HomeMy WebLinkAboutPermit Building 1987-1-8
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CITY Uf SPRlilGfIELO
Cm1BIIIATIDN APPLICATION/PERMIT
EIIERGY SOURCES:
Heat
:'Iater Heater
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'1 UISPECTIDII LIIIE
726- 37 69 .
I NfORlIA TI J'j l1,',t.
726-3753
Sq. Ftq. f.lain
~q. !='tg. Access.
Sq. Ftg. Other
Ilew Add ~.1ter ~ep.
--Fence Demo Change/Use
Other - -
Address
PC:>/V ~/ /EEfi 'B<:::6'0<'!.
<i? 8~-~c: 7"r.>?P/C
7 A;; ~,:)""BS
.i;'.iu-
Ranqe
ValUE of Hark:
?ao.-C:::>
l3ui hiinQ Pen11it Info: Describe Hork{ i.e..
Far:1i 1 v nes i dence I-lith /It tached fiaraoe 1
Build Sin9le
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Job Address 33&S" CN.Y/np/C ~7:
Legal Description / 7-.:'z-~.'3' </. Cl~ 70=
Owner
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Construction Lender
-4777) (?97Jl;'n._..../'?? 72::> &..cv-"""""
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Address
Ul:.:::lllifl TEN1
(name)
Phone
(address)
(1 ics. no.l
(exo;res)
(ohane no. I
Primary
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Structural
Electrical
11echanical
CONTRACTORS
(name)
(addres!\ )
(l ic<;.. no. \
(pxnirpc;.)
(ohnnp nn. )
Genera 1
/JW'J~~
Plumbino
Ow^" E??
Electrical
Ilechanical I?W-~~
PLUIIBIIIG
L ELECTRICAL
I FEE CHAReE I.
I Residence of
7.:;:> (~ SQ. FT.
INew circuits alts.
or extensions
!SERVICES
MECHANICAL
110.
l_~~~
rH~ -1JO
2-
Each single fixture
furnace/burner to
BTU's
I...E" I rH~
/Relocated building
(new fix. additional)
Is,F. Residence
(] bath)
IOuplex (1 bath) each
IAdditional bath
LIf$Ar.J.(e8fCJ:OR''''''''. ~ /$':-
Sewer I
I
I
I
I
Floor furnace
and vent
Recessed wall
~Onrp hp~tp~ ~nrl ~pnt
10f
I COI1l-I. /l NO. FEEDERS
I Install/alter/relocate
rli~trih fppnpr~
amps.
Appliance vent
seoaratp
I Stationary evap.
cooler
I V'ent fan wi th
sinole duct
I Vent system apart
heat.ino nO' A.C.
I ~lectianical exhaust
hn0~ rln~ ~lIr,t,
from
Storm Sewer
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I I ISSUANCF OF PFR!lIT
?~ '-I TOTAL CHARGES I TOTAL CHARGES M/ij. /.57 d>r::>
tti-af 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
Temporary Construction
Change in existing
rp~.i ~~I1CP
multifamily. comm. or
InolJ(,tri;l1
Wood stove/heater
Of
amps.
TOTAL CHARGES
WHERE STATE L~W REQUIRES
shall not be valiJ until the
I HAVE CAREFULLY EXM1INED the completed aprlication for ~ermit. and do hereby certify that all information hereon is true
and correct. and I further certify that any and all work oerformed shall be done in accordance with the Ordinances of the City
of Soringfield and the Laws of the State of Ore()on pertaining to the work described herein. and that IIC OCCUPAIKY will be made
of any structure without the permission ~f the Ouilding 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 701.055 will be used on this nroject.
IIAIIE(please printl-:rl\M.. S-\:ee..'" b\oc-lC SIGII^TURF.~ .b./.AZdhd
FD~ OFFiCE USE DilLY
Sq. Ftg. t1ain x Value
SQ. FtlJ. Access x Value
Sq. Ftg. Other ~ ~~"" Value -::7----
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TOTAL VALUATION
om.i:::J- P 2
20ne )VJ ..YJ
Fire Zone
Tyoe/Const. ~--~
Flood Plain
Bedrooms
Stories
/
Units
Occy Load
Occy Group H- ?>
BUILDING PERfIlT 0 ~ Plan Ck.
Charges an~ ___.15:._=-_____ 65%!Bld(1
Surcharges). t:-/..r') Plan Ck.
- / "'" 30%lBl do
PLUI1BING PERMIT ____~....", I Fence
Charges and ( ~.-'.
Surcharges /.::<'0 I O~mo
..ElECTRIC~.L PERI~IT i Sidewalk
Charges and '-'\ -------_____
Surcharges I Ale Paving
IIECHANICAL PERMIT . . /:)':.-.... Curb Cut
Charges and , _ ___J_j_~_____
Surcharges \fJ . be:>
COITlll/lnd
Ppr Fee
Res
Per Fee
,c, _ So
Systems Development
Charqe (1.5~) .
17.#.
ITotal Comb. rermit
_ f?? <?o
b 5. ;<:;>
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bl1l..\ OCl'-fOTAL
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example~ Tax Lot 100, lane County Map Reference
11 O"j 43
2. example- Lot I, Block 3. 2nd Addition to
Sprlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sourc~s
1. exam~le- heat/electrical ceiling/or forced air Qas
2. examole- waterheater/electrical/or solar
E. Square footage or valuation, etc. -
I. example- 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. examole - 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. 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, ~lechanical, & 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 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 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
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.
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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PERMIT VALIDATION
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!J67toro
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Permit Clerk
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information: ~Z:>~ ,/C>
Wf/~ /5 _~c...L- &.,T/I/S-
PLANS REVIEWED BY:
name
/C>8~. ,7Z.-
signatureO~
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date 1~:;;?-82-;:;
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".quired
Inspec.ns ..
IT IS THE RESPONSIBILITY OF Tlffi PE~~IT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TIME,
THAT EACH ADDRESS IS READABLE FROM THE STREET, AND THAT THE PERHIT CARD IS LOCATED AT THE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIMES.
PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
job address, type of inspection requested and ~men you will be ready for the inspection. Contractors
or owners name and phone number. Requests received before 7:00 am;will be w~de the same day, requests
received after 7:00 am will be ~de the following work day.
Your City Designated Job Number Is :---t!fi>S <::J ~~-
Job Address:-/~k:$" ~~~C ~7:
;Owner:ph -;V-~Hi?C~Ck- Phone: 72~.~S.e~
Contractor: ~~~~ 'Phone:
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SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
!JNOERS~UllBING) ELECTRICAL
6 ~ffiCHANICAL: To be made before
. ~ ,any work is covered.
O CONCRETE SLAB INSPECTION: To be
made after all inslab building
'.. :,.. .. service equipment. conduit. piping,
.'. accessories and other and llary
" - ,. equipment items are in place but
~r .: before any concrete is poured.
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FOOTINGS 5 FOUNDATIONS: To be made
after trenches are excavated and
forms are erected, all steel in
place, but prior to pouring concrete.
trnDERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer, Storm Sewer, D
Water and Drainage lines. To be
made prior to covering or filling
trenches. \V~
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 installation -
of decking or floor sheating.
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MASONRY: Steel location, bond beams
grouting or verticals in accordance 0
with U.B.C. Section 2415.
ROOF SHEATHI~G k~D NAILING: Prior
to installing any roofing.
ROUCH PLtJ1.ffiING. ELECTRICAL &
MECHANCIAL: No work 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: Must be requested 2 days in advance of the date you
wish inspection. All project conditions such as landscaping, parking lot striping etc. mus~
be com~leted before requesting this inspection.
D
ATTIC ORAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior to placing facing
materials and before framing
inspection.
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.
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.
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LATH AND/OR GYPSUM BOARD INSPECTION: :J
To be made after all lathing and
g)~sum board, interior and exterior,
is in place but before any Plasterin,g:J
is applied or before gypsum board
joints and fasteners are taped and
finished.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
WOODSTO\~S: 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
.asphal t
SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the Owner/
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 CONCRETE: In excess of 3000
P.S.I. (306 a,I)
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 ANO
'FILLING: l)>.Jring earthwork. (306
i; 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. (2501-U.B.C. STDS.
25-10, II).
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* 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.
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FINAL ME01ANlCAL
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F\7l FINAL BUILDING: Must be requested after the final Plumbing, Electrical, Mechanical 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 tho Building Division and posted on the premises
FINAL ELECTRICAL
FINAL FIRE OEPART~ffiNT
SIGNATURE
DATE
,.4_' J._.
*ALL MANHOLES AND CLEANOUTS MUST BE ACCESSIBLE, ADJUSTMENT TO BE MAOE AT NO COST TO THE CITY..
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