntil the label has been signed by an Electrical Supervisor and tractor, the electrical portion of this permit returned to the Building Division FULL E XAM I comp ap D I ,l c ti on for t-an d do he reb.y ce rt 'I fy t t a 'I n forma t 'I on he reon 1 s L rueand corect, and I further c erti fy of the permi ffect tha t a ny a nd a I I wor k pe rmed s ha I ,I be don e 'I n ac cordan ce wl th the Ordi na nce of the Ll tyof Springfie of any struc I d and th e La ws Sta te of 0reg 0n pe rta 'I nl ng to the work descri bed he rel n an d t ha L NC 0c CUPAI'ICY wl 1 I be madeturewlthoutthe'I of the Bui I d ing 70 nce D 'I '|,lssons on I fu rt he r ce rt 'I fy t ha t m.y reg i s tra t 1 0n uJl th the Bu 1 I der sBoardI'I n fu I I fo rce and as requ 1 red by ORS 0s5 tha t 'I f exempt the ba S 'I s for e xempt 1 o n 'I s noted he reon and tha tonly subco ntractors and ernployees who are in comclia with 0l?S 701.055 wi lI be used on th.i s oroject llAl'lE(please print)BEAE \*rUX\S IGNA' : USE ON \- Tone tr' ?rn. fyoe/Const.*//R. >4)n i ts So. Ftq. l,lai n Val ue Fire Zon Bedrooms Load Ftg. Acce ss x al up Flood Plain Stories j r'-72,2,2. occ.y Group B.?S q.Ftg |therlztrf€4 Val */#/a-- \TOTAL VALUATION---- BUILDING PERMIT Charges and Surcharges _f_/_4 f,o Plan Ck. Comm/lnd 65%/B1dq Per Fee "4.v, Systerns Deve Charqe (1.52 opment ( PIan Ck. Res 30%/Bldq Per Fee PLUI4BING PERMIT Charges and Surcha rges __/3._:?___Fence Demo Sidewal k A/C Paving Curb Cut Total Cornb. Permit / 77. {6 I,IECHANICAL PERMIT Charges and Surc harges ) cru> TOTAL 42o.7., 0f amps ??z=7./< ELECTRICAL PERI,IIT Charges and ,. S u rcha rges COMBINATION APPLICATiON/PERMIT (CAP) I. Applicant to furnishA. Job AddressB. Legal Description1. exampie- Tax Lot 100, Lane County Map Reference 17 03 43?. exampie- Lot 1. Block 3, 2nd Addition toSpringfield EstatesC. Name, etc. of owner and construction lenderD. Energ! Sources PERMIT VALIDATION 1.) Sq 1. 2. exampl e- exampl e- uare footag heat/el ectrical or forced air gas wa ea e ec or solar E e or valuat on, example- 1250 sq. foot house, 500 sq. foot garage example- if new project, check-new - if addition, check add, etc. II. 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 inlorestaurant (change of use)G. Value of work as defined in Sect.ion 303 (a) of theStructural Specialty CodeH. DESIGN TEAM AND CONTRACTORS To avoid design or construction delays, Building Division Staff must be able to contact appropriate persons regarding design information or job sitecorrections, 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 Schedulesare available at the Building D.ivision1. To conserve space on the perm.it form the schedules have been abbreviated2. If the item(s) to be installed are not covered onthe abbreviated schedules you should consult theful I schedulesC. BUILDING DIVISION STAFF hIILL FILL OUT ALL FEES AND CHARGES ON THE SCHEDULESD. As noted on the CAP, the label must be de'livered to theeiectrical contractor for signature by his electricalsupervisor. The general contractor is not authorizedto s'ign the electrical label Applicant to sign and date Hhenever possible, the initial application will be used asa,worksheet on1y. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actual permit is.issued for his si gnature. Fees and Charges Plan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are paid. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE USE ONLY III. IV V Permit Clerk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information : PLANS REVIEWED BY: s'l gnature aate /-27-EAname IT IS THE RESPONSIBILITY OF TIIE PERMIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TI}IE,THAT EACII ADDRESS rs READABLE ERol! THE srRflEr, eun iuar rIIE pERI.{rr cARD rs LocATED AT TrrE FRoNT oF THEPROPERTY. BUTLDTNG DrvrsroN AppRovED pLANs l,flist ne oN JoB srrE AT ALL TntEs. PRoCEDURE FoR REQUESTTNG rlIsPEcrroNS: Cal1 7-26-37(tg (record-er) state-you Crry DEsT6NATED JoB N1MBER,Job address, type-of inspectlon requested and ort." i-o,i will be'r..av-r6i the inspection. contracrorsor olmers name and phone number. Iteqlests,received'u"r"i"-z'oo-.r,irrii be rnade irh. ""re day, requesrsreceLved afrer 7:00'am will be made ihe i"ti."t"i-;";I-;;;. ' "'v' srulw-rr 3PF'{OfELD Your City Deslgnated Job Number Is Job Address: Owner: Contractor: .. P 'quired lnspecti'ns.. ? a ry <-J SITE INSPECTION: To be madeaf6r ex;vatIfi, but prior to setup of forns. I'NDERSLAB PLM{BING, ETECIRICALt-riEeHffie any ;o;I-fcovered. C0NCRETE SLAB INSPECTION: To be ffiiraing service equipnent, conduit, piping, accessories and other ancillary equipment items are in place but before any concrete is poured. FOOTINGS G FOUNDATIONS: To be made after trenches are excavated and forms are erected, all steel in place, but prior to pouring concrete TNDERGROUND: Plumbing, Electrlcal, Gas, Sanitary Sewer, Storn Sewer, Water and Drainage lines. To be nade prior to covering or filling trenches. T,NDERFLOCR i4Ah;Icat e: Phone: 7 ATTIC DRAFT STOPS 6 CURT.WALLS FIREPLACE: Prior to placing facingiltE;iEIE and before iraming , * inspection, INSUI"ATION G VAPOR BARRIER: To be made aftcr all insulation and required vapor barriers are in place but before any lath or gypsun boardinterior wall covering is applied. !3AIII9: To be nade after the roof, all framing, fire blocking and bracing are in place and all pipes, chinneys and vents are complete and the rough electrical, plumbing and heating wires, pipes and ducts are approved. FIRE & SEPARATION WALL: Located G cons.ru-ied-EEoiding to plans. LATH AND/OR GYPSIJM BOARD INSPECTION In accordance th o Building Code a special employed by the Onner/inspector shall be Contractor during construction of thefcllowing work. A copy of the special ng reports shall be furnished to the,ing Division. STRUCTURAL CONCRETE: In excess of 300m;f. -Go6 a.1)- STRUCTURAL WELDS: Preformed on thejob. (2722 f) HIGH STRENGTH BOLTING:During allSolt insEltatid-;a tighting operations (306 a.5) SPRAYED 0N FIREPROOFING: (U.B.C.StanaEa;-as-8I- SPECIAL GRADING, EXCAVATION .{ND FILLING: During earthwork. (306 a.11 G Chapter 29) GLU-LAM BEAIIS: Inspection Certificate by an approved agency, furnished tothe Cityrs Building Division before beams are placed. (2501-U.B.C. STDS. 25,- 10, 11) * In addition to the inspections specified hereon, the Building Official :ray make or requite other inspections of any construction work to ascertain compliance with the Building, City or Zoning Codes. Bui 1d V tr w installation of floor insulation, decking or floor sheathing, POST G BEAM: To be made prior toinstallation of floor insulation, decking or floor sheating,. FLOOR INSULATION 6 VAPOR BARRIERS: To be made prior to installation of decking or floor sheating. I"IASONRY: Steel location, bond beams grouting or verticals in accordance with U.B.C. Section 2415. ROOF SHEATIIIIIG AllD NAILING: Prior made and approved To be nade after a1l lathing and\b i'J sum board, interior and exterior, in place but before any plast is applied or before gypsum boardjoints and fasteners are taped and finished. WOODSTO\IES: After installation is complet ed. SIDEWALK 6 DRIVEWAY:Required for all concrete paving within street right-of-way, to be made after all excavating complete Q forn work I sub-base material in place. CURB AND .qPPR0ACH APRON: After forns are erected but prior to pouring concrete. PARKING L0T: After gravel is in place but prior to placing asphalt or concrete. : , Plumb,Tobe ing, made Electrical, prior to B FINAL PLI'MBING L<A FINAL ELECTRICAL bt FINAL IIEC-I{ANICAL t/,1 FINAL FIRE DEPARTT.'ENT CITYTS SITE PLAN RE\IIEW BOARD INSPECTION: Must be requested 2 days in advance of the date yor suchas1andscaping,p.rii,glotstripin8etc.muSt be conploted before requestlng this inspection. :{ I n FINAL BUILDING: Must be requested after the final Plumbing, Electrical, trlechanical and FireI ^ I Department inspectlons are nade and approved. No Occupancy of the premises can be made untila Certificate of Occupancy has been issued by the Building Division and posted on the premiser SIGNATURE IAt INSP X *ALL MANHoLgs AND cLEANours lrusr BE AccEssIBLE, ADJUSTMENT To BE MADE AT No cosr ro rHE clfi. tr tr tr t3 A N LINE COMB I APPL IT 7? Job Address 7H l-ega.I Descri ption ? Owner EIIERGY SOURCES Hea t l,later Heater Ranqe a Val u€f Cr,F=l,Jo rk F I'la i n Sq. Ftg. Access.-. Sq F tg 0ther llew Ad d A I iEi-Tep. ha nge/Us ther Address tl r/Ph;n{ l"Builciinq Pernrit Info: Describe [,loi[FFanrily Residence l,lith Attachea Garaqd ,e., Bui1d Single FltStst4 Ta >qilr ov**zs Ela Construction Lender P' ^*t?r-r l4, t?i1,Ul- .4ffi8 Address Phone DES I GN TEAI,I name addre s s 'lcs. no-exo i res ohone no- Pri mary u\ Structura I El ectr i ca I * T\ Mechani ca'l s. addn"es s (1ic</ na hres (ohone no- ) Genera I PI umbi l'lechani caI F{_{frlB1fltG ELECTR I CAL MECHAN I CAL N0.FTE CHARGE NN FFF CHARGF I.JO FFF CHARGF /?Each sirnEle ,fixture 73 /osn furnace/burner to BTLI' s Relocatedi hilrtrding (new fix- additionaI) New circuits alts. or extensions Floor furnace and vent S . F. P.es'idle,nce(l bath)SERV I CES Recessed wal I Snarp hpatcr and vpnt Duplex (X bath) each Additional hath Temporary Constructi on Apol iance vent seDa ra te l.later service Chang resid e in existing ence Stati onary evap coo l er Sewer multifamily, cornm 0r I ndus t-ri a I Vent fan with sinole duct Storm Serm 2 ot Q--7a-/#urp,2?",/f Vent system apart from heatino or A.C. COMM./IND. FEEDERS Mechanical exhaust hood and duct Instal I /al ter/rel ocate distrih. feeders !'lood stove/heater 0f amp s.77*< ISSUANCE r)F PFRI1IT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES GE) WHERE STATE Lltl REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pernitshall not be valj'l until the label has been signed by an Electrical Supervisor and returned to the Building Division I HAVE CARTFULLY EXAMINED the completed apnlication for oermit, and do hereb.y certify that all information heieon is tmeand correct, and I further certify that any and all work oerformed shail be done in accoidance with the 0rdinances of the Cityof Springfield and the Laws of the State of 0regon pertaining to the work described herein, and that NC 0CCUPAI,ICY will be madiof any structune without the permission of the Building Division. I further certify that my registration yrith the Builder's Board is in fuil force and effect as required by ORS 701.055, that if exempt the baiis for Lxemfition is noted hereon, and thatonly subcontractors and employees who are in comcliance with 0l?S 701.055 rvill be used on this Droject. E\)2Wl,lAl"lE (p1 ease pri nt )S IGNATURE \DAT F F Zone e/ Const n its Ftg. l'lain x Value_ Fire Zone Bedrooms Load Sq. Ftg. Acces Value F1 ood Pi ai n S tories 9 f RAF.7. Occ.y Grou 6.2 Ftg. 0t Val TOTAL VALUATION BUILDING PERMIT Charges and Surcharges )/2a Plan Ck. Comm/lnd 65%/81do Per Fee /7e, //Svs Cha terns De rqe ( 1. VE 57 opment 722-* Plan Ck. Re 30%/Bldo Pe SrF ee PLUI4BING PERMIT Charges and rSurcharges 5 Fence Demo ELECTRICAL PERI,IIT ----y5=&> Charges and Surcha rges q z.2t Si dewa l k A/C Paving Curb Cut Tota'l Cor.nb. Permi t lsa 7f t.,IECHANICAL PERMIT Charges and :Surcharges \_/ AO -?;TOTAL /r57.a6 Residence of sQ. FT. ue <//j-oa.+7-- __2?_2._- /_4fi_& . COMBINATION APPLICATION/PERMIT (CAP) I. Applicant to furnish A. Job AddressB. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 03 43 ?. example- Lot 1. Block 3, 2nd Addition to Springfield Estates C. Name, etc. of owner and construction lenderD. Energy Sources 1. exampi e-2. exampl e- Square footag hea t/ e cal I In or forced air gas WA ea e ec or solar E e or valuat on, e1. example- 1250 sq. foot house, 500 sq. foot garage 2. example- if new project, check new - if addition, check add, etc.F. Building permit information:l. example - construct singie 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 Structural Specialty CodeH. DESIGN TEAM AND CONTRACTORS 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 instailedB. Full Plumbing, Mechanical, and Electrical Schedules are available 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 onthe abbreviated schedules you should consult theful l schedulesC. BUILDING DIVISION STAFF WILL 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 electricalsupervisor. The general contractor is not authorizedto sign the electrical iabel. Applicant to sign and date I'lhenever possible, the initial application will be used asa worksheet only. Where possible, Building Division Staffwill prepare a type written copy and return it to theapplicant at the time the actuai permit is issued for his s i gnature. Fees and Charges PIan check fees are due and payable at the time of theapplication, and no plans will be processed until thesefees are pa'id. All other fees and charges are due andpayable when the permit is issued. FOR OFFICE UsE ONLY II III IV V PERMIT VALIDATION I 5 1 s0 [(-\1 ' Permi t Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY: Permit applicant exempt from registration with the Bujlder's Board because: Add i t'i ona I P roject Information: PLANS REVIEWED BY: name signatur da te ,//^7-G? .. f_ )quired ln spec { __)n s .- IT IS THE RESPONSIBILITY OF TIIE PERMIT HOLDER TO SEE THAI ALL INSPECTIONS ARE MADE AT TIIE PROPER TI}IE, THAT EACII ADDRESS IS READABLE FRO}{ TIIE STREET, AND THAT TIIE PER},IIT CARD IS LOCATED AT TIIE FRONT OF THE PROPERTY. BUILDING DIVISION APPP.OVED PINNS MUST BE ON JOB SITE AT ALL TIIIES. PROCEDLIRE FOR REQUESTING INSPECTIONS: Ca11 726-3769 (recorder) state you CITY DESIGNATED JOB NIIMBER,job address, type of inspection requested and when yorr will be reedy for the inspection. Contractors or owners name and rrhone nu:nber. Requests received before 7:00 am will be nade the sarne day, requests recei.ved after 7:00 am will be nade the fo1-lowing work day. Your CiEy Designated Job Number Is 9666a? Job Address Oraner:€t.vhone: Contractor: ffi SITE INSPECTION: To be nadeEIt6;;iffiI6.n, but prior to setup of forms. I,NDERSI-A,B PLIN.BING, ELECTRICAL G IIECHANICAL: To be nade befcre any workE-covered. CONCRETE SLAB INSPECTION: To beffirding service equipnent, conduit, piping, accessories and other ancillary equipment itens are in place but before any concrete is poured. FO0TINGS 6 F0UNDATICNS: To be made after trenches are excavated and forms are erected, all steel in place, but prior to pouring concrete TNDERGROUND: Plumbing, Electrical, Gas, Sanitary Sewer, Storm Sewer, Water anC Drainage lines. To be nade prior to covering or filling trenches. TNDERFLOOR:, Plumbing, Electrical, Mechanical. To be made prior to installation of floor insulation, decking or floor sheathing. POST G BEAM: To be made prior to installation of floor insulati.on, decking or floor sheating,. FLOOR INSULATION € VAPOR BARRIERS: To bc nade pri.or to installetion of decking or floor sheating. l"lqSONRY: Steel location, bond beans ffi-ing or verticals in accordance with U. B. C, Section 24 15. made and approved ATIIC DRAFT STOPS & CURTAIN WALLS. FIREPLACE: Prior to placing facing naterials and before framing inspectio1 , $ INSULATION E VAPOR BARRIER: TO bC e r{ith Sec 306 o Bui.lding Code a special inspector shall be employed by the Owner/ Contractor during construction of the fcllowing work. A copy of the special testing reports shall be furnished to the Building Division. AL Utr w E FRAMING: a=ff-Eanin rnade aftcr all insulation and required vapor barriers are in place but before any lath or gypsun board interior wal1 covering is applied. STRUCTURAL CONCRETE:F-lil-Gofi:ll--In excess of 3000 STRUCTUR{L [{ELDS: Preformed on thejob. (2722 f) HIGH STRENGTH BOLTING During all -bolt installati.on and tighting operations (306 a.5) SPRAYED ON F IREPRoOFING: (U. B.C StanCards 43-8) SPECIAL GRADING EXCAVATION .qND LLINC:During earthwork a. 11 e Ctrapter 2s) GLU-LAM BEA},IS Inspection Certificate, by an approved agency, furnished to the Cityrs Building Division before beams are placed. (2501-U.B.C. STDS. 25-10,11) * In addition to the inspections specified hereon, the Building Official nay make or require other inspections of any construction work to ascertain compliance with the Building, City or Zoning Codes To be nade after the roof, ,9, fire blocking and bracing are in place and all pipes, chinneys and vents are complete and the rough electrical, plumbing and heating wires, pipes and ducts are approved. FIRE & SEPARATION WALL: Located & .ccnstructeC according to plans. .LATII AND/OR CYPST'M BOARD INSPECTION To be made after all lathing and g)?sum board, interior and exterior, is in place but before any plasteri is applied or before gypsum boardjcints and fasteners are taped and finished. WOODST0VES: After installation is conpletea: SI!E!A!I_-E DIIILE 4Y: Required for ;il concrete pavfrg within street right-of-way, to be rnade after all excavating conplete & forn work & sub-base naterial in place. CURB AND APPROACH APRON: After forns are erected but prior to pouring concret e . PARKING LOT: After gravel is in place but prior to placing asphalt or concrete.a 8,. a w INAL PLUMBING FINAL ELECTRICAL FINAL IIECHANICAL FII.IAL FIRE DEPARTIUE}IT CITYTS SITE PLAN REVIEI^l BOARD INSPECTION: Must be requested 2 days in advance of the date you wish inspection. A11 project conditions such as landscaping, parking 1ot striping etc. must be conpleted befcre requesting this inspection. l-Xl FINAL SUILDING: l"lust be requesteC after the final Plumbing, Electrical, l',techanical and Firel,/ 1 Dcpartment inspections are made and approved. No Occupancy of the prenises can be made untila Certificate of Occupancy has been issued by the Building Divisicn and posted on the premises SICNATURE DATEw I *ALL t'tAt'tHolEs AND cLEANours lrusr BE.{ccESsIBLE, ADJUSTTuENT To BE MADE AT No cosr ro rHE cITy. Legal Description Job Address rH TI -l7 I c0MBrilf L liLIllC APP LICATI EIIERG Hea t Y SOURCES J/)i Ranqe l,later Heater Owne r Addres s Va1 of rk i.-. - - \r. Ll. ACCeS S - Sq, Ftq. other - _lJerv_Add A ltE;-E;--j;;: :_rm._c i, -n f e 7u s e So. Ftq . tia n Phone t rkden n Descri fed Ga .e. ' 8u ngled Constructi L der .\ddres s Phone aPri ma r Structural EI ectri ca I llechanica I n'tI'le PLUIlB I IIG ELECTR I CAL V )MECHAN I CAL Each single fixture SQ. rr Res i dence of fu rna cel b n:ner to <..- BTtl'5oRecadteUbdnInewtaddtonaNew cj rcuor extens jts alts. i ons ence FI oor furnace and vent SERV I C ESDuplex (l bath) each esRec sed wa Additional bath Temporary Constructi o_nl,later servi ce Apoi i ance vent Cha n n existing Sewer ta t nao r CVv p orMUtfamvcomm s rm ran r.ri thVen t 0f ntVe sy atem rt fpa r0morc0r4t!./IND. FEEDERS ch an ca ex hau tnstaaterreaocte I.iood stove/heater 0f amp s. 7 I TOTAL CHARGES issuAtlcF 0F pFRr{lT TOTAL CHARGES z/z TOTAL CHARGESLlUI,JH EER s TA TE R RESEQU that t El)e eha c ctri anot rkt{0bea be dou,l nt beathe h as been s gned anby EI ne Lnaby c C Lon ra ctor th ee ec tri c aec rt0acp o ofnrSu htpevir sanC'Dernret tu rned to Bthe U d n Ds s 0 n H comp for rebvrk ny nqBoa ty deth noted T DA LY ED theand correc eted apD l cati ont, and I fu oermit, andrthe n certi f_v that do heof Sori any and ajl rvo certi fy thatngfield and al i infothe Laws performed shal I mationof the State be hereon iofadone i s trueofn accordancestructure wi De rta i nt with the 0rdinathout the to the work de nces of the Cipermission of scrirdi bed herein, ands in full fo 0reoon the Bui I di nQ Div that tJC 0CCUprce and e isi oJr. I furtherffect as requi 'AI,ICY wi I 1 be maonly su certi 1.y thdtred by ORSbcon trac to ri 701.055,m.y reqistration wiand emnl the Builder,sthat i foyees who are exemot thein comcli basis forance w.ith OpS 701 exemotion is055 r.ri l I hereon, and thatused on th is n ect ljAilE(please print)lc, * ICiIATURE -2t- g 6t lue 'I ue lue Pt? 9OO Ioil ' (<v.o +^ Ftg 0c c.y Zone TyDelCons tFjre ZoneI Bedrooms Fiood plain Storie FtgLoad sn___-_:_--"Y. G.orp_.1/--Z_-_sq.Ftg. TTO LA ALUA,T P an Ck Comm/nd teris 0eve rqe 1. 5c o pmen t ITULDr{b P ERI,l aCh rges an uS rcha rges 2J7. ta45Plan Ck Res Fence PLUI4BING PERMIT Charges and Surcha rges Demo Sidewalk PEEL ECTR iCAL Charqes and S urcha rges z/7, 5a a8 Total Cor'tb Permi t a3 A/C Paving Curb Cut TIECHANTcAL pianli Charges and Su rc ha rqes ILI IAL / ?r4 z3a7 DOs G\'sa ) 'I I I ectri I. Ii. iII. 1V. COMBINATION APPLICATION/PERMIT ( CAP) Applicant to furnish A. Job AddressB. Legal DescriPtion I. example- Tax Lot 100, Lane County Map Reference 17-T3-T3 2. examole- Lot 1 Block 3, 2nd Addition to SErlngIield Estates C. Name, etc. of owner and construction lender D. Energy Sources 1. example- heat/electricgl ceili!g/or fgrced air gas 2. example- waterheater/electrical/or solar E. SquaiE-t-ootage or valuation;-eTE. - 1. examole- 1250 sq. foot house, 500 sq. foot garage 2. examplErlT-new project, check new - if addition, ElecFadd, etc.F. Building permit information:1. example - construct single family house with an ;tTacha garage 2, examole - remodel existing garage into family room 3. ExaffilE - convert single family residence into reslilFant (change of-use)G. Value of work as defined in Section 303 (a) of the Structurai Specialty CodeH. DESIGN TTAI'I AND CONTRACTORS To avoid design or construction de)ays, Building Division Staff must be able to contact appropriate persons regarding design information or iob site correcti ons , etc. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except where blank spaces occur in the description portion of the Mechanical and Electrical Schedules, the appl icant need fill-in only the No. Boxes adjacent to the appropriate item(s) to be installedB. Ful l P'lumbing, l-lechanical, and Electnical Schedules are available at the Building Divisionl. To conserve space on the permit form the schedules have been abbreviated 2. If the item(s) to be installed are not covered on the abbreviated schedules you should consult the ful I schedulesC. EUILDiNG 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 electrical supervisor. The general contractor is not authorizedto sign the electrical label. Applicant to si-on and date'llhenever oossible, the initial application will be used as a worksheet only. Where possible, Building Division Staffwill preoare a type written copy and return it to theapplicant at the time the actual permit is issued for his s i qna tu re. Fees and Charges Plan cneck fees are due and payabie at the time of theapplication, and no plans r./i1l 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 OCCUPAI{CY: Permit applicant exempt from registration r^tith the Builder's Board because: PLANS REVI EI,JED BY : date 1-77-a 2names i gnature PERMIT VALIDATION Eu€a=t"1 -*(-8 I Perm'i t Cl erk Additjonal Project Information: .c