HomeMy WebLinkAboutPermit Building 1989-1-18
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I.eg.l Oescription 11
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CITY Uf SPRINGfIEI.O
COMBINATION APPLICATION/PERMIT
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EIlERGY SOURCES:
He.t
.-"") 7 Hater Heater
.?'- -0&'
Ranqe_~_~__
ValuE of Hork:
H' .000
Phone 71'iI . ) Bui loinQ Pennit Info: Oescribe Work( Le., Build Single
fL1.'/53, _ Familv l'tesidence Hith Attached GaraQe' .
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INFURl1ATlON LIOt I
726-3753 /. "Y'\
Sq. Ftg. Hain IJ...buu lP ~
~q. Ftg. Access. 8'J
Sq. Ftg. Other
-11ew_Add__Alter--y-ep. .
_Fence_Demo_Change/Use t>
_Other .
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Job Address
:; 'f 0;).
(Ii') U , '"
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Owner
Address
W'A.I.(
37'02
I"I-"'\~(h .-
Y'/l ,4 ,'f\.
Construction lender
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Fou......lllr'.dn. ./)er-,.,....... (Orlly)
So',.,. Or~,yt,,<L'''' .,0...._.'-,- (0.,(.')
i
Address
DESIGN TEAl'
(name)
Phone
(address I
nics. no.l (exoireo;.)
(ohone no. I
Primary
Rrc...(k VV\t'AA
[;'"",.
J'",{.
(O,-p: e./\&IY>t""I'""pr(
.....:....
,
Mechanical
CONTRACTORS
(name}
(address \
(lice;.. no.' lexnire.sl
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(oh'nnfl nn _ \
Structural
'-.T A.c
Il'V:/({1"4'>
V"lC7A ( I ~" '/ ,..(, ^'l)
Electrical
General
~t 'n <? j.'Ct,v'\ (r,..t c;: j;.
\~'~I'C. '" i~ 4'/1':- Vi'1.-,
13.!S" r_ II,. _Cp,,;,if
Q29<1.)
q h~/ff'i 7'(7''1!f<rs
01"'- '7 'It,. '(>);Z
Plumbina
Electrical
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'ilJrj)
~1echanical
1.,-:(1
PlUltB IIlG
ELECTRICAL
MECHANICAL
NO.
FH CHI\RGE Nf'.-
FFF J:lJAR"F NO.
CH ' rHMfi[
SQ. FT.
furnace/burner to
BTU's
Each single fixture
Residence of
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
11 bath \
Duplex (1 bath) each
Additional bath
SERVICES
Recessed wall
~ra~p hp~tpr anrl upnt
ZS!> 'Stonn Sewer
&-2-
Of
amps,
Appltance vent
sp-oarate
Stationary evap.
cooler
iient fan wi th
sinolp l1urt,
Vent system apart from
h~':ltinq or A.C.
Mechanical exhaust
hnnd -'Inti tiurt
Sewer
Temporary Construction
Change in existing
res j dy"nce
multifamily, comm. or
'nrfllll;t.ria1
Water service
COMI.I. /I NO. FEEDERS
Install/alter/relocate
~ill;tr;h. fppdpr~
Wood stove/heater
Of
amps.
TOTAL CHARGES
WHERE STATE l~W REQUIRES
shall not be vali1 until the
ISSUANCf OF PFRllIT
5""Gi - TOTAL CH^RGES TOTAL CHARGES
that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this pemit
label has been signed by an Electrical Supervisor and returned to the Building Division
1 HAVE CAREFULLY EXM1INED the completed aprlication for permit, and do hereby certify that all infonmation hereon is true
and correct, and 1 further certify that any and all work Derfonmed shall be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Ore<]on pertaining to the work described herein, and that rm 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 ORS 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who.are in compliance with OP.S 701.055 will be used on this project.
IWIE(please print) r<,.r, 'GO<"
E
12" ',..e h to' vc-. SIGrlATURF. 1?-
fZ,,>-_.~
DATE l/' fJ I her
BUilDING PERfIIT
Charges and
Surcharges
-:2~.o, So
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../3.~J
'i?M.. l.:'>aJq
Plan Ck. ConmlInd I . 3
65%/Blde Pj'r Fpp 'L:29. . ,~
Plan Ck. Res
30%/Blde Per Fee
FO~ OfFICE USE O/llY
Sq. Ftg. Main x Value
Sq. Ftg. ~ p"......,~4r4aAr Value_<l~~
Sq. Ftg. Other<~ 7.).Q~~""'Value 7_~ ~
. '. TOTAL VALUATlOtIj:'.7-~c>
,
Systems Development ~/1~. ~..
Charqe (1. 5%' /"./~' .
Zone L /"
Fire Zone
Flood Plain
Type/Canst.
Bedrooms
Stories /
Units
Dccy load
Dccy Group$-2
PlUI~BING PERMIT
Charges and.....
Surcharges
_____~._~_ Fence
::< _::)e> 0,,"0
Sidewalk
ELECTRICAL PERrHT
Charges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
AlC Paving
Total Comb. Permit
::?2G..O?f;
Curb Cut
TOTAL
/d~/,t7:3'
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
1. Applicant to furnish
A. Job Address
B. legal Description J
1. example- Tax lot 100, lane County tJbp Reference
II Uj 43
2. exa~le- Lot 1. Block 3, 2nd Addition to
~prlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceiling/or forced air Qas
2. example- waterhealer/electrical/or solar
E. Square footage or valuation. etc. -
1. examole- 1250 sq. foot house. 500 sq. foot garage
2. example- if new project, check-new - if addition,
check add. etc.
F. Building pennit information:
1. exam~re - construct single family house with an
attached garage
2. examole - 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. 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
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. ---
Ill. Applicant to sign and date
Whenever possible, the initial application will be used as
a worksheet o~1y. 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.
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V. FOR OFFICE USE ONLY
Permit Cl erk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE -GGGUPMCY-: 1;55c....r?'p/C:E C::>~ ~fi/77rr
I~ 71FC.F'/r'/ e::>F ;;;~/Yc.D PEI/~( C'P"A4~/.:?7 ~?i'FE./'7?E/::P?:
"::(~.7?E.cE/.7? &?~ k/"'/Yov6D h/Y~ ::;;~A#/Y.
Permit applicant exempt from registration with the Builder's Board because:
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Additional Project Infonnation: ?LA'A/"5 ?' ;::::'E/-'r~/.T5 #/?'e-&P'?o/.....rED
-;:;;~__c: I9'~CP/~. ~ &;::rc7?1"/~R<O. ~5?r'Y/.ce-. /~
v - ,,/
h/=L/. k~/S /N/"-,-S :;.~L>, ,..);b'/'"A/r #~&O'A/
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.:t7c-k-/;-~ Ci5?c...y?~CNr-,
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PLANS REVIEWED BY:
L~JZ!/';IE ?<::'~~ 5ignature4~....:::-........, date '2-2--89'
name
,..:.~k~
.~equired
Inspewons ..
IT IS THE RESPONSIBILITY OF TlIE PER!1IT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT TIle PROPER TIl-lE,
THAT EACH ADDRESS IS READABLE FROI1 THE STREET, AND TIIAT TlIE PERl'lIT CARD IS LOCATED AT TilE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS M.UST BE ON Jon SITE AT ALL THlES.
PI\OcEDURI, FOP. REQUESTING INSPECTIONS: CnU 726-3769 (recorder) state you CITY DESIGNATED JOB NUl-mSR,
job ~ddrcs~, type of. inspection rc~ucstcd and when YOll will be r.c~dy for the in5pcction. Contrncto=s
0:.4 O\oJncr::; name and nhonc number. Rcquc::tc received before 7:f)('I am \o.'i11 be rr.adc the same clay, requests
l"cccivcd after 7: 00. am will be ~dc the following work day.
You~ City Desifinatcd Job Number Is;
Job Address: ~ ?f~2 MA'/'h'
Olmer: 1A:/:tj:-( 7' Ah-E.c'h';'"
~ '7'"t::'L?<;/O
<('~
Phone:
COlltr.1ctor: .Phone:
F;:.O/)./P,l-7/C76-' 7-i-;5/2>"V:;:; #i/f1Y/Y~:C:? o;ij7c.p. -
O snE INsrr:r.nON: To he m.1cJc . 0 ATTIC. n1tAFT STOPS r. r.UnTAHl WAI.I.S."
after excavation, but prior
to $ctup cf form::;, 0 FTREP!.Ar.!:: Prior tc placing f:Jcin~
lINnEltSI.AB Pl.llHIlING. EI.Er.TIUr...\L mntcrinls nnu hcforc framinr.
r, !>IECIIANIr.AI.: To hc :n<lue bcferc inspection.
any "'01'1: is covcrcu.
o PIN:\l. PI.lI~I!IINr.
D FB1AI. ~I.ECTRICAJ.
D F1NAI. HECIJANICAI.
D FINAL FIlUl IlE!'ARTIlE~rr
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C0NCr:ETE SloAn IN'sPECTlON: To 'he
:n:H.Ic nftcr a) 1 in:;Iab bui !uinr.
:>cl'vice equipment, conuuit, pipili~,
acees:iorics ;tlld othcr ;mcillnry
cquipmcllt items aI":: in jlln~c but
hcforc ;1:\y eoncl"ct~ i:; pourcd.
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FOO'l'f NGS (, FOIlNIlATI ONS: To he m:IlJe
:d'ter -trcnchc:> ;:11"C eXC:<lv:atcd. ;lnd
forms :I\'C erccted. all'stccl in
pla~c. lnlt prior to pourinr. concrete.
1I:-1I1Enr.nnIlNl1: J'lulIlhinl:, ElcctriC:II,
G:l:> , Sanitary Scwcr,c:::::u.orlll SCW~
W:ltCI' ':l11d Drainage 1 illcs. 'l'o.hc
mad::: [1riol' to covcl'inl; 01" fill'inl:
t l'cnches: .
IINlll:I{FI.001t:, Plumhing, IHcctl"lcal,
Mechanical. To hc madc prior to
illst;lll:ltioll of floor insulatioll,
(Icckjll~ or rlool' :;llcatllillr..
POST ~ IH:AM: To he m::dc Pl'jor to
j n:;t;lll;lt ioa of rIO:ll' il:Stil:lt lon,
decking or flOOl' ::he;:tlll1:.
Horm INSUJ.ATlON ~ VAPOR IlARlltHnS:
'!'o he m;lde pri(I\' to install:":tioll
of deddnr. 01' fIool' :-:heat ing,
f.-IASONny: S'tce I I oca t LOll, hand bcalllS
~l"olltil~r. 01' vCl"ti~~al~ -in .Iceordnnce
witll II.n.C. SecticlI 2~15:
IWI~F S!lEA'!lll~!r. M!1l'N.^.IJ.INr.: Priol"
to instil II inl~ any roofinl:'
11fJUr.ll 1'1.1!1-11\tNr.. EI.I:CmlC/'.I. r.
1-1EC!lANCIA1.: No work is r.o be covcred
lu~ti I thc~e in~pectio:ls havc hcen
m;Hlc .1m] :lppl'oveu.
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INStIIATION (, VAJlnn RAnn! En: To bc
mnde nftcl" all jnsul;ltion ';1lld
rcquired vapor harricrs nrc in plncc
but hcfore <lny I;tth or gyp sur.: hoard
interior wall covcril~r. i5 npplicd.
SPECIAl. INSPECTIONS: In accord:mce Idt!:
SC::t.ioll 306 of the Buillling Code ;t spccial
inspector sh;tll he cmploycd by the O\-:IICI"/
Contr;tctor uuring con:;truction of the
followin& I-Iork. ^ ccpy of the spccjal
testing reports 511<l11 be furnishet! to the
Uuilding Division.
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~:TlulcrunAI. CO~Ir.I~ETI;:
'P.S,I. (306 ;\'1)
In e~cess of 300'}
FnAMING: To hc m;tdc aftcr the roof,
;tll frami'.lg, fire hlockinf~ ;lllu
br<lcing are in plnee ami <Ill pipc$,
chimneys nnd vcnts ;lre completc <lnu
thc rough clcctrical, plumbing ;101l
hC:lting wit.cs, pipes ;llld duct!; arc
;lpprovcd.
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IA11l ANn/On (;YPSUM BOAlm INSPECTION: I
To hc made <lftcr all l:'thir:g a:1lo --.J
p,)'psum honru, intc-rior' :tnu exterior,
is in place hut bcfore :IIlY plastc1'ln~ I
is :lppIied or hefore r,ypsum hoard --.J
jojnts and f<lstcncrs ;I1'C taped anr.!
fi nishcd.
FIRn 1; SEPAIlATlON IMI.l.: !.OC:ltcu ~
constructed ncconling to pInns.
STRlICHIRAI. I'lEl.nS: Preformed on the
job. (2722 f)
IlH~I'1 STI~ENr.r1l 1l00,TING: During :111
holt installation :Intl tightinl:
operations (306 a.5)
1'lOOIlSTOVES:
complctctl.
$Inm~AJ.K ~ OltlVEl'MY: Hcquircr.! for
:111 conc.rcte pavilll: \-lithin street
right~of-I-I<lY, to bc m:l.r.!e aftcr nll
cxcavating complcte ~ form ....ork ~
sub-bnse nl;lteri<ll in pl;lce.
ClllU\ ANn API'rmACII ArnON: Aftcr fOl'ms
are ercctcr.! but prior to pouring
concrete.
Aftel' installation is
rAnKINfo 1.01': After gravel is in
placc hut prior to pl<1cinl: asphalt
or concrctc.
SPIlAYr:n ON FIHr:PltOOFlNG:
St:muanls 1\3~B)
(tJ.B.C.
SPECIAL r.llAOINr..
'F] I.UNG: During
~ Ch;lpter 29)
EXCAVATION :\ND
cartlll'lOl"k. (306:1.] I
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r.W-I.AM BEMiS: l:1spectioll Certi fieate,
by an approvcd a~e:lcy, furnisher.! to
thc Cjtyls Uuilr.!ing Dlvision befol"c
be::ms <ll'e pl:lced. (2501-U.n.C. STllS,
25-10, \1).
-j('In addition to the inspection:;
sp~cified hercon, the Huiluing
Offici<lI :nny :r.:lke or rcquire other
il1spcctiol~S of ;lny construct ion
\~ork te ascert:lin cOr.lJlli:ance I~it.h
the Uuillli!1g, City oj' !onilll: Coucs.
CITYIS SIn: PIAN ItEVIE11 nO.'\RO INSPECTION: Mu:;t bc rCGucstcu 2 da)'s in :luvancc of the J:ltC yell
\dsh 111SjlcctiO:l. All p'rojcct ~on~ltions such <I:; l:musc:lpir.g, i~arkin& lot striping etc. 11111r.t
be COn:;11ct.cd ~1efo1'c rcquesting this il:Spcction.
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,FINAl. RlIlI.OINr.: Must he requestcd <If tel' thc fin:tl Plumbing, Electric:ll, ~tech;tnic;J.I <lnd Fh'c
Oepartm~nt inspcctions ;trc mnde <lnu approved, No Occupancy of thc prcmbes C:lll !:Ic mndc ~ll1t i I
a Certificate of Occupancy h:lS been issued b)' thc Buillling Divisien aroll postcd on the Jlremi~;c:>
5 r'CNATURI;
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DATE