HomeMy WebLinkAboutPermit Building 1988-11-21
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I' INSPECTION LINE
726-3769
, Job Address J(,S-G. () I..-Y,Nt PIc...
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CITY OF SPRINGFIELO
COMBINATION APPLICATION/PERMIT
EIIERGY SOURCES:
Heat
Ilater Heater
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INFORlIATION LINt
726-3753
Sq. Ftg. 1.lajn~. 'j':;?"'>
~q. Ftg~s.'/"2~O
Sq. Ftg. Other
New Add Alter Rep.
Fence -Yemo _Change/Use
_Other
'.
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Legal Oescription 17.,1'),:?-"x-C/.; eJ0700
,
Address
OESIGN TEM
Phone
(name)
Structural
Electrical
Mechanical
CONTRACTORS
Genera I P"'; 7)
(name)
ljA"ST",
r
(address 1
(l ics. nn.)
(p:.:nirp~)
(ohnnp nn 1
A(.~#A/n
Plumbina
/\ '1,
(\0j ,I/IV
Electrical
~lechanical
PLUIIBI NG
ELECTRICAL
MECHANICAL
NO.
B
Each single fixture
7.S<:; ~....,
FEF rHARr.F Nn~
Residence of
F><
r".o.&liE. NO,
SQ. FT.
furnace/burner to
BrU1 s
FFLJ:liAIllif.
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
(] bath I
Ouplex (1 bath) each
SERVICES
Recessed wall
Sn~rp hPAtpr Anrl vpnt
Additional bath l!emporary Construction I
l"A1~later service "2-",_ IChange in existing I
7" ;;1V. fP'S j d"'p.nrp
q,,'ISewer '2I"'l....' Imultifamily, COTml. or I
/V :A/"' Indll,,-trii'l;l
'7J'6t Storm Sewer 2?S.- IOf amps, I
I I COMI-I. II NO. FEEDERS I
I I Install/alter/relocate I
rli~trin fpprlpr~
I IOf amps. I I I I
I ~h?n- ~.H'"~..t5: ~_: ~73A:?/ r- ?c..?'..b:.....~
-I ~/r ?~.;b-~~~/";;>/:r:~~h-.
I I I I I I SSUANCf OF PFRllIT '
TOTAL CHARGES 'EJ-r5 ~ TOTAL CHARGES I TOTAL CHARGES
WHERE STATE L\li REQUIRES that the Electrical work be done by an, Electrical Contractor, the electrical portion of this permit
shall not be va111 until the label has been signed by an Electrical Supervisor and returned to the Building Division
Appliance vent
lj~o_ar"'tp
Stationary evap.
cool~r
Vent fan with
sioole duct
Vent system apart from I
heatino or A.C.
Mechanical exhaust
hond ",od durt
Wood stove/heater
Fi re Zone
Flood Plain
I HAVE CAREFUllY EXAMINED the completed aprlication 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 OCCUPAllCY 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 compliance with ORS 7Q1.055 will be used on this project.
1lAJ.IE(please print) kE.\ll(0 -H ot.U-ll/2D SIr,rlATURE~
FOR OFFICE USE ONLY
Type/Canst. ,.c;"-N Units Sq. Ftg. /1oin ';'2 9ZS-n,..~~a1ue ,1'.y~.~
Bedrooms Occy Load Sq. Ftg. Access_ x Value
Stories/.::?e A;P7., Dccy r,roupR-3'.f'~2Sq. Ftg. Dther~ ,.r~~..Z>_ Value_~:5".~c>lO
. ri' '"" TOTAL VALUATlOrl.~3.5".oCSc:>
U,./ /P-'2C-$12 .....~ '")..-;L..
, Q ~"=l o<:5e> Plan Ck. ConmlInd~' XV ""'"" Obl7.~SysteJ;\s Development q L'" .r..o
""-- __.L....._'.....-'____....2.2.!!/BJdo ~pr Fpp ~'II.S" Charoe tI,5~ ' "''7~.
r Plan Ck. Res /..., /.. z>
,/ ~f!J..':;S- 30%/B1da Per Fee L.><::- r~'-#F~KnC~L> F"",A'
'<____u_____ Fence ~OO \1g..-a;lf~rA>ML.. -Z~jI'."'"
D~A1O _ ":<~~~~~:-~ ~~~~~o-
'Sidewalk /< yo' It, -:2.ti3.6C>
A/C Paving 'i? I '1"33 OC>
I Curb Cut '1" 5r6' \-;1.. /6, ~C>
I I
DATE 11- 2.(-~
Zone
I.,MI
-. '-..
BUILDING PERl-lIT
Charges and
Surcharges
PLUI~BING PERMIT
Charges and, ,--'
Surcharges
ELECTRICAL PERIHT
Cha rges and
Surcharges
"^
-:7.tj'<tC 6'e>'
____~_Jd.......___
/9'. 7:?
Irotal Comb. Permi t
/9/'9. 'e::>
I'
MECHANICAL PERMIT
Charges and
Surcharges
I
I TOTAL
11,'2/0. d>?>.
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
l. Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
17 Dj 43
2. example- Lot 1. Block 3, 2nd Addition to
spr,ngtield Estates
C. Name, etc. of owner and construction lender
D. Energy Sources
1. examole- heat/electrical ceilinq!or forced air Qas
2. examole- waterheater/electrical/or solar
E. Square footage or valuation, etc. ------
1. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project. check-new - if addition,
check add. etc.
F. Building pennit information:
1. examele - construct single family house with an
attached garage
2. example - 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 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
fu 11 schedu 1 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. ---
Ill. Applicant to sign and date
Whenever possible, the initial application will ba 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.
) 2y;DCJ.--
(( <2_( - rv
V, FOR OFFICE USE ONLY
Permit Clerk Cf.-
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
~'l
'. . ~.."
PLANS 'REVIEWED BY:
. name
L~LVc:!" }>CC>:;67f>
Signature~~~- ~~~
'v--- v. /'
date //~/9- €S
j
.......,-,
S"'~:CF~
Lh.-
,,~
,
.
..'equired
Inspeci'>ns ..
IT IS THE RESPONSIBILITY OF THE PERtlIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT T1!E PROPER TIllE.
THAT EACH ADDRESS IS READABLE FROM THE STREET, AND TIIAT THE PER!-lIT CARD IS LOCATED AT TilE FRONT OF THE
PROPERTY, BUILDING DIVISION APPROVED PLANS MUST BE ON Jar, SITE AT ALL THlES,
PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
job .:1ddres~, type of inspection rCClucsted .::md ~lhen you will be reedy for the in:Jpcction. Contractors
or owners name and phone number. Reqt1cst~ received before 7:00 am will be reade the same day, rcqucsts
received after 7:00 am will be ~dc the followinh work day.
Your City DcsiBnated Job Number Is,~09R3'
Job Address, :20<;-0 ~"""""".l.z?'C
Owner: '&Y,<""'''''->>/>>h9.-'?R=-\/
Contractor:
CONCRETE SI.AR INSPECTION: To hc
made after ~ll inslah hui llling
service equipment, cOIhJuit. pipin~.
acces:;ories .lIul othcr anci 11ary
cquipment items ar:;;: in jllace but
'heforc any concrcte is pourcd.
1:)1.1 F~TlNr.S r. FnIlNOATlONS: To he maue
after trcnchc5 .Irc cxcnv,lted nml
forms .:ll'C crccted, all stccl in
place. ~Ult prior to pouring concrete.
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SITE INSPEr.TlON: To be maue
after excavation, but prior
to setup ef forms. , I '-' I
UNmmSIAIl PI.mmINr.1 EI.lkTRIC.\I.
I; ~IECIlANICAI.: To he :nadc befere
allY lI'ork is covered.
1l~IlElU~nOllNn: Plumhing, Electric.ll,
Cas, S:lnitary Sewer, Storm Sewer,
l'Jater :l111J Dr,. in:Jge 1 incs. To be
maue prior to covering or l'i II ing
t rcnches.
UNOERFIOOU: . Plumhing, Electrical,
~'cchanical. To he maue prior to
installatioll of floor insul:ltion.
decking or floor she:lthing.
POST ti REM1: To be m:luc prior to
illst.lll:ltion of floor insul:ltion,
decking or floor r.he;:t ing.
FLooll INSlILATION r. VAPOR RARllIER5:
To he made prior to instal1:lt.ioll
of decking or floor sheuting.
MASONI!Y: Steel location, hond be:lms
grouting 0" vcrticals in accordance
with U.B.C. Scction 2~15.
ROOF S!lE^'!111 !'lr. M'm Nt. t 1.1 Nr.:
to inst:llling ,lilY roofing.
Prior
HOUGH i'I.l!MIlING, ELEr.TnlCAt. ti
~I1!CIIANCI^1.: No \\'OI'I( is to he cm'ered
tlI~til thesc inspect.io:ls h:lve been
made <l1l\1 appl'oved,
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FINAl. I'l.ml!HNG
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<7';0;".:0-<=/
Phone: -.:2S~-- _"'S"bZ/
Phone:
ATTI~^FT STOPS"j, CURTAIN lY'ALl.S.
SPECIAl. INSPECTIONS: In accordance Il'ith
Section 306 of the Building CorJe a special
inspector slwll he cmplo)'ed by the O\\'ner/
Contractor during construction of thc
fellowinc work. A copy of the specinl
testing reports shnll be fllrnisheu to the
HuilrJing Ilivision.
FIREPLACE: Prier to placing bcing
m:lterlllls and hefore framing
inspection. I ~
INSIII.I.T'alN f, VA1'OH MRRHn: To hc
mnue :lfter all insulation nnd
reqllirerJ vapor hnrriel"s nre in place
but heforc ~ny lath or gypsum hoard
interior wall covering is applicu.
FRM-llNG: To he made nftcr the roof,
all framing, fire hlocking and
brncin~ arc ill plncc nnd nil pipcs,
chimneys and vents arc complete <InrJ
thc rough electrical. plumhing nnu
hC<lting wircs. pipes and duct~ are
,lpproverJ .
STRlJCTIIRAI. CONCnETE: In exccss of 3UOl)
1',5.1, (306 a.l)
:J
:J
:J
STRlJCTUnAL NEWS: Preformed on the
job. (2722 f)
III GII STRENr.T1I ROI.TJ NG: Du d ng ,Ill
holt install.ltion ami tighting
operations (306 01.5)
~
IA'11 ANn/OR r,vrSUM 1I0Altn INSPECTION: I
To he made after all lathing :mtl -.-1
gypsum boarrJ, interior and exterior,
is in place but before any Plasterillt:---,
is applied or hefore gyp5um hoard -.-1
joints nnu fasteners arc taped and
finished,
FI nE Ii SEPAIlATION '''^I.I.: 1.0caterJ Ii
censtructed according to plans.
SPRAVEO ON FInEPROOFING: (V.ILC.
Stanuards 43.8)
SPECI^,. GRAfllNG, EXC^V^TION ANn
.PII.I.JNC: lluring e:lrtll\~ol'k. (30{, :1.11
f. Chapter 29)
GLlI-I.AM REMIS: I:lspcction Certificute.
by an apjlrovcd agcncy, furnished to
the City's Building Uivision before
benms arc placed. (2S01-U.n.C. STIlS.
25-10, 11).
D
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IY'OODSTOVES: After instnllation is ---,
completed. '1 0./1 --1
SIOE\"AI.K r. nRIVEIY'^~ Rcquircd for
all concrete paving within street
right-of-way, to be marJe after all
excavating complete ti form work G
sub-base material in placc.
CURn ANn :\PPltOACIl APRON: After forms
arc crecterJ hut prior to pouring
concrcte.
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* In ,lrJtlition to the insJlect ions
gpccificd hereon, thc Builuing
Officinl :nay mnke or require other
inspections of :lI1Y construction
work te nscertain compI i,mce Idth
the Building, City or Zoning COucs.
PARr.INfo IlIT: After gravcl is in
place hut prior to placing nsphalt
or concrete.
o
CITY'S SITE PI.AN nEVIEIY' RO:\RO INSPECfION: Must he requested 2 unys in arJv<lnco of the date you
wish inspcctio:\. All project conditions such llS lllnrJscllping, pnrkin& lot striping etc. mllst
bc com~leted hefoTc requesting this inspection.
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Fl~AI. EI.ECf'nICAI.
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FINAl. BlIIJ.OING: Must he requcsted after thc final Plumbing, IJIectrical, ~lechanical :Inti Fire
"Oepartment inspections arc made and npproved. No Occupancy of thc premises cnn be m:lde until
:t Certificate of Occupnncy has hecn issued b)' the Building Division and posted on the premb;cs
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FINAl. ~IECIIANICAL
r~~L FIRE nE!'ARTME~rr
SICNATURE OATE