HomeMy WebLinkAboutPermit Building 1987-2-3
'J INSPEHLON LINE
. )726-3761
.
CITY Uf SPRINGFIE~D
COMBINATION APP~ICATION/PERMIT
E!IERGY SOURCES:
Heat P7~
Hater Heater
Range
.
INF0R11ATlON UNl
726-3753
Sq. Ftg. '.lain
~q. Ftg. Access.
Sq. Ftg. Other
New Add Alter Rep.
--Fence Demo Change/Use
Other- -
Job,Address :3 ~&1 /:I1A--/A..J S/ ( #4-2
Legal Descrip!ion /'1t?2. _~ L 42.. 047t?/ ff.,+L,
~~A~
Owner..JE'.t ~ '/tfe/ r!.-E
Address '2- / / / ~OU '/ ST
c::4;::;".., i Ck.
Phone
ValUE of I~:
SOD
Builciina Permit Info: Describe Work(i.e.,
Familv ~esidence With Attached Garaael
Build Single
\))
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Construction lender
_.q0?4r~ ~-EiJ rE/f./-r..E;
//I)t5'HttL. ~~ lhiof'/ /; J -c 7-;~
Address
OESIGN TEAr~/ Inamel
Primary I -..4;:iI)
Structural ~
Phone
(address)
~~;c~ no.)
J
(exoiresl
(ohnne no '
I
77J
r5</ )"( ~
JA
vAl ~~~ y
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Electrical
Mechanical
CONTRACTORS
(name)
(address 1
nic~_ M.)
(pxoirp~'
(ohnnl'lo nn ,
Genera 1
Plumbina
, Electrical
~'echan1cal
PLUIIBI NG
ELECTRICAL
MECHANICAL
NO.
FEF rHARr,F Nn
J:'~L-.C..I:iARG.E. Nn
~!:'r: r\.l~
Each single fixture
Relocated building /
(new fix. additional) -
l's.F. Residence
(1 bath)
iDUPlex (1 bath)
IAdditional bath
"ater
Residence of
SQ. FT.
furnace/burner to
BTU's
I
New circuits a1ts.
or extensions
Floor furnace
and vent
Sewer
SERVICES
Recessed wall
So~rp np~tpr ~nrl v~nt
Storm S
/
/
/
V
/1
I
Temporary Construction
Change in existing
rp'l j dJ'.nc~
Imultifamily, comm. or
Tndllc:.t.rial
10f amps.1
ICOffi~./IND. FEEDERS
I Install/alter/relocate
rlic:.trih. f~pdprc:.
IOf amp~1
Appliance vent
S~Daratp
Stationary evap.
cooler
Vent fan with
~inalp (ill('t
Vent system apart from I
heiltinq or A.C.
Mechanical exhaust
hood ilnd dur:t
Wood stove/heater
I
TOTAL CHARGES
WHERE STATE L~W REQUIRES
shall not be valid until the
ISSUANCE OF PFR!1lT
TOTAL CHARGES I-TOTAL CHARGES
that the Electrical work be done by an.'E1ectrica1 Contractor, the electrical portion of this permit
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 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 OCCUPAHCY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Bui1der'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 ORS 7nl.055 will be used on this project.
IWIE(please print) Rj M,c..r SIGrMTURE (-f?~~ DATE ~ -..;~- $"7
FOR OFFICE USE OiIL Y I
Zone Tvpe/Const. Units Sq. Ftg. t1ain x Value
Fire Zone Bedrooms Occy Load Sq. Ft~. Access x Value
Flood Plain Stories Occy Group Sq. Ftg. Other x Value
TOTAL VALUATION
BUILDING PERHIT
Charges and _~.
Surcharges
10"0
-----------
.-(0
-~-
Plan Ck. Comm/Ind
65%/Bldo Peor Fee
Plan Ck. Res
30%/Bl dQ Per Fee
Fence
~
-
Systems Development
Charoe (-!. 5~) .
PLUt~BING PERMIT
Charges and
Surcha rges '-2:.
Demo
_ __./..5_~_ ___I Sidewalk
I GO lAIC Pavi ng
~ I Curb Cut
------------1
I
I
ELECTRICAL PERlm
Charges and \ I
Surcharges 'f
MECHANICAL PERMIT
Charges and
Surcharges
ITotal Comb. Permit
I
I TOTAL
U>~
.
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Oescription
1. example- Tax Lot 100, lane County Map Reference
II oj 43
2. example- Lot I. Block 3, 2nd Addition to
Springfield Estates .
C. ,Name,' etc. of owner and' cons"truction fender
D. Energy Sources
.~, h 1. "examDle-' heat/electrical ceilinqJor forced air Qas
2. examole- waterheater/electrical/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 pernit information:
1. exam~le - construct single family house with an
attached garage
2. example - remodel existing garage into family raom
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 ANO 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 OIVISION 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 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 CONDITIDNS TO BE SATISFIED BEFORE OCCUPANCY:
.
" l.
PERMIT VALIDATION
"
G111~
,~ /[._ ~1
C)./ - J
"
Permit Clerk
Q/
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
name
signature
date
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,
, ,
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. ',."...:D-=t
,~
.,
".quired
irispec.>ns ..
~' I,S THE RESPONSIBILITY OF THE PE~~IT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TItm,
T EACH ADDRESS IS READABLE FROM THE STREET, AND THAT TIlE PERMIT CARD IS LOCATED AT TilE FRONT OF THE
ROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL Tums. .' .
PROCEDURE FOR REQUESTING INSPECTIONS, Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
job address, type of inspection requested and when you will be ready for the inspection. Contractors'
or owners name and phone number. Requests received before 7:00 am,will be WAde the same day, requests
received after 7,00 am will be made the following work day.
Your City Designated Job Number Is, ~O ~Cf4
Job Address, <r;.,~7 "7J/f..l'1:Z1 J #4-2-
Owner, t-lt:0-.v0~' ,IJ~/t!.E Phone,
Contractor, ~~~A/~ Phone,
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SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNDERSLAB PLUMBING1 ELECTRICAL
& ~ffiCHANlCAL: To be made before
.any work is covered.
CONCRETE SLAB INSPECTION' To be
made after all ins lab 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.
~DERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer, Storm Sewer,
Water and Drainage lines. To be
made prior to covering or filling
trenches.
UNDERFLOCR: 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 installation
of decking or floor sheating.
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MASONRY: Steel location, bond beams
grouting or verticals in accordance 0
with U.B.C. Section 2415.
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ROOF SHEATHI~G ~~D NAILING: Prior
to installing any ~
ROUGH PLL~mING. ~ECTRIC^L.k'(..-t)
MECHANCIAL: No WorK 1S to be covered
until these inspections have been
made and approved.
FINAL PLUMBING D
~"\ 'tl
FINAL ELECTRICAL
FINAL MECHANICAL fir
D
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.
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LATH AND/OR GYPSUM BOARO 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.
FIRE & SEPARATION WALL' Located &
constructed according to plans.
WOODSTOVES: After installation is
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.
PARKING LOT: After gravel
place but prior to placing
or concrete.
is in
.asphal t
SPECIAL 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.
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STRUCTURAL CONCRETE: In excess of 3000
P.S.I. (306 a.l)
STRUCTURAL WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BOLTING: During all '_
bolt installation and tighting
operations (306 a.S)
SPRAYEO ON FIREPROOFING, (U.B.C.
Standards 43-:8)
~IAL GRADING~ EXCAVATION AND
FILLING: During earthwork. (306
& Chapter 29)
a.ll
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GLU-LAM BEMts: Inspection Certificate.
by an approved agency, furnished to
the City's Building Division before
beams are placed. (2501-U.B.C. STDS.
25-10, II).
*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.
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. mus~
bu com~leted hefore requesting this inspection.
JINAL BUILDING: Must be requested after the final Plumbing, Electrical, ~1echanical 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
,,~-Q7 ~
* ALL MANHOLES AND CLEANOUTS miST BE ACCESSIBLE, ADJUSTMENT TO BE MADE AT NO COST TO THE CITY.
o FINAL FIRE OEPAR~reNT
DATE
2.-3-
%7
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