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Home My WebLink AboutPermit Building 1986-1-9 . . ~ I INSPECTION LINE 726-3769 ' Ownerr7l< ~ 1;,$ Address J9' 0 B 0 'E rJ'7t1 C/.J ___"I:::. Construction Lender RoM;',,-s 71(' {J~ LITY U> SPRINGFIELD Cm1BI1IATlON APPLICATION/PERMIT EIIERGY SOURCES: Heat Hater Heater Ranqe ValuE of Hark: rO /!Is {JO Builri;na Pernlit Info: Describe Work(i.e., Phone Familv nes;dence With Attached Garaael ':.1; ?~7-: INFORIIATlON liNt 726-3753 Sq, Ftq. 1,Iain ~q. Ftg. Access. Sq, Ftg, Other Ilew Add Alter Rep, -Fence Demo Change/Use Other- - Build Single I % ~ ~ ~ ~ '" Job Addressj:L ." n M A ('" tJ~U7S A., ;r . <- Lega 1 Description 17.I)Z. ?Y- '$/,/ t!f)~Vt!J2 Address OESIGN TEAl,' Phone (address) R.I.,/) 20D... ,e c- I'oor - H<!'A..fl", '" fA:> J '7111!~ 'S,l...e/ "'be k. . C/?J~ 15000A!b /;'S;' p.,.,..( /ivtdl (l;r~. no.1 (exo;res) IAJ {name) I no'\ (ohone Primary (! Co<.. te f,'< K/J i.l/^, \ l1echan;cal CDNTRACTORS (name) (address) (1 ir::s no.) -I~ '~ Y'''- (pxoires' (~hone _no.) Structura-I Electrical f'1!!~r/~.I!!r?.tJ .6/.:,." 1/0<. Genera 1 Plumb;na E1 ectri ca 1 p;(~ 1'//...,-1 ~'/,n. -fR./.t. f,lechanical PLUIIBING ELECTRICAL MECHANICAL NO,I Each Single fixture I' FEF I CHARGE NO I I ~n I rI-lARr.F NO.' Residence of furnace/burner to SQ. FT. BTU's j ~I="I=" j rI-lAR(.;F Relocated building (new fix, additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence 11 bath) Duplex (1 bath) each SERVICES Recessed wall So~~P hp~tpr rind vpnt Storm Sewer Of amps, Appliance vent seoarH_p Stationary evap. cooler Vent fan with sinale duct. Vent system apart from heatino or A. r [MeChanical exhaust hnnd ..nd rlurt. I t.Jood stove/heater I I I Additional bath Sewer Temporary Construction Change in existing re"jqf'J'~P, multifamily, comm. or Tnd1J<:.trial ~Ia ter servi ce COMM,/IND. FEEDERS Install/alter/relocate di<:.trih. fepders Of amps. TOTAL CHARGES TOTAL CHARGES WHERE STATE L'\\~ REQUIRES that tile Electrical work be done by an shall not be vali1 until the label has been signed by an Electrical ISSUANC, OF PFR'IIT TOTAL CHARGES Electrical Contractor, the electrical portion of this permit Supervisor and returned to the Building Division I HAVE CAREFULLY EXN1INED the completed aprlication for permit, and do hereby certify that all information hereon is true and correct, and I further certify that any and all work Derformed 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 rw OCCUPAUCY 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 OR$ 701.055. that if exempt the basis for exemption is noted hereon. and that :~l,:(:~::::t::~::~:~d~:~:ees ~~t~;o:oliance with :~::I:::RC:2/i 2' DATJ.~ -~k FO~ OFFICE USE OiILY /' Sq. Ftg. t1ain Sq. Ft~. Access ........ Sq, Ftg, Other /','I=:AI7'//'f x Tyoe/Const, <5'~N Bedrooms Units Occy load Occy Group , Zonet::~ 4 R '- x Value Value Value S'"~. - Fire Zone x Flood Plain Stories It-I TOTAL VALUATION BUILDING PERHIT Charges anC: Surcharges ___.lt2., '-0 ,,~ Plan Ck, Comm/Ind 65%1Rl do Per Fee Plan Ck. R-es 30%/Bldo Per Fee Fence Systems Development Charqe (1.5%) j PLU!1BING PERMIT Charges and Surcha rges D~mo ELECTRICAL' PER::IT Cha rges and Surcharges !1ECHANICAL PERMIT Charges and Surcharges Sidewalk I A/C Paving I Curb Cut I ITotal Comb. Permit J I I TOTAL I~Y~ . . . COMBINATION APPLICATION/PERMIT (CAP) PERMIT VALIDATIDN I. Applicant to furnish A, Job Address B. Legal Description 1. example- Tax Lot 100, Lane County Map Reference 17 oj 43 2, exa'!2Ple- Lot I. Block 3. 2nd Addition to sprlngtield Estates 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- 1250 sq, foot house, 500 sq. foot garage 2. example- if new project. check-nfw - if addition. check add, etc. . F. Building permit information: 1. example - construct single. family house with an a ttaChed garage 2. example - remodel existing garage into family room 3. example - 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 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, 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 Permit Clerk ~ ," PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board because: Additional Project Information: PLANS REVIEWED BY: name ~ ~r~~ signatllre4 ,'1-~-7 date I-~ad: . . , IrISPECTION LINE 726-3769 , OwnereL< ~ I,-s Address/lO Ilo" r"ld C/9.QdC RoM/I-'~ 7'(' (J~ CITY Uf SPRINGfIELD COMBIIIATlON APPLICATION/PERMIT EIIERGY SOURCES: Heat Nater Heater Range ValuE of I-lark: roo... DO . Phone BullGinQ Pennit Info: Describe Work{l'.e.. _ .1_ ?~..., -, Familv rlesidence \-lith Attached (;araae) 1.>, .,.,. , f INFORl1ATION LIN< I 726-3753 Sq. Ftg, ',lain ~q. Ftg. Access. Sq, Ftg. Other Ilew Add Alter Rep, --Fence Demo Change/Use Other- - Build Single % ~ <,) '-0 ~ ~ Job Address,.s.2 '<In 111 AI'" P",ns A. .xi' _<:- legal Description /7.tJ2.??~I/ tt>~Ve!J2 Address Ul:.~ HiU IE.An (name) Phone (address 1 R,../)AZ..... !te-I'oo,c - }/..,-A-P.<># f'-4H 7'1li1w 'Sb....'T Ac k- . 1 . ellS#!: 15000"D /;'s# A-~-I jivtd/ flies. no.1 {exoiresl IV Construction Lender (ohane no. Primary I! G<. .e f,'c /f>l) if/^, \ Structural Electrical f'1?~ r i~~<?.t? ,€ /..-r> I/o c. Hechanical CONTRACTORS (namel r address) (1 ;t:s,. no.' (p)(n;re"l (ohol'lp !"In \ Genera 1 Plumbina Electrical p~~ r//p,,-! ~/~n -fRo/~ t. ~1echani ca 1 PlUllB IrlG ELECTRICAL MECHANICAL -1!Q..,,1 Each Single fixture I FF~ I fHI\RhF ~(l..........l Residence of I ~~~ I r~;&GL Nn I I ~~~ I r~1l1lliE furnace/burner to SQ. F1. BTU's Relocated building (new fix, additional) New circuits alts. or extensions Floor furnace and vent S.F. Residence fl h"th' Duplex (1 bath) each Additional bath SERVICES Recessed wall ~n...~p hp...tp~ ...nn vpnt Storm Sewer Of amps, Appl iance vent s.eoa ra tp Stationary evap. coolpr Vent fan.with s.inole duct Vent system apart from I heatino or A.C. . I' Meehan i ca 1 exhaust hand and dUl"t. I Hood stove/heater I I I ~Iater service Temporary Construction Change in existing rps- j riJ'J1~P multifamily, comm. or Induc;.trial Sewer COt~'I./!ND, FEEDERS Install/alter/relocate rlic;trih_ fppdprc; Of amps. lSSUANcr OF PFR!IIT TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES WHERE STATE l,"j REQUIRES that the Electrical work bo 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 I HAVE CAREFULLY EXAMINED the completed aprlication 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 rw 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 ons 701.055, that if exempt the basis for exemption is noted hereon, and that only subcontractors and employees who are in.comOliance with OP.S 7nl,055 will be used on th~P:Ojj?t. UAf.fE(please print~" 1'2't/~ ~jt,1" S SIr.IIATUR{!~/ ~ DnJ.cr -8'1. FO~ OFFICE USE Otll Y / Sq. Ftg. f1ain X" Sq. Ft9. Access x Sq, Ftg, Other ;:i?~.(.r;' x ZoneC:t: 1 R L Fire Zone Flood Plain Type/Const. -S-~,N Bedrooms Iloits Occy load Occy Group ~-I Value Value Value S'"~. - Stories TOTAL V AlUA T ION BUILDING PER~IIT Charges anC: Surcharges .(,.,..0 Plan Ck. ___L~L_____ 65%/Rldo L-I~ Plan Ck. . -, 30%/Bldo Fence Conm/! nd PJ'r Fpe Res Per Fee Isystems Development CharQe (1.5~) I I I I PlUl1BING PERMIT Charges and Surcharges Demo ___________-' Sidewalk I A/C Paving ____________1 Curb Cut I ITotal Comb. Permit J ElECTRICP,l PERI~IT Charges and Surcharges MECHANICAL PERMIT Charges and Surcharges I I TOTAL /~y~ . 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, exam~le- Lot I, Block 3, 2nd Addition to ~prlngtield Estates C. Name. etc. of owner and construction lender D. Energy Sources 1. examele- heat/electrical ceilinq/or forced air Qas 2. example- waterheaterjelectrical/or solar E. Square footage or valuation, etc. - I, exam~le- 1250 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. example - 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 (al 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 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 0, 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 c .V OF SPRINGFIELD , ~_H~ . Sprlngfteld. Oregon Department of Public Work. .-,..t'\~.~'h-;. . OFFICIAL RECEIPT No. B - ( 65828 DeJ.el)A-N. ~. 198(;" C Rec'd From t::1J;''rL$ _~~~..s ~l) f:~~V~W::.~~~ <n~8 Address J or , ( Received For: e5C>~66 (I It!). -.,. -~-~ 13.7/, (t' -t-~t!?- -- o ....,;;, /t7 JI tP , Ct c. ~;F~~:2. , (J lb>. $liP - (I Amount Received /~~~ ") / \ ~' II . -. ,..... . Permit Cl erk PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY: Permit applicant exempt from registration with the Builder's Board becallse: Additional Project Information: '. PLANS REVIEWED BY: name ~ ~r~-':::; Signature4 !Z'....r~-...:. -' date / -~ li~ ,I ~ .equired Inspe.ons .. IT IS THE RESPONSIBILITY OF Tlffi PE~~IT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER Tn,m, '!, THAT EACH ADDRESS IS READABLE FROM TilE STREET. AND THAT THE PEroUT CARD IS LOCATED AT THE FRONT OF THE PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES, PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER, job-address, type of inspection re~uested and vmen you will be ready for the inspection. Contractors or owners name and phone number. Requests received before 7:00 amtwill be ~~de the same day, requests received after 7: 00' am will be made the following work day, . Your City Designated Job Number Is: .8.<::'f!!:)'91({:; Job Address:S? <tlf> _/<-,,~~~ ,:s? A- Owner:_C~~T"_<I, ,if""'>13J!!1/#,-r Phone: Contractor: O SITE INSPECTION: To be made 'after excavation. but prior to setup of forms. O UNDERSLAB PLUMBING, ELECTRICAL 6 MECHANICAL: To be made before any work is covered. O CONCRETE SLAB INSPECTION: To be made after all inslab building service equipment. conduit, piping, : 'accessories and other ancillary . :;-~:'" equipment items are in place but .~~~: before any concrete is poured. o o o UNDERFLOCR:, 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."" FLOOR INSULATION & 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 o o o o ROOF SHEATHI~G ~~D NAILING: Prior to installing any roofing~ ROUGH PLUfffilNG, ELECTRICAL & MECHANCIAL: No work is to be covered until these inspections have been made and approved. .-' o o 00 o FINAL PLUMBING D 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. FINAL ELECTRICAL [g] o o o D ~ D D D D ~ ~C 9"3 7- ~ ??-"/ 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. 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. :J LAlli 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 plasteri.ll8 :J is applied or before gypsum board joints and fasteners are taped and finished. FIRE & SEPARATION WALL: Located & constructed according to plans. 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 place but prior to placing or concrete. is in asphal t r5PECIAL INSPECTIONS: In accordance with Section 306 of the Building Code a special inspector shall be employed by the Owner/ Contractor during construction of the following work. A copy of the special testing reports shall be furnished to the Building Division. :J :J :J STRUCTURAL CONCRETE: In excess of 3000 ?,S.I, (306 a,I) STRUCTUR~L 1iELDS: Preformed on the job. (2722 f) HIGH STRENGTH BOLTING: During all ~ bolt installation and tighting operations (306 a.5) ~ 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. SPRAYED ON FIREPROOFING: Standards 43..,8) (U,B,C. SPECIAL GRADING. FILLING: ~~ring & Chapter 29) EXCAVATION ,'-ND earthwork. (306 a.11 :J GLU-LAM BEN5: Inspection Certificate, by an approved agency, furnished to the City.s Building Division before beams are placed. (2501-U.B.C. STDS. 25-10,11) , " , ). * 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. 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 FINAL MECHANICAL eAPl/lItS O;Y, 't. FINAL FIRE DEPAR~ffi~IT SIGNATURE DATE * ALL MANHOLES AND CLEANOUTS MUST BE ACCESSIBLE, ADJUSTMENT TO BE MADE AT NO COST TO ruE CITY.