HomeMy WebLinkAboutPermit Mechanical 1989-6-7
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It/fORI1Al: .:1 LI..:.
726-3753
So. Ftq. Hain
~q. fllJ. Access.
SQ. Ftq, Other
!leI" . Add "',1 ter ~eD.
--rence Demo Change/Use
Other- -
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Job Address
-gB7,<) /-?7#/A/"':?7
LIlY ", SI'Hlm;IIElU --..~
COIIBWMION APPLICATION/PERMIT
E!IERr,y SOURCES;
Heat
\later Heater
Ranl1e_
Valur of I-Iork.:
'/'l ..__
-~./ / t!!/. .v-
Uu'i It;ino Permi t Info:
F~~ilv nesidencc With
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j I NSI'ECTlUll lINl
726-3709 '
le9al Description
Owner 8,,,,,; 7ii.pY;;N~~q--~~?T 1'_'
,'''dress ~5" ~/^'" ~,.... Phone
-<- ~,
,5')2>.r?- D, .t? /"'? .
Construction Lender
Describe \'/ork{ i.e.. Bui ld Single
Attached r.araoc)
,\ddress
Ul)!LiIl 11I1r'
I /~~.cL.7.j;.,...."" ~~ .~~
- h ,./-:. _..-...,.....--......~ ~....".....
, ....
{name
hone no.
Primary
Structural
Electrical
~1echanica 1
CONTHACTORS
PLUlmlllG
ELECTRICAL
MECHANICAL
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(nclme J
{address}
( 1 irs. no. 1
(~xojres)
(Ilhone no
General
Plumbina
Electrical
ttech-'nic-,l
/:.
",'#'
.. Z:-;;..' .:;-~__~~.
--..BL.
...li.L C/lARGE JIlL.
Each single fixture
Residence of
.-.Ill..- J:.IIAll
...!llL..
furnace/burner to
~~_c_ OHl',
sq. FT.
'2
-,-Relocated bU-if"dincj"""".
(new fix. additional)
IS. F. r.es idence
r 1 both I
IOuPle, (1 bath) each
IAdditional bath
-I~!ater service
Isewer
I Storm Sel'ler
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New circuits alts.
01' extensions
lor
ICOHI1./INO. FEEDERS
I nSlo II/a 1 ter/re 1 oca te
~ih_ fpprlpr~
or
amps.1
I Floor furnace
and vent
I Recessed wa 11
~~~rp hp~tpr ~nrl
I
I' Apoliance vent
..eoarat!!
I Stationary evap.
cooler
I Vent fan wi t11
sinnlp. duct
I Vent system apart from I
heatino or A.C.
I Nechanical exhaust
hood Mtd rllJr t
I Uood stove/heater
!SERVICES
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ITemporary Construction
-1'Ci';a;1Qe in existing
rros id~nr~
I Imultifamily, conl!\. or
Inrltl~trial
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TOTAL CtlARGfS I TOTAL CHARGES
HIIEnE STATE l-\U REQUIHES that tile Electrical \~ork be done by an
Shall not be valj-J until the label has been si~ned hy an Electr-ic,)l
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amps.1
Electric,)1
Supervisor
I SSIJA/lCf or PrP.!11T
l!OTAL C/lARGES ~h'. /.57-'"'"
Contractor, the electrical l1ortion of this permit
and returned to the Building Division
I IIAVE-Ci\[!(rully-tXMlIr/CD VIe c:ompleted ap~lic(1tion for I}crmit, and do hereb.v ccrtify that all information hereon is true
and correct, and I further certifv that any and all Hork oerfonned shall be done in accordance with the Ordinances of the City
of Soringficld and thp. laws of the State of Ore(Jon oertaininl) to the work described hel'(~in, and that 110 OCCl'PAflCY I~ill be made
of any structure wilhout the nermission of the lIuilclinfl Division. I further certif that my re~istration "lith the Ouilder's
Ooard i, io full force and eflect ., re~uired by OIlS 701.05S, tto,ll il e,emut t e "? lor e'emntion IS noted hereon. and that
'::::,::::::':::::::;~ ;:':~~" ';;:'::::~~'" ~':,,:::.~; ,~"" '~~ .,,-r~lLcJ ~1
~, FO~ or" Cl USE
Zooe L c...
Fire 70ne
Flood Plain
__Tyoe/Cons t.
Bedrooms
Stories
lJni ts
Occy load
Occ.Y Group 7'- 2.
s~.
SQ.
S~.
x Value
x Va I ue
)( Value
TOTAL VALUATIOII
OUILOIllG PER/'lIT
(ha r']es an:::
SurCharges
Plan Ck.
_ _ __ ___ __ __ _ 65!/Oldo
Plan Ck.
JOt/Oldo
I Fence
I Demo
I Sidewalk
- --- - - --- ---:-_1 A/-C Pavin9
LS. ..-.; - I'Curb Cut
-- --~:75---1
Conm/lnd
P-,>r' _F",""
nes
PE'r Fef'
Systems Development I
Chuoe (I. 57,)
PLUI10l/lG PERMIT
C~ilrges and
SurCharges
------------
,ElCCTRICf.L rER/llT
Cha rQes and
Surcharges
/fECIIAl/ICAL PEP,/11T
Charges and
Surcharl')es
ITotal (amb. Permit
-TOTAL
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
I. Applicant to furnish
-A. Job Address
8. legal Description
1. example- Tax lot JOO, lane COU;lly Map Refe/eoce
11 03 43
2. example- lot 1. (Hock 3, 2nd Addition to
~prln9fjeld [stales
C. Name. ctc. or owner and construction lender
0: Energy Sources'
1. example- heat/electrical ceiJin'l/or forced air QdS
2. examOle- wdterheater/clectriC;I~/or solar
E. Square footage or valucltion, etc. -
), examo)e- 1250 sq. foot house, 500 sq, foot garage
2. eXdlllple- TTnew project, checknew _ if addition,
check. add. etc.
F. Building permit information:
1. "example. construct sin!Jle family house with an
attached gar~ge
2. examale. remodel existing garage into family room
J. eXdlllole - convert single filfllily residence into
restaurant (change of use)
G. Value of \'Iork. as defined in Section 303 {a} of the
Structural Specidlty Code
If. OESIGN TENI ANO COIITRACTOIlS
To avoid design or const'.uclion 'delays, Uuilding
Division Staff must be able to contact appropriate
persons regarding design information or Job site
corrections, etc. .
II. Abbreviated Plumbing, NechanicaJ, & Electrical Schedules
A. Except ,',here 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, Nechanical. 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. BUIlOING OIVISION STAFF Illll FIll OUT ALL FEES AIID
CHARGES 011 TIlE SCHEUUlES
O. 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
appl icatian, and no plans l'Ii 11 be processed unti 1 these
fees are pa i d. A 11 0 ther fees anll cha rges d re due ilnd
payable when the permi t is issued.
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PROJECT CONDITIONS TO 8E SATISFIED BEFORE OCCUPArlCY:
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Perm it Cl erk
V, FOR OFFICE USE ONLY
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Permit appl icant exempt from registration with the Builder's Board because:
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Additional Project Information:
,
PLANS REVIEWED BY:
I~
nameLfl?.AZ~ ;9~t5;?f> signature
d~J0
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Owner ,;q,,,,,,, 7hp".r;NiI"',,~,?
,'.ldress ~S ~/.N ~,....
,5'JZ>A:. 2:'/ -?,/Z?
Construction Lender
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1"~"lcrlU" lIlIl
IZo-)]69
Job Address
leqJl Oe~criplion
,\JJrcss
UL~ J lill HAil
Primary
Structural
Electrical
!techanical
CONTRACi(ii(;
Genera 1
Plumbino
I Electrical
I 'lp.ch,lniC.,'d
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ItHOIU1AT: .:/ ll,,:'
IZ6-)];)
So. ftQ. Hain
~q. fllJ. Access.
Sq, Ftq, Other
!leI;' Add ft.t ter ~eD.
--renc~ Oemo Change/Use
Other - -
. LilY ,,' ~1'HIfMI(7~
COIlBl/lnTIOII ^PPlIC^TIOII ERMIT
~~ no.
EIIERr,y SOURCES:
Ileat
Hater IIcatcr
Rani'Je
.
'3iS?S P#/N"'?'7
-'"'X-.. '~,.., ~~
f --- I.
Phone
Value of I-lark:
4(,W&:>. -~
(!uil(;inQ Permit Info: Ueser be l-Jork(i.e.,
F.lr.lilv l"lp.sidC'ncc Hith "ltached r.arao(')
/Ms)-:;9.cL T~ ~F ~_, ,_
,4.:-p ~~~". - ._- ---= ~/,.....
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lndmcJ
Phone
{address}
{exniresl
( I ics. no.)
.,.
Bui Id Single
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(ohone no. J
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7~S:- "Z77?:
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(n,lme)
lexoires'
(llhone no
(address )
( I ics no.)
M[CII^1I1C^l
sq, FT.
furnace/burner to
~ DTU's
~.......~~ k I~ !v. S~_2=~'-:'-:',-:,,~,
PlUrlB/lIG ElECTRIC^l
. .
...ilL CIIARGE JUL_'
Residence of
'...Ef.L. _CHAllG.f.
Each single fixture
'2
---
I Floor furnace
and vent
I I Recessed wol II
I ~~~rp hp~tpr ~nrl
-I
Relocated bui lding
(new fix. additional)
S.F. P.esidence
(I bHh 1
Duplex (1 bath)
Additional bath
I-!ater service
Sewer
I Storm Sel'Je~
-,
-,
New circuits alts.
or extensions
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ISERVICES
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[Temporary Construct ian
IChanqe in existinl)
rp5;dr.nrr.
Imultifamily, coorn. or
Inrfu'i.tri.11
lor amps,l
I C0l11'I, /1110, r[EOERS
-1?nstilll/alter/relocate
. rHL (pprlpro;.
Of - amps.1
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I ApDl iance vent
",~O.1I'iltP
I Stationary evap.
cooler .
I Vent fan wi th
..inole duct.
I Vent system apart from I
heatino or A,C:
I Nechan i ea I exhaus l
hood .'nri dllr t .
I Hood stove/heater' .
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I SSIJMCf OF prnm T
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TOTAl CIIARGfS TOT^l CIIARGES TDT^l CllARGES ~h". /:57-"'"
I HIIEr.E STATE L\H REQUlnES that tile Electrical \10rk be done by an Electric.ll Contractor, the electrical flortion of this pemit
shall not be valH until thp. label has becn signed by an [)ectr'ical Supervisor and returned to the Building Division
I HAVE CAllErUllY OA!1Hl(J) t~le cOll1pleted ,1llfl1ication fur I"Jcrmit, tUl(J do heret"v certify that all information hereon is true
and correct. clnd I further certify that any and all \1ork oedonned shall be done in accordance with the Ordinances of the City
of Soringfield and the laws of the State of Orenon Ilertainin~ to the work descrihed herein, and th<1t UD OCCl'PAUCY \1ill be made
of any structure without the nermission of the l1uilclinl1 Division. I further ccrtif that mv rellistration \"lilh the Builder's
Ooard is in full forcp. ,1nrJ e(fect as required bV 01:5 701.D~5, tll.H if .cxelllot t e si for excmntion 15 noted hereon, and that
::,:::::':::::::;~ ;:':~: .~::::"::~'" :::,,:::.~' . " ,. '~~ .'VdUCW'd
I - ro~ OrrlC[ IlSE /
lone ..::::. c..
Fire lone
Flood Plain
DUIlOlflG PERmT
Chitrl)Cs an~
Surcharges
PlU'lD I fiG PERMI T
C~clrgcs and
Surcha rges
. [l[CTRIC/,l nnr:1T
Cha rQeS and
Surcha rges
r'ECIIAIIIC^l rEr.rllT
Charges and
SurcharfJes
Tyne/Cons t.
l3edrooms
Stories
x
\Jnits
Dccy' Load
Occ.Y Group A' - :2
s~.
SQ,
Sq,
x
x
Voduc
Value
Villue
, TOTAl'V^lUMIOtI
Plan Ck. Comm/lnd
____________ ~5t/[Jldn P,pr Fpp
Plan Ck. nes
3D%/l3ldo Per Fec
I Fence
------------
J OP,mD
I Sidewalk
------------
'.1 A/e Pavin9
/,5 - --. I Curb Cut
-- --~;,s:----I
Systems Development
Cha rQe (I. 5.. J
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hotal ('ornb. rp.rmi t I.
---i TOTAl /5': ? s
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COM81NATION APPLICATION/PERMIT (CAP)
I.
II.
Applicant to furnish
,A, Job Address
D. legal Description
1. examole. Tax lot 100. lane Counly Map Refel
II OJ 43
2, examnle- lot I. 810ck J. 2nd Addition to
~Pr1l1gtield [states
C. Name, ctc. of Owner and construction lender
0: Energy Sources'
1. .example- hcat/electrical cell iOll/or forced
Z. examOle- watcrtacalcr/eleClt'ic.ll/or solilr
E", Square rootage or valuation. eLe. -.
1. examolc. 1250 sq. foot house. 500 SQ. foot
Z. . example- 1Ti1cw project. checknew _ if add"
check add. etc.
F. Building permit information:
1. "examole - construct sin!Jle family house witt
attached gilrage
2. examole - remodel cxist1nlJ gar"9C into ramil '001
3. cxall1lJlc - COflvcrl single fdlllily residence in
restaurant (change of use)
G. Value of \'iork as defined 1n Section JDJ {a} of t.
Structural Spccidlty Code
II. OESIGN TEA/.I ANO COIlTRACTORS
To avoid design or construclion 'delays. Uuil<1iug
Division Staff must be able to contdct approprial
persons regarding Ucsiyn information or' job site
corrections. etc.
Abbreviated Plumbin9,'Mechanjcal~ & Electrical Schedu
A. Except ",here blank spaces Occur in the descriptio
portion of the Mechanical and Electrical Schedule
the applicant need fill-in only the No. Boxes adj,
to the appropriate itern(s) to be 1nstilllcd
B. Full Plumbing. Ncchanical. and Electrical Schcdult
are available at the Building Division
1. To conserve space on the pcrmlt form the sche<:
have been abbreviated
2. If the item{s) to be installed arc not covered
the abbrev1ated schedules you should consult t
fu 11 schedu 1 es
C. 8UILDING DIVISION STAFF IIILl Fill OUT ALL FEES AIIO
CIlARGES Oil TIlE SCHEUUlES
O. As noted on the CAP, the label IllUSt be delivered tl nc
electrical contractor' for slgnature by his electric
supervisor. The general contractor is !.!..Ql authorlL__
to sign the electrical label.
Appl1cant to slgn and date
Whenever possible. the initial application will be used as
a workSheet only. Where possible, Building Division Staff
wi 11 prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
signature.
fees and Charges
Plan check rees arc due and payable at llle time of lhe
application, and no plans l'Iill be prOcessed until these
fees are paid. All other fees anl.l charges are due and
payable when ~he permit is issued.
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CITY OF c~~~INl
Sprlngfteld, Oreg
Office of Community and Econo
OFFICIAL RECEIP
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..' Date !/OH8 /("198-9'_
Rec'd From / ~..~..._..~C~
:J/~~ ~
Address ~;;:; ~.~
-'- Received Fa";) t?ll5#-~~.:2
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IV,
V, FOR OFFICE USE ONLY
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPAtICY:
Amount Received
A~
. 7'-Alm-lORlZEO S1GNATUR
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p:J2-
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....
/5. 7~
fnlntler BUSINESS fORMS. INC.
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Permi t Clerk
.
Permit appl icant exempt from registration with the Builder's Board becau~f
Additional Project Information:
PLANS REVIEWED BY:
name~;qAZE /2!?~6?'P signature
..
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;~
"da te <!:
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,,,- '.;:
. .
.. Required
Inspectio.w ..
-,
IT IS THE
THAT EACII
PROPERTY,
RESPONSIBILITY OF TilE PER!<IT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TUlE.
ADDRESS IS READABLE FROlI THE STREET, AND TIlAT TIlE PERI'llT CAnD IS LOCATED AT TilE FRONT OF THE
BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL THlES,
PROCEDURE ,POR REQUESTINr; INSPECTIONS, Cnll 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER.
job "ddrcs!:;, type of inspection re'luesteo and \-1hen YOIl will he recdy for the in::;peetion. Contractors
or owners name and phone number. Requests received hcfore 7:00 amjwill be made the same day, requests
received after 7:00 am will be mnde the following work day.
'8?c:> <:"bY
Job Address, '5 8>5" fr'~.;17 ~r
Owner: 't?.c=//.~;I-; b'~,;::-~
Contractor: ~~C,,?#'C #~.
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Your City Dcsip,nated Job Number Is:
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SITE .INSPECTION: To he mndc
nEtcr cxcnvntio.n, hut prior
to setup cf forms.
UNllEHSJ.An PI,mmlNr.. ELECTHlr..'\1.
f, ~1I:CIIANICAI.: To he :nade hefcre
any Iwrk is covered.
C()NCm~TE SI.AR INSPECTION: Tn hc
madc aftcr ~II.I inslab Illli Idill~
scrvicc cquipment. conduit., pipitl~,
acces:;ories and other and 11ary
equipment itcms arc in placc hilt
he fore any coilcrctc is pourcd.
o
FOOTI NG5 fl FOllNnATI ONS: To hc mnde
:1["tel" tl'cnchc5 arc excavated :lntl
fm.ms :JI.C crcl.:ted, all stccl in
pJ:I~C, hilt prior to pouring I.:OI1l:I'cte.
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1I:--JIlEnGROIlNIJ: Plumbing, Electrical,
l;a~, S;1I1itary Sewcr, Storm Sewcr,
1\':1 tcr and Dra in:JR,e I incs. To he
made prior to coveri.ng or fi II in~
trcnchcs.
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IINllEltFI.mm:. Plllmhi.nR., Electric:I],
t1cch:lIlicnl. To he mnde prior to
illst:1! lation of floor insulation,
decking or floor shcnthin,~.
1'0S1' r. I\EAH: To be mnde prior tC'
il15tallation of floor insulation,
t1cckin~ or: floor shc<lting.
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F1.00H INSUI.ATION fl VAI'On I1AIUnERS:
To he molt1e prior to install:ltion
ol~ decking or floor shealing.
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~l,\SONnY: Stccl locntion, hond bcnms
irotltinr. 01' vcrticals in :lcconlancc
Idth U.B.C. Section 2-115.
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IWC!F S!lEA.I1IH!G ANn NJ'.I 1.1 Nr.: Prior
t.o inst,Il1 in& any roofin~. 0
!Xl HOUr.1I i'l.\JI'-lIHNG. ELECTHICAL f;
L..::J ('"Jo.1ECII^NU^f..,;) No ",'ork is to be covered
lint i I these inspecti.ons have hecn
1tI:ltle :lnt! npproved.
Phone:
Phone:
?~'<5?<7
FIREPLACE: Prier to plncing facing
matel"i:lls. nntl hefol'e fr:uning
inspect ion.
'SPEC1AI. INSPECTIONS: In nccordnncc II'ith
Scction 306 of thc Bui lJing Code n special
inspector shnll he cmplo)"ed hy the Ol\'ller/
Contr;lctor durillR construction of thc
followill~ work. A copy of the special
tcsting report5 shOll I he furnished to the
Buildill~ Oivisioll.
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f:TIUJCTURA1. r.ONCIU~TE: III eXl~CSS of :W(lll
P . S. I. (306 a. 1 )
ATTIC nnAFT !1TOPS (j ClllnAIN l'lAI.I.S.
INSlIlI',TION f, VAI'OIl Mlm!En: .To he
made :lftcr :111 in5ul:ltion :lnd
reqllil'ed vnpor h:trricrs arc in place
hilt heforc any ]:t th or gypsum hO:ll'd
interior wnll covering .is npplicd.
FRMllNG: To hc made :Ifter t.he rO{lf,
nil framing, fire Idocking and
hr:lcinJ: are in pl:ll..l~ and all pipes,
chil11nl~Ys :lnd \'cnts al.C cnlllpll~te nnd
the rOllgh clcctricoll, plumhing. 01111.1
heating wi rcs, pipes and dllct~; arc
approved.
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l.A"nl AND/OR r.YPSll~1 1I0AIUl INSPECTION: --,
;]"0 hc madc ;lftCI" all I:lthill~ and -.-J
~rp~lIl11 hannI, interior :Ind cxtel'ior,
is ill placc hilt hcfllrc an)" Plllsterin~:J
i5 appl ied 01" hefo)'c ~yp~;lIm hoard
joints and fnstener!~ :lI'C taped and
fi 11 ished.
FIRE r. SEPAltATION l'lALJ.: LOCated ~
ccnstructcG ncconlil1~ to pl:lns,
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After il15tallation is
STRUCTlml\L \'lEI.IlS: Preformed on the
job, (2722 f)
mell STHENGTlI BOI.TING: DurinJ: all
holt inst:lllation nnd tightin{.:
operations (306 :1.5)
SPRAYEI) ON FIREPIlOOFING:
Stnndnnls 43-8)
(lI,A.C,
D
h'OODSTOVES:
completed.
Slnm~AI.K r. nRIVEh'AY: Ikquired for
nil concrctc pavilll~ \~ithin strcct
right-of-\~ny, to he made :trtcr al I
excnvatinR. complct.e r. form work r.
suh-hasc material ill placc.
f.IlRB ANn :\PPlmACII Al'ltoN: Aftcr forms
arc ercctcd hut prior to pouring
concretc.
SI'EC1AI. GRAOINr:.
FI LI.1NG: !luring
r. Chnpter 29)
EXCAVATION :\Nn
earthwork, {306 a.ll
rARKING 1.0'1': After gravel 1s in
placc hut priOl' to placing nsphnlt
or concrete.
:J
(;I.U-I.AJ.t nEArIS: Inspection Certificate,
hy an npprovcd agency. furni5hclI to
t.he City's nuilding lHvJ$ion bcfore
hcnms arc placcd. (2:.01-U.I1.C. STDS.
25-10, \ I).
*In addition to thc inspections
sp'::!cified hereon, the RlIildinl:
Offici tll :nny make or rCI!ui re other
inspect ions of ;my construction
work t.o n~ccTtnin compliance with
the Building, City or Zoning Codes.
o FIN.'\!. Pl.lJI'--U\lNG
o FIN/\!. U,ECTIUCAJ.
I X I F [NH ~[EC[[^NI C^L
o FrNM. FinE IlEPAnTMHrr
o
CITY'S SITE Pl.AN ItEVIEW HOARn INSPECTION: ~ll1$t he requcstcd 2 days in ndvnnce of thc dnte you
wish inspcct.ion. Ail project con~.itions stich a5 Inndsc.aping, pnrldn& lot striping etc. must
be com;:tlctcd heforc r('f1\lcstint:: this inspection.
D
.FINAL !\llll.llING: ~ll1st he rcqllc~;t,d aftcr thc fin:!1 Plumbing. Elcctric:lI, ~lcchnllicnl :1I\d Fire
Department inspections :lrC m:lde :lIlJ approved. No Occupnn::y of the prcmiscs call be m:Hlc until
a Ccrtificntc ef Oc.cupancy h:ls heen issued h)' the.Rllilding Oivisien and posted on the premise5
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