HomeMy WebLinkAboutPermit Building 1990-3-28
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.. RESID~T1AL"
APPLICA1Y1N/PERMIT
225 North 5th Street
SpringfieZd, Oregon 97477
BuiZding Division
726-3753 '
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(}Jner:~mQ{ \\~ D'lhlt-Qr'A-Lo -52;\ \
Address: f) 4N 0 \'f\C\ ~ ~","e: q ~l-md.3
City: ~~\~~\ l_~ Zip: qvy_\- {n
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Job Loca.tion:
1140lo \S'('Ll f\ ~OooL
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Asoeaaor3 Map
Subdivision:
QNm,'
n Additicn
n Remodel
n HobiZe Homa
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en
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Dats of Application R
Contract~ Arlrlress
.Generall~~\~OU ........'
i Plumbing UnomGA \h.QtJO.J_V'Y\ ~t);-~LOQ,4'? ~cm~iR~ '5 \'1,37
i Hechanical ' - ()
I El,ectrical (l gn 1lfl f'\I. A "( N.b~ , r\nJi)
I Suoe"",a.e.,;;:o1g Electrician II ~
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Value
. ,Lisc.- II
Rcae-:.pt if
I { DS~ \
Siqr.ed:
Date:
Bldrs Board Reg.
Phnnp
.Expires
ClI\?t/Cj(X' ~A_
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he . L t' 'h~ - ..
t propel' t1J1l~.. tr.a eac .:uu.re8~ 1.8 rea=a.o..6
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It i.s the rBsponDi.bitity of ths permit holder to Bee that all. inopeati0118 al"'e made at
from the street. and that the p""": t card is located at the front of the 'property,
-Bui!di'!'tg D!.vi::ior: approved plan, shaH remain on thz Bu-:.Zdinfr Sits at all times.
PHOCEDUP.E FOR INSPECTION RE:QUEST:CALL 726-3769 (recorder) state your City designa.ted job nwr:ber, job adi:rcss, type of in3pee-;icn
requested ar~ when you will be ready for inspection, Contractors or Owners name end phone number. Requests received befere 7:00 am
lo.'il1. be rrruie th6: same day, requests made afte.r 7:00 am L1iU b2 made the nczt :xJrking day.
. " ',:. Y~ City Desigr.ated Job Nwnba IlJ: ~ 1311
Rp.oui~p.d rnSDp.cticns
O SITe INSPECTION: To be mde after
excavation, but prior to set up of
. forms.
O ' UNDERSLAB PLUMBING. ELECTRICAL &
MECHANICAL: To be made before any
work is "overed.
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FOOTING & FOUNDATION: To be /TUde
after trenches are excavated and
forms are erected, but prior to .....
pouring ccneret~.
UNDSRGROUND PLUMBING. SEWER. W.1TER.
DRAINAGE: To be made priOl' to fil-
.1.ir.g trenches.
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UNDERFLOOR PLUlfBING & MECHANICAL:
To be made prior to in3tall.ation of
{LOOl' insul<:tion or decking.
POST AND BEAM: To be /TUd. PM.ol' to
instaUation of floor insz,;,Zatior. 01'
decki"G .
[7J ROUCH PUP-mII'G. ELECTRICAL & MECH-
ANICIft: lW :.;ark is to bc covered
.ur.til these inspections have beer.
made and approved. .
D FIr~EPLACE: Prior to p'Lacir.g facing
materials and before framing inspec-
tior:.
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FRAlHNC: Must be requeDted after
approva.1. of rough p1.wr.bing, e1.ectri-
cal. & mechanica1.. AU roOfing
bracing d chimneys, etc. Tir..lst be
. completed. flo worok is to be CQ11-
.. cea1.ed until thin inspeation has
'be~n made and approoved.
U lNSULATIONIVAPOR BARRIER INSPECTION:
To be made after aU insuk:.ti:m w.d
.' .' required vapor barriers are in plaae
. . but before any lath, gypsum board or
wU covering is applied, and before
any insulation is concea1.ed.
O DRYWALL IIISPECTION: To b. made
aftel' aU drywalL is in plaae~
. but prioro to any taping.
Rl MASONRY: Steel 'Location, bo1u:l
If=l beam3, grouting or vertiaal8 in
acaordance with U.B.C. Section
2415.
O WOODSTOVE.: After instal.lation is
ccmpleted.
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CURB & APPROACH AP.f:!ON: Aftezo forms
are created but prior to pouring
concrete.
. DEnOLITION OR gOVEr; BUILDINGS
:J Sanitary 8e'.Jer aapped at ~op<=r~' line
~ Septic tank p".c;:ped and fille~ LJith gra~eZ
I Final. - f{Jum above ite."!ls are completed
~ and when demolition is comp1.ete or stru~-
ture moved and pr2mises cleaned up.
Mobile Hcmes
~ Blocking a1Ui Set-up
~ Plumbing conneations -- s~el' and watero
---, E1.ectrical Connection - BLocking, set-u?
-.I and plumbing aonnections TTr..lst ce approoved
beforc roequesting electrica1. inspection
~ Ac.zesso~d Sui 7.ding
:J Fina1. - Aft::ro porcr.es,
etc. are completed.
sHrting, decks,
,
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SIDEWALK & DRI~'EWAY: For all con-
crete paving within stroect right-
of-fX.Y~ to be made after all exca-
vating acrrrp1.ete & fo1"m ruork & sub-
base rrr::.terial in pla.ze.
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D PENCE: When comp1.€te -- Provide
gates 01" movable sections through
P.U.E. '
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AlL project conditions, Guch as the instaUation of street trees, co::rpZation of the
roequiroed landscc.pir.g, eta., must be satisfied bcforoe the BUILDING FI!lAL~~n be request.$d.
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FINAL BUILDING: The Final. Building Inspection must be roequested afte'l" the Pina1. Plwnbina
El.ectl'ica1.~ and Mechar.ical Inspectio1UJ hal.lO been made and apPr:0t12~..
!6i/PIIIAL PLUMBIIIG
o FIliAL /1ECHAIIICAL
k81 FINA~ ELECTHICAL
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~ALL MANHOLES,"AND CLEANOUTS HUST BE ACCESSIBLE, ADJUST!fENT TO BE 1-MDE AT NO COST TO CITY f Pa~c ! of 2
I JOB NO,
R EQ.l'ttfa "
L-COG~
Zona:
,SOLAR ACCESS
OccuDanc~ Gr.
LOTTrPE
Bedrooms:
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~Obi e,!lame ;\ y~ I, ~J i
\ 1 A '_ (J _" I \ \ ,Qe, I /'
--, I ,1 (if!'~q
I TOTAG AJ.!OUI~T, DUE,' cQCf ,r; fcj . rignza
[,at Sq. Ft{;.
S af tot C~erag~
I!I of Stories
Total Height
I
I Topography
I
lITEM
I Main
I GaPaae
I Carvol't
IACCBS80Ml
! S~.FTG
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TOTAG VAWE
S.D.C.
(UC:l.UC)
1.5 :r:
Building Permit
State Surcha:rge
Total Cha.-ges
.lITEM
I Fi.xtures
'Residential (1 bath)
I Sanitary Sewer>
I WateP
I
I NO.
I
I
,
'I
Pl:onUing Pe=i t
State Surcr.apge
Total Cha'l'oes
lITEM 1110'1 FEE
I Res. Sa. fta.
N3W/Exterui Cil'c:uits I I
Temporary Service , ,
I I I
Electrical Permit
State SUrcharae
Total Cht:U'CBS
IITSM I NO, I FEE
I Furnace ETU'S
I Exhaust Hood I I
I Vent Fan I I
I ' I I
I Jloodstove
, , ,
Permit Issuance
Me::hanic::zl Permit
State SUrcharae
Tntn I r.Nrrrum
-- ElICROACHMENT --
I SeC-.lritl! D200sit
I Storage
Maint~e
Permit
Total. Chal'aos
Curbcut:
sid""",lk
Pence
Electrical Label
< "
,
-,
Interior
Corner
Type/Cor.st: .
II
Setbacks I I
House Carage Access. I I
II
II
II
II
Enel'rt.lJ Sources
Heat
Water YfWtm'
Range
Fireplace
wood:;tove
TiI'Oe
I Lot Faces -
I
I P.G.
INorth
lEast
South
IWest
.
Panhandle
Cul-de-sac
Fees
x
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( 'I. 'SQ
. 'X~
.15.-2A1'
IPlan Check Fee:
I Date Paid:
IReceipt g,
I Signed,
Value
Building Value & Permit
This pernr;t is g~nted on the express condition that the sdid construction
shall~ in all l'espects~ confor'l1l to the Ordinance adopted by the City of
Sp:rin.gfield~ including the Zoning Drdinance~ regul.ating the ccnstl".J.cticn
and use of buildings~ and m::J.y be sucpended 01' revoked at c:r.y time upon vic-
lation of any provisions of said Ordinances.
FEE
CHARGE
Plumbing Permit
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No person shall construct~ installJ alter or change any new cr e:tsting
plumbing or drainage syst~ in whole 01' in part~ unless such person is tr~
legal possessor of a valid plumber's license~ except that a pe~son may do
plwr.bing work to property which is OtJnedJ leased 01' operated by the appli-
cant.
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CHARGE
Electrical Permit
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Where State LalJ l'equires tr.at the clectl"ical l.JOrk be done by an Ele~t:rical
Cont1'actor~ the electrical pOl'tion of this pel'mit shall not be valid until
I the label has been signed by the Electrical Contractor.
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CHARGE
Mechanical
Permit
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Plan E:ram'/..ner
vate
I HAVE CAREFULLY EXANINED the completed application for pemt, and do
hereby certify that all. info:m::ztion hereon is tt'Ue and correct, and I
f.Jrthel' cel'Hfy that any ar.d all !JQrk pel'loM/ed shall be do:-ze in ac~ol'-
dance :.Jith the Ordinances of the City of Springfield, and th~ La..:s of tha
" State of Oregon p81'taining to the lXlrk described herein, end that NO OCCU-
PANCY will be nnde of any structure without p3rrnisaion of the Building Di-
vision. I further ~ertifY that O:1ly contractors ar~ e~l~yecs who are in
compliance with CRS 701.055 will be used on this project
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Permit No: R1/ ~) ]
Address: \~n( n ~ 9. ^ ) I/'\
Issued by:1 ; .~O-=L Date~ 3..1f;J1U
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STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants
who are not registered with the Construction Contractors Board to sign the
following statement before the building permit can be issued, Licensed Architect
and Engineer applicants, exempt from registration under ORS 701.010(7), need
not submit this statement This statement will be filed with the permit.
Fill in the applicable blanks, and initial box 1 and either box 2A or 2B:
1, L.A.J I own, reside in, or will reside in the completed structure.
2. A. ~ My general contractor is rn;;.\'t!I-J.--fi1/1CI<. /J10,),(~
Contractor registration number
I will instruct my general contractor that all subcontractors who work on
the structure must be registered with the Construction Contractors Board.
OR
B.%(
I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the
Construction Contractors Board. If I change my mind and co hire a general
contractor, I will contract with a contractor who is registered with the
Construction Contractors Board and I will immediately notify the office
issuing this building permit of the name of the contractor,
I hereby certify that the above information Is correct and that I have read and understand
the Information Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
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Signature-of Permit Applicant
Ji-r;ff'~6
'Date' ' .
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CONSTRUCTION CONTRACTORS BOARD'
0244.1 10/24/89
~~py TO ISSUING AGENCY PERMIT FILE
CD rld ~~ TO APPLICANT
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