HomeMy WebLinkAboutPermit Building 1980-09-16I
hlr clrY 0F SPRIIIGFIELD_- --. CJiEIIIRTION APPLiCATION/PERMIT 7 37
Jo$ Address
l-ega I Descri pt ion
EIIERGY RCES
Hea
llater Heater
Ranqe
Sq. Ftq. l'la
Sq. Ftg. Access
Sq. Ftc. Other__
Y I'lew Add Al ter Pep.
-Fence DE-mo Chan-nqe/Use
_0 ther-
=NDc
ss
$
, .t^
ffi--;til
Value of l,lork:? r1c ea
-Bull?lnq-Fernlit Info: Descril
Fan i l v Res i dence t,li th Attache<
re l,,lo rk (
I Garaqe
l;€
I
Build Single
Address r Phone
Construction Lender /5'k}
Addre s s Phone
T
name 'I
Pri ma
-\)
S tructura l
Electrical
l"lechani ca I
TR
P
5 I
'i al 1"
llecha n
PLUIlSI iIG ELECTR I CAL 14ECHAN I CAL
FEE CHA PGF NN FFF CHARGF nrn FFF
2Al Each single fixture
/i PlS. rt ?i L\.
Residence of
SQ FT
furnace/burner to
BTU. s
Re.l ocated buiiciing
(new fix. additional)
New ci rcui ts al ts
or extensions
Floor furnace
and vent
S.F. P.esidence(l barh)SERVTCES ,:! L],*r;Recessed wal I
Soace heater and vent
1,-.Duplex (1 bath) each *rrs, iOo fiMfr,lStrn Qaa;
Additional bath Temporary Construction Apoi iance vent
se Da rate
I [,later servi ce Chan
res'i
ge in existing
dence
Stati onar-v evap.
cool er
t Sewer multifamily, coffin. or
Tndrrstrial b Vent fan with
sinole duct 3ao / tae
,I
Storm Sewer 0f amps.
Vent system
heatinq or A
apart from
.c.
c0r4r.r./lND. FEEDERS ,*Mechanical exhaust
hood and duct {,sb 2.'7, a,.
I nstal I /al ter/rel ocatedistrib. feeders l'lood stove/heater
0f 7'00 amp s.;5.m Vti;,a
ISSUAIICF 0F PFRI'IIT i,,.;. ^.
TOTAL CHARGES TOTAL CHARGES / lC.ca TOTAL CHARGES F,f aa
I^JHERE STATE Ll',^l REQUIRES that the Electrical work be done by an E
shall not be valiJ until the label has been signed by an Electrical S
'lectrical Contractor, the electrical portion of this permit
uoervisor and returned to the Buiiding Division
H IXAIl the comp eted appl
and
0reg
the B
'1 ca t 'i 0n fi0 r DE rmi L and do h ere b.y c ert I tha t a I l j n forrnation hereon is true
he 0rdinances of the City
NC OCCUPAI,ICY w.i I I be made
tion r,r'i th the Builder'sis noted hereon, and that
and correct, and I further certif-v that aof Soringfield and the Laws of the Stateof any structure without the permission o
Board is in full force and effect as requ
ny
off
a I I wo rk oe rfo rmed S hall be do
-work desc
further cf exemot t
.055 rri II
ne I n a cco rd an CC t h t
on DC rtain
ng Di
701.0
'|n d the r i bed he re I n an d tha t
U i I di s I on I .t fy tha t m.y req i s tra
I red by nD(55 th t j he ba s I S for e xemot I o n
on I v su bco nt ra cto rS an d emp I 0yee n r,omcl i
ft, Lc
wl th 7 0 1 used on L h 'I s p ro,j ct
*/-,WI,lAtlE(piease print)S IGi{ATURE DATE
Zo \7
T,voel Cons t 7 - ,J LJni ts
Fire Zone - Eedrooms
Flood Plain,r;f Stories
Load 35 S q. Ftg. Access jB{oc ii.l x J'l,a C v lue f.?r ''l3tg, ao
lj{.-Group r-:.i t it-1 Sq. Ftg. Other l
rx I I i .. l)-
BUILDING PERt.lIT
Clrarges anC
Surcharges
#ntuqE-
A r")
Plan Ck. Comm/Ind
65i/B1do Per Fee
.Lb's.3O Svstei;rs Deve
charqe (1.51 opment .l lQA n.n*v J -,,'a v. .
Plan Ck. Res
30%/B1dq Per Fee ?NC
PLUI4BING PERMIT
Charges and
Surcha rges
Fence Zo-cryU ,7
D6mo fl.C H Drr6.4t,1e
ELECTRICAL PERIIIT
Charqes an,
Surct.a roc s
I{ECHANICAL PERMIT
Chargei and
Surcharges
sf ,*,a-.!LV-.-!+-.-
'1^.r.: ..i r_)
Si dewa I k
A/C Paving
Curb Cut ,-1r/'
Tota'l Comb. Permi t \{ T,S E.
/.2,qfl
TOTAL
7 3'.1t9, g*
Ax-11-Ltl iL, 94oo
-s6rnr i.sal o* L1T t<l t\\,12, iq7
ST,
exnl resN TEAI.I
pYn r rpqACTORS
f,
7 I
r i] AQNF
TOTAL VALUATTOU i ''i5, !.eC.z:d
+ A '1C Dt)E.
, ar ^---iL-lZr--9-
C-
coMBINATI0N AppLICATION/PERMIT (CAp)
I. Applicant to furnishA. Job AddressB. Lega l Descriptionl. examole_ Tax Lot 100, Lane County Map ReferenceI7-0T-432. example_ Lot_1. Block 3, Znd Addition toSprin-gfield Estates
\E5
:ITY OF SPRINGFIELD
City Holl
Springfield, Oregon
Doporlment of Public Works
OFFICIAL RECEIPT
,,t I
C. Name, etc. of owner and construction lender0. Energy Sources
2
examol e-
exa;;1"-
re foota
heat/electrical cei or forced lr as
E. Squa ge or valuat oD'
l{0. B 5476i-
I
()
o
.l
iT
,.7
!
t
'r9
wa ter ter ec ca or so arer
examp j e-
examp'i e-
check add
1250 sq.if new p
, etc
From
2
foot house, 500 sroject, check-new
q. foot garag- if addition
e
ESSF. Bui )ding perm 'i t i nf orma ti onexamole - con struct single family house w.ith anattached ga rage
remodel existing gara ge into fami ly roomconvert si ngle famil y residence intores taurant (change of use)ue of work as defin ed in Section 303 (a) of theStructurai Spec.ia
H . DES I Gi,I TEAI,I AND C
I ty Code
ONTRACTORS
Additjonal project Information:
PLANS REVIEI,IED BY:
To avoid desiqn or construction delays, BuildingDivjsion Stafi must be able to.oniult appropriatepersons.regarding design information or jbO ,it.--corrections, etc.Abbreviated p)umbing,, i,lechanical, & Electrical Schedu.lesA. rxcept wnere brink ap;;;s-;;;r; ;;';;" desriptionportion of the Hechanical anO Eiectricai Scnelufel,the applicant need fill_in onfV ine No. Boxes adjacent
^ to_the aporopriate item(s) to 6e-instatteOB' Ful I prumbing, llecnanicJi, ira'Et..i"icar Scheduresare ava.ilable at the Building 0ivision1. To conserve space on the-permii iorm the scheduleshave been abbreviatecJ?. J.f tne jtern(s) to be installed are not covered on
;trg,aouleyiSted schedute, yor r[ortO .onsrit-inJrurr schedulesC. BUILDIIJG DIYISION STAFF l^JILL FILL OUT ALL FEES AND- CHARGES Oi{ iHE SCHEDULESD. As noted on the CAp, ah; label must be deiivered to theelectrical contractor fo. sitnutr"" [, nr, e.lectricalsupervisor- The generar .on[.u.to" i'r not authorized
App I rcanL to sign and date
Whenever possible, the initiai application will be used asa worksheet onlv. tJhere possibl!, Suiiaing D.ivision Staffwili.prepare u iype written .opy-jnJ-""iurn it to theapplicant ar the time the u.irui p".rii"is issueo for hiss i gna tu re.
Fees and Charqes
Plan.check feis are due and payable at the time of theapplication:,and-!9 pians wiii"b; ;";;";sld until theserees are paid. All other fees and cnargei'are due andpayable vrhen the permit is issueJ. -'-'r-"
FOR OFFICE usE oNLY
2 exanole -
efimDTe -
ved F CC
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CO
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3.
G. Val
II
CD
III
IV
AUTHORIZED SIGNATURE
SXEI'ON'IURNAULL PRINIERS - EUCEXE OR 9"O!
Perm'it Cl erk
.t
r,
---.2
t ilt i.-C
nt Received
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAI.ICY:
Permit appl icant exempt from registratjon w.ith the Builder's Board because:
name Si gna tu re da te
I
I
a
- 2q-4 /,/
I
I' -')' TiCII PROCEDURiS FOR THE CIT T :PR
-JILDIiiG DIVISIOiI 346 irrii,*rTP
INSPTCTiOiiS 726-3759 IiIFORiiAIION
rriul lEL:Jr3i
1a. ^1aat Lo-Jt )5
The follorvin indic d inspections are requ'ired for your constructjon atIt is the responsibi'lity
are made at the proper time,d that the perrli t card i s
of the permt
that each add
located at th
holder to see t dL d 1 inspect on
ress is readable from the street,e front of the property. - .
S
an
1. SiTE INSPECTI0N: To be made after 11. FRAi'1Ii'lc INSPECTI0TI: ltlust be requested
2. U\DEI?SLAB PLUI.IB I NG ELECTRI CAL &
E CHAN I To be ma e ore any
work is covered.
3. FOOTiIIGS & FOUIIDATIOII To be made
ated and al I dryrrra]1 -i--fi11ace,
any taping.
excavation, Sut prior to setup of
forms
after approval of rouqh plumbinq, elec-trical & mechanical. AIJ roofinq,
bracinq & chimneys, etc. nust be com-pleted. llo work is to be concealeduntil this inspection has been made and
approved.
72. DRYi'JALL II,ISPECTI0N: To-rdl rer trenches are excav
forr,rs are erected, but prior topouring concrete.
i3. SEr//ER. bIATER & DRAIi\lAGi LIITIES:4. MASOiIRY I.IALLS Prior to fi I I jng in trenches
eams , grcui'ing
cordance r.rith U.B.C. Section 2415.74. SIDI!./ALK & DRIVEI.JAY:Required for all
concrete par,,ng rv
bem
but
ade afterprior to
b
Steel location, bondor verticals in ac-
5. UiIDTF.FLCOR PLUI1S I i,IG & i'lECi-1AN I CALTobe ,.na o e prior ro jnstallation
7. ROUGH PLUi\iBIIIG . ELECTRICAL &
l'1[ c l-]A)l o v;ork i s ro be
jn street right-
of-way; to be made after all excavat-ing complete & form r,,ork & sub-basematerial in p1ace.
15. l,J00DST0VES: After installation is
conpi eted.
i6. SPECIAL IIISPECTIOI,IS:lJhen required bythe Building Code, soecial inspector to
be present when rvonk is in proqress. A
copy of the spectal testing report to
be furnished to the Buildinq Division.
!
L
m
of floor insulation or decking.
6. P0ST & BEAtl: To be maCe prior toInsialEr]on of f I oor insul ationor decki ng.
n
I CAL: N
covered until these inspections
have been made and approved.
8. FIRTPLACE
facing materials.
9. FIRE & SEPA,?ATIOiJ IJALL:
Prior to plact'ng
Loca ted
ation
ction must be requested after th
have been made and approved. No
Buildin g Insoection has been ma
ISSU BY THE BU
ION APPROVED PLAI,IS q
E COiIPLETED IN ACCCROAi{
tructural Concrete: In excess of 3000.S.I.
tructural t,lel ds: Performed on the job
I u-Larn Beams: Inspection certi fi cateby approved agency) supplied to BLrild-
ng Dfvision before beams are placed.
i re Retardant Roofing: Before instal -
r-
;tx
S
P
construct accorcjing to plans.
O.. INSULATION VAPO R BARRIER INSPECTIO :1.To be made a ter al nsu dL on and
FiI'IAL BUILDING
S
G
(
i
r
I
lequired vapor barriers are in place r:-^ ,but-before.any 1ath,-gypsum board or lXit7. OTHER INspicriOtis: May be requ.iied intvall.coveringisappriLa,andbefore-ffiildinqCode,to-be
any insulation is concealed. lng:qqted_in plans or by notice frogr- Building Inspector.
FINAL PLUMBING E FINAL ELECTRICAL B,-,N0, I'IECHANICAL ffi ,,*0. FIRE OEPT.
All project conditions, such as the installation of street trees, completion of therequired landscaping, etc., must be staisfied before the BUILDII{G FIl,lAL can be requested.
The Final Buildinq Insoe
l4echani cal Inpseitions
be made until the Final
CATE OT OCCUPANCY I.IAS B L
e Final PlLrmbjnq, tlectrjcal and
occupancy of the premises can
de and approved, and a CEi?TI FI -
ION AIID POSTED ON THE PREi'IISES.
Phone 7 -_)70
Da te
Name of perm hol Ce
Signature
BUILDII,IG DI
I.JORK I4U5T B
HALL RETIAIN ON THE BUILDING SITE AT ALL III]ES, AND ALL
C5 I,JITH THOSi APPROVED PLAIJS
N0TE: All manholes and cleanouts are to be adiusted at no cost to the City.
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JOB INVOICE
32J.7
lll'i,iliitll 0,,,* P[ : I{6- ggaS
I heEby stisfactory
compl"tion ot thc abov. described mA:
orI.
P,I.
HELPA
o oaY woRx
o coxTn^ct
O TRA
AT'OUXT
COXPLETEO
,4UrA . RfS/DEl/r/At . COt4n4EpC/AL
GOq IAffi 8Y
BILL TO /
CTTY
JOB NAME ARO LOC.ATIOT'
D€S'CEIPTIOH OF WORK
OESCRJPTION OF XATERIAL USED PRICE
/aH
/A fi\*u.r "otrrful)
o(do arta-/
3 .h4/r/6fu/ *ztda,
LABOR AMOUI IOTAT
lttlERtttsMECHANICS@
I(lIAT
UB(lRHELPERS@
TOTAL LABOR
SIGNATURE oA'
TOTA.L a
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L:
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7
L cITY OF SPRiNGFIELT
LUI1BI NATI ON APPL I CATION/PERMIT 726-3753
d
Jor. Address
l-egal Description
,
RCES
l.Jater Heater
Range
EI]ERGY
Hea t
0wner;I Value of hlork:t f5o,-(rD.oa
Ftq. t4ain 4-iloorq. Accei{@
Sq. Ftq. Other
Xt,lew Add Alter*-TEo. -
Jen-e_Derno Chai-ge/Use
0ther
Sq
Sq
Addres s Phone'rgr // 5T Farni I Ga ra
n c .e., Build Single
Construct.ion Lender 5 Q,aattl
Addre s s Phone
I
na
Structura I
Pri ma
El ectri cal
l'lec ha n i ca I
CONTRACTI RS name add res s I'ics. no.exn i res )ohone no.
)G I t
PI
rical
r.,!e nt
PLUIlB I ItG ELECTRI CAL MECHAN I CAL
N0.FEE CHARGE NN FFF CHARG F tio _FFF C HARGF
30 Each single fixture
RPI$, 6ilL\t S.oa /Shu
Res idence of
SQ. FT
furnace/burner to
BTU' s
Relocated buildino
(new fix. additional )
New circuits alts
or extensions
Floor furnace
and vent
S.F. Residence(l bath)/SERVICES 3OO fln1Ps 36roo Recessed wal l
Soace hcatpr and vcni
b Duplex (1 bath) each a t'f,*rs) l0o Fttfr,l$ta ldoo
Additional bath Temporary Construct j on Apol iance vent
seDarate
I [^later servi ce ge in existing
dence
C han
res i
Stati onar-v evap
cool er
t Sewer Industrial
multifamily, comm. or la Vent fan with
sinqle duct 3ao /La,l
Storm Sewer 0f s.Vent system apart from
heatino or A.C.
c0r,1t!./IND. FEEDERS 4 Mechani cal exhaust
hood and duct {rsZ 27,ai,
Instal I /al ter/re1 ocatedistrib. feeders l'Jood stove/heater
3 of 2"O O amp s.ll,m '/€a
ISSUANCF 0F PFRI1IT tddrt
TOTAL CHARGES ./,td,a TOTAL CHARGES /'l0,oo TOTAL CHARGES ,ffoa
WHERE STATE Ll\l,J REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permitshall not be valiC until the Iabel has been signed by an Eiectrical Supervisor and returned to the Building Division
tion for Dermit, and do hereb.y certify that all information hereon i
urork performed sha'll be done in accordance with the 0rdinances of the Cityoertaining to the.work described herein, and that NC OCCUPAIICY will be madeDivision. I further certify that m.y registration rlith the Builder's
055, that if exempt the basis for exemotion is noted hereon, and that
o.ru
nq
7At
1
I
I HAVE CAREFULLY EXAI1INED the comp.leted apnlica s true
and correct, and I further certi f-v that any and a1 1of Springfield and the Laws of the State of 0reoonof any s
Board is
tructure without the permissionin full force and effect as re,
of the Buil di
quired by ORSonly subcontractors and ernpl0yee I ian 701.055 wi'll be used on this projectwi th
tlAl,'lE(p1 ease pri nt)I GiIATU RE
D F
Bedrooms
TorAL VALUATTON lg 3 tlp,,od
?
c.y Group.*24 R-t !q
Access 3ts6O F-l
S ;W;
Flood Ptain A/A S tori es
oe/const. E-A/y' uni ts lla i
lue 92,131o, oo
lue
JI.V t2a
0the r
Fire Zone -
Zone
Ftg
Ftg
cy Load 33 Sq
Plan Ck. Comm/lnd
65%/8ldo Ppr Fec L39 30 0VC
Fqa rge
tems De
1.&818-ooBUILDING PERI'IIT
Charges anC
Surcha rges
yae
Plan Ck. Res
30%/81dq Per Fee
Fence t-PLUI'4BING PERMIT
Charges and
Su rcha rges
/-€0r-o9-
Dgrno 4X,1o gig.
PI,CE Du€,44,qo
Si dewal kJfD,oP-
t A/C Paving Total Cornb. Permit 8t1r,s I
Curb Cut Aqt t2.4n 31?9,4a/I,IECHANICAL PERMIT
Chargei and
Surc ha rge s
5{.oo_
a o
TOTAL
Go
"rhrnrk t
,/
74 q-{u-?C
?t-c ryA
ELECTRICAL PERI1IT
Charges and
St!. "i,a"fgf,
\7..r Y
COMBINATION APPLICATiON/PERMIT (CAP)PERMIT VALIDATION
Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
17 03 43
2. example- Lot 1. Block 3, Znd Add.ition to
Springfield Estates
C. Name, etc. of owner and construction lenderD. Energy Sources
1. exampl e-2. exampl e-
E. Square footag
heat/electrical cei 1 ing/or forced air gas
wa terhEa terl gl_e.-iia;l7 or s6far
e or valuati
exampl e-
examp'l e-
check add
1250 sqif new
foo
on, etc.t house, 500 sq. foot garage
project, check new - if addition,
, etc
F Building permit information:
1. example - construct single family house with an
attached garage
2. example - remodel existing garage into family room3. exampie - convert single family residence into
restaurant (change of use)
Value of work as defined in Section 303 (a) of the
Structural Specia lty Code
DESIGN TEAI,I AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or job site
u
corrections, etc.II. Abbreviated Plumbing, Mechanical, & Electrical SchedulesA. Except vrhere blank spaces occur in the descriptionportion of the Mechanical and Electrical Scheduies,
the applicant need fill-in only the No. Boxes adjacentto the appropriate item(s) to be installedB. Full Plumbing, Mechanical, and Eiectrical 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 on
the abbreviated schedules you should consu.lt the
ful I schedul esC. BUILDING DIVISION STAFF l,JiLL FILL OUT ALL FEES AND
CHARGES ON THI SCHEDULESD. As noted on the CAP, the label must be delivered to theelectrical contractor for signature by his electrical
supervisor. The general contractoris not authorizedto sign the electrical label.III. Appl icant to sign and date
Hhenever possible, the initial application will be used as
a worksheet only. l^lhere possible, Building Division Staffwill prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
s i gna tu re.IV. Fees and Charges
Plan check fees are due and payable at the time of the
appl ication, and no plans will be processed until thesefees are paid. All other fees and charges are due and
payable when the permit is issued.
l/. FoR oFFrcE usE 0NLY Permit Clerk
PROJECT CONDITiONS TO BE SATISFIED BEFORE OCCUPAITCY:
Permit applicant exempt from registratjon with the Bu'ilder's Board because:
Additional Project Information :
PLANS REVIEWED BY:
name signature
---
date ?-Z/-YO
1