HomeMy WebLinkAboutPermit Electrical 1984-3-6
I IrISPECTION LINE
726-3769
Job Address ~'207 MR/N ~7'.
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CITY UF SPRINGFIELD lNFORlIATlON liNE
C0I1BlilATlON APPLICATION/PERMIT 726-3753
EilERGY SOUaCES: Sq. Ftg. 1.la;n ..~.;
Heat NA. ~q. !=tg. Access.
Water Heater SQ. Ftg. Other
Ilew Add Alter Rep.
Range -Fence Demo Change/Use
Valu, of Work: -J)ther- -
~t?e1. -~ 6FM.PcR_V .
Builtiina Pernlit Info: Describe Work(i.e., Build Single
Fa~ilv nes;dence With Attached haraae)
Addres~
h'_~ /"'" /.'"'<.-#IIRA.IV
Phone
Owner
Construction lender
Address
UlS Hil< fEAl1
(name I
Lnt:.~T J99""".~ 7.EA1ll1P~ ~
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(address) ,. (llcs. no.l (exnirp"'1 (ohone 00.\
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Phone
Primary
~~""'A:T W.li'~~
Structura 1
Electrical
Mechanical
CONTRACTORS
General ~~ ~
Plumbina
E1 ectri ca 1
~lechanical
NO.
(namel
(address)
(1 ir:c:. no. \
h~),o~
(pxoi rp,,~)ll
;/
(ohnnp no. \
PLUIIBItlG
ELECTRICAL
MECHANICAL
FFF I rHARr,F Nn
eEL..cJJABliE. Nn
1=1:"1= r~ARG.E.
Residence of
furnace/burner to
BTU1s
/
Each single fixture_
~c-...., 7nkR
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
(] bath 1
Duplex (1 bath) each
Additional bath
~Iater service
Sewer
Storm Sewer
~-=A ~.
SQ. FT.
SERVICES
Recessed wall
So~rp hp~tpr ~nrl vpnt
lremporary Construction
IChange in existing
rpc:. i dp..nrp
Imultifamily, comm. or
TnrllJc:.t.r;~l
IOf amps.
ICOMI.I./IND. FEEDERS
I Install/alter/relocate
rlhtrih. fppfipr'c:.
Appliance vent
, c:.poarate
Stationary evap.
cooler
Vent fan with
"inole duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hood and durt
Wood stove/heater
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amps.
I SSUANCf OF PFR!1lT
TOTAL CHARGES
"Electrical Contractor, the electrical portion of this pe~it
Supervisor and returned to the Building Division
TOTAL CHARGES TOTAL CHARGES
WHERE STATE LW REQUIRES that the Electrical work be done by an
shall not be valil until the label has been signed by an Electrical
I HAVE CAREFUllY EXAtlINED 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 UO 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 ;s in full force and effect as required by ons 701.055, that if exempt th as.s for exemption ;s noted hereon, and that
only subcontractors and employees who are in compliance with OP.S 7nl.055 wi e d on this project.
/),& DATE_~/~
1lAl-IE(please prin: IJlo~!S \.d&~,;::'J.P SIf,ilATUR
FO~ OfFICE USE OIlL i
20ne <:::. c::..
Fire Zone
Fl ood Pl a i n
BUILDING PERf1lT
Charges an<::
~~.lIges
PLU/~BING PERMIT
Cha rges and
Surcharges
ELECTRICAL PERI~IT
Charges and
Surcharges
11ECHANICAL PERMIT
Charges and
Surcharges
Tyoe/Const.S- At' Units Sq. Ftg. f1ain ~O>,. x Value ~~-
Bedrooms Occy Load Sq. Ft9. Access x Value
Stories Occ,Y Grou;;fl-"'_ Sq. Ftg. Other x Value
TOTAL VALUATION
/__ _ Plan Ck. Conrn/lnd
.E~. 65UBldo Ppr ~"'P
---- -------"""""PTan Ck. Res
.. f<t:> 30%/B1 do Per Fee
Fence
~LI: / __ Systeos Oevelopment
"'-17 ~.,- CharQe (1.5~)
r~~_
N..#.
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Irotal Comb. rermit
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I TOTAL
1e:>.4(0 .,
Demo
___________J Sidewalk
I A/C Paving
I Curb Cut
------------
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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
11 D3 43
2. example- lot 1. 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 q
2. example- waterheater/electrical/or solar
E. Square footage or valuation, etc. -
I. example- 1250 sq. foot house, 500 sq. foot garag.
2. example- if new project, check-nfw - if addition
checlc add. etc.
F. Building permit information:
1. example - construct single family house with an
a ttached garage
2. example - remodel existing garage into family rOI
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 TEAI'I AND CONTRACTORS
To avoid design or construction delays. Building
Division Staff must be able to contact appropriate
. persons regarding design infonnation or jab 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 adjacen
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 schedule
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
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.
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.
III.
V. FOR OFFICE USE ONLY
!
CK,Y OF SPRINGFIELD
. City Hall
Sprlngflald, Oregon
Departmant of Public Worka
OFFICIAL RECEIPT
No. B 62533
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Received For.
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Amount Received
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, ,. AUTHORIZED SIGNATURE - \
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...11)08 ,.ltINT~It./L.ITHOGltA"H~ft.. ~UQJ:NJ:. OltJ:GON
Permit Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit appl i cant exempt from regi strati on with the Buil der' s Board because:
Additional Project Information:
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PLANS REVIEWED BY:
~RiSNE ~~Signatur~...
-,
name
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Inspecens ..
IT IS THE RESPONSIBILITY OF TilE PER..'!IT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TUlE.
THAT EACIl ADDRESS IS READABLE FROM TEE STREET. AND THAT THE PER1'UT CARD IS LOCATED AT TilE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIHES.
PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB Nu}lBER.
job address, type of inspection requested and vlhen you will be re.:::.dy for the inspection. Contracto::-s
0= o\mers name and phone number. Requests received before 7:00 am. will be reade the same day, requests
received after 7:00 am will be ~de the fol1owinb work day.
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Your City Designated Job Number Is:
Job Address:
Owner: 0~(
Contractor:
SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNOERSLAB PLmlBING, ELECTRICAL
& ~IECHANICAL: 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 concreto 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.
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UNDERGROUND: Plumbing. Electrical.
Gas. Sanitary Sewer. Storm Sewer.
Water and Drainage lines. To be
made prior to covering or filling
trenches.
UNDERFLOOR: I 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.
ROOF SUEAlln~!G A.'ID NAILING: Prior
to installing any roofing.
ROUGH PLUMBING. ELECTRICAL &
MECHANCIAL: No \\'ork is to be covered
until these inspections have been
made and approved.
0 FINAL PLU}.fBING D
0 FI~AL ELECTRICAL
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FINAL MECIlANICAL
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Phone:
~>?-/g.o:a..
Phone:
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ATTIC DRAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior to placing facing
materials and before framing
inspection.
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SPECIAL INSPECTIONS: In accordance ~ith
Section 306 of the Building Code a special
inspector shall be employed by the O~ner/
Contractor during construction of the
following work. A cepy of the special
testing reports shall be furnished to the
Building Division.
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STRUCTURAL CO~CRETE: In excess of 300)
P.S.r. (306 a.1)
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.
F~1ING: 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 arc
approved.
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LAlli AND/OR r,YP$lff.l BOARD INSPECTION; ---,
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 &
censtructed 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 APRO~: 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
STRUCTUR~L WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BOLTING: During all _
bolt installation and tighting
operations (306 a.5)
SPRAYED ON FIREPROOFING: (U.B.C.
Standards 43-8)
SPECIAL GRADING. EXCAVATION ~~D
FILLING: ~Jring earthwork. (306 a.ll
& Chapter 29)
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GLU-LAM BEMIS: Inspection Certificate.
by an approved agency, furnished to
the City's Building Division before
beams are placed. (2S01-U.B.C. STDS.
25-10,11) .
*In addition to the inspections
specified hereon. the Building
Official ~ay make or require other
inspections of any construction
work to ascertain compliance \dth
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 inspectio~. All project conditions such as landscaping, parking lot striping etc. must
be cOffi~leted before requesting this inspection.
o FINAL FIRE DEPARTIIENT
SICNATURE
Must be requested after the final Plumbing. Electrical, Hechanical and Fire
i ns are made and approved. No Occupancy of the premises can be made until
cupancy has been iss by the Building Divisien and posted on the premises
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DATE _ -?k. ;;'-1
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*ALL ~~HOLES AND CLEANOUTS ~ruST BE ACCESSIBLE, AOJUS~ffiNT TO BE ~~DE AT NO COST TO THE CITY.