HomeMy WebLinkAboutPermit Building 1988-10-28
--..
I INSPECTION LINE
726-3769
Jfio Addr/!'ss
~
CITY Uf SPRINGfIELD
COMBINATION APPLICATION/PERMIT
ElIERGY SOURCES:
Heat
l~ater Hea ter
-?'3Y~~1"'//Y 57
Legal Description /7-c?2-3~. ~/ (!:".<;:~ 16_~;:>
Owner'. ~/kx~H">"",c=.~'"7:::-/,/ ~ i/r/_=.,
Address _~=3 ~'7" ~/..(/ -6r
Phone
Construction lender.
Address
DESIGN TEAr1
1 Primary
! Structura 1
j
! Electrical
i
, Mechanical
1 CONTRACTORS
(namel
Phone
(address \
(name)
(address)
Range
ValuE of Hork:
7Iz~ ....-0 .
BuildinQ Permit Info: Describe Work{i.e.,
Familv nesidence With Attached Garaoel
INfORllATION LlNL
726-3753
Sq. Ftg. I.lain
~q. Ftg. Access.
Sq. Ftg. Other
New Add A.ter Rep.
--Fence Oemo Change/Use
Other- -
~
\)
~
\l
~
(lies. no.)
General /)""'A/E:z:?
P1umbinal1..,unr:."..h7E""-# q:2/;;::/ ~J""'__~~ :l?T:> ~~.
, - ~ ~
E1ectrica1/'::'h"~ V/~ /N" EL Fe:.7, ~~~ #;1i'/..o;...; ji?~ .<)P~D .
'lechanic'a1~'" /5-'7.-,.. r(,,/~~q~.- 52p.<:" 6?~~~~,c: ,5j>,Q:.p.
. , I
PLUMBING ELECTRICAL
NO.
Z Each single fixture
Relocated building
(new fix. additional)
S. F. Residence
11 bath)
i Ouplex (1 bath) each
,
i Additional bath
I
I Water service
,
:
'. Sewer
Storm Sewer
./ ~ do/' /~;Z>
Build Single
C"'$AP<~TEJIJl=/7/~'/ OvC:.l""7.>/~
. -
o;Q. . -,,-p., ,-<: /7.?ECA""',,"" "c., E,C~.c;r.
~.....~___....... ..z..,.......--*:::<i...ol.--
'#_7? k~~"::"r";;;'-...." ~ h"Y~'
(lies. no.) (exo;res) (ohone no.:
':1.... I ,
\j'- ~ f
A
<'::1,00 .,..-'i\
_..~
y~
(pxoi res.'
(ohone nn
9:;1 3-'2ZC:> 7
h&7~/292
7qb -.is'?7' /
MECHANICAL
FFF rH~.JJn FFF r4AB.IiE. NO I
Residence of furnace/burner to
7.~ /5"--'" SQ. FT. BTU's
,~ New circuits alts.
c",.r or exteJl.Sions
----:;?<:> 1"f ~/-?~
SERVICES
Temporary Construction
Change in existing
rpsj(i..rJ1re
multifamily, COI1ll1. or
Tnrlll"t.rial
Of
,..-'j.-
COMfI./IND. FEEDERS
Install/alter/relocate
~;~trin fpprlpr~
I HAVE CAREFULLY EXAMINED the completed application for permit. and do hereby certify that all information hereon ;s true
and correct. and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPA[~CY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption is noted hereon. and that
only subcontractors and employees who are in complian~e with ORS 701.055 will be used on this project.
1lAr-IE(please print) W,II/at11 W,~ tyc..1':- SIGNATURE 11f~~....tj()./~
FOr. OFFICE USE DlII.Y
Sq. Ftg.
Sq. Ftg.
Sq. Ftg.
I
Of ?cC>
Zone ,,-; .,-
Fire Zone
Flood Plain
Type/Const. ~-~
Bedrooms
Units
Occy Load ~ 9'$
Occy Group A-3
Stories
2.
BUILDING PERmT
Charges and
Surcharges
n)
&> Plan Ck. ColTlirtrnd
_2~7~~_______ 65%/Blda P.rr Fee
Plan Ck. Res
30%/Blda Per Fee
').
.'
4"??"5
PLU!1BING PERMIT "..' -<LCJ """'" Fence
~~~~~:~g:~d/ ~- -- __.L -/ S-;? -- D~o
ELECTRICAL PERIHT t..,t$: - I'Sidewa1k
Charges and \J. ----1:..;...------
Surcharges 1 -:2. -zS I AIC Paving
~~~~~~;C:~/ERMIIT^ ___L~:...~~J CU;b Cut
Surcharges ~ ~ ~ 1_
I I
I I
I I
I ITota, Comb. Permi t ~ ...253.~
.1 ~
I I TOTAL ge3.gs:-
amps.
amps.
b.~.
I
I
I
I
I
I
\z:>.P
I
I
I
I ~n. I rl1ARG.E..
Floor furnace
and vent
Recessed wall
Sn~rp np~tp~ ~nrl vpnt
I
Mt?'UE?7:'/:r:-r'
Appliance vent
~eDaratp
Stationary evap.
cooler
Vent fan with
sinnlp nlJrt
Vent system apart from
heat.ina or A.C.
Mechanical exhaust
hnnti ~nrl tillrt
/
Wood stove/heater
OATE/O-jr -:f8
r1ainx Value
Access x Value
Othe./'/1'7?P~~ Value q?,~.-
TOTAL VALUATION
""'.
-
;e.;>r,# /266 Y
, Systems. Development
/#'t'.5'~ AfJ-2t:..1U Charpe tJ.5~ '.
- .
C~.
c:ro
[~
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. ~xample. Tax Lot 100. lane County Map Reference
1/ 03 43
2. example- Lot 1. Block 3, 2nd Addition to
sprlngtield Estates
C. Name, etc. of owner and construction lender
O. Energy Sources
1. examole- heat/electrical ceilinq/or forced air Qas
2. examole- waterheaterjelectrical/or solar
E. Square footage or valuation, etc. -
1. example- 1250 sq. foot house. 500 sq. foot garage
2. examp.le- if new project. check-new - if addition,
check add, etc.
F. Building pennit information:
1. example - construct single family house with an
attached garage
2. exam21e - remodel existing garage into family room
3. examyle - 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 job sHe';\-- -
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
fu 11 schedu 1 es
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. ---
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:
i
--
t. ~'I.
PERMIT VALIDATION
l~" r:~
';..,__ ~Q/ri
--~{'U' ~ .
Permit Cl erk
cU
.
1
Permit applicant exempt from registration with the Builder's Board because:
Additional Project. Information:
-5ee r/oB #8Bo S/c b /2::.A? nJl'.?S7' 'e
,
'.
PLANS REVIEWED BY:
<.
. name Lt9R/YC h CZ;;'afE?
Signature~~>__~ p~.~ date/~-z:;::?-:B-8
//' ,<7
, ,
CITY UF SPRINGFIElD
COMBINATION APPlICATION/PERMIT
EIIERGY SOURCES:
Heat
!-later Heater
#'.=:>. ~'f$7"3 :S?.A::'.o.-4~W.<!':~ #/A;'Y.
I >>> I r"IIIl!>.JJllL...1
"
.
.
I INSPECTION lINE
726.3769
.
, .
'.
Job Address/5""3</LI MA//V ",:;r
legal Description 17-<:72-"33'-3 / 6Pa6~ t::5'"o"?
/ .
"
Owner '0-~;zj'A'-.a<;: ~F- ~€/"""/Y' ~,c;>.~
Address /, 3f9"~ .o7....../A/ ~"".
,<P.F.<::D. ~. 97<r?~
('nn~t..t,...t; . / -
n_n_... .... """'L:A// h?/u,.r~_~~ C>~
Phone
7;'7-7::>-;"7
AdJ...... 1R/L.L71ER~
UI:~H:iN 1I:.A'(.I. (name J
Phone
(address)
, Primary
Structura 1
Electrical
MechanicalftE~#Lc hE,.;::;:..,
CONTRACTORS Inamel
(addrpssl
Genera 1
Plumbina
Electrical
~lechanic'al "71~Ar 4L<f
Plur.IBING
ElECTRICAl
NO.
FEF
rHIlF&L Nn
Each single fixture
Residence of
Relocated building
(new fix. additional)
New circuits alts.
or extensions
S.F. Residence
f1 bath)
Duplex (1 bath) each
Additional bath
SERVICES
.
INFORllATlON llNl
726-3753
SQ. Ftg. 1.lain
~q. Ftg. Access.
SQ. Ftg. Other
New Add Alter Rep.
-Fence Demo Change/Use
Other - -
~
~
~
\J
~
Range_.-.
ValuE of Hork:
#,S-~ ....e.
BuiloinQ Permit Info: Describe Work(i.eo.
Familv nesidence With Attached Garaoel
Build Single
b~#/)#m.c; D~7"",~76
~Z>7.7/Tfi.::r;'; :r /#'5'T.#LC. _/~&
l?~~~ :r... ,~~~____n;;;..-?",",. .
(lics. no.) (~xnir~s) (ohon~ no.
(l ics. no.)
7j/7y.:;97.2
(ohnnp nn, )
(exnirpc:.)
(; II~
V .
5 "l,OP
'X/?-C?.2 :2
MECHANICAl
I s:s:s: I ru
SQ. FT.
furnace/burner to
BTU's
Floor furnace
and vent
Recessed wall
So~rp hp~tpr ~nrl vpnt
amps.
./' Q/~io ~t+~.K h.
Appliance vent
S~DaratF!
Stationary evap.
cno 1f~ r
~ Vent fan with
""" 5in~l1e duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hood "nd durt.
Water servi ce
Temporary Construction
Change in existing
rps i rlJ'Jlrp
multifamily. comm. or
Tnrluc:.tri"l
Sewer
Storm Sewer
Of
1:..... ,b.
COMfI./IND. FEEDERS
Install/alter/relocate
dic:.trih. fppdpr,
Of
Wood stove/heater
amps.
ISSUANC, OF PFR!IIT
TOTAl CHARGES TOTAL CHARGES TOTAL CHARGES /1'7/Ar. / -s: -
WHERE STATE L\l/ REQUIRES that the Electrical work be done by an.Electrical Contractor, the electrical portion of this pennit
shall not be valid 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 OCCUPAI~CY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder1s
Board ;s 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 used on this project.
NAlIE(please print) 'vv,/f,o...... YV.Ite.Y'C-i SIGrIATUREW~ 11),f41.('
FOR OFFICE USE DilLY
Sq. Ftg. riain )C Value
Sq. Ftg. Access x Value
SQ. Ftg. Other~~ ~P//. Value ~ --
= .... TOTAl VAlUATION
ffC.;!>;r.'T-~
~ystems Development
~6..,.-?::J /o--zf' r harae (J.5~ .
Zone c::.L...
Fi re Zone
Flood Plain
Tyoe/Const. ~~
Units
Occy load Q4/R
Occy Group ~--~
Bedrooms
Stories
-;>
BUilDING PER~IIT
Charges and
Surcharges
Plan Ck.
65%/Blda
Plan Ck.
30%/Bldo
COIl1l1/lnd
Ppr Ff!f!
R-es
Per Fee
PlU!1BING PERMIT
Charges and.."-
Surcha rges
Fence
D/lRlo'
I'Sidewalk
I AIC Paving
/c- - I Curb Cut
----I-c.>-:-~-1 .
<.
ELECTRICAl PERr~IT
Cha rges and
Surcharges
MECNANICAl PERMIT
Charges and
Surcharges \..,
DATE /0-).. ?-f!?
I
I
I
ITotal
I
I TOTAl
Comb. Permit
/5:75
.
.
it.
'- "
COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
,.
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
II 03 43
2. example- Lot 1. Block 3, 2nd Addition to
..~pr1rigtield Estates ~
C. Name, etc. of owner and construction lender
D. Energy Sources
1. examole. heat/electrical ceilinQ/or forced air Qas
2. examole- waterheater/eJectrica(/or solar
E. Square footage or valuation, etc. -
1. exam~le- 1250 sq. foot house, 500 sq. foot garage
2. exam~le- if new project. check-new - if addition.
Check. add. etc.
F. Building permit information:
1. exam~le - construct single family house with an
attached garage
2. examele - remodel existing garage into family room
3. examjple - 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.
11. 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
signa ture.
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.
.'
~J ~& Sf
lo-~-g(
V. FOR OFFICE USE ONLY
Permit Clerk
~Q//
.
1
PROJECT .CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
.6c-~ /ks,7?#8Bc>&/hb ~R n/Zs;r #~-::--::~
..
. ........
PLANS REVIEWED BY:
..
. name
/~He ?L~'~
Signatura~~ --"
// P' '
.
date /~-'2.;>-&8
.,~
..,equired
Inspe.ons ..
", IT IS THE RESPONSIBILITY OF TilE PER.'lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE l-'.ADE AT TP.E PROPER TUlE,
THAT EACH ADDRESS IS READABLE FRotl TEE STREET. AND THAT TllE PERl'1IT CARD IS LOCATED AT TilE FRONT OF THE
PROPERTY. BUILDING PIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES.
PROCEDURE FOR REQUESTING INSPECTIONS, Call 726-3769 (recorder) state you CITY PESIGNATEP JOB NU}:BER,
..job <lQdress, type of inspection requested and \<lhen you will be re~dy for the inspection. Contracto:"s
or Q\mers name and phone n~~ber. Requests received before 7:00 am will be ~ade the sa~e day, requests
received after 7:00 am will be ~de the followinh work day.
Your City Pesignated Job Number Is: ~BC:> "7/'7
Job Address: ~ ~ y V. ~'l"'/ -::::7
Owner, 1/ F W. Phone:
o
o
o
o
o
o
o
o
o
o
~
[lJ
[X]
[X]
m
Contractor:
SITE INSPECTION: To be made
after excav~tion, but prior
to setup of forms.
UNDERSLAB PLUHBING, ELECTRICAL
&- ~IECHANlCAL: To be made before
any work is covered.
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.
f.:?
~
FOOTINGS & FOU~DATIONS, 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.
UNDERFLOCR:. Plumbing. Electrical,
Mechanical. To be made prior to
installation of floor insulation,
decking or floor sheathing.
POST 6 BEAM: To be made prior to
installation of floor insulation.
decking or floor she&ting.".
o
D
lZ]
FLOOR INSULATION & VAPOR BARRIERS,
To be made prior to inst311~tion
of decking or floor sheating.
~"SONRY: Steel location, bond beams'
grouting or verticals in accordance D
with U.B.C. Section 2415.
RoeF SHEATHIXG k~O NAILING: Prior
to installing any roofing'~~I;'1 D
ROUGH PLU~mING, ELECTRICAL & ...,
~IECHANCIAL: No ",'ork is to be co\'ered
until these inspections have been
made and approved.
?-~
FINAL PLU~19ING
[Xl
CITY'S SITE rLA~ REVIEW BOARD INSPECTION: Must be reGuested 2 days in advance of the date you
wish inspec!io~. All project conditions such as landscaping, parkinb lot striping etc. must
b~ com~leted hefore requesting this ir.spection.
'1~
FISAL ELECTRICAL
IPj
[Z]
.FINAL SUILDI!\G: ~fust be requested after the final Plumbing, Electric:!.l, ~lcch:lnical and Fi:-e
Dcpartm~nt inspections are made and approved. No Occupancy of the premises can be m3de until
a Certificate cf Occupancy has been issued by the Building Divisicn ar.d postcd on the premises
2.,~
FINAL ~n:CHA.~ICAL
1?'-1
FI}:'\L FIRE DEPARnIE~:T
SIC'ATURF
Phone,
ATTIC DRAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior to placing facing
materials and beforelaming ""
inspection. 4 I ~
INSULATION & VAPOR B RR!ER: To be
made ~ftcr all insulation and
required vapor barriers are in place
but before any lath or gypsum b03rd
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.
D
~
~
LATH AND/OR GYPSijfl BOARD INSPECTION, ---,
To be made after all lathing and ~
g)~sum board. interior and exterior,
is in place but before any plastering I
is applied or before gypsum board ---3
joints and fasteners are taped and
finished.
SPECIAL INSPECTIO~S: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the O~~er/
Contractor during construction of the
following work. A copy of the special
testing reports shall be furnished to the
Building Division.
~
~
~
STRUCTURAL CO~CRETE: In excess of 3000
P.S.!. (306 a.I)
FIRE &'5EPARATION WALL, Located &
constructed according to plans.
1\
D
D
WOODSTOVES: After installation is ---,
completed. ---.J
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.
STRUCTUR~L ~ELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BOLTING: During all ~
bolt installation and tighting
oper~tions (306 a.S)
SPRAYEO ON FIREPROOFING: (U.B.C.
Standards 43.8)
SPECIAL GRAOING, EXCAVATION ANO
FILLING: ~4ring earthwork. (306 a.l1
& Chapter 29)
GLU-LAM BEA!'iS: Inspection Certificate,
by an approved agency, furnished to
the City's Building Division before
bea.ms are placed. (2S01-U.B.C. SlOS.
25-10,11). .
*In addition to the inspections
specified hereon, the B~ilding
Official may ~ake or require other
inspections of any construction
work to ascertain compliance with
the Building, City or Zoning Codes.
DATE
;;. ALL ~t,\."'HOLES .\~D CLEA:\OUTS ~IUST BE .\CCESSIBLE, ADJUSnlE:-;T TO BE ~1,\[lE AT XO COST TO TIlE CIn'.
PARKING LOT: After gravel is in
place but prior to placing asphalt
or concrete.