HomeMy WebLinkAboutPermit Building 1986-3-24
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I IrISPECTION L1f1E
726-3769
-#5/00 ~~t!if-J '~~,. d;;o'
. CllY Dr SPRINGFIELD ~ t- INFOR/IATIDN LINE
CDMBIflATION APPLICATION/PERMIT 726-3753
E!lERGY SOURCES: Sq. Ftq. "Iain~/n-,,",
. Hea t ~q. Ftg. Access.
Water Heater Sq. Ftg. Other
, flew)(Add Alter Rep.
Ranqe -Fence Demo Change/Use
l ValuE of Hork: Other- -
1........L7.ao.oo
Bu;lGlnQ Permit Info: Describe Work(i.e., Build Single
Familv nesidence With Attached Garaoel
Ce:w~r;u<:',r /a.8 t;6 ,"'8crrL~
l':;;;rn~~t:E" -4DZJ/r/c:::w J.; 7-//
Phone <7"~# -" ~bD L_T?"pP-~/N~. \
(address) -(l1c5. no.l (exoiresl (chane no..
26/J.(IfJ /fJ.;;il/1;;t PI/nd 97?a9 ~ ~Q'-I-/)JI()
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Job Address .~fl"8 MA//V
Legal De5Cription 17.~Z.33-C/1
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Owner 01'1+1daJld
Address
Construction lender
Address
DES I Gtll EAI1
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(~iJim.-
Phone
Primary
YdJJ )
(name)
() A ./'JiLCr)! j/.)
Structural
Electrical
Mechanical
CONTRACTORS
(name)
General
Plumbina
Electrical
~1echanical
PLUllBIIlG
-llih
Each Single fixture
IRelocated building
(new fix. additional)
IS.F. Residence
(] bath)
IDuPlex (1 bath) each
IAdditional bath
I ~Ia ter servi ce
I Sewer
'sa'l Storm Sewer
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Zone LC:
Fire Zone
(address)
flies. no.)
(~xoirps\
(ohonp nn
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Iza-
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ELECTRICAL
EEL IJ:IiARIiE.! "0
MECHANICAL
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I ~J:~ 'rl-lJ1RG..E.
Tyoe/Cons t.:ZZZ - N
Bedrooms
Stories
Flood Plain
BUILDING PERmT
Charges and
Surcharges
PLUI1BING PERMIT
Charges and
Surcha rges
ELECTRICAL PERI~IT
Cha rges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
I FEE r.Hi\Rr.E Nn I
/
/'/<.
Residence of
furnace/burner to
STU's
I
I
I
TOTAL CHARGES ZOo - TOTAL CHARGES IS". 00 I TOTAL CHARGES
. WHERE STATE L'l~ REQUIRES that the Electrical work be done by an."Electrical Contractor, the electrical portion of this pemit
shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division
I HAVE CAREFULLY EXM11NED 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 oerformed 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 IW OCCUPAIKY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
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 ORS ]Q1.0~5 will be ed on this project.
llAl-lE(please printl--LJs. /~, /V). ,I\I/-I-s jt'5IGlIATURE t!. (?t7!/!<' /1t'H,/{ DATE.s..;)l.I-"8?.
FOr: OFF I CE USE ilL '. .
Units So. Ftg, 11ain /CR" x Value ,?~._
Occy load Sq. Ft9. Access x Value
Occy Group ~-"< 5q, Ftg. Other x Value
~.J,.. _ /~ IMlc.r TOTAL VALUATION
-,.:) 0.,. Plan Ck. COIl1l1/ind I'O-"U - 1,'>0..... Systems Development _ ~
___'5~..._____ 65U~lo~ P~- 000 rlvrl:.Sh $ID'lO.W Charoe (1.5%) " 2.... .....;0
Plan Ck. Res
3DUBldo Per Fee
",<0 00. Fence
_n_--~S;--I Demo
___~..s: ot> I Sidewalk
. 6a I A/C Paving
SQ. FT.
,.
I
New circuits alts.
or extensions
IS:-
I
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I
I
I
Appliance vent
seoarate
Stationary evap.
cooler
I Vent fan with
sinole duct.
I Vent system apart from I
heatinq or A.C. ,
IMechanical exhaust
hood and dur:t
I Uood stove/heater
I
I
I
Floor furnace
and vent
SERVICES
Recessed wall
So~rp hp~t~r ~nrl vpnt
Temporary Construction
IChange in existing
rp~ j ri!:nrf'l
I multifamily , COlllTl. or
Inrll/"tri...l
10f
ICOMf,./IND. FEEDERS
l'Install/alter/relocate I
rHc:.tY'ih fpprlpr<:.
10f amp~1
I
I
I
amps.1
ISSUANCe OF PFRIIIT
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I
6S".S"<
Curb Cut
ITotal
I
I TOTAL
?/.02
Comb. Permit
..
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. legal Description
1. example- Tax Lot 100. lane County Map Reference
17 03 43
2. example- Lot I, Block 3. 2nd Addition to
Springfield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. exam~le- heat/electrical ceiling/or forced air Qas
2. examole- waterheater/electrical/or solar
E. Square footage or valuation, etc. -
1. examole- 1250 sq. foot house. 500 sq. foot garage
2. exa~le- if new project. check-new - if addition,
cneck. add. etc.
F. ,Building permit information:
1. example - construct single family house with an
attached garage
2. examele - 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. DESIGN TEAM ANO CONTRACTDRS
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 OIVISION 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.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
PERMIT VALIDATION
/
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-:y :>L\ -- ~0
Permit Clerk
C?
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
, \
name...L.. OC"NF ~~~ Signatur~~
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date 5'- 3-.8b
Gi,.":-f-"1 /6,!) 20
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'I' IIISPECTIOII LlIIE
726-3769
flis:/o'o ~~e~~
Job Address
.~~C;~ MAI/V
<r
C2;:1al
cln Uf SPRlrlGFIELD
CDMBHIATIDN APPLICATION/PERMIT
E!IERGY SOURCES:
Heat
Nater Heater
Ranqe
ValuE of Har\{:
L 71!/k:) . 00
Builciina Pennit Info: Oeser be Work.(i..e.~ Build Single
Farnil v Residence III th Attached Garaae)
Cc::w"5~po.:::r I".R f6 2?~ r7"'L~
'~n::)'RAt::;tS' '.#D:D/;'/~ 7.; 7-(/
Phone ,<7"~~ ., A~D 1-9~_'D...pt9--.P/N~ .
(address), (l1cs. no.l lexniresl (anane n~.
21"5 (J,pU !1u.t.JA})f. /Jlfnd 97'?C<9 -!J:;l/- n
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""~FORl1ATlON LINe
726-3753
Sq. Ftg. 1,lain /n$!;l
~q. Ftg; Acce~s.
Sq. Ftg. Other
--1iew)(Add_Al ter -,~ep.
Fence Oemo Change/Use
Other - -
f
~
I~
IN
.\ij
Legal Description /7-02- 33 -<1/
Owner 5-"tl+AJ QJ'lcl
Address
(I hrpOYtLh{~
Phone
~
...
~
,S
~,
Construction Lender
Address
Ul:.::::dliN Il:.An
Primary
JjrJj. )
(name)
Ij J/ j1J?jUA' )/.J
Structural
Electrical
Mechanical
CONTRACTORS
(name)
(address \
(1 ir:<:. "0. \
"pyr!irp.; ,
(I'}h(lrll:' !'In \
General
Plumbina
Electrical
~1echanical
PLUIIB I NG
ELECTRICAL
MECHANICAL
tlO. I
. FFF I r.HARhF NO
Each single fixture
Residence of
'~~~ r~~-liP
~~L...c.I:lARG..E.
SQ. FT.
furnace/burner to
BTU's
Relocated building
(~ew fix, additional)
S.F. Residence
11 bathl
Duplex (1 bath) each
Additional bath I
Water service j
Sewer I
,~<,' Storm S~wer I
I
I
I I
I I
I I
I I
I
New circuits alts.
or extensions
ISO.
Floor furnace
and vent
SERVICES
Recessed wall
c:;..."",..... h...;ot-.... ;on'" .....nt-
za-
Temporary Construction
Change in existing
rp<:. i npn('p
Imuitffamily, corrm. or
Innu<:.trit11
IOf
ICor~'I.IIND. FEEDERS
I Install/alter/relocate
rfidrih fpprfpr<:.
IOf amps.1
I
I
I
amps.
Appliance vent
~PI1~r~t:.~
Stationary evap.
cooler
Vent fan with
sinole duct
Vent system apart
heatino or A.C.
I Mechanical exhaust
hood t1nd durt
I \'Jood stove/heater
from
TOTAL CHARGES
WHEnE STATE L1W REQUlnES
shall not be vali1 until the
zo....... TOTAL CHARGES
that the Electrical work be done by an.
label has been signed by an Electrical
I
I
I
I
15".
00
ISSUANCE OF PFRlllT
TOTAL CHARGES
Electrical Contractor, the electrical portion of this pe~it
Supervisor and returned to the Building Division
I HAVE CAREFULLY EXN1INED 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 oerformed 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 UO OCCUPAr~CY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
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 ORS 701.055 will be ed on this project.
Zone LL
Fire Zone
Flood Pia i n
Tyee/Cons t..2'Z% - N
Bedrooms
L IE. J::.. iV/.' 11/ /-t-~5 .If::SIr.IIATURE /
. ---,
- - FO~ OFF I CE USE ilL
Units So. Ftg. rlain /CR "', Va1ue-" ?~.....
Occy Load Sq. Ft9. Access x Value
Occy Group...Ji" - '< Sq. Ftg_ Other x Value
~.J.. _ ,i;<l L<.tl<.r TOTAL VALUATION
Plan Ck. Conm/Ind' I'O-'ZU - 1.'>0..... jsyste~s Development ~
65%/Bldo po. >~o ^lv,LSItn $IO~C PiX' Charqe (!.5~) , ;Z $". c.:>;o
Plan Ck. Res
30%/Blda Per Fee
-'<0...... I Fence
-----_.!._--...;--
. 80 I Demo
_~_.t'..s;_,::~_-' Sidewalk
. (;a I A/C Paving
I Curb Cut
------------
I
.'4 r ?[t't4 A ~DATE.5' ..;)1.1- i?t:;
NAI,IE(please print)
Stories
I
BUILDING PERI'lIT
Charges and
Surcharges
<~oo
----~-=._---
/. /<.
PLU'IBING PERMIT
Charges and
Surcha rges
ELECTRICAL PERI~IT
Cha rges and
Surcharges
11ECHANICAL PERMIT
Charges and
Surcharges
ITotal Comb. Permit
6~.::;<
~
I
I iOTAL
'7/.02
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Adaress
B. legal Description
1. example- Tax Lot 100. lane County Map Reference
11 03 43
Z. examole- lot 1. Block 3, 2nd Addition to
~prlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceilinqlor forced air Qas
2. examole- waterneater/electrlcal/or solar
E. Square footage or valuation, etc. ------
1. examole. 1250 sq. foot house. 500 sq. foot garage
2. example- if new project, check-new - if addition.
eneck add, etc.
F. .Building permit information:
1. examole - construct single family house with an
attached garage
2. exam~le - 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. OESIGN TEN1 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
full schedules
C, BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO
CHARGES ON THE SCHEOULES
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.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
PERMIT VALIDATION
,/'
~(Jo) 5~
yd-L1--- ~0
Pennit Clerk
C?
J
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Infonnation:
PLANS REVIEWED BY:
name
L02Nt!= ~~~ Signatur~
.
;,
.
"..-
~~~
.
I
date
5'-'3-.8~
,
}~~:~4.I .~'equired Inspectons..
>"'.'
"j{~IT IS THE RESPONSIBILITY OF THE PER-'lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TUIE,
"','THAT EACH ADDRESS IS READABLE FROIl TIlE STRFET, AND THAT TIlE PFRHIT CARD IS LOCATED AT THE FRONT OF THE
:,,';,~ rROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TUlES.
)~~'::PROCEDURE FOR REQUFSTING INSPECTIONS: Call"726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
:':,,:;'-::Job address, type .of inspection requested and \omen you will be ready for the inspection. Contractors
:.~_.or owners name and phone number. Requests received before 7:00 am1will be made the same day. requests
. :~'_,:;received after 7: 00 am will be made the following work day.
f~'Y~~r City Designated Job Number Is:~ / t:?2"3
}i,;:~ob Address: ,').&:::>R .h'/A-/N ~
;:~iOwner: ~orHL-t$'-Nn C~2P, Phone:
"..'~f.. .
":~":'Contractor: Phone:
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....;."1:--.,.....:...::
..,,'.. :.~.....;.,..::_.. " ,"
. :,~-;.
~' SITE INSPECTION: To, be made
[2,:...J" after excavation. but prior
. "~~.o.;.:~to setup of forms.
,1"'+ UNDERSLAB PLUMBING, ELECTRICAL"
',' III MECHANICAL: To be made before
:.:~J~~.~Y work is covered. " ;'
"r:1,,:CONCRETE SLAB INSPECTION: To be
~ ::made after all ins lab building
-";'l~.:;:~s~ervice equipment. conduit. piping.
)~:accessories and other ancillary
.;~.~ .~ O:t.;~iquipment items are in place but
~~f?~'~~~~~~ any .c.oncr~t~_.~~ .p~ured:.,. :: ........ 0
IXI FOOTINGS & FOUNDATIONS: To be made
after trenches are excavated and
.:...~\\:..,:fonns are erected. all steel in
,;'i..;~~.;;f'Flace. but prior to pouring concrete.
. rvr -UNDERGROUND: Plumbing~ Electr1.cal.'
~ Gas, Sanitary ~ewer. Storm Sewer.
....:'f.L._.>::":,Water and(15Jain3p,e lines) To be '
\~~t~:_::;'uiade prior to covering or filling
..... ;:f}.~: trenches.
D
UNDERFLOOR: . Plumbing. Electrical.
Mechanical. To be made prior to
installation of floor insulation.
.~ decking or floor sheathing.
O POST 6 BEAM: To be made prior to
installation of floor insulation.
'....:'.. ".decking or floor sheuting.'.
o
',.
~
FLOOR INSULATION 6 VAPOR BARRIERS:
To be made prior to installation
of decking or floor sheating.
MASONRY: Steel location, bond beams
grouting or verticals in accordance
with U.B.C. Section 2415.
o
~
ROOF SHEATHING k~D NAILING: Prior
to installing any roofing.
ROUCH PLL~mINGrELECTRICAL');
MECHANCIAL: No work 15 to be covered
until these inspections have been
made and approved.
'.;'
''{
~ FINAL PLUMBING
~ FINAL ELECTRICAL
o FINAL ~IECHANICAL
D FINAL FIRE DEPARTI-IE,rr
o
"0
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D
D
D
D
ATTIC DRAFT STOPS 6 CURTAIN WALLS.
....;,
FIREPLACE: Prior to placing
materials and befo~e framing
inspection.
fac ing
'SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector'shall be employed by the Ownerl
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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STRUCTIJRAL CONCRETE:
P.S.I. (306 a.I)
STRUcnJR.o\L h'ELDS: Pref~rmed on the
job, (2722 f)
HIGH STRENGTH BOLTING: During all
bolt in~t3llation and tighting
operations (306 a.s)
INSULATION 6 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.
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
. appro'Ved.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
D
D
=:J
LAm AND/OR GYPSlJl-.1 BOARD INSPECTION: ---,
To be made after all lathing and ~
g)~sum board, interior and exterior,
is in place but before any plastering---,
is applied or before gypsum boar~ ---l
joints and fasteners are taped and
finished. .
In excess of 3000
SPRAYED ON FIREPROOFING:
Standards 43..,8)
(U.B.C.
D
D
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
=:J
SPECIAL GRADING.
FILLING: ~Jring
& Chapter 29)
GLU-LAM BENIS: 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).
PARKING LOT: After gravel
place but prior to placing
or concrete. .
is in
asphalt
EXCAVATION AND
earthwork. (306 a~ 11
* In addition to the inspections
specified hereon. the Building
Official ~ay make or require other
inspections of any construction
work to ascertain coopliance.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 before requesting this inspection.
jg]
FINAL BUILDING: Must be requested after.the finai Plumbing. Electrical. Mecha~ical and Fire
Department inspections are made and approved. No'Occupancy of the p~emises can be made until
a.~ertificate of Occupancy has been issued by the Building Division-and posted on the premises
SIGNATURE
'OATE
*ALLMANHOLES AND CLEANQUTS ~ST BE ACCESSIBLE. ADJUSTI-IENT TO BE MADE AT NO COST TO THE CITY.