HomeMy WebLinkAboutPermit Miscellaneous 1988-7-12
I IIISPECTIOII L1I1E
726-3769
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Job Address
Legal DescriptIon
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CITY UF SPRINGFiELD
COMBJrIATION APPLICATION/PERMIT
EIIERGY SOURCES:
Heat
l-later Heater
INFORlIATlON LiNE
726-3753
Sq. Ftq. l'\ain
~q. Ftg. Access.
Sq. Ftg. Other
lIew Add Alter Rep.
--Fence Demo Change/Use
Other - -
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Owner C:://Y a"" "5P-"i"'/","",,"R~C'p
Address ~"? 5" !y <2 ~??:2- 1i?"". " Phone
7'<~-%SY
~~ ~. ""}7"77
-'->': .~l" . -'<7~"'; ?'Jrry
Ranqe
ValuE of Hork:
10,,,,,..<
BuilriinQ Permit Info: Describe Work(i.e.. Build Single I
Fami.l~ n~~id~nc~ 1Hth J'.tt.ach~d Garaoe)
6,,=n;"';' r- ~~??d"~ ~
r~ h.?~ ~~r.r,? - i1Y:?
Address Phone
DESIGN TEAM (name) (addre~$) (lies. no.l (exoires)
, /b<::e ~""""/y&;>;' *. :;x:...rns :f/~
Primary <)~~...; {,;~>~ ~~.- ."_.~_.~..:~....r~'=-.'.5- /f?? <9'7'!i"&</
Structural
Electrical
Mechanical
CONTRA~TOR.<
General
.
(ohane no.)
:?'.v:? .7<"/"<::)
~}S- , ~,.}OV
J&nn
1';
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Ifllaroe\
(address )
(lies. no.)
(pxnirp",)
Plumbina
Electrical LJi.' ~AW~./HC"_. /~a;"'..o /52'~' .2>.~~2).
"echani~al6N/~?~';A?;3? >::::.",,?"q~7 W- ?0b~..e-
It.r:.
NO.
Each single fixture
SQ. FT.
Relocated building
(new fix. additional)
S.F. Reslclence
f1 bathl
Ouplex (1 bath) each
Additional bath
,~. '
..='~(';~'
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1~~~
'<j'
......,.
'>'.
:~:r.
:~"
,1,'-'
'I:tii
.I~:J
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:,:~! _ Storm Sewer
:::hlJ.~
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Water sem ce
Sewer
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?50'";:>-~
-:?9''7-<~.8/.
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P\JllliIIlIG
ELECTRICAL
MECHANICAL
Ir"TI
furnace/burner to
BTU's
Floor furnace
and vent
I IOE.L-I JJlARGl:
FH I fHAIU:;F
'I!'
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Residence of
New circuits alts.
or extensions
SERVICES
Recessed wall
50ace he~ter ~nrl V~nt
Temporary Construction
IChange in existing
rp'S- j dynrp
/multifamily, comm. or
Tndllc;trial
Appliance vent
spoaratp
Stationary evap.
r:ooler
I Vent fan with
sinole duct
I Vent system apart from,
heatino or A.C.
'Mechanical exhaust
hnod ~nd durt
Il.JOOd stove/heater
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I ISSUANCE OF PFRl11T
TOTAL CHARGES I TOTAL CHARGES
that the Electrical work be done by an Electrical Contractor, the electrical portion of this pern1t
label has been signed by an Electrical Supervisor and returned to the Building Division
CO~1,/IND. FEEDERS
Install/alter/relocate
pdprc:.
Of
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TOTAL CHARGES
WHERE STATE l,\W REQUIRES
shall not be vali1 until the
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 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 NO 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 1s in full force and effect as required by ORS 701.0559 that if exempt the basis for exemption is noted hereon9 and that
only subcontractors and employees who are in compliance with OP.S 701.055 will be used on this project.
IlAf.IE(please print)
20ne P~.
Fire Zone
Flood Plain
BUILOING PERfllT
Charges and
Surcharges
PLur~BING PERMIT
Charges and
Surcharges
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ELECTRiCAL PERI~IT
Charges and
Surcharges
MECHANICAL PERMIT
Charges and
SurCharges
.""".....,...
SIGU^TURE_
FOrr OfFiCE USE mil.. Y
Sq. Ftg. 'lain
Sq. Ftg. Access
Sq. Ftg. Other
)( Value
Jt Val'ue
x Value
TOT^L VALUATION
OATE
Type/Const.
Bedrooms
Stories
Units
Occy Load
Occy Group
. Plan Ck. Comm/Ind
_________'-__ 65%/Rldo P.rr ~pp
Plan Ck. Res
30%/Bldo Per Fee
Fence
Syster:\s Development I
CharQe t)'5~) '.
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/YO' fr~.~:~k
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10_
I Sidewalk
, A/C Paving
~-______---._: Curb Cut
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!rotal
: TOTAL
Comb. Permit
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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. exa~le- lot I, Block 3, 2nd Addition to
~prlngtield Estates
.C. Name9 etc. of owner and construction lender
D. Energy Sources
1. examDle~ heat/electrical ceilinq/or forced air oas
2. example- waterheater/electrlcalJor solar
E. Square footage or valuation, etc. ------
1. example- 1250 sq. foot house. 500 sq. foot garage' L
2. examele- if new project, check ne~ - ~~~Jddition.
,- . Check: add, etc. : , . '. . ".. ," :. ,
F. Building permit information: ..
1. examDle - construct single family house with an
attached garage
2. examDle - remodel existing garage into family room
3. exa~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 AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design infonmation or job site
. corrections. etc.
-.11. Abbreviated Plumbing, Mechanical,'& ElectHcal 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 ANO
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 du~ 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.
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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:
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PLANS REVIEWED BY:
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name LR~ J?~~
Signature~ _ .- ~-""'::->
'/ ' /'-
~'J.'.
.......' :
date 7-/':<-8'13 ,-'
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Inspec.>ns ..
IT IS THE RESPONSIBILITY OF TilE PER."!IT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT TP.E PROPER TIllE.
THAT EACII ADDRESS IS READABLE FROt! Tl'E STREET. AND THAT TilE PER.'fIT CARD IS LOCATED AT TilE FRONT OF THE
PROPERTY, BUILDING DIVISION APPP.OVEO PLANS MUST BE ON JOB SITE AT ALL TItlES.
PROCEDURE FOR REQUESTINr. INSPECTIONS: .Call 726-3769 (recorder) state you CITY DESIGNATED JOB NU}rnER,
job .i1ddress. type of inspection requested nnd \olhen you will be re.:.dy. for the inspection. Contractors
or m~ers name and phone n~~ber. Requests received before 7:00 am w~11 be ~~de the same day, requests
received after 7:00-am will be ~de the following work day.
Your City Designated Job 'Number Is: - ~t!:)/
Job Address: I/?t:::-')" ./S7A./A/~.r:
Owner:.6r-y ~ ~......~:,r:-......~
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Contractor:
SITE INSPECTION: To be made
after excavation. but prior
to setup of forms.
UNDERSLAB PLmIBING, ELECTRICAL
Iii ~lECHA.'IIICAL: 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.
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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.
UNDERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer. Storm Sewer,
W3~er and Drainage lines. To be
made prior to covering or filling
trenches.
UNOERFLOOR:, 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 install~tion
of decking or floor sheating.
~~SONRY: Steel location. bond beams
grouting or verticals in accordance
with U.B.C. Section 2415.
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O ROOF SHEA'!1n~!G A.'ID NAILING: Prior
'to installing any roofing. '>1 D
IV1 ROUc:H PLL~'BING.c;LECTRICAL"" ,..(}
I!L.J CfIECHA:\CIAL!) No work is to be covered
until these inspections have been
made and approved.
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Phone: ~~ &~ ?:;;>~S5t"
:J SPRAYED ON FIREPROOFING: (U.B,C.
Standards 43-8)
LATH AND/OR r.YPS~1 BOARD INSPECTION: :J
To be made after all lathing and
g)~sum board, interior and exterior,
~s in p~ace but before any Plastenfl6:J ,GLU.LAM BE~1S: Inspection Certificate,
~s.applled or before gypsum board by an approved agency, furnished to
JOlnts and fasteners are taped and 'the City's 2uilding Division before
finished. beams are placed. (2S01-U.B.C. SlDS.
WOODSTOVES: After installation is :J 25-10.11).
completed.
SIDE\';'ALK & DRIVEI'iAY: 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.
Phone:
ATTIC DRAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior to placing facing
materials and before framing
inspection.
INSULATION & VAPOR BARR!ER: To be
made after all insulation and
required vapor barriers are in place
but before any lath or gypsum bo~rd
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.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
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PARY.ING LOT: After gravel
place but prior to placing
or concrete.
is in
asphalt
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SPECIAL INSPECTIONS: In accordar.ce ~ith
Se~tion 306 of the Building Code a special
inspector shall be employed by the b~nerl
Contractor during construction of the
following work. A copy of the special
testing reports shall be furnished to the"
Build~ng Division.
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STRUCTURAL CO~CRETE: In e~cess of 30(0:
P,S.I. (306 0,1)
STRUCTUR\L \';'ELDS: Preformed on the
job, (2722 f)
HIGH STRENGTH BOLT1~G: During all
bolt installation and tighting
operations (306 a.S)
SPECIAL GRADI~G.
FILL1~G: During
& Chapter 29)
EXCAVATION .\.'\0
earthwork. (306 a.l1
*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 PLUMBING
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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
b~ com~leted hef~re requesting this inspection.
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FINAL ELECTRICAL
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FINAL MEOIANICAL
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FI~AL BtJlLDING: Must be requested after the final Plumbing. Electrical, ~lechanical and Fire
Department inspections are made and approved. No Occupan~y of the premises can be m3de until
a Certificate of Occupancy has been issued by the Building Division and posted on the premises
FINAL FIRE DE!>ARTME~IT
'SICNATIJRF
OATE
* ALL MANHOLES AND CL~ANOUTS ~rusT BE .\CCESS1BLE, ADJUSTI1ENT TO BE MADE AT NO COST TO THE CITY.
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