HomeMy WebLinkAboutPermit Building 1988-7-5
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~ CITY Uf SPRINGFIEeD
COMBINATION APPeICATIONfPERMIT
ErlERGY SOURCES:
Heat
\'later Heater
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INFORlIATION UNt
726-3753
Sq. Ftq. I.lain
~q. Ftg. Access.
Sq. Ftq. Other
New Add Alter Rep.
-Fence Demo ChangefUse
-Other - -
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",!IlSPECTIDN UNE
) 726-3769
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Legal Description / '70.ol. ~ 0 () 0 011 7fJ{)
Owner U:;, I~- r~
Address ? fq~ ;If/fttc~
Job Address
Phone
Range
ValuE of Hork:
~':;>~~"-
Builtiinq Permit Info: Describe Work(Le., Build Single
Familv nesidence With Attached Garaoe)
~tJcLd' a'i' ~fh~JV
fJ!?M.t1 /;;:!;s ~ ~
Construction lender~J'~~
Address ~
Ut~lGN T~ (name)
~)
/
Phone
(address)
flics. no.)
(exo;rps)
;'
(ohol1P no.)
Primary
Ii
<;("")LI. ~m(') ~
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Structural
Electrical
Mechanical
CONTRACTORS "(name) (, _ ,
General ~./ ~-
Plumbina
(addre~s) (lies.
~f/.JrMv Znt1~_
no.) (px~;rps)
(ohone !"In )
c.( c...'t).:J 3
L(~ 30 ~t'/
.'
Electrical
(I ltJ1JlJ JlJ1iItI/ A
~l
~
~1echan;cal
I'UInIlJIIG
EeECTRICAL
MECHANICAe
NO.
Each single fixture
1m
C.l\AJ1GE
Nn
I ~~~ 1 n.lARt:~ NO I
I ~~r I rl-lll.Qr.r
Residence of
furnace/burner to
SQ. FT. BTU's
I Relouated building
(new fix. additional)
IS. F. Residel>oe
(1 bath)
IDUPlex (I batb) each
IAdditional batll
I ~Iater se"ic~
Sewer
~-New circu~ts alts.
or extenSlons
'2='1 ~g-
SERVICES
"ZZ5t
Floor furnace
and vent
Recessed wall
S~~rp hp~t~r ~nrl vpnt
Storm Sewer
I
Of
'"2 c:>r5
amps.1
?/. 5- .
Appliance vent
seoa ril. te
Stationary evap.
r.nol~r
Vent fan with
sinole duct
Vent system apart from I
heating or A.C.
Mechanical exhaust
hnnri and dUl"t
I
Temporary Construction
Change in existing
rpsidpf\l"p
multifamily. COnIn. or
Tnduc;trirll
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TOTAe CHARGES TOTAL CHARGES ~~~ . TOTAL CHARGES
WHERE STATE L~ REQUIRB that the Electrical work be done by an.'Electrical Contractor. the electrical portion of this permit
shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division
COMM./IND. FEEDERS
Install/alter/relocate
r{ic:trih. fPPrlprc:.
Wood stove/heater
Of
amps.
ISSUANCE OF PFR!lIT
Zone
Fire Zone
Flood Plain
I HAVE CAREfUlLy [XAMI~ED the completed application for permit. and do hereby certify that all information hereon is true
and correct~ and i further certify that any and all work performed shall be done in accordance with the Ordinances of the City
of Springfield and the taws of the State of Oregon pertaining to the work described herein. and that NO OCCUPArlCY will be made
of any structure ~thout the permission of the Building Division. I further certify that my registration with the Builder1s
Board is in full force and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon. and that
only subcontractors and employees who are in compliance with OP.S 7nl.055 will be used on this project.
Stephen Kneller SIG:IATURE~za_
FOR OFFICE USE OljL Y I I
Units Sq. Ftg. r1ain x Value
Occy load '~ Sq. Ftn. Access x Value
Occy Group' g-""2-Sq. Ft~. Other ~~ Value ~S=.
-r7"\/ .! TDTAe VALUATION
"I IlltJ:1..,
/ l..I/ Plan Ck. Conm/lnd......,C/,<:; ?
_J.L-';i?.:~f?.__ 65%/Rldo Per ,pp "fJ.;;l....,
Plan Ck. Res
30%/Bldo Per Fee
1 Fence
I O~1I10
60~ <:>-Ci> ISidewa I k
L./ ------3---~-1 AfC Paving
1 Cu'rb Cut
I
T yoe/CDns t.
Bedrocms
Stories
_ 5"-N .
DATE ?-s -~ t
I
NAHE (p I ease print)
/
BUILDING PERIIIT
Charges and \
Surcharges C7'"
J~ ,"') syste, ms Development
lI<cKt CharQe (I. 5%)
,f/ #- -
/_ ;1':3
PeUMBING PERMIT
Cha rges and
Surcharges
I
I
EeECTRICAe PERr~IT
Cha rges and
Surcha rges
ITotal
I TOTAL
J
Comb. Permit
MECHANICAe PERMIT
Charges and
Surcharges
--:;;:/6.8'5
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
I. Applicant to furnish
A. Job Address
B. legal Description
1. example~ Tax Lot 100, Lane County Map Reference
II 03 43
2. examole- Lot 1. Block 3, 2nd Addition to
Sprlngtield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. example- heat/electrical ceilinqjor forced air qas
2. example- waterheaterjelectrlcalfor solar
E. Square footage or valuation, etc. -
1. examp.'e- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check new - if addition,
checl< add, etc.
F. Building permit information:
1. example - construct single family house with an
attached garage
2. exam~le - remodel existing garage into family room
3. exam~le - 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. OESIGN TEAM ANO 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
fu 11 schedu 1 es ' .
C. BUILDING OIVISION STAFF WILL FILL OUT ALL FEES ANO
CHARGES ON THE SCHEOULES
O. As noted on the CAP. the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contracto~ 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 p~rmit 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 penmit is issued.
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V. FOR OFFICE USE ONLY
Permit Clerk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Addi~ional Project Information:
PLANS REVIEWED BY:
name
tcn~~ !--,~
signature
~---- ~_ ~date
~~ / r'
h-/3'-E?'B
I
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./ ~ ~'';''''mTI'' '~R!:i:o:~ ro,~ ,,,~n:.~::,:!S~: """
. i THAT EACH ADDRESS IS READABLE FROM THE STRF.ET, AND THAT THE PErour CARD IS LOCATED AT
PROPERTY, BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TInES.
PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
job address, type of inspection requested and when you will be ready for the inspection. Contractors
or owners name and phone number. Requests received before 7:00 amrwill be reade the same day, requests
received after 7:00 am will be made the fqllowing work day.
88C>V~ /
"6 ~z;- ,hYh"RC?iLo pD
Owner: M....c ~R-/C..n c-E""A"r-~"'<:>
Contractor:. /V~/ft..-c?''''''::'c.~
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FOOTINGS & FOUNDATIONS: To be made
after trenches are excavated and
forms are erected, all steel in
-place. but prior to pouring concrete.
UNDERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer, Storm Sewer,
Water and Drainage lines. To be
made prior to covering or filling
trenches.
Your City Designated Job Number Is:
Job Address:
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SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNDERSLAB PLUMBING. ELECTRICAL
& MECHANICAL: To be made before
any work is covered.
CONCRETE SLAB INSPECTION: To be
made after all ins lab building
service equipment, conduit, piping,
accessories and other ancillary
equipment items are in place but
before any concrete is poured.
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UNDERFLOOR:, Plumbing, Electrical,
Mechanical. To be made prior to
installation of floor insulation,
decking or floor sheathing.
POST & BEAM: To be made prior to
installation of floor insulation,
decking or floor sheating/t
FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to install~tion
of decking or floor sheating.
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~~SONRY: Steel location, bond beams
grouting or verticals in accordance D
with U.B.C. Section 2415.
D
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ROOF SHEATHING AND NAILING: Prior
to install ing any _~oofing. LJ.J. D
ROUGH P!,UloffiING.(''11'LECTRICA'"D&
~1ECHANCIAL: No work 1S - to be covered
until these inspections have been
made and approved.
D FINAL PLUMBING
'-fC)
~ FINAL ELECTRICAL
,.. D FINAL 'lECIlANICAL
o FINAL FIRE DEPARTMENT
D
,.,
~
Phone:
~Y'v-~/.-z:>
Phone: ? v:;>- ~o,,:;
ATTIC DRAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior te placing facing
materials and before framing
inspect:j..on. I })
INSULA~ON & VAPOR BARRIER: To be
made after all 1nsulation and
required vapor barriers are in place
but before any lath or gypsum board
interior wall covering is applied.
FRAMING: To be made after the roof,
all framing, fire blocking and
bracing are in place and all pipes,
chimneys and vents are complete and
the rough electrical, plumbing and
heating wires, pipes and ducts are
approved.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
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LATH AND/OR GYPSUM BOARD INSPECTION: ---,
To be made after all lathing and ~
g)~sum board, interior and exterior,
is in place but before any plastering I
is applied or before gypsum board ~
joints and fasteners are taped and
finished.
WOODSTOVES:
completed.
SIDEWALK & DRIVEWAY: Required for
all concrete paving within street
right-of-way, to be made after all
excavating complete & form work &
sub-base material in place.
CURB AND APPROACH APRON: After forms
are erected but prior to pouring
concrete.
After installation is
PARKING LOT: After gravel is in
place but prior to placing asphalt
or concrete.
THE PROPER TUlE,
TilE FRONT OF THE
'SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the O~~er/
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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STRUCTURAL CONCRETE:
'P.S.!. (306 a.I)
In excess of 3000
STRUCTUR~L WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BOLTING: During all
bolt installation and tighting
operations (306 a.5)
SPRAYED ON FIREPROOFING:
Standards 43.,8)
(U.B.C.
SPECIAL GRADING.
FILLING: frJring
& Chapter 29)
EXCAVATION AND
earthwork. (3-06 a.11
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GLU-LAM BEAHS: Inspection Certificate,
by an approved agency, furnished to
the City's Building Division before
beams are placed. (2S01-U.B.C. STDS.
25-10, II).
*In addition to the inspections
specified hereon, the Building
Official may make or require other
inspections of any construction
work to ascertain compliance with
the Building, City or Zoning Codes.
CITY'S SITE PLAN REVIEW BOARD INSPECTION: Must be requested 2 days in advance of the date you
wish inspection. All project conditions such as landscaping, parking lot striping etc. must
be com~leted heforc requesting this inspection.
FINAL BUILDING: Must be requested after the final Plumbing, Electrical, Mechanical and Fire
Department inspections are made and approved. No Occupancy of the premises can be made until
a Certificate of Occupancy has been issued by the Building Division and posted on the premises
SICNATURF
DATE
* ALL ~tANHOLES AND CLEANOUTS ~IUST BE ACCESSIBLE, ADJUSTMENT TO BE MADE AT NO COST TO THE CITY.