HomeMy WebLinkAboutPermit Building 1984-2-17
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I INSPECTION LINE . CIn Uf SPRINGFIELD . INFORlIATION L1No
726-3769 COMBIIIATION APPLICATION/PERMIT 726-375~
Job Address /'..1. CLnDl-.. l"Y"\"",' ,,, ) JiIlERGY SOURCES: Sq, FIg, I.lain CSJ
(-y')' I.~,)\ ~ \ '{ 1 k 1I\. .. eat !:q. Ftg. Access. r,\
Legal oescription\'1 ffi ~\ \.\\ C\?f~ i' ter Heater Sq. Ftg, Other \..J-'
i1.A~ J,r:.o/jj -.Jlew_Add_A1ter-,~ep, n '"
(' \1- ange _Fence_Demo_Change/Use ':::J-.I
owne~\\t)(\ \ ldiH) '~- I ValuE ~1'rWyy:O , _Other Q)
Address \\r\~ b;,..k"......; '-- ru HI Phone Buil<iino P~rmit Info: DescrIbe Work(i,e,. Build S;ngle (t;-
1 ' \~ rt ~ \AM U V] , \ :A'~~~s~d~ce ,Hlth A~Ch:d ~O:I Q1{ sf\..' \J\
::~! ,"~I ,"00. '?in ~ ~ '\)mr. . ~ \ r~
DESIGN lE!U1 Lnamel (addressl flics. no. I {exoiresl (ohone no.'\
::::::ra~~R'iQ.. \ }-\OH~ltL \~l) ~'LR3ffi,\\t\'Qu.~,~;c,&\. ~~ f)lm
, ~
Electrical
I~echanical
CONTRACTORS (name!. (address) flies. no.). (pxoirp<;,) (o!tnnp nll",;; ~
Gener!l ro.l'l'\ 6..(L L.9-\\H ."itb!t \i 1\.(\.0~ \, ffi \\.N. t. \ ~n~.A..~S8. \ 0tt'l\ \~ ~4L\J1\CD
Plumbino' ~\\'H'{'\d\ J \. U\\~b C'J
Electrical
~'echanicak
~ 0 Q Q ~ tt ') ,I (' fUJ..1'( Jl.[j )-;
PLUIIBING U
NO.1
\ \ Each single fixture
ELECTRICAL
I FFF I fH^Rr,f
Nn I
Residence of
I FFF I f"~ NO,
~r:o ffi.-
\
SQ, FT,
Relocated building
(new fix, additional)
\~:- \5-
I
I
Temporary Construction I
Change in existing I
rp<;.idf'I1~P
Imultfiamily. CQJJJJl. or I I
Induc;.tr;ill
10f amps,l I
ICO~1./INO. FEEDERS I I
IInstall/alter/relocate I', I
di<;.trih. fppdpr<;.
10f amps.1 I
I I
I I
I I ISSUANCf OF PFRlllT
TOTAL CHARGES .s~.- TOTAL CHARGES \ ~ ,- I TOTAL CHARGES
WHERE STATE L'li REQUIRES that the Electrical work be done by an,'Electr;cal Contractor. the electrical portion of this permit
shall not be valid until the label has been signed by an Electrical Supervisor and returned to the Building Division
S.F. Residence
(I bathl
I Duplex (1 bath)
IAdditfonal bat~
1 \<Ia ter servi ce
Sewer
Storm Sewer
New circuits a~.
or extensions
.~ ~v ~ .D~
MECHANICAL
,
furnace/burner to
BTU's
iT
I I
I
I
I
I
SERVICES
each
Floor furnace
and vent
Recessed wall
So~~p hp~tpr ~nrl vpnt
Appliance vent
seoariltp
Stationary evap.
cooler
Vent fan with
sinale duct
Vent system apart from
heatinq or A.C.
Mechanical exhaust
hood and dur:t
Wood stove/heater
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 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 NO OCCUPANCY will be made
of any structure without permission of the Building Division. I further certify that my registration with the Builder's
Board ;s in full force d ffect as requ'red by ORS 701,055, that if exempt the basis for exemption is noted hereon. and that
only subcontractors and em oyees who a On compliance with ORS 701.055 will be used on this project.
llAI.IE(please print
Zone /' C--
Fire Zone -
..J' A' ... --"'...._ ~ -........SIGtlATURE
y" 'OFF I CE USE DilLY
Units \ So, Fto, 11ain r;..,~
Occy Load ?- ~ S~, Ft~, Access
Occy Group ~-~ Sq. Ftg, Other
Tyoe/Const:m -,"'I
Bedrooms
Flood Plain _ Stories \
BUILOIrlG PER/lIT
Charges and
Surcharges
PLUf1BING PERMIT
Cha rges and
Surcha rges
ELECTRICAL PERI~IT
Cha rges and
Surcharges
I1ECHANI CAL PERM IT
Charges and
Surcharges
-:::!.(") _ Plan Ck. Conm/Ind
.~ L . 65%/Bldo Ppr Fpp
----- -\--i~- Plan Ck, Res
, 30%/Bl do Per Fee
_____5_~._=_ Fence
?... 'ZO Demo
1.~' -Sidewalk
----- -.W-r A/C Paving
I Curb Cut
------------1
om~/I'(Jf?1
x
Value
Val ue
Value
,
x
TOT^L VALUATION
f\ () r..:lA rlystems Development
-"1 . TA) Charoe (1.5~) .
l{O~-~ J (\d) )1..09 \45
Total Comb. Permit
J TOTAL
\CXo.cB
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
1. Appl icant to furnish
A, Job Address
B. legal Description
1. example- Tax Lot 100, Lane County Map Reference
11 03 43
2, exa~le- lot I. Block 3, 2nd Addition to
Spr.ngfield Estates
C. Name. etc. of owner and construction lender
D, Energy Sources
1. example- heat/electrical ceilinq/or forced air qas
2. example- waterheater/electrical/or solar
E. Square footage or valuation, etc. -----
I, examole- 1250 sq, foot house, 500 sq, foot garage
2. examp'le- if new project. check-new - if addition,
check add, etc.
F. Building permit information:
1. example. construct single family house with an
attached ,arage
2. example - remodel existing garage into family room
3. exa~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 TEM4 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 OOT All FEES AND
CHARGES ON THE SCHEDULES
0, 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
wi 11 prepare a type wri tten 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
(' AA1-~
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
\) <"Yc.\S\~,- 'C ~ ~\. ~\=>~~ '\ \) f.;~:::tJ~
?~ <;?Q,,- '\C'",:~"\A t"'\ c. \'-'1 c.C"'\ \~ '\(' \ \
5)C.('\\\:)\\'\Dk~ C""\~ \)tI..\>\~"\C'~. ~~Oa...~\ \-<"IQ ~V\l..\\.)~ ~Qp~
~) ';:).LL \2..ED\ ),Q1:;,,^,~.,,~ \... ~~p~ ~") \...~l'D~~'\\\ D\~'lG. 9\~~
Permit ap~lica~t exempt from rsgistratioR \/itR tr: r~"~:~': ~Jara DSGaUse+
rN )"'\~\C""1.."1l'o.. (")0;:.
\:)~\G\'\ ,\-~(')-~i'
'L.-(...-'Kll
'b\~\.'('>\~\8S1 ~\QF \.....l-:~~. "\2.F.~ )\~~ ~~ ~hn ? -\~~~4
,
Additional Project Information:
PLANS REVIEWED BY:
nam~~\~ ~\.=:>U~rSignatur~~ ~~ \.
.
I
d~~e ~ -\Co-~L\
--'
..~
.. .quir::ed
'In~pecans ..
IT IS THE RESPONSIBILITY OF TilE PERNIT HOLDER TO SEE THAT A1'.1. INSPECTIONS ARE HADE AT THE PROPER TmE.
THAT EACII ADDRESS IS READABLE FRml TEE STREET, AND THAT TEE PER'fIT CARD IS LOCATED AT THE FRONT OF THE
PROPERTY, BUILDING DIVISION APPP.OVED PLANS MUST HE ON JaB SITE AT ALL TUlES,
PROCEDURE FOR REQUF.STIN" I.NSPECTIONS, Call 726-3769 (recorder) state you CITY DESICNATED JOB NUHBER.
job address, type of ins?cction requested and vrhen yot! will be re~dy for the inspecticn. Gontracto~s
or o~mers name and phon2 number. Requests received before 7:00 am ~ill be ~~de the sarr.e day, requests
received after 7:00 am will be ~de the followin~ work d~y.
S~22(jc::"
Your Ci~y Designated Job Number Is:
Job Ac!drcss, ~ ~ '\ s, "^'-\).. \ , '1
Owner, '\\~ \2.<-': \;') L\'--r.4 \ )\ F. V ,-'
Contractor: n ~ '\-.'\r-,Q,_ ~,r.:D! C, \-'.~\\)~
O SITE I~SPECTIO~: To be made
after excavation, but prior
~.o setup cf forms.
I ./1'/lmDERSLAB PLU~IBISG. EI.~CTRIC.\L
'" f; ~lEC~iA.'\IC'\L: To be :nade before
any work is covered.
D
CO;":CRETE StAB I~SP=CTlO~: To be
made after all inslab building
service equipment, conduit. piping,
accessories and other ancillary
equipment items are in pla~e b~t
before any concreto is poured.
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mWERFLOOR: , Plumbing, Electrical,
tlechanical. To be made prior to
installation of floor insulation,
decking or floor sheathing.
POST & BEN-I: To be made prior to
installation of floor ir.sulation,.
decking or floor she~ting..
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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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O ROOF S!-iEATIfI~!G '\.'In NATLI:-;r.: Prior
to installing any roofing. D
r-:::::r"R0Ur.1l PLl.!~IR[~G. ELECTP..ICAL &
~ ~IEC!!..\.o,,;CJAL: No ",'ork is to be co\'ered
until these inspections have been
made and approved.
I ./(;"\L PLU~IBING
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[2J FI~AL ELECTRICAL
0 FINAL MECIlA'H CAL
/
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,
[:;2]' FI~:AL FI RE DEPARnIE~IT
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CITY'S SITE PLA:-1 REVIEI'I BO.\RD IXSPECTIO~l: ~Iust be requested 2 d3Ys in ad.vance of the date you
wish insr>ec!:io:1. All 'proj~ct ~onditions such as landscapi:":g. parking lot striping etc. must
b~ co~~leted ~efore requestinc this inspection.
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[2]
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D
D
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Phone:
Phone, ~ L\ <.J. - '" \\y)
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ATIle DRAFT STOPS & CURTAIN NALLS.
D
FIREPLACE: Prier to
materials and before
inspection.
INSUL~TION & VAPOR B^RR!ER: To be
made after all insulation &nd
required vapor barriers are in place
but before any lath or gYFSu~ bo~rd
interior wall covering is applied.
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'SPECIAL I~SPECTIONS: In accordance ~ith
Se~tion 306 of the Building Code a special
inspector shall be emplo)'ed by the O\\"Oerl
Ccntractor during construction of the
fcllowi~g ~ork. A ccpy of the special
testi~g reports shall be furnished to the
Building Division.
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STRUCTURAL CO~CRETE:
P.S,I. (3060,1)
In excess of 300~
[21
FOOTIXGS & FOUNDATIO~S: To be made
after trenches are excavated and
forms are erected, all steel in
place, ~ut prior to pouring concrete.
~DERGROUND: Pl~~bing, Electrical,
Gas, Sanitary Sewer, Storm Sewer,
W~ter and Drainage lines. To be
made prior to covering or filling
trenches.
placing facing
framing
STRUCTUR\L WELDS: Preformed on the
job.. (2722 f)
HIGH STRENGTH BeLTING: During all :
bolt install.:!ticn and' tighting
operations (306 a.5)
SPR~YED ON FrREPROOFI~G:
Standards 43-8) -
(U,B.C.
'~FRMII~!G: 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 TOUCh electrical, plumbing and
heating wires, pipes and ducts arc
approved.
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LATH AND/OR r,YPStN BOARD INSPECTION: I
To be made after all lathir.g and - --.J
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 "ALL:
ccn~tructed according to
"
Located &
plans.
SPECIAL GR~DING.
FILLI~G: During
& Chapter 29)
EXCAVATION AND
earthwork. (3116 a.11
\>,'0005TOVES:' 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.
"'r:o:,:';'2:.~~,\\(.,
PARY.ING LOT: A.rter':"gravel'-:is-:in
placc-but...prior-to--placing-asphai t
or-<:oncrete-.-
=:J
GLU-LA.M BEA;~IS: Inspection Certificate.
by an apyroved agency, furnished to.
the City's Building Division before
beams are placed. (2501-U.B.C. STDS.
25-10.11) .
*In addition to the inspections
specified hereo~, the Buildin&
Official ~ay make or require other
inspections of any construction
work te ascertain compliance with
the Building, City or Zoning Codes.
1_ ....-1.... 'FI:-1i\1. 9(1[UHXG: ~lust he re~ucsted after the fin.:!l Plumbing. Elect:dc~l. ~lech:tnical and Fi:-e
~ Department insyections are made and approved. ~o Occupan:y of the premises can :e made until
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