HomeMy WebLinkAboutPermit Building 1989-4-10
NFORI1AT: ;:{ l:,.-.
726-3753
$0. FtQ. (.lain
~q. Pt9. Access.
SQ, Ftg. Other
UeN' Add P.l ter ~eD.
Ranqe_ - -Fence Demo Change/Use
'!;1J1Uf of Hark: I -Other- - ~
Owner 1I/i!.L. Jf.-?A'-U ~--?~ "",,-s ~ CaC\O. _a .. ~ . .- I 0<;)
BUl (;ino Permit Info: Describe \'lork(;-.e., Build Single JI
Address 9ao .N.Z;!~~~(~Jt--'/~...:~. .,:,~honc Far:1ilv nesidence Hith ".ttached r,araqe)
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n.,"7.t.9-...,..~.......;? '97'2/7 ?//<<<>J.w'~.A" T,,a,r"b....h'-&-oA.o<~!
Construction Lender ~~A,(~_~~.N'....-~,P~__ I
,\Jdress Phone 5~1~s.':,,--:,..-"") ,......-~~_. . I
Ut~ltir{ TEI\I1 /name) (address) - flies. no.l (eX[llrest (ohnf1e no. I
""<j';l/-:<.:;r"<'?./-~R .
Primary 0/~"r.r~;A-~""",~---=- ,/......,-:. ;5'........=~~~ 9?~~
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IPSPECT 1011 L1ilE
72~-3769 '
C11Y UF SPRIrIGFIELD
COIIBIrIATION APPLICATION/PERMIT
E!IERGY SOURCES:
Heat
1,later Heater
.
, .~ f" -
Job Address :;2&'''0 MA;:f'.c~LA' Ro.
I.egal De'cription/7~3-:Z_,-oo ~r~;::
9~~
Structural
Electrical
!1echan i ca 1
CONTRACTORS fn~~
General /J~C.T# ~#S7.
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Ipxnlrp~l~ (nhonp no I .
~S~-72~-::? I
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flies. no.)
Plumbino
(address)
6. (C~dlP6'::- 57'A-;o'(~)
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Electrical
r"\-chanical
PLUlIBIrIG
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ELECTRICAL
no.
, FEE 'CHARGE I -EEL CHARGF; II ,
' Re,s.,idence of
SQ. FT,
,- New circu(is '~lts. - -~-
or extenSlons I
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17'5"-1
17.:< -I
1/6"51 IOf
ICOIjl'I./lND, FEEDERS
I [Install/alter/relocate
rli~trih_ fpprlpr~
I Of amps. I
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Each single fixture
-jRelocated bUilding-j-
(new fix. additional)
IS.F. Residence I
(I bath)
IOuPlex (1 bath) each I
IAdditional bath
2/5 ....~!ater service
SERVICES
jTemporary Construction
IChange in existing
rps i d~nC'P
Imultifamily, comm. or
Tnrluc;.triil.l
!7j15 Sewe r
~"rStorm Sewer
amps.1
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TOTAl. CHARGES :2 7". c>-'> J TOTAL CHARGES
HHEnE STATE L,\11 REQUIRES that the Electrical work be done by an
shall not be valiJ until the label has been signed by an Electrical
MECHANICAL
furnace/burner 'to
BW's
I Floor furnace
and vent
I Recessed wall
I\O,lC'P hPiltpr' ;Inri
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I TOTAL CHARGES
vpnt
I Apol iance vent
c;poaratp
I Stationary evap.
cooler
I Vent fan \'1ith
sinole duct
I Vent system apart from I
heating or A.C.
I ~lechanical exhaust
hood and duct
11'lood stove/heater
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ISSUANCF OF PFRrHT
Electrical Contractor, the electrical J1ortion of this perr.lit
Sunervisor and returned to the Building Division
I HAVE CAREFULLY EXN1INED the completed apr1ication for ~ermit, and do hereby certify that all information hereon is true
and correct. and I further certify that any and,all work oerformed shall be done in accordance with the Ordinances of the City
of Sor i ng fi e 1 d and the laws of the S ta te of Oref)on pe rta i n i n9 to the work descri bed here in, and tha t rw OCCUPAUCY wi 11 be made
of any structure without the permission of the OUilding Division. I further certify that my re~istration with the Builder's
Ooard is in full force and effect as required by ORS 701.055, that if exempt the basis for exemntion is noted hereon, and that
only subcontractors and emn10yees who are in comnliance with Or.S ]t11.055 l-li11 be used on this rroject.
SIr,ilATURE }L "tY' U ,~~ OftTE4-lo' 8'''1
FOP. 0fFICE U;:,t UilU
'Sq. nf!. r1ain x Value
SQ. Fta. Access x Value
Sq. Ftg. Other~Ao'.t::"-~'~~Value-2.&: -::___~._
2f/SfB'I TOTAL VALUATlOtI
ilA:-IE(please print) <S"'u'r=, n. S-\-...p\es
lone Tyoe/Cons t. Uni ts
Fire Zone Bedrooms Occy Load
Flood Plain Stories Occ.y Group
:5~<5 64".tl-~,~ /yL? f-'47'7~/7 ~
G;:K'",z;;...,.. dll/~~---P4?N ~~ '
BUILDIrlG PER1,IIT ' Plan Ck,
Charges an~ ___________ 55'!. Bld
Surcharges ~~_~~.
PI.UI1BING PERMIT
Charges and
SurCharges
5co<8
(;?6"IP
----~qq'-~-
1'3-St:7
Fence
-
Syste~s Development
Charqe (L 5~)
;.:-:- ....-
~ ~95.-><!>
~,.T..(E'.r.T~,q "7,,-...,.,,
~//Y';:;;' 4#0 :<;c. ~,,"/7'
-,;?a:::S, """'"
O~mo
,EI.ECTRICf.,L rERl~1T
CharQCS and
Surcharges
/lECHANICAL PERljlT
Charges and
Surchart]es
Sidewalk
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.~. .'
/"::r-=?~. 77'
.. --,.....
ITotal Comb. Permit
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AIC Pavin9
I Curb Cut
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+,LP-'.YZt?S
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TOTAL
~~:713: ZS,
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COMBINATION APPLICATION/PERMIT (CAP)
1. Applicant to furnish
A. Job Address t .
B. legal Descriptiori
1. examole- Tax lot 100, Lane County Map Reference
17 03 43
2. examDle~ lot 1. Block 3. 2nd Addition to
Springfield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example. heat/electrical ceilinq/or forced air Qas
2. examole- waterheater/electrical/or solar
E. Square rootage or valuation, etc. .,----;
1. examole- 1250 sq. foot house. 500 sq. foot garage'
2. example- if new project. check new _ if addition.
check. add, etc.
F. Building pennit information':
I. example - construct single family house with an
attached gar~ge
2. examole - remodel existing garage into family room
3. examole - convert single family residence into
restaurant (change of use)
G. Value of work as defined in Section 303 (a) of the
Structural SpeCialty Code
H. DESIGN TEN! 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.
II. Abbreviated Plumbing. Mechanical, & Electrical Schedules
A. Except where blank spaces OCcur in the description
portion of the Mechanical and Electrical Schedules.
the applicant need fill-in only the No. Boxes adjacent
to the appropriate item{s) to be installed
B. Full Plumbing. Mechanical. and Electrical Schedules
are available at the Building Division
1. 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
full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is not authorized
to sign the electrical label. -
III. Applicant to sign and date
Whenever possible. the initial application will be used as
a worksheet only. Where possible. Building Division Staff
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
signature.
IV. Fees and Charges
Plan check fees are due and payable at the time of the
application, and no plans will be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
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V. FOR OFFICE USE ONLY
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PERMIT VALIDATION
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4. ,(0' 75U(
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Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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Permit applicant exempt from registration with the Builder's Board because:
AMftional Project Information:
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PLANS REVIEWED BY:
. 'na~e' L~~ l?:-~ ~
sig~a~~~eLZ-:.....~~~ __
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date ;s:.Z-P-89
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~I'I~~G':LU -:1
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IT IS THE RESPONSIBILITY OF TilE PER!UT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TUIE,
TIIAT EACII ADDRESS IS READABLE FROII THE STREET, AND TIIAT TilE PERI'fIT CARD IS LOCATED AT TIlE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES.
.. R,uired
Inspectiotf ..
PROCEDURE FOR REQUESTING INSPECTIO:;S: Call 726- 3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
job ~ddrcsf; I type of inspection requested and \-1hcn yon will be re.:::dy for the i~:Jp.ection. Contractors
or owner5 name and phone number. Requests received before 7:00 am,will be made the same day, requests
received after 7:00 am will be ~dc the followinh work day.
Your City Desi1\Mted Job Number Is: .e9a//8
Job Address: "2~ ~~.c""'~ /?fz:>
Owncr:flL..L~..<? 7J?c~""'~/"",,-~ ~W'.. Phone:
Contractor: Phone:
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S 11'1: INSrEr.rlON: To he' mndc
after cxcav:ltioll. but prior
to setup c f fo rms.
lINOEIlS1.An PLllllnlNr., E1.ECTIHc.\1.
f, ~IECII^NJC^I.: To he :nalle before
:II\Y I\'orl: is covered.
CONcnr:Tt: Sl.An INSP1-:CTTON: To he
:ll:H.lc :lftcr all inslah building
scrvicc cquipment. conduit, piping,
nccessories nnll other nnci llary
equipment items :11"0 in jlln~e but
hefore any concrete is poured.
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FOOTINGS f, FOIINIMTIONS: To he mnde
after trenche~ 1I1'e excavated and
forms :Ire erected. ;111 steel in
pl:tce. lmt pdol' to pouring concrete.
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W.Jll!:RGnOUNO: Phlmhinl:, Electrical,
r;as, Snnit:lry Sewer. Storm Sewer,
\'/:ltcr ;llHI Dr:tin:\gc I ines. To be
m:ldc Pl.j or to covel" illl; or fi II ing
tt'cnches.
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llNOERFJ.OOU: . Plumbing, Electrical.
Mcchanic:Jl. 1'0 he made prior to
inst:lll:1tipll of fIoor ins~ll:ltion,
t1cckilll~ or ["JOOI' shc:lthinl:.
POST r. I\EMl: To he m:lllc PI' io r to
in:.t;lllatiO:l of floor iI:su1:ltton,
decking or floor :~he::ting.
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FLoau INSUI.ATION Ii VAI'OR nARltlERS:
To he m:alc prior to install::.t.ion
of decking 01' 1"1001' :ihc:lting.
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~1A.sONRY: StC'el location, hond heams
g l'OUt i Ilg 0 I' vert i l~:J I sin accordanc~
,,,ith U.II.C.. Section 2"15.
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ROOF S!lEA'!'lI~:r. M!Il N:'.lI.INr.:
to inst:111 ing :lIlY rooHnl:.
Prior
ROUr.1I PJ.t!MI\lNG. EI.ECTRICAI. r.
MECIIANCI^I.: No ','ork is to be co\'ered
IIntil thesc insJlcctions have bcen
nmtlc :Jnd approved.
IKJ FINAl. PI.U>!lllNG
o Ft!llAI. EI.ECTRICAI.
o I:INAI. MEOIANICAI.
D FINAL rIlm nEPAltTIIENT
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^TIIC Oil^,'" STnpS f; CIIIlTAHI WAl.I.~.
FIREPLACE: Prior to plncing facing
mnterials nnd beforc framing
inspection.
INSUIATTON r. VAPOR RARR!ER: To be
made nfter all insulation nod
rcquired vapor barricrs arc in placc
but before any lath or gypsum hoard
interior wnll covering is applied.
FMMING: To hc made after thc roof,
all framing, firc blocking and
bracing are in place and all pipes,
chimneys nnd ,"ents nrc complete ~md
the rOllgh electric3I, plumbing and
heating wires. pipes ami ducts are
approvcd.
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UTI' ANn/OR GYPSUM BOARD INSPECTION: )(l
;1"0 he madc after alI lathing and ~
g)'psum hoard, interior 3nd exterior,
is in placc hut before any plnsterint: =:J
is :Ippl ied or heforc gypsum hoard
joints :lIld fasteners lire taped and
finished.
rIRI: r. SEJ1Mt^TTON \~ALI.: Locnted r.
ccnstructed according to plans.
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WOOOSTOVES: After installation is
completed.
SIOm~AI.K r. ORIVEW^Y: Required for
nIl concrete paving within street
right-of-,,,ay, to he mal.lc oftcr all
excavating complete G form work &
sub-bnse material in place.
cUlln ANO APPIlOACII APnON: After forms
:lTC erected hut prior to pouring
concrete.
'SPECIAL INSPECTIONS: In accordance ,l'ith
Section 306 of the Building Code a special
inspcctor shall be emplo)'ed by the O\'merl
Contractor during construction of the
following work. A copy of the special
testing reports shall be furnished to the
Building Division.
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STRUCTUML CONCRETE: In excess of 300n
P.S.I. (306 a.l)
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PARKING UYf: After gravel is in
place but prior to placing asphalt
or concrcte.
STRUCTUIt"L WELDS: Prcformcd on the
job. (2722 f)
IIIGH STRENGTII ROLTING: During all
bolt installation and tighting
operations (306 a.S)
SPRAYEO ON FlnEPnOOrINr.: (u.n.c.
Standards 43.8)
SPECIAl. r.nAOING. EXC^VATlON ANO
I:ILLING: During c::arthwork. (306 a.ll
fi Chaptcr 29)
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GI.U-LAM BEAUS: Inspection Certific::ate,
by an approved agency, furnished to
the City's Building Division before
benms arc placed. (2501-U.B.C. STDS.
25-10, U).
* In addition to the inspections
specVied hereon. the Building
Official :nay make or require other 7
inspections of any construction .1
work to ascertain compliance with ,.
the Building, City or Zoning Codes..
CITY'S SITE PIAN REVIEW OO..\RD INSpeCTION: Must bc rcquested 2 days in advance of the date you
wish i~spection. All project conditions such as landscaping. parkinc lot striping etc. must..
be cODl~leted heforo requesting this inspection.
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.FINAl. UlITI.DING: Must he requcsted after the finnl Plumbing, Electric:!.l, ~tcchanicaI and Pire
Ilcpnrtmcnt inspections are m.'lde and approved. No Occupancy of the premises can be m.:1dc until
a Certificatc of Occupancy has bcen issued b)' the Building Division and posfcd on the .premises
SICNATURE_
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