HomeMy WebLinkAboutOccupancy Application 1984-06-08I :.i
,,,.,f 'CITY OF S
Department o
Bui I di ng Sa
?25 North
Spri ngfi e1 d,
7?6- 3753 ( Bus . )
DATE:
. __') r
IO,S
i on
974779 (Insp.)
OCCUPANCY I}JSPEC'fION
APPLICATION
tr
uE\r reor
l-
SPRINGFIELO
E
00
PRINGFIELDf Public t,fety Di vi s
eetStr
on
376
5th
0reg
7 26-
*
JOB ADDRESS:883 N 28th Street
-/*
field, 0r. 97478 //
June Bth, 1984
0!JNER: Artrs Masonery
OT,,INERS ADDP.ESS:883 N 28th Street (attached building)
APPLICANT:Looking Glass Youth & Famil y Services, Inc.
APPLICANTS ADDRESS:lL77 Pearl Eugene, 0r. 97407
FOR ACCESS TO PROPERTY..PLEASE INCLUDE TELEP}IONE NUMBER:
344-5028 (Don Griffin) c/o Lookin g Glass
PROPOSED USE:Sma11 woodworki ng project for youth for 8 weeks
A $30.00 TNSPECTTON FEE rS REQUIRED AT THE TII'IE
OF APPLICATION
rHIS APPLICATION FORM MUST BE SIGNED BY TI{E OI.]NER OF TIIE PROPERTY TO
BE INSPECTED.
SIGNATUP.E OF PROPERTY Oi{NER71.\( tlz3cFOR OFFICE USE ONLY V
DATE OF IIISPECTION: C - / )''*Y lj
DATE OF REPORTT /',- L/ t4
DATE OF CERTIFICATE OF CO}{PLIANCE:
CoMMENTS , d.//{'q t"e /t 4'€-"'l lt cc ct*c.l /)
RECEIPT NIIMBER:
DATE PAID:
(e/4€ C *tfc \/n-c,/aS a f
/ot-,t/4
- . -..a .:..
ffia uCIf tNsPECroR {' l a-..(-tla-*-r,,na DATE 6- f A'
I CITY OF SPRINGIIETD
J BUITDING DIVISION
WE HAVE
THIS
TO
346lYtAlN STREET
THE ELECIRICAL WRING AND EQUIPMENT INSTALTED BY YOU AT THE PREMISES NAAAED HEREIN AND SUBMIT
RECORDS.
OWhIER OR
TENANT
tocATroN
JOB
E A PERMTT rS REOUIRED
726-375?
OF 3
E WTRTNG APPROVED FOR CO\fER
E APPROVED FOR SmVrcE E HEAT CABLE.A,PPROVED FOR COVER
E WIRING tNCOrlliPtETE fl UN,DERGROtIND APPROVED FOR COVER
tr WRING COVERED WTtlOt T tl.lSPECrlON tl CONDUIT SYSTEIvt APPROVED FOR COVER
E Dl,rE TO THESE PREMISES BENG TOCKED AN ||.EPECT|ON COULD NOT BE I ADE
E DUE TO NO ONE HOME AN INSPECION COULD NOT BE TvtADE'
E WR|NG APPROVED FOR COVEHNG E0CEPI rHE
&
,l
a$F a 6ot + VUrt a*-t/t 4 e ,Ala7/t,-r*(k,
\,\,
i^,
,-..,f 'CITY OF SPRiNGFIELD,-,,
Department of Publ i c Hd ,sBuilding Safety Division
225 North sth Street
Spri ngfi el d, 0rego n 97 477
726-3753 (Bus.) 72G-3169 (tnsp.)
OCCUPANCY INSPECTION
APPLICATION
SPRINGFIELO
ar'a
\,ri\ t ,.,o\
DATE:June Bth, l9B4
883 N 28th Street S r].n
4,-t'
* Erl Orlo 6
fie1d,0r. 97478 1/JOB ADDRESS:
OWNER:Art I s Masonery /
OI,INERS ADDPGSS: 883 N 28th Srreer (attached building)
APPLICANT:Lgqking Glass Youth & Famil y Services, fnc.
APPLICANTS ADDRESS:lL77 Pearl Eugene, 0r. 97407
FOR ACCESS TO PROPERTY-.PLEASE INCLUDE TELEPHONE NTMBER:
344-5028 (Don Griffin ) c/o Looking Glass
PROP0SED USE: Sma11 woodworking pro.ject for yourh for B weeks
A $:O.OO INSPECTION FEE IS REQUIRED AT THE TIME
OF APPLICATION
FoR oFFrcE usE oNLy
-7LlG Ez=o
3 //4- {o 2{,---
THIS APPLICATION FORM MUST BE SIGNED BY THE OI.TNER OF TI{E PROPERTY TO
BE INSPECTED.
SIGNATUPG OF PROPERTY OWNER
DATE OF I}ISPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF CO},{PLIANCE:
RECEIPT NI]MBER:
DATE PAID:
COMMENTS:0ra //(-=Z'a(r) ?.r,//l' Wnt^; r)ur-r,t (94 'r/1 2lV
D, n ru:* f nN)t- (ry)LUnr 4re ^1,^/4 s ? -4'
eN T-rt4./w d ,v/
t
.a
Job Number fficqor DATE 6'lA:dY T
CITY OF SPRINGFIELD
BUILDING DIVISION 346 MAIN STREET 7263753
WE HAVE .INSPECTED THE ELECIRICAT WzuNG AND EQUIPMENT INSTALLED BY YOU AT TTIE PREMISES NAAAED HEREIN AND SUBMIT
THIS REPORT RECORDS.
TO
OWNER OR
TENANT
tocATtoN
JOB
E WTRTNG APPROVED FOR COI/ER E A PERMTT lS REQUIR@
E APPROVED FOR SERVICE E HEAT CA,BL,E AI'PROVED FOR COVER
E wtRTNG rNcoAlprETE tr UNDERGROT ND AFPROVED FoR coVER
E WRING COVERED WTHOT T rl.tSpECTtON E CONDUIT SYSTE T APPROVED FOR COYER
E DUE TO THESE PREMISES BENG LOCKED AN II{SPECTION CO{.,,LD NOr BE MADE
El DUE TO NO ONE HOME Al.l INSPECION COULD NOT BE tvtADE'
OF
E WR|NG APPROVED FOR COVERTNG E(CEm THE
G
tl
f,.Cotnpony, lnc, Eugen ,9rcgon
It
'\sPECroR (// a-.:!., )ai .-o ,nt
L6\oU
NG
ubl Sy Divis rn
225 North 5th StreetSpringfield, 0regon 97477
726-3753 (Bus.) 726-3769 (lnsp.)
DATE:June Bth, l9B4
JOB ADDRESS:BB3 N 28th Street Springfleld , 0r. 97478
CITY OF
Department
Building S
SPRIof P
afet
/,'t)ic l^l
* E,t0Vo64*
OWNER:Art I s Masonery
BB3 N 28th Street (attached buildi nc)OI'INERS ADDPGSS:
APPLICANT:Looking Glass Youth & Family Services, Inc.
APPLICANTS ADDRESS:7777 Pearl Eugene, 0r. 974OL
FOR ACCESS TO PROPERTY-.PLEASE INCLUDE TELEPTIONE NI]MBER:
344-5028 (Don Griffin) c/o Looking Glass
PROPOSED USE: Sma11 woodworking proiect for youth for B weeks
OCCUPANCY II'{SPECT.*ION
APPLICATION
\cl-\e- u8u-\t
SPRINGFIELD
A $30. OO INSPECTION FEE IS REQUIRED AT TLIE TIME
OF APPLICATION
THIS APPLICATION FORM MUST BE SIGNED BY T}IE OI.INER OF THE PROPERTY TO
BE INSPECTED.
SIGNATUPG OF PROPERTY OWNER
7u\ ( gz3c,
FOR OFFICE USE ONLY
DATE OF I}ISPECTION:
DATE OF REPORT:
DATE OF CERTIFICATE OF CO}4PLIANCE:
COMMENTS:
RECEIPT NUMBER:
DATE PAID:
opmentSvsterns Deve
charqe (1.5qan Ck.I
PIan Ck. Res
31%/Bldg Per Fee
BUILDING PERMIT
Charges and
Surcharges
Fence
DEmo
PLUI4BING PERMIT
Charges and
Surcha rges o---__(2
Sidewalk
Tota] Cornb. Permi t
ELECTRICAL PERIIIT
Charges and
Surcharges A/C Pavi ng
Curb Cut 5aDTOTAL
14ECHANICAL PERMIT
Charges and
Surcharges
6q1^/R1do Ppr Fep
+
CITY OF SPRINGFIELD, OBTUON
Department of Public I'iorks
225 North 5th Street
JOB ADDRESS:,hg,g3 . .4/a. :)yr".t/
TO:,rl 5 r+'//)f n)
BUILD.T-NG II{SPECTION DIVISI0N
JOB NI[4BER: 6 4l 4 o f
DATE:/, */ 2 -"tq
. NOTE:
/rt e /Hf dtalr.,Vt' f*relrc-i t
/- /" GA'/r ,*y'& * /4 " At/ n?-*< / t"t€ s I
Lt/ p ,n* /,flro /* /g,yd s r4r / ^/i.(t
1rr"*
INFOR}TATIOI{:
INSPECTION:
7 26-37 53
726-37 69 CALL FOR REINSPECTION
INSPECTOR:d /,{ c,,n".e)L OV Y
n)
\<
COMBINATION APPLICATION/PERMIT (CAP)
I. Appiicant to furnishA. Job AddressB. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
17 03 432. e{ample- Lot I. Block 3, Znd Addition toSFIIngFietd EstatesC. Name, etc. of owner and construction lenderD. Energy Sources1. example- heat/electrical ceilinq/o2. example- waterh-eaTerTeIecT7lcI rE. Square footage or valuation,Gtl-
r forced air gas
sol ar
II
III.
IV.
l. example- l?50 sC. foot house, 500 sq. foot garagez. example-.if new project, check new - if addition,
check add, etc.F. Bui lding permit information:1. examp'le - construct s.ingle family house with anattached garage
?. examp]e - remodel existing garage into family room3. example - convert single family-residence iniorestaurant (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, Build.ingDivision Staff must be able to contaat appropriitepersons regarding design information or job sitecorrections, etc.
Abbreviated Plumbing, Mechanfcal, & Electrical SchedulesA. Lxcept where blank spaces occur in the descriptionportion of the Mechanical and Electrical schedules,the applicant need fill-in only the No. Boxes adjiient
- to the appropriate item(s) to 'be .installed
B. Fu'll Plumbing, Mechanical, and Electricai Schedu.lesare available at the Building Division1. To conserve space on the-permit form the scheduleshave been abbreviated2. JI tf,: item(s) to be installed are not covered onthe abbreviated schedules you should consu.lt thefulI schedulesC. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULESD. As noted on the CAp, the label must be de.livered to theelectrical contractor for signatur. fy ni, eteci.iiai"-supervisor. The general coniractor ii not authorizedto sign the electiical jabel. ----
Appl icant to sign and date
Whenever possible, the initial app.lication will be used as
.a_worksheet only. t,lhere possibli, AuiiOing Oivislon Staiiwr I r.prepare a type wr.itten copy and return it to theapplicant at the time the actuii peim;i-ir"irrr.o io. tiss i gna ture.
Fees and Charqes
Pian.check fe6s are due and payab.le at the time of theapp)ication,,and-no plans wiit-Ue proieiiia until thesetees are paid. All other fees and cnargei-are due andPayable when the permit is issued.
FOR OFFICE USE ONLYV
PERMIT VALIDATION
Permit Clerk
5 0o€o
I
5eo
l-Jt-83
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI{CY:
exempt from registration with the Builder's Board because:Permit appl icant
Additional Project Information:
PLANS REVIEWED BY:
datenamesigna tu re
@
10