HomeMy WebLinkAboutPermit Building 1984-7-23
CITY UF SPRINGFIELD
CmIBlllATIDN APPLICATION/PERMIT
/Q _ / . ~_ j~ ~ E!lERGY SOURCES:
Job Address / -/;20 0'1~...u-. ~::----:')J~' . Heat ;2); Tu. J.e,..M" Aif<.
legal De<<r;ption I.Z'<2J!..,2!j~;;>/ <:> ~O i'later Heater
";:{ ~) Ranqe
/Jm~ /~;M ~. Ct:lfUl (5 \ ValuE of flork:.,?p.:;",,,",""
Owner r/ .trI R a. n1 S 4 Y ./
Address ~ ' Phona.t...... ~. BUllriino Permit Info: Oeser be Work:{i-.e..
.2 ~ S- to S/. 'J'T'{-T7h Familv nes;dence liith Attached Garaoel
<;pfi~L;//
cons'tru~;;-o,(f.;;d~I?-t:.un_L/I I'~
Address Phone
DESIGN TEAr~ (name) (address)
.-
-\IIISPECTIOIl L1IIE
726-3769
Primary
Structural
~
e
.
......
INFDRlIATIDN UNt
726-3753
Sq. Ftg. l'lain----L..'>OO
~q. Ftg. Accesr:-
Sq. Ftg. Other
--'lew_Add_AI t~__Eep.
Fence Demo~nange/Use
Other -
~
-t
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...t.
'-l
""'C,)
Build Single
r.k7&L~~ fK,.-.-. _. ,-~ C7~ M.//ATL,-"':/
. If
--L7".;P!;; -4 CJ-UCt'~d/XLA a-i.
'7;"'/1 , r,
0.1ti./~~ ~~-<'(r_
(lies. no.) (exnires)
(ohane 00.'\
A:;1..;., ~... C/ /15:1. r:. ~.
,;/<; J.I"'V'/A<Ot6~/f.l d (~.2/--; SOd'> /07' ~- 6:~2
PlUllB lNG
Electrical
11echanical Co-?7/?76>'1:.e..'c.-I. fi. " It..
CONTRACTORS (name) (address) (1 i c:s. no. l (p.xoi res)
General AI//? TOI1 Cd...,~ r. Ce. 6" /S- Nav/J"',..,IJr;/a. (;7~2/-51) S--~
, ~.:
Plumbino F~,~l?h/......~ :B4i.2II.0"",npJ./.INY' (~Oj2) /;Z-I'7-[~
, Electrical p::;,.L:.... t:;'TOP/PA/u FhZ,. 5.F? Nve7T":: Ilvt!' (;;'O-/'1f(;.)
"echanical ,..n,.."......,..-..,.,./~A7 IJ/I?. :?/S">> W.j/~P; ,
rIO_
/6
J>rS'- ;23'}~
(ohon€! no.)
JiZY6 - 6 S:S-L
'*-?I- '?~.lftJ
6~~~..zo '
:?i".~-::JJ' ?4
ELECTRICAL
MECHANICAL
Each single fixture
FEE C~ .1:Ill.--1
c'" ~- Res idence of
/. m '_, _____ SQ. FT.
6.-
IRelocated building
(new fix. additional)
Is.F. Residence
11 bath \
IDuplex (1 bath) each
IAdditional bath Temporary Construction I
Iwater service Change in existing I
res j ngnc.e
I Sewer multifamlly, COl1ll1. or I
tndu5.trial
I Storm Sewer IOf amps.1 I
I ICor-U-l./IND. FEEDERS I I
I' Install/alter/relocate I I
rl;~tr;h fpprlpr~
I Of amp~1 I
I I
I I
I I I mtlllI'lCE OF PFRI1IT
TOTAL CHARGES BII? - TOTAL CHARGES /.5."'" TOTAL CHARGES ~.-
WHERE STATE l'W REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portIon of this permit
shall not be vali~ until the label has been signed by an Electrical Supervisor and returned to the Building Division
Zone
~.c.
Fire Zone
Flood Plain
BUILDIrlG PERflIT
Charges an~
Surcharges
PlU'~B lrIG PERM I T
Cha rges and
Surcha rges
ELECTRICAL PERI~IT
Charges and
Surcharges
IIECHAMICAL PERMIT
Charges and
Surcharges
", IJ:IlAIlG.E. NO_
/'
'll-1.CJ!ARUl~
~ New circuits alts.
or extensions ~
".2 e>R-~o;:;;-
SERVICES
;s:vc
furnace/burner to
,%h.~~<i ~).3~.
Floor furnace
and vent
Tyoe/Const.:fZZ:-,y ~~nits
Bedrooms Occy Load
Stories./ Occy Group
/"<1 oe> I Plan Ck. Conm/lnd
. ~/Blda Pi"l" Ff>f>
------;;:a'l- ~~~~B~~~ ~-~~ Fee
____$'..'2:::_0_<<::_ Fence
;J.::i!C Oemo
_n_/.::L._~-' Sidewalk
. ~tP I A/e Paving
3':3. ~ I Curb Cut
------T~2-1
.....
Recessed wall
SQ'<~t~r .il.n~t
fl"" ,. ~ )7q)i1- '
~ ,,~
I App 1 i ance vent
5~paratp.
I Stationary evap.
cool~r
I Vent fan with
s.inala duct
I Vent system apart from I
heat;na or A.C.
I Mechanical exhaust "
hood and duC':t
I Hood stove/heater I
I I
I
I
I HAVE CAREFUllY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true
and correct. and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that UO OCCUPAI{CY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
Board is in full force and effect as required by ORS 701.055. that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who are in comoliance with OP.S 7Ql.055 .w: be used on this projec~;::1I
IWIE(please print) /1//1 r ~/I7 t3. .;Y';;, T(N' 5Ic,rI^TURE_/hA1~ c: /fZ;"'-L,-;;:. DATE ') -:::E-,r~
FO~ OFFICE USE OrllY
Sq. Ftg. Ilain. Value
Sq. Ft9. Access x Value
75'- < Sq. Ftg. OtherK.Fh9i>~5'~ffalue.:2R__, O'C.
.
Bt..3/7't TOTAL VAlUATlml
po /1 n / ",.. i~,-'~~ Syste, ms Development
-/d'"'''''.J''.::.;4.,,_CharQe (I.5~) -
I
I
17
I
6,-
I
I I
1:1'''' I 2/'''
I
I
I
I
I
I
(id..
I
I
/Total Comb. Permit
2;$, ,~
26"8. 9~
j
I
I TOTAL
....
.
.
.
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. legal Description
1. examole- Tax lot 100. lane County Map Reference
II 03 43
2. example- Lot I. Block 3, 2nd Addition to
~prlngtield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. examole- heat/electrical ceilinq/or forced air aas
2. examole- waterheater/electrlcal/or solar
E. Square footage or valuation, etc. ------
I. examole- 1250 SQ. foot house. 500 sQ, foot garage
2. example- if new project, check-nfw - 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. examole - 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 TEAl,' 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 Pl~mbing, 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 O~ 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 ~ivision Staff
will prepare a type written copy and return it to the
applicant at the time the actual penmit 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.
PERMIT VALIDATION
./
b~~ <o~
~ / ';) '7/ ~'I
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(fe!'
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V. FOR OFFICE USE ONLY
Permit Clerk D, JA~ ./
-
,
.
PROJECT CONOITIONS TO BE SATISFIEO BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
......\..
"
.-.
Additional p.roject. Informatio~_;
PLANS REVIEWED BY:
name L.oHN~ ~&C;:;~ignatur~~~-7date ?.../~-aY
.
,: ;.D~
~
.. equired
Inspec.ns ..
""
IT IS THE RESPONSIBILITY OF THE PER-'lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT TEE PROPER TUlE.
THAT EACH ADDRESS IS READABLE FROlI THE STREET. AND THAT THE PERNIT CARD IS LOCATED AT THE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TUlES.
PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUHBER,
job address. type of inspection reqcested .and \-lhen you will be reedy for the inspection. Contractors
or Q\mers 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 followinh work day.
$ Yo 'I 79
/9*2d e:JtrM.P/~ "';.>/-"<<fE.tP7"
77;>.1 ~.MS'A' ~ Phone: 7,/~-g~,?J
Contractor:JIIN<:6'hr ~J(lr--er~ Phone: 7"t;.-6_~<:j2
Your City Designated Job~umber Is:
Job Address:
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SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNDERSLAB PLUllBING. ELECTRICAL
& ~IECHA."IICAL: To be :nade before
any \~ork is .covered.
CONCRETE SLAB INSPECTION: To be
made after all inslab building
service equipment. conduit, piping,
accessories and other ancillary
equipment items are in place but
before any concrete is poured.
o
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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.
D
~DERGROUND: Plumbing, Electrical.
Gas, Sanitary Sewer. Storm Sewer.
Water and Drainage lines. To be
made prior to covering or filling
trenches.
D
UNDERFLOCR: I Plumbing. Electrical,
~rechanical. 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 & VArOR BARRIERS:
To be made prior to installation
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 NAILINC,:
to installing any roofing.
Prior
ROUr.H PLL~IBING. ELECTRICAL &
MECtiANCIAL: No ,.:ark is to be co\'ered
until these inspections have been
made and approved.
. ~ FINAL PLlJ1.'BING
. [KJ FINAL ELECTRICAL
1KI FINAL MECIlA.'ICAL
~ FINAL FIRE DEPART'~NT
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ATTIC DRAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior to placing
materials and before framing
inspection.
facing
'SPECIAL INSPECTIONS: In accordance ~ith
Se~tion 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.I. (306 a.1)
STRUCTUR~L WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BOLTING: During all
bolt installation and tighting
operations (306 a.S)
D
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.
In excess of 3000
SPRAYED ON FIREPROOFING: (U.B.C.
Standards 43-8)
~AL GRADIt\Gt EXCAVATION AND
FILLING: During earthl<.'ork. (306 0.11
& Chapter 29)
:J
GLU-LAN BEA.:'ts: Inspection Certificate.
by an approved agency. furnished to
the City's Building Division before
be<lms are placed. (2501-U,8.C. STDS.
25-10,11) .
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.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
:J
LATI-! ANn/OR C,YPSUM BOARD INSPECTION: :J
To be made after all lathing and
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.
WOODSTOVES:
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.
After installation is
PARKING LOT: After gravel is in
place but prior to placing asphalt
or concrete.
*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,
CITY'S SITE rLAN REVIEW BOARD INSrECTION: Must be requested 2 days in advance of the date you
wish inspectio~. All project conditions such as landscaping, parking lot striping etc. must
be com~leted before requesting thi~ inspection.
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FINAL BUILDING: ~tust be requested after the final Plumbing, Electrical, Hechanical and Fire
Department inspections are made and approved. No Occupan~y of the premises can be made until
a Certificate of Occupancy has been issued by the Building Division and posted 'on the prcmises
SICNATURE
u~~ E $k--7A.
v
DATE
7- .23-,p-+,
* AI.!. MANHOLES Mm r.I,F.ANOUTS ~lI1ST R~ .."r.r.F.SSlRT.P. An.lIISTMENT TO RE M.\l"F. AT ~O r:nST TO l1~E e1TI'.