HomeMy WebLinkAboutPermit Building 1984-1-11
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.. Aquired
Inspeclms ..
IT IS THE RESPONSIBILITY OF THF. PER."1IT HOLDER TO SEE TIlAT ALL INSPECTIONS ARE MADE AT TP.E PROPER TIllE.
" THAT EACH ADDRESS IS READABLE FROM THE STREET. AND TIlAT TlIE PER 'lIT CARD IS LOCATED AT TUE FRONT OF THE
PROPF.RTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIMES.
PROCEDURE FOR REQUF.STING INSPECTIONS, Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER.
job ~ddress. type of inspection requested and when you will be re~dy for the inspection. Contractors
or o\vners name and phone n~~ber. Requests received before 7:00 am will be ~Ade the same day, requests
received after 7:00-am will be ~de the following work day. .
Your City'Designated Job Number Is, "1. ~2~69_
Job Ac!dross: ;")C\O"S \-\~ \?C()\ ~ Q't)
Owner:~-m..\ \~~l:>,,\'A 'V'>~ C~\\ "'~~\\ Phone:~'2..(...,... \~\("'~
Contractor~ G~\.\ ~ C_r. \...J" \=-9_ Phone:
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SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNDERSLAB PLl>>lBI~Gl ELECTRICAL
6 ~IECHA."HCAL: To be made before
~ny work is covered.
CO~CRETE SLAB INSPECTIO~: To be
made after all inslab building
service equipment, conduit, piping,
accessories and other ancillary
equipment items are in pla=e but
.before.any concrete is poured.
r::::l--FoOTlNGS & FOUNDATIONS: To be made D
~ ~fter Lrenches arc excavated and
forms are erected, all steel in
place. bu~ prior ~o pouring concre~e_
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VSDERGROUNO: Plumbing, Electrical.
Gas, Sanitary Sewer. Storm Sewer,
Water and Drainage lines. To be
made prior to covering or filling
trenches.
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UNDERFLOOR: J Plumbing, Electrical.
Mechanical. To be made prior to
installation of floor insulation,
decking or floor sheathing.
POST a BEAM: To be made prior to
installation of floor insulation,
decking or floor sheeting.'.
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
with U.B.C. Section 2415.
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ROOF SHEATHI~G k~D NAILING: Prior
to installing any roofing.
ROUr.H PlL~IB!NG. ElECTnIC,\l &
~lF.CHANCI^L: No worlt is to be covered
until these inspectio~s have been
made and approved.
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~ FINAL PlUMBINr.
~ FINAL ELECTRICAL
o F,"Al ~IECllANI CAl
o FI~AL FIRE DE!'ARnlE~IT
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ATTIC DRAFT STOPS & CURTAIN WAllS.
FIREPLACE: Prior to placing facing
materials and before framing
inspection.
INSULATION & VAPOR BARRIER: To be
made after all insulation and
required vapor barriers are in place
but before any lath or gypsum board
interior wall covering is applied.
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FRAMING: To be made after the roof,
all framing, fire blocking and
bracing are in place and all pipes.
~himneys and vents are complete and
the rough electrical. plumbing and
heating wires. .pipes and ducts are
approved.
FIRE a SEPARATION WALL: Located 8- '--'
constructed according to plans. ---l
LATH AND/~R r,YPSlTh1 BOARD INSPECTION: ---,
To be made after all lathing and ---l
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: After installation is
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
ore erected but prior to pouring
concrete.
PARKING LOT: After gravel
place but prior to placing
or concrete.
is in
asphalt
SPECIAL INSPECTIONS: In accordance with
Se=tion 306 of the Building Code a special
inspector shall be employed by the ~~er/
Contractor during construction of the
following work. A copy of-~he special
testing reports shall be furnished to the
Building Division.
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STRUCTURAL CONCRETE: In excess of 3000
P.S.I. (306 a.l)
STRUCTUR~L WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BOLTING: During all
bolt installation and tighting
operations (306 a.5)
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SPRAYED ON 'FIREPROOFING, TU.B:C.
Standards 43-8) .
SPECIAL GRADING. EXCAVATION .~O
FILLING; ~Jring earthwork. (306 a.11
& Chapter 29)
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GLU~LAM BEM-tS: Inspection Certificate,
by an approved agency, furnished to
the Ciry's Building Division before
beams are piacea. t2S01-U.B.C. SinS.
25-10,11) .
*In addition to the inspections
specified hereon, the Building
Official ~ay make or require other
inspections of any construction
work to ascertain compliance with
the Building, City o~ Zoning Codes.
CITY'S SITE PLAN REVIEW BO.\RD INSPECTION: Must be rCGuested 2 days in advance of the date you
wish inspectio~. All project conditions such as landscaping, parking lot striping etc. must
b~ com~leted hefore requesting this inspection.
I v~Al BUILDING: ~ruSt be requested after the fin' I Plumbing. Electric.l, "ech.nical and Fire
Department inspections are made and approved. No Occupan=y of the premises can be made until
a Certificate of Occupancy has been issued by the Building Division and posted on the premises
SICNATUR~~ ~4A~U-
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DATE
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Job Address
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CITY OF SPRINGFIElD
COMB! IIATION APPlICATION/PERMrT
o nn c iIVln .,,^_I ll!I~Rtr,y SOURCES:
'-~,,-n.J IIW('.otClpQ. NA
('>"2.. (f" f'() (){)1tf) I'/ater Heater
Ranqe
Valu, of Hork:
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I INSPECTION 1I1IE
726-3769
Ownediental Health for Children, Inc.
Address 3995 Marcola Road. S . f' 1"" :126 146' Buildino Pennit Info: Oeser be Work(i.e., Build Single
prl ng le U,on9' - ) Family nes;dence 1.lith Attached Garaae)
OPeN -?T/<<..I.Cj'lJft: ~ f(<DWO[, u>Vct.
Fof.. C>lAT~ PLAY ~qv~t.
$2500.00
INFORlIATlON UNt
726-3753
Sq. Ftq. 1.lain
~q. Ftg. Access.
Sq. Ftq. Other
lIew Add Alter P.ep.
-Fence Demo Change/Use
Other - -
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legal Description \ l
Construction lender
The Child
Center
Address Same
UI:.:::dbN H:.AH I name I
Primary Robert L. Shaw. Re~i s tered
Phone
(address)
Archi teet.
(lies. no.) Cexniresl
2094 Fairmont, Eugene. OR
(ohane no.1
342-2909
Structural
Same
Not Applicable
Not Il.ppl icable_
(namel
(address)
flics. no.)
(pxoirpc:.l
(nnnnp on \
Electrical
Mechanical
CONTRACTORS
General The Chil d Center, Gordon lvri qht, Ass i stant Di rector
Plumbina NA
Electrical NA
flechanica1 tJA
PlUflB IrIG - NA
ElECTRICAl - riA
MECHANICAl - flf-
NO.1
Each single fixture
I FFF I [HARr,F Nn I I JOEL'.LI!ARli.E. Nn. I
Residence of furnace/burner to
SQ. FT. STU's
1~'.LI!ARli.E.
I
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
11 bath 1
Duplex (1 bath) each
Additional bath
SERVICES
Recessed wall
C::;lli'lrp hp:ltp... i'lnri ./pn'"
Storm Sewer
Of
amps.
Appliance vent
~pni'lri'ltp
Stationary evap.
cooler
Vent fan wi th I
c:.inol~ duct
Vent system apart from I
heatina or A.C.
Mechanical exhaust I
hood and dud
\'/ood stove/heater I
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~Iater service
Temporary Construction
Change in existing
rpS i dJ)Jl("p
multifamily, comm. or
Tnduc:.tri<il
Sewer
COMH./IND. FEEDERS
Insta11lalterlre1ocate
dil:.trih fppdprc;;,
Of
amps.
I SSUANCf OF PFRf1lT
TOTAl CHARGES TOTAl CHARGES TOTAl CHARGES
WHERE STATE l'W REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit
shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division
I HAVE CAREFUllY EXAMINED 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 laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAr~CY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builderls
Board is in full force and effect as required by ons 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 701.055 will be used on this project.
IIAI.IE(please print) boe~ --V - W~14H( . SIGIlATURE?~ r[) '/~~OATE~/~ I
". ~.~, FOn OFFICE USE mIL Y .
Zone~_(r13TYOe/Const.V-\\ Units \ Sa. Ftg. flain x Value
Fire Zone - Bedrooms - Occy load Sq. Ftg. Access L.l-Q 'l_ x Value
Flood Plain- Stories \ Occy Group 'Il..u.. Sq. Ftg. Other x Value
BUIlDING PERmT
Charges an~
Surcharges
r-} ~ ~ Plan Ck. Comm/lnd
~ ~\. 65%/Bldo Ppr ~~e
---- --n-(--- Plan Ck. Res
'"'I /) 30%lBl do Per Fee
\\~ Fence
.}.,!~__n____
OalrJ
IJ.IJ~
(JIf61~
TOTAl VAlUATION
Systems Development
l.lc1lo-)?", Charqe 0.5%)
'2>Co, 00
PlUt1BING PERMIT
Charges and
Surcharges
D~mo
~~;~~::C:~/ERrm .Dh. __ ___ ___ Sidewalk
Surcharges AIC Paving
!IECHANICAL PERMIT
Charges and
Surcharges
_\)~________ Curb Cut
ITotal Comb. rermjt
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I TOTAl
100,~(Q
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COMBINATION APPLICATION/PE~~IT (CAP)
PERMIT VALIDATION
J1 (Pdd- /9
/- /I~fcf
III.
1. Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, lane County Map Reference
II 63 43
2. exam~le- Lot I. Block 3, 2nd Addition to
~prlngtield Estates I
C. Name, etc. of owner and construction lender
D. Energy Sources . (
1. examole- heat/electrical ceilinQ/or forced air Qas
2. examole- waterheater/electrlcal/or solar
E. Square footage or valuation, etc. -----
I. examole- 125D sq. foot house. 500 sq. foot garage
2. example- if new project. check-new - if addition,
check 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. examyJe - 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 TEM4 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. ---
Appl icant 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
Permit Clerk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because':
Additional Project Information:
PLANS REVIEWED BY:
namecA ) \\) 0. \='\. u=\ '\"""\
Signatur~,^f\(~:;~\~ Y
d~teO :?,'b -~?\
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