HomeMy WebLinkAboutPermit Building 1983-03-30I
i
..REsloEtITIAL
2zs North rfi iro"ff'LicATro,
/PERI'trr
Sprtngfield' 1regon 97477
Building Diuision
7 26- 37 53
SPFIINGFIEI-D
Date:
Job Loecticn:
Tcs Lat #Aasessore Map #
Subd.)urst-cn:
jnter:
-5Phsr-teAdtbess
?
Desertbe l'lor'/<:
Vai.ue
ac.
Date of App
RanoCe
GeneraL
)!eclvt:icaL
DE!.IOLITIO!! OR :.:C
Sanilat1 seser ea;ped zt Wcperi! Lire
Septic totk p'^::-ced atd. frlled uith gra::zl
linal _ i.,4ten cbcue itens aye cc;toiecei
arC uhen lencl'.tion is :cncle:e ot slt-tt-
tuye eoueC al =rerJses eleanei u>.
ijcfles
?Lutrzbing ccnnecticns -- saiev al. ua=er
ELect?JccL Ccnnect.:o't1 - Blcekir,4, set-u:
and pltnbing eonnections m:st be apptcted
before nequesting elec:ieal insaec=iot:
.4. c e e s s o,.3' 3ul Li'- n4
Firzal - .t,fter :crekes, skirting, Ceci-s,
etc. @e c;nole-.ed.
tsLocking ad 1at-:tp
ConsJrtct:en_ !endg!-
I) ia lhe resporibility of tle penrtt ioller to see tho.t eL! ,Jnapecttorls @e r,acie at )he proper !'Lne ' that each aldrese is ro-a;al':-e
jront tha st?eet, anC:ha.x the pet*rtt cazd, is l*ca'.ed at the frctzt of tl'e property.lSuiUitq v)uiciot cpirw^ed c!,qt s'itcll remain on the Suil<izng S'Jtc at aLI. i;.nes.
?ROC1DUP| IOR IltSPSq)lpll_$2t'ES!;CALL 726-3769 (tecorCet) state yout City Cesigu.ted iob nurben, iob aCiress, lAPe- of inspecticn
@eeiyforinspeciion,conitdctcl8o-ran,.rs-,,a,,e-e,dpt.anernmber.Pequestsreceitedbefcro.7:00r,'-ILL be rnde the sane Ccg, "eouests ncde aftet, 7:00 an vLLL be naCe the ne.xt'.nrkinE daE.
tOSDL/
si!9 iitsP,c:2t!:u;AfiaruAC To be natie afterprior tc set up of
fotns
A1D|PSL;3 ?LL":.BIIG, ZL;C:PIC,I.L )
)!ECE:.;||C;L: lo be nctie be;'ore cny
-
tb?K Ls ccoetted,.
q! Lryqlg tt:ip ? r!!? :; c,--5!wi,_!]l_!1,
DRllllArjE: ?o be nnJ.e pr.or to fil-a-LLr4 tr2|:Cl"e,e.
UilDEPF,C)R ?iU!9 i:lc 1 ;4!a:!.a.:trcAL,ffi
fLoor ineula.tion or Cecking.
?OS! AilD 3EAt,!: lo be ncde prJot to
TGlalGiiof ftoor ir.suittzion or
Ceekinq.
EOI.IC:I ?'O|EI:!C. ILECIPICAL i IIECH-
4!-A:: .:;o ,orZ i; tc ce eou'etei
w:til ;kese irscec'.iaz:s h;ur- been
noie ard. qoorcue!.
PI?IPLACZ: Pm)or '"o plcetrq icctngmcxerials ard. before i'ra:dr-g inspec-
tion.
FRa,I'lIilC: i4ust be rec.testeC af'-et
approual of z'ough plwr,btng, electri-
cal & nechanieal. ALl, rooijq
btacing E chinmeys, ete. ntsc be
conpleted. ilo ,;crk is to be con-
cecled until this insoeeicn hzs
been mad.e cnC apotc"*ed.
FIIIAL PLU!|BI:IC
FI1IAL !,!ECEA:IICAL
|!!IAL ILEC!?ICAL
Iour Ci,ty Desigr,ated Job Nunber Is
|NSULA?:AN /VAPCR tsARRIiR I|IS?IC?ICII :
lo be nade after aLL insulcticn ei
tequired uqor beriers Ge in pTace
but before oty lath, Wpsutn bcatC cr
unLL corsering is cpplied, cnd befote
ay insulaxion is concealed.
DRYIIALL IIISPZC?I1N: Tc be naCe
after. atT@iArt-is in olace,
but p*ior io aay tapitt4.
MAS1!!.I: Steel Location, bond
6ffiijgtautit4 one?ticdls in
accordorce btith U.ts.C, Section
,|)ODS!C'/E: After ir.stallation,)s
atryLeted.
lA pcor:tG ,, ?ar-,itDAllcv: ?o be tp.Ce
L) 4t;;'"r"-""Es """ "rcanated ard.
forms are erectei, but prior to
pourirq canclet€.,I
I
cuPB & .A?P1CA.C\! .4?9.2N:
ae erecxeC but crior
coficTete.
SIDgl,lAL;{ 1 DRf',Tl!,Y: lor aLL con-
Ai'ter fornsto Pofi*,,n€
tight-
! ezea-
erete pauirq aivhtn sxr'eet
of-,;cA, *-c be nade afta-r aL
uatinq eanolete d fotn wrk & aub-
base rcternJal it place.
I
I
:l
!ENC!: 'rrher conolete -- ProuiCe
@G or mooable' secticns through
P, A. E.
ALL project. cor.Ci;ions, suci as the installatlcn cf 6..reet trees, 21:cl.eiion ci iie
required Landscc,pir.g, etc., aasi be sattsi'ieC before the tsUiLDIilG ?MAL :cn be requesteC.
?mAL tsafLDlflc: Tne Final Bulldtnq lr.soection "-ast be requesteC =ftet, the linal Plur.birqElectrical, cnC t4eciun.iccl inspectlcns tlaue been naCe ad ctotouzi.
'ALL !4AilHCLES AND CLE{ilOATS tlUST BE.lCCES3Itsi.E, .r.DJUS?:!i::l lO 3z:.,JiE ll !10 j35? ?C Cl?y ?cie 1 of 2
\
I*b
tr
D--6
'
JOB NO
:cv.
Lot Sq. Ftg.
7 of Lct Couerage_
I of Stor-es
!ota1. leight
?oooarehu
),,-'1).'-- .^*''
Total Cl"aryes
PermLt fssu,stce
Mechdnicel ?erntt
soLAR. .CESS REQ.-
LCT !Y?E
_ Interiot
_ Corner
_ Panhantile
_ Cul-de-sac
,ecraons
t#
Siqred:
Mechqnicol Permit
L-CO G*
Building Vqlue & Permit
This geotct is granted on the etc?esa eondiiion tlat the said consytwc;ion
s-)uL.L, -in.aZl .r.bsoeets, lon!:rn':o the )z,Citwt:ce zd.ocied. biy the CiJT oiSpr.tr4f)e7.e, incltcing :he Jcn.Jno CrCi":cnce, negalcit,tg :iL ecr.st:._ti:--cnand.use oi butl,Lirqs, and mau be ;usoerieC or reuckeC at "r.y t-Jne upcn uic_lation cf zr,.y crcui;tozs cf ieJc jrdirances.
Lot ?cces -inettru Soutces
Setbacks ieat
Df Cctaee Aceess.i,later i.a:erllorr it
iireoLace
Souxh riooastore
llest
x
anf 4r .raf t,d
s.D.C. r.5 :
i !a LfllTUL
Fi:zutes
Resi.dzntial (1 bath)
Sa,i Seuer
oo
Plumbing Permit
No_ person shc.ll eonstp"tct, instal!, alter or eltange dnA "ea cr ecistingqlm2iru cr dtainage sysr? in ,shole or in part, -rnt.es-s sueh person is- theLe-gal.possessor of e ualid plwberts License, e.eept that o pZtson na.1 doplunbing uork to ptope?t! ahich is otsned, Leased or operctei lg the oppti-@tt.
PZunbing Pen::it
State
'io
Neu/Eztend. Cinctits
!ql@c"@V Setvice
Electricol Permit
were state Lan requires tlwt the eleetrLcal uork be done by cn llectrtealcontraetor, the electrical portion of this permit slta,Ll not be ualic untilthe LabeL iu.s been eigned. ly the Electrical'Contr.acto".
?oldl Ci4lces
Stcte
F!g CIIARCE
?TU I
*ha/st Hood.
tlent ?at
|lcoistote
-- ilc?.cAC!]E:l! --
Stora.ce
i4ainteacnee
Pormit
;7a75Cutbeui
s/
Leca?Lcl
?o?.4t A,r!0u:1? DUE:'fl)st
i'Lclt Ea6nlne?LtACe
f EAW CA-REFULLY 9XA!4fNED t!"e cotnpleted copllcation fot pezmit, cnn da
herebg cettify tlut aLL info:natton hereca is true anC cbn,ect, cni I
fwlker celtiii that ang crd aLL xork >eriorned elall be done it accor-
dance trith the 1rdinorces of the City of Springfield, anC ..he Lcxs of theState of 0reccn peri:ainina to tke wrk CescribeC herein, sC :iuv :10 OCCA-
P!.!lCy aiLL be rm,ie of dry st"uctute aithout permission of the Suil,dinE Dt -uision. I futther :ertifE that o:tlg ccnt?acto"s o-d. mplcgees aha cte in
ccnpliance ar,th CRS 707.055 uilL be used cn thie project
?ence
i
, :,lobile Ecne
Label
SiEneci
(
/ION TINE
INSPECTION IINE
72&3769
CIIY OF SPRINGTIETD
COI\ABINAIION APPI'tCAIION /PERMII
'53
Job Addrerr
Legol Dercription
33d*02"3
ram rt
Sq. Ftg. Moin
600.o9
Fo Residen
P"r-;r l.fo, Dercribe Work (i'e,Euild Single
of Work:
Woter Heoler
EN ERGY
Heo t
ohv.cAddrersC
4
e-
ts
o
$
PhoneAddre rr
(lics. no.)
DESIGN IEAM
no.)(e
(nome)
/(
Mechor,i
(
Str It
)l
I
RS
PTUMBING
It
tl
t{
It
El e <tri co I
Mcchonicol
CHARGE
A{ECHAN ICAL
FEENONO.
ETECTRICAI.
CHARGEFEECHARGEFE9
furnoce/burner to
--BTU'S
Residpnce qf
fr.t!oc la,9l1
Eoch rinole {ixture Applionce vent
reporo le
New cirsuils, olterolions
or exlension:Relocored building
(new fix. odcjitionol)
2,-
4?925i!sERvrcES 2o0a*a+lL Slolionory evop.
cooier
Vent fon with
sinqle CuclTemporory ConitructionDuolex (l bolh) eoch
S.F. Residenge
(t t'4")
Vent sysiem oport from
heotinq or A,C,Addirionol borh Mechonicol exhourl
hood ond duct
Ampr.
Woter rarvice
Wood rtove/ heoterI oP9
Heot PumpFEEDERS
Air hondler to
r0,000 cfA{Ampr.
$swerI
Sewcr
-too Pt
Air hondler over
10,000 cFM
tSsu{NcE oFTPERMIT
TOTAI. CHARGESoo
TOTAT CHARGES
SIGNATUR
a rTE
0
thisof sholi banot unrilYolidclcctricolthaConlrocror,porlion pcrmitlheE!ertritolbeworkdonewUIRESEOthcrhotElscrricolby
'I
WHERE ,IEA LA'
the alccrricolloCotlolntro ponel.otrochedsnCn0nElactricolhorlobclbcrbyrigned
EXAAIINED ihc comPleied
oll work performed :holl City of
withoutof ony
required thot if exempt
on lhi3 proiect,
ond furtherItionformohereonnitueltcortect,ondthotollffodoondcertifyt.herebyopplicolionpermiYEFUTICARHA,VE ofLows Stotethe oflhe OrcgonondofrheSpringf ie ldthwithOrciinoencesbelndonerdq nceqc@thotondonycerrify 3!lon lheof Build Divi slo n.furiherthengstructurePermwitlbeomdethotondoNOCCUPANCYthckheri n,dercribedloPertoining t5 notedfortheboris70tORSexemption.055,oeffe ct bytnIfuondforcerllheBoordBuilder'sihotwirhregiilIotionetli(Y ny 701 will.0s5 urcdbeoRswithemqtewhoomplionceondnttoglottqndthotployecrrubcoonlyheron,
fi."9 TOTAI CHARGES
Bosir for Builder'r Eoord cremPtionl
NAME (pleorc prinl)
-O-
FOR OFFICE UsE ONIY
'ftl.><>;E
G,oup-E3L-
l't I ----
Acce ss
a*,Flood Ploin Nr>
x
x
'AI.UA'
xFtg
Ftg
Sb5
Zone
Fi re
Sq.
5q.
Sq.
.Type / Conrl.
Ecdroomr
Sy:tems Development
Chorqe (l.5"i,)Plon Ck. Comm/lndBUITDING PSRMIT 1,tog
l,L9 ob
30"/"i Per
Plon Ck. Res
OD 66^, ^ ----9-b----
Chorgcr ond
5 u rcho rge s tagr.ErE PLfe-
L zo\r(,
loSfotol Comb. Permit
PLUMBING PERMIT
Chorger ond
Surchorges
_Jo
Demo
rt 3lELECTRICAL PERMIT
L2-
A cz---t
_5L,Sidewolk
Curb Cut
Chorger ond
Surchorges
MECHANICAT PERMIT
Chorger ond
Surchorges '
4oAA TOTAI
.Y6 Frg. Other
Acce rr.
-Altar Ure
Euilding
With Atoched 9"t"9.)
tr
NO. I
I
o
L s-5'6t|t56427
I
I
I
' COMBINATION APpLICAT|ON, r -.(MtT (CAp)
l. Applicoru. to f urnish
A. Job Address
B. Legol Descriptionl. exomple-tox lot .l00, Lone County Mop Reference lZ 03 432. exo-EjE-Lor l. Btock 3, 2nd Addiiion ti Sp.iisit"td Ertor.,C. Nome, etc. of owner ond construction lender
D. Energy SourcesI. exomole-huotr{rg.kol gstng /or forced oir gosz. exomote-woter heoteri electricolu.or solorr. sqr;;;oge or rolrorioilii:
I. exomole-.1 25g rq.foot house,500 sq. foot goroge2. ex.ompie-if new proiecr, checkiEi_if oddirtn, checkodd, etc.
F. Building permit informotion:
l. exomple-construcr single fomily house with on ottochedgoroge
2. exomple-remodel existing goroge into fomily room3. exo;Fj-e-convert single fomily risidence into
restouront (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structurol Speciolty Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys, Building Division
Stoff must be oble ,o contocl oppropriote p.rro-n, regordingdesign information or job site correclions, etc.
ll. AbLrevioted Plumbing, Mechonicol & Elecrricol Schedules
A. Except where blcnk spoces occur in the description portionof the Mechonicol ond Electricol Schedules, the oppiicont
need fill-in only rhe No. Boxes odiocent to the oppropriote. item(s) to be insrolled
B. Full Plumbing, Mechonicol, ond Electricol Schedules
ore ovoiloble ot the Building Division
'l . To conserve spoce on the permii form the schedules .:
hove been obbrevioted
2. lf the irem(s) to be insrolled ore not covered on fhe obbrevi-. oted schedules you should consult rhe full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ATL FEES AND
CHARGES ON THE SCHEOULES
lll. Applicont to sign ond dote
Whenever possible, the iniriol opplicotion will be used os o
worksheer only. Where possible, Building Division Sroff will
prepore o typewritten copy ond return it to the opplicont of
the time the oouol permit is issued for his signotuie.
lV. Fees ond Chorges
Plon check fees ore due ond poyoble ot the time of the opplicolion,
ond no plons will be processed until these fees ore poid. .nll
other fees ond chorges ore due ond poyoble when ihe permit
is issued.
V. FOR OFFICE USE ONLY Permit Clerk
PERMIT VALIDATION
PROJECT CONDITIONS TO BE SATISF|ED BEFORE OCCUpANCyT
(
Additionql Proiect lnformorion:
PLANS REVIEWED BY:
?atnomesignotdote
t
*
CtIY OF SPIINGf IETD
COMEINATICN APPTICAIION / PERT{IT
rrt INFOPMAIION LINE
726-3753INSPECIION TINE
7?63769
ts
o
s-02*^2-
oo{-]..o9
cne
Phone
(licr. no.)(oddress)
3
/7
c
e-'
(no.)(ex(nome)
c
Ro
J 3 g
Fom Re ri dence
o
D"r.r;b. Work (i e., Build Single
ran
of Work:
EN ERGY
Heo I
Woler Heoter
Addre rr
De rcri p tion
Owner
Ad drc: r
B u ild ing Permit I nfo:
4
Addrc rr
DESIGN TEAM
Sq. ttg. Moin
-New_-Add -Alrcr -RcP'- - -Fence '-Damo-Chonge/ U re
n6,^,,
<ol
M:chor,icol
/(
)l
/t
l(
ress)ACTOTS
honeli cs.nomo)
/t
FEECHARGE
({
Mcchonicol
MECHANICALETECTRICAT
tr.
PI.UMsING
No.FEENO. r i r:g I C!-TARGE
furnoce/burner io
-BTU'r
Resid.e4ce qf
4-
-sq.
ft
Applionce vent
seporq te
New circuilr, olterqtions
or extensicnt
Stolionory evop.
cooierc0aSERV ICES2-
Vent fqn wilh
:inglc ducl
?i.
Temporory Contlruclion
a: aa)t^ 2i-
Duolc I bolh) eoth
Aciditionol borh
Ralocoted building
naw fir. oddirionol)
S.f. Reridcnce
I both)
?,:r., :
Eqch
Vent ryrlem oport from
heoting or A.C.
Mechonirol exhourl
hood qnd ducr
Ampg.
Woler:crvicc
Wood stove/ heoter')
Heol PumpFEED ERS
Air hondler to
r0.000 cFiiAmpr.
v'_I
SewerI
Sewcr
1
^:r-t ) < )
Air hondler over
r0,000 cFM
ISSUANCE OF,PE?I'1IT
TOTAT CHARGESTOTAT CHARGESTOTAI CHARGES
SIGNATUR
+
TE
{A aa0,09
othirofrhsliuntilbcvalidnotclcclricglthctheConlrsElcrtrirolclo7 I portiori pcrmilworkElartricoldoncbeREOUIRESwlhcbythot5IWHEREtAAIEloottochcdclcdricolthocto?Conlro snc Ponel.bcon o El.(rri(qlnhorrig ned bylobcl
HAVE
of ony
requireci
nd ond furtherollthothereoninformotionlruerlocortect,for doond certifyrh.ED ,leied l.herebyICAu.REFU EXAAlIN comP opplicotion parmiY thesnd 3Low theof ofSioicoIn<e i rhe Orcgonofn<e rhwith Ordino ciry SpringfieldeIIbetndoneqcerdqoondilkfrformcd:hoP.thol onycettily In.thathout l!!ton theol Divirio furtherBuilding3lrucluredemqPermwillPANCYDEtholqndoccuNOtothGdeworkCtrher i n,ixdperloining I3 notcdfor70roRsthoittlhcbosi.055,aromPl exemptionoeffcclbytnItforcef ull ondthcrhuilder'B Boordsthotmyragi tttolionetlaly 701 will.055 uredbe ihitoncomoRswilh proioct.ho tnqre plionceondondlhqtcmPloyeG3lubcontrqstoruheron.only
Borir for Bvilder't Eoord exemption:
NAI!{E (plcorc print)
-C-
FOR OFFICE U5E ONTY
')fll)C);;T
c,ouo-E3l-
H.L
mt
5b
Sq. Frg. Moin
5q. Ftg. Access
Zone .Type / Conrt.x
----Voluex Vo luc
Sq. Frg. Orhcr-r
-
TOTAT VATUA'
Sy!rcmr Developmenl
Chorqe (1.5?6)1,r9
a:,DrE P4{4e-_c:i 1;;fl,
Plqn Ck, Comm/lndBUItDING PERr\tlT 4h
--sJ:e NA
r FJ-30"h1 Per
Per
Plon Cl. Res
tsb
'j*_Chorgat ond
Surchorge:
o zoL*\=cJ frr-3,b9J.tv fiztac tolt\Flv.Tolol Comb. Permil
PLUTASING PERMIT
Demo
/ o,09Chorges ond
Surchorgar
?9-7r'r--
rt 1l
Cvrb Cut
<A
C
oa)
Sidewolk i I
I,
Chorgcs ond
S ur cho rge:
A ECHANICAL PERMIT
Chorocr ond
Sr.<h-orger 'TOTAL
I
tt
tl
IrI
(-HAPGENo- I
t] ,i(:
,1!:
Flood Ploin
Fire
J
COMEINATION APPLICATION,
l. Applicoru ?o furnish
A. Job Address
B. Legol Description
*I -a,trtr (cAP)
2.
foot house, 500 sq. foot goroge
roiect, check new-if oddition, che,
F. Euilding permit informotion:l. exomole-consrruct single fomily house with on ottc (a
goroge
PERMIT VALIDATION
Ciry Holl
Springfield, Oregon
Deportmenl of public Works
OFFICIAT RECEIPT
c.
D.
E.
I. exomole-tox lot 100, Lone County Mop Reference t7 03 43
1: ",;;;-Lor t. Block 3, 2"d AJJi;rn'iSsp.insrietd EsroresNome, etc. of owner ond construction lender
Energy Sources
2. e-GiiJlE-worer eO le r,.ectr
or forced oir oos // --?+ l/ or solor
CITY OF SPRINGFIELDl. exomole-heot/elecr ricol ceilin
Squore footoge or voluo lion, etc.
(.'
exomole- I 250 so.
---
exomore-ti new o;?a-rc.
,Kl
llo. B 5BbB1
2. exomole.remodel exisring goroge into foniily roon3. exompl-e-converr single fiiiiy residence into- resrouront (chonge of use)
G. Volue of work os defined in Seciion 303 (o) of theStructurol Speciolry Code
H. OESIGN TEAM AND CONTRACTORS
To ovoid design or construction cieloys, Building DivisStoff musr be oble ,o contqc, oppropriote p"rrJr,, ,"gdesign informotion or iob site correclions, etc.
It' Ab6reviored prumbing, Mechonicor & Erecrricor scheduresA' Except where brcnk spoces occur in the description ocof the Mechonicol oncj Elecrricol ScheCules, ,i; ";pi;;need fill-in only rhe No. Boxes odiccent to the opjrop. irem(s) ro be insrolled
B. Full Plumbing, Mechonicol, ond Elecrricol Schedulesore ovoiloble or rhe Building Divisionl. To conserve spoce on the permit form the schedulehove been obbrevioted
2. tf the irem(s) to be insrolled ore not covered on the. ored scheduler you should consult the full schedule
C. BUILDING DIVISION STAFF WILL FILT OUT ALL FEES AICHARGES ON THE SCHEDULES
lll. Applicont to sign ond dore
Whenever possible, rhe iniriol opplicotion will be used osworksheer only. Where possible, 'Building
Division Stoff vprepore o typewrirren copy ond return it to the oppliconlthe time ,he oc?uol permit is issued for his signoture.
lV. Fees ond Chorges
Plon check fees ore due ond poyobte ot the time of the oond no plons will be processed until lhese f.", or. poid.other feer ond chorges ore due ond poyoble *t"n ih" pir irsued-
+_V. FOR OFFICE UsE ONLY
R
\
(
For:
(
C
/
a
=
o
OD
3
rlo
m (
'rL.
(
(
Amounl Received
(
rit
AUTHORIZEO SIGNATUREaxa!iot-YuitauLL aitillEi3 aucEtE oi 97aot !a!lt.a
Permit Clerk
(.
I
l
I
l
I
-.(
rl /-r
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Additionol Prolect tnformorion;
PTANS REVIEWED BY
signotu dole s-2&l ?at
(
I
(.
(
IY
""-" -l ^r^.\ Sha,,ab.*