HomeMy WebLinkAboutPermit Building 1987-9-18
CITY UF SPRJr/GFIELD
COIIBJr/ATION APPlICATION/PERMIT
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HISPECTIO/l lIilE
726-3Cj;9 .
Job Address
I.el]a 1 Oe~cri pt ion
Ran(le
IlFORlIAT: ;:1 L'", I
726.37;3 .
So. FtQ, i.;ain 722 I (\~ i
~CJ. H!:J. Access. W I
SQ, Ftg. Other \.J
/leI< Add ~.1ter ~eD, (\ I
-Fence Demo Change/Use V ,
Other - - \J\ I
Oescribe Hork(l.e., BUlld Slngle I ~ I
(l,ttached r.araoe) ~
VI"<;rJ...Aot.L-e) -.k IIJ~"-",,,~ ~
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Valu€ of Hark:
O.-z:,
Bui ltiino Perm; t Info:
Phon "?y,-t,'I' F.~ilv Residence Ilith
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O....ner ana~a. VI.~
,'"dress .3t>7D YIl 'eu" J..
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SDv,\....t A<:./ ,L
Con~truction'lender
Address
U,SIGrI r,m
Phone
(address)
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Primary
Structural
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Electrical
!lechanical
CONTRACTORS
_(n:,~
(address)
Mechanical
PLUllBIrlG
EtECTRICAL
j:O.
~ I Each single fi;tu;~
-----/Relocatedlbuilding
(new fix. additional)
-----IS,F. Residence
(I bathl
IDuPlex (1 bath) each
jAddltional bath
SQ. FT.
HARGE
Residence of
.New circuits alts.
~ or extensions
, '2 ""~ l'n4i&?E
SERVICES
~!ater service
ITemporary Construction
IChange in existing
rp~iq~n("'~
[mul tifami 1y, camm. or
Tnrlllc;.trifll
Sewer
Storm Se1,o/er
amps.1
BU ItD IIIG PERI.lI T
Charges an'::: ,
Surcharges ,..,
Plan Ck.
6SVBlrlo
I Plan 0.
30t/Bldn
PlUI~BING PERMIT . /2: ~t:> I Fence
~~~~g:~g:~d ~ ---- ---'-75--, Demo
. ELECTRIU.L PERI:IT ?-=? -:5(~ I Sidewalk
Charqes and _ __
Surcharges y - -- /.-; =:3-1 A/C ;avi-ng
11ECHANICAL PERI11T I Curb Cut
Charges and ____________
Surcharges I
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COrml/lnd
Ppr Fpe
R'es
Per Fep.
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(1 ics. no.l
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(exn~n"si
(ohanp
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MECHANICAL
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General .c>N/Y'e:-....;>"
Plvmbinn ~ '1/;,\
Electrical
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I T. IIC0I111.(lND. FEEDERS
I I I I IInstarl/alter/relocate I
dic;.trih fpprlpr,
I I IOf amps,l
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I -Ll. I I I ISSUANCf OF PFRr1lT
TOTAL CHARGES -. ,.-.- , [5':~L CHARGES ?'2-SR TOTAt CHARGES
1.1fIERE STATE L'l.J REQUIRES that the Electrical work be done by an Electrical Cont~~ctor. the electrical rortion of this permit
shall not be valiJ until the Jabel has been signed by an Electrica] Su~ervisor .ndii;turned to the Building Div;sion
I HAVE CAREFUllY EXNlINED the completed apfllication for !:lermit. and do hereby c~rtify that all information hereon is true
and correct. and r further certify that any and all work nerformed shall be done in~accordance with the Ordinances of the City
of Sori ng fi e 1 d and the laws of the S ta te of Drenon De rta i oi og to the work descr i bed'~here in. and tha t liD OCCUPA1KY wi 11 be made
of any structure without the permission of the ~uilding Division. I further certify that my re9;stration ~lith the Builder's
Board is in full force and effect as required by ons 701.055, that if exempt the basis for exemntion is noted hereon. and that
only subcontractors and employees \...ho are in comoliance with OP.S 7f)l.D55 I.lill be used on this nroject.
1/AiIE(pl""e print-;)ea.i'1.1"---rt... JSro s:h 1'1'1 k... SIGIMTURE.t!},...,. .7?:tJ::, ,;{< ~ /~..l,,,.d
FOn OfFICE USElDuty LI
Zone L: ~ Type/Const. 5"-# Units <iC'!.vFtg. 11ain x
Fire lone Bedrooms Dccy Load SQ. Ft!J. Access x
Flood Plain Stories ( Occ.v Groupff -<. Sq. Ftg. Other it? _;+ _/;?~<'i..
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furnace/burner to
BTlI's
Floor furnace
and vent
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I Recessed wa 1 1
~~~rp hp~tp~ ~nrl vpnt
Apoliance vent
~eo_a ra tp
Stationarv evao.
cooler ~ .
Vent fan I'o'i th
sinal!:' durt.
Vent systeM apart from I
heiltino or A.C
i'lechanical exhaust
hood and durt,
Wood stove/heater
DATE_ <j /I'll/Sf?
VilluE'
Value
Value
/q.c>c::> _ .......
TOTAL VALUATION
Syste~s Development
CharQe (1.5")
/v -4
.-I~ot~l Comb. re~m~-~-' h.
TOTAL
7&.8/
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COMBINATION APPLICATION/PERMIT (CAP)
I.
Applicant to furnish
A. Job Address
B. legal Description
1. example- Tax lot 100. lane County Map Reference
1I oj 43
2. examole- lot 1. Block 3, 2nd Addition to
Springfield Estates
C. Name, etc. of owner and construction lender
D. Energy Sources .
1. example- heat/electrical ceil;nq/or forced air Qas
2. examole- waterheater/electrlcal/or solar
E. Square footage or valuation. etc. -
1. examole- 1250 sq. foot hause, 500 sQ. foot garage
2. examole- 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. 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 TEAM AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design information or jab site
corrections, etc.
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 FILt OUT AtL 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. -
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.
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.
PERMIT VALIDATION
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9-16~f/
II.
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IV.
V.
FOR OFFICE USE ONLY
Permit Cl erk
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PROJECT CONOITIONS TO BE SATISFIED BEFORE OCCUPMlCY:
j
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
.
!'
name
PLANS REVIEWEO BY:
L~,q'ij~ /~~~signature 4.,.. .~--:; date
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9-/gg-:>
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.. tequired
Inspect"s ..
IT IS THE RESPONSIBILITY OF TilE PER!lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TrUE.
THAT EACII ADDRESS IS READABLE FROU TilE STREET, AND THAT THE PERl'lIT CARD IS LOCATED AT TilE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIUES,
PROCEDURE FOR REQUESTING INSPECTIONS, ~ll 726-?7~reCorder) state you CITY DESIGNATED JOB NUMBER,
job address, type of inspection requested ana vnlen you will be ready. for the inspection. Contractors.~
or owners name and phone number. Requests received before 7:00 amrw~11 be ~~de the .same day, requests
received after 7:00-am will be made the following work d~y.
Your City Designated Job Number Is, ~ i7G'~~~
Job Address, 5/ G" D c~ ~/h'" .
Owner"k~TrtF'.lkA7e>(E ~.N'~..K Phone, 7<'/";-.r: y/-=?
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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.
~DERGROUND: Plumbing, Electrical,
Gas. Sanitary Sewer, Storm Sewer,
Water and Drainage lines. To be
made prior to covering or filling
trenches. .
FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to installation
of decking or floor sheating.
~~SONRY: Steel location, bond beams
grouting or verticals in accordance D
with U.B.C. Section 2415.
Contractor:
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SITE INSPECTION: To be made
'after excavation, but prior
to setup of forms.
UNDERSLAB PLUMBING, ELECTRICAL
& ~ECHANICAL: 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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UNDERFLOCR: } Plumbing, Electrical,
Mechanical. To he 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~:
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ROOF SHEATHING k~D NAILING: Prior
to installing any 'n. ~ D
ROUr,~RIC^L ? '-Ii
MECHANCIAL: -No work-1S to be co~ered
until these inspections have been
made and approved.
Phone:
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.
FRAMIN~ 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.
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LATH AND/OR GYPSUM BOARD INSPECTION, ::J
To be made after all lathing and
g)~sum board, interior and exterior,
is in place but befOre any plastering ::J
is applied or befOre gypsum board
joints and fasteners are taped and
finished. .' .'
FIRE & SEPARATION WALL, Located &
constructed according to plans.
WOODSTO\~S: After installation is
completed. "r) "'1/
SIDEWALK & DRIVEWAY: Required for
all concrete paving within street
right-of-way, to be made after all
excavating complete & fOrm ~~rk &
sub-base material in place.
CURB AND APPROACH APRON: After forms
are erected but prior to pouring
concrete.
PARKING LOT: After gravel
place but prior to placing
or concrete.
is in
asphal t
SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the ~~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:
r.S.I, (306 a.I)
,.' ..
In excess of 3000
Preformed on. the '~"
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STRUCTURAL WELDS,
job. (2722 f)
HIGH STRENGTH BOLTING, During
bolt installation and tighting
operations (306 a.5)
all :"'1 t':
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SPRAYED ON FI REPROOFING: (U. 8. C. y~ "
Standards 43~8)
~PECIAL GRADING! EXCAVATION AND
FILLING: ~Jring earthwork. (306 a.l~
& Chapter 29)
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GLU-LAM BEAHS: Inspection Certificate',
by an approved agency, furnished to
the City's Building Division before ~:;~
beams are placed. (2S~~;U.B.C. STDS:~.
25-IO,ll)..~ ~. =","".
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*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.
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~ FINAL ELECTRICAL
c.ov.r--
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-pleted before requesting this inspection.'
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rj(1 FINAL BUILD!N~: ~st be requested after the final Plumbing, Electrical, Mechanical and Fire
~ Department 1nspectlons 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
SICNATU~~~ &/._,../....;,L
* ALL '''''''HOLES AND CLEANOUTS 'lUST BE ACCESSIBLE, ADJUSTMENT TO BE MADE AT NO COST TO TIlE CITY.
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FINAL PLUMBING
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FINAL ,mCHANICAL
FINAL FIRE DEPARllmNT
DATE
9- /)"- '?7