HomeMy WebLinkAboutPermit Building 1987-3-9 (2)
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CITY UF SPRINGFIELD
C0I1BIIIATIDN APPLICATION/PERMIT
EilERGY SOURCES:
Heat
Hater Heater
Range
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INFOR/1ATION LINE
726-3753
Sq, Ftq. l'lain
~q, Ftg. Access,
Sq, Ftg, Other
Ilew Add A Her Rep,
-Fence Demo Change/Use
Other - -
J?
~one ..j
'7" r^ / <J
-..,. - - - ,
7Y'I.-K~3
ValUE of flork:
1'1 ~."-
BU1-'inQ Pennit Info: Describe \~ork{Le..
Family nesidence With Attached Garaael
Build Single
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1\1)
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"'" '\' HISPECTION LINE
I 726-3769
, Job Address J f 7-5 ' ~>h .S-1"Y/l/;',./),rr,
Legal Description /7-6 <.~'3I"-Y/~ /)z;-rb---"""
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Owner' ~o c/ /2n / /:: !;o,.. F
Address 3t,.J~-1 Jt/'''-JdPX/l,!llJ.7?'
~rlSd//T ~.p/ t?}p,
Ad-/'~ __
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tJ 1'f: ;.. R
L /JrKob ~;,)H? S'
~.J! ~ h4
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Construction lender
Address
DcS I uN I cAr'1
(name)
Phone
(address)
(lies. no.)
(exniresl
fQhone no.)
_ A
~~
~r
Primary
Structura 1
roo IA. J n(')
C,"/I"tl\"-
Electrical
Mechanical
CONTRACTORS Iname)
General ~..o,~~~~r~;:<.~
Plumbina
Electrical ~/T""" I//E~ 7C.~=7.
/
(address)
f1 ;r:<;. no.)
(pxo;rl'ic;)
(ohnnp nn.)
~p,<::Ln_ 67?
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~L->''<::'~'''''''.c ~/l?
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..;~. 'If
"1echanical
PLUJ,IBING
ELECTRICAL
MECHANICAL
NO.
FFF r.HARGF Nn
~~~ r~ARr,~ Nn_
~~~ I rJ.1ARh~
6
Each single fixture
1.10 If::>
Residence of
SO, FT.
furnace/burner to
BTU's
Relocated building
(new fix, additional)
~ New circu~ts alts.
or extenslons
-:L c>P. ~
SERVICES
'2Z~'
Floor furnace
and vent
S.F. Residence
(] bath)
Duplex (1 bath) each
Additional bath
Recessed wall
~nar.p hp~tpr ~nrl vpnt
c../'
WA'-'t...II6:m-?4'/2 ~
Appliance vent
seoarate
Stationary evap.
cooler
Vent fan wi th
sinole duct
Vent system apart from
heatina or A.C.
Mechanical exhaust
hood and dur.t
Sewer
Temporary Construction
Change in existing
rp".i denr.1i'
Imultifamily, comm. or
Tndllc:.trial
~Jater service
Storm Sewer
Of
amps.1
com,!. /IND. FEEDERS
TOTAL CHARGES
WHERE STATE L~W REQUIRES
shall not be valid until the
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54;':'......... TOTAL CHARGES 2~-;~c> I TOTAL CHARGES h:7/N I'-S"":<?....
that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit
label has been signed by an Electrical Supervisor and returned to the Building Division
I Install/alter/relocate
r1ic;trih fpprlprc;
10f
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Wood stove/heater
amps.
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ISSUANCE OF PFR!fIT
I HAVE CAREFULLY EXA~1INED 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 Spri ngfi e 1 d and the Laws of the State of Oregon pertai n i ng to the work descri bed herei n, and tha t NO OCCUPAf~CY 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 comoliance with ORS 7nl.055 will be used on this project.
1JA!.IE(please print)~//~ ~tJr:...r., SIG!lATURE/~Mz",~ OATE
. - -:::::::-- FOr OFFICE USE IlLY
Type/Const( ~A() Units Sq, Ftg, !iain / x
Bedrooms ~ Occy Load .;.---- " Sq. Ftg, Access x
Stories Occy Grou'P B-2) Sq, ftg, Otherh"E~O~
~ ..------.. .
/"B6'7qC~
Plan Ck ConmlInd II {J h Systems Development
65%/Bld~ Per 'ppl. ,_ (.7,9:3 ?::'-l -~j I Charqe (1.5~)
Plan Ck. Res "--I _______
3D%/Bldq Per Fee ,
PLU!1BING PERMIT L...c- ~ Fence I
~~~~~;~g:~d C; __n_'Z~~8o-1 Demo I
~~~~~~~C~~/ERm~ _ ___ ~:?-=-~ISldewalk I
Surcharges --70 I A/e Paving I
__n'22.:~J Curb Cut I
lo _~ I I
~/9/%7
=----
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Zone ,r.. G )
Fire~
Flood Plain
Value
Value
Value~ ..----,.~
BUILDING PERfIlT
Charges and
Surcharges
/ /5E L'=P.? &'<> /'
d.. -- ..L~_"t:.~"?_
€/./8
TOTAL VALUATION
.&' -rf-
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ITotal Comb. Permit
MECHANICAL PERMIT
Charges and
Surcharges
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I TOTAL
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
I, Applicant to furnish
A. Job AMress
B. Legal Description
I, example- Tax Lot 100. Lane County Map Reference
17 03 43
2. example- Lot I, Block 3, 2nd Addition to
Springtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceilinq/or forced air Qas
2. examole- waterheater/electrlcal/or solar
E. Square footage or valuation, etc. ------
I. example- 1250 sq, foot house, 500 sq. foot garage
2. example- if new project. check-n€w - if addition,
check add, etc. '
F. Building.permit information:
1. example - construct Single family house with'an
attached garage
2. examole - remodel existing garage into family room
3. exam~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 avo;~ 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 Schedul.es
are available at the Building Division
1. To ~onserve 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 schedul es
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. ' -
III, Applicant to sign and date
Whenever pos'sible, the initial application will be us'ed 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.
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V, FOR OFFICE USE ONLY
Permit Clerk
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,PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
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Additional Project Information:
PLANS REVIEWED BY:
t!.-~~V~~Signature~A~~' ,
. f c.- .... , /' ~~,; ,
date "3-20-8"/
name
.),....~ .. .quired InspecAns..
IT IS THE RESPONSIBILITY OF TIlE PER.'lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT TP.E PROPER TIl'lE.
THAT EACH ADDRESS IS READABLE FROM TEE STREET, AND THAT TIlE PERHIT CARD IS LOCATED AT TilE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES,
PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB Nu}IBER,
job address, type of inspection requested and ",hen YOll will be re.:::.dy for the inspection. Contractors
or o\~ers name and phone number. Requests received before 7:00 am will be ~ade the same day. requests
received after 7:00 am will be ~de the following work day.
Your City Designated Job Number Is:
Job Address: -=?~~ )-'4#/#
Owner: ~~ -{PA?It:... N#...EB.a> <::;;k
Contractor: ;t:f.;c:> &N~.
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SITE INSPECTION: To be made
after excavation, but prior
to setup oJ., forms, '-II
UNDERSLABqrLUHBING. ELECTRICAL
Ii ~IECHANICAL: To be :uarle before
any work is covered.
CONCRETE SLAB INSPECTION: To be
made after all insIab building
service equipment, conduit, piping,
accessories and other ancillary
equipment items are in place but
before any concrete is poured. I ~I
FOOTINGS & FOUNDATIONS: To be ~
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.
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UNDERFLOOR:, 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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ROOF SHEATHI~G k~D NAILING: Prior
to installing any roofing. 1 I 0
ROU~ ~LUMBjNG. EIi~ICAL-t
MECHANCIAL: No ~ork is to be covered
until these inspections have been
made and approved.
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FINAL PLUMBING
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CITY'S SITE PLAN REVIEW BOARD INSPECTION: ~rust be requested 2 days in advance of the date you
wish inspection. All project conditions such az landscaping, parking lot striping etc. must
be com~leted before requesting this inspection.
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FI~AL ELECTRICAL
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FINAL BUILDING: Must be requested after the final Plumbing, Electrical, ~techanical 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 Divisicn and posted on the premises
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FINAL ~IECIIA,~ICAL
l,Py
FINAL FIRE DEPARTMENT
SICNATURF
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Phone:,7:?~-S-c::t$ <7'
Phone:
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ATTIC DRAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior to
materials and before
inspection.
placing facing
framing
SPECIAL INSPECTIONS: In accordance with
SecLion 306 of the Building Code a special
inspector shall be employed by the ~~er/
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 CO~CRETE:
P,S,j, (306 a.I)
In excess of 3000
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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.
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 AND
FILLING: During earthwork. (306 a.ll
& Chapter 29)
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GLU-LAM BEAHS: Inspection Certificate,
by an approved agency, furnished to
the City's Building Division before
beams are placed. (250l-U.B.C. STDS.
2S-IO,1l) ,
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 arc
approved.
FIRE & SEPARATION l'lALL: Located &
constructed according to plans.
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LAlli ANn/OR GYPSUM BOARD INSPECTION: I
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 ---1
joints and fasteners are taped and
finished.
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
asphalt
*In addition to the inspections
specified hereon, the Building
Official ~ay make or require other
inspections of any construction
work to ascertain compliance with
the Building, City or Zoning Codes.
DATE
.. ALL ~IANHOLES AND CLEANOUTS ~fUST BE ,\CCESSIBLE. ADJUSTIfENT TO BE HADE AT NO ~OST TO TIlE CITY.