HomeMy WebLinkAboutPermit Miscellaneous 1988-2-9
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Job Address '3~22 OL Y'M..P/C
"':;7:
CITY OF SPRINGFIELD
COMBIIIATION APPLICATION/PERMIT
EIIERGY SOURCES:
Meat
liater Heater
Range
ValuE of Hork:
i",aaeJ. .#-'>
BUl16inQ Permit Info: Oescribe Work(i.e..
Familv Residence Hith Attached Garaoel
.
1 NFORllA Tl ON II Nl
726-3753
Sq. Ftg. l'lain
~q. Ftg. Access.
Sq. Ftg. Other
flew Add Alter Pep.
-Fence Demo Change/Use
Other - -
.
~ IrISPECTlON LINE
1 726-376g
I
Owner 2~6.t<'R P lluPPEG
Address % S't:J(;/ N. LA 6 e:>dA/
~pr44h'Z:>. o-K 972/7
Phone
Build Single
~
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legal Description /7-0Z'3t:;.a:::;> OIQ,2C;
Construction Lender
,
".,a-~G>-SS- 0 A
,Al/,c 26"x 73' A?,7U)/V I.&N~
1/./..,.<;,.. 5;n~ 6,c 7?">/LD<q'>"- b.//T#
c;PR~CZ::> :5'".7ed/>> ~LC~W~ ~7~. I
(address) flies. no.) (exoires) (OhOM no.\
~.o PEoC.r~ 6' W Y NA,
;30/_,1;:/",1' DP. Ci'?L,/41~
Phone
Address
UtSluN IEAll
(name)
Primary t;U6~'YP ~-"., t 6;>o4...-E':::'.
Structural
hR:::;:~?""t!J~
Electrical
t:iot.P I ~C?i'1~
Mechanical
CONTRACTORS
(name)
(address)
(1 ics. no. l
(pxnirpc:;)
(ohnnp no_ \
General
Plumbino &~"y~ ~HD. C;:;RA v~L ~/p,c;- }???AS"AO-?:>5!..o.-.o......6)
E1 ectri ca 1
.,..Al
bR~~-7<,11
~'echanfcal
PlUI.1BING
ELECTRICAL
MECHANICAL
-1J!h
FFF ~M?r,F NO
~~~ r~~-liP
HF r~q&Gf,
Each single fixture
Residence of
SQ. FT.
furnace/burner to
BTU.s
Relocated building
\ (new fix. additional)
S.F. Residence
11 bath]
Duplex (1 bath) each
Additional bath
Ilater service
&'5' Sewer
S to nn Sewer
New circuits alts.
or extensions
Floor furnace
and vent
SERVICES
Recessed wall
~n~rp hp~tpr ~nrl vpnt
Of
amps.
Appl iance vent
~eoaratfll
Stationary evap.
cooler
Vent fan with
~inale duct
Vent system apart from
heatino or A.C-
Mechanical exhaust
hood and durt.
Temporary Construction
Change in existing
rfll~ j dJ'J1rp
multifamily~ comm. or
Tnrlud.rhl
CO~1./IND. FEEDERS
Install/alter/relocate
rlic::trih. fpprlprc::
Wood stove/heater
Of
amps.
I v1\ V\
ISSUANCF OF PFRIHT
TOTAL CHARGES 30 TOTAL CHARGES 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 valid until the label has been signed by an Electrical Supervisor and returned to the Building Division
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 110 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 ons 701.055, that if exempt the basis for exemption is noted hereon, and that
only subcontractors and employees who are in compliance with ORS 70.1.055 will be used on this project.
NAt.IE(please print)
BUILDING PERMIT
Charges anC:
Surcharges
Plan Ck.
65%1Bl do
Plan Ck.
30~/Blda
Fence
SIr.IIATURE
FOr. OFFICE USE OIlL Y
Sq. Ftg. riain x Value
Sq. Ftg. Access x Value
Sq. Ftg. OtheW/~ /.82..,9' Value A!!J,.:JaO. -..
/(""'lj TOTAL V ALUA Tl ON
( I / 1J:>?-"'f-R~
Conm/lnd V'<-<rr. '/.:> '"j'// Systems Development '1--"") /~C>, ~
Ppr 'pp I~<f? :;r'-'.-k..." Charoe (I.5~) :...=z. -y <
Res
Per Fee
DATE
Zone..ML
Fire Zone
Flood Plain
Tyoe/Const~ Y/~
Bedrooms '
Stories
Units
Occy load
Occy Group
PlU~BING PERMIT ;;>~ ....
~~~~~:~g:~d c;_n_u/~-50
ELECTRICAL PERIHT
Charges and
Surcharges
Demo
Sidewalk
A/C Paving
.$\::/. So
Total Comb. rermft
117..0<!>
MECMANICAL PERMIT
Charges and
Surcharges
Curb Cut
TOTAL
~&:z.~
.
COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
II OJ 4J
2. examole- Lot 1. Block 3, 2nd Addition to
. SPrlngfield Estates .
C. Name. etc. of owner and construction lender
D. Energy Sources
1. eiam~le- heat/electrical ceilinq/or forced air Qas
2. example- waterheater/electrical/or solar
E. Square footage or valuation, etc. ------
1. exam~le- 1250 sq. foot house, 500 sq. foot garage'
2. example- if new project. check new - if~addit;on,
cneck add. etc. .
f. Building pennit information:
1. exam~le - construct single family house with an
attached garage
2. examEle - 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
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
r
.CITY OF SPRIN.rFI~ilD
City HilI
Sprlnglold, ~on
Oll1ce of Community end Economic Developmenf
OFFICIAL RECEIPT
(
10911
o
Data FEB. 9, ,g8A
(. Rac'd From C~P~? ~"" p- S::>~A".A".s-
. 5"'O~ I ~. E.4-~t:>'DH
.' Address 'P~rt!A'_Z:>. 4€". 97217
O. I ~ /~r.
Received For:,~" -g~o I~ / ,/' c"! ~M ,
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o PoP:. ~c:> -..
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PVfW.l?~YI'<!:'''V' rcc...- 2'0......
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?or.4L
2,.S?2. ""..
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Ct
~ ~::? t::.5<<:;
.ct
"2.82. c.~
',t'
Amount Received
C)
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C) .
~-?~'i!~~""I~
l' AUTttORlZED 51GNATUFh;"" /' \..
frDnIlIer ,US'NESS FORlllS. lMe. 110313012."'" '.'
. -
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
.
Permit applicant exempt from registration with the Builder's Board because:
Additi ona 1 Project Informati on.:
1
PLANS REVIEWED BY:
name /"'P/l/P ~~~ Signature4'"7___/,~:~"" ,-'? date 2-<)"815
-
w....~ .. Required Inspections..
IT IS 'THE" RESPONSIBILITY OF THE~IT HOLDER TO SEE THAT ALL INSPECT.S ARE MADE AT THE PROPER TillE,
,/ THAT EACH ADDRESS IS READABLE FROM TIlE STRF.ET, AND THAT TIlE PERJoIIT 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 NUMBER,
job address, type of inspection requested and when you will be ready for the inspection. Contractors
or owners name and phone number. Requests received before 7:00 am,will be made the same day, requests
received after 7: 00 am will be made the following work day.
Number Is: .J?.RCY'OO
I':?L Y'.m/Zo/ L S-r
Owner: Rc>~~ ? 7?b/'?~~
Contra~tor: Ea:::;.EN~ s.;~ ~ h7i"#Yc"
CITY'S SITE PLAN REVIEW BOARD INSPECfION: Must be requested 2 days in advance of the date you
wish inspection. All project conditions such as landscaping, parking lot strip!nl etc. must
be c~leted before requesting this inspection. .
~~ 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 the Building Division and posted on the premise~
Your City Designated Job
Job Address: -:r ~ 2 '2
o
o
o
~ITE INSPECfIDN: To be made
after excavation, but prior
to setup of forms.
UNDERSLAB PLUMBING. ELECTRICAL
'6 MEotANlCAL: To be made before
any work 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
FOOTINGS 8 FOUNDATIDNS: To be made D
after trenches are excavated and
forms are erected, all steel in
place. but prior to pouring concrete.
UNDERGROUND: Plumbing. Electrical,
Gas ,(SlJriitarr ,..sewer.) StOnD Sewer.
Water and Dra1n3gG lines. To be
made prior to coverinik~illing
trenches. Y f
~
o
UNDERFLOOR: J Plumbing. Electrical,
Mechanical. To be made prior to
installation of floor insulation,
decking or floor sheathing.
POST Ii BEAM: To be made prior to
installation of floor insulation,
decking or floor sheating,'.
FLOOR INSULATION 8 VAPOR BARRIERS:
To be made prior to installation
of decking or floor sheating.
MASONRY: Steel location, bond beams
grouting or verticals in accordance 0
with U.B.C. Section 2415.
o
o
o
D
D
o
o
ROOF SHEAnnNG AND NAILING: Prior
to installing any roofing.
ROUGl PLUMBING. ELECTRICAL 8
MECHANCIAL: No work is to be covered
until these inspections have been
made and approved.
[8]
I ><1 ~ PLUMBING
D
o
o
o
FINAL ELECTRICAL
FINAL MEOlANICAL
FINAL FIRE DEPARTMENT
SIGNATURE
Phone:
Phone: .t::B3- !{;"'?o/ /
o
D
ATTIC DRAFT STOPS 8 CURTAIN WALLS.
SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the Ownerl
Contractor during construction of the
following work. A copy of the special
testing reports shall be furnished to the
Building Division.
FIREPLACE: Prior to placing
materials and before framing
inspection.
facing
D.
INSULATION 8 VAPOR BARRIER: To be
made after all insulation and
required vapor barriers are in place
but before any lath or gypsum board :J
interior wall covering is applied.
:J
:J
STRUCTURAL CONCRETE:' In excess of 3DO
P.S.I. (3D6 a.l)
STRUCTURAL WELDS: Prefol'llOd on the
job. (2722 f)
HIGH STRENG11l BOLTING: During all .
bol~ installation and tighting
operations (306 a.5)
o
D
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:
constructed according to
:J SP.RAYED DN FIREPROOFING: (U.B.C.
Standards 43.8)
:J SPECIAL GRADING, EXCAVATION AND
LATH AND/OR GYPSUM BOARD INSPECTION: FILLING: During earthwork. (306
To be made after all lathing and & Chapter 29)
g)~sum board. interior and exterior.
is in place but before any ptasterin&--,
is applied or before gypsum board ---l
joints and fasteners are taped and
finished.
Located 11
plans.
a.ll
"vv~lvJES: After installation is
completed.
SIDEWALK & DRIVEWAY: Required for
all concrete paving within street
right-of-way, to be made after all
excavating complete 11 form work 11
sub-base material in place.
CURB AND APPROAot APRON: After forms
are erected but prior to pouring
concrete.
GLU-LAM BEAUS: Inspection Certificate.
by an approved agency, furnished to
the City's Building Division before
beams are placed. (2S01.U.B.C. STDS.
25-1D,l1).
:J
PARKING LOT: After gravel
place but prior to placing
or concrete.
is in
asphalt
-In addition to the inspections
specified.~ereon, the Building
Official may make or require other
inspections of any construction
work to ascertain compliance with
the Building, City or Zoning Codes.
DATE
. ALL MANHOLES AND CLEANOUTS MUST BE ACCESSIBLE, ADJUSTMENT TO BE MADE AT ND COST TO 1llE CITY.
I
.
"
I INSPECTION LINE
726-3769
,
CITY UF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
EilERGY SOURCES:
Heat
Hater Heater
Range
ValuE of Hark:
It) aaD ..." I
( .
BuilGinQ Permit Info: Describe Work(i.e.,
Familv nesidence With Attached Garaae)
,
INFORllATION UNt .1
726-3753
Sq. Ftq. 1.lain
~q. Ftg. Access.
Sq. Ftq. Other
New Add Alter Pep.
--Fence Demo Change/Use
Other - --
Owner ;l2~ 6GR P 2?u.Z? PEG
Address % 5" ()6/ AI. L...4 ~ ~
l:t.X?7"44A/Z:>. O"K <772/7
r
Construction lender
Phone
Build Single
~
~
.........
\')
\)
Job Address '3'1'22 OL Y'M.P/C -<;7:
Legal Description 17-0Z'30.cc>. 0/ Q2'G
Address
Ut~JGN TEAM (name)
Primary G../-v~~",~ ~.Hn t ~... v.....~.
Structural
7'T"'-~~$S- PAJ//C 26"~ 73' /JPnD/Y A,-_.-!'~
1/./-",-<: r ..e;;n~ 6,c /S.""'/L T-l/~ In//rH
Phone C;,W?t;:5CZ:;> ~"f,," L('L:'€'~"'~ ~"?Q51. .
(address) nics. no.) (exoiresl (ohone no.l
~e> :o~..-? 6'wy NSit.
r.!o~~e/Y"i' DP <??#4/r:>
LJ<':? ~ (; ~ .t)~
Electrical
Mechanical
CONTRACTORS
(name)
(address)
(l ics. no.)
(pxoire...)
(ohnnp M. )
Genera 1
Plumbina &~_p' ~_L> qfC:;:;RA.vE<:..W,..a,.;- .i?R6A&>5~""R..6)
Electrical
b-!!i:~ ~~ 7 c.J/
~'echani ca 1
qO~ / 'l.,0""1"'l
PLUI.lBI NG
ELECTRICAL
MECHANICAL
--'!Q..,.'
, FEr 'FHARGF Nn
nF . rHARliE JIll.....
SQ. FT.
furnace/burner to
BTU's
I...E.E.L' .cJfARG.E.
Each single fixture
Residence of
IRelocated building
(new fix. additional)
Is.F. Residence
() bath \
IDuplex (1 bath) each
IAdditional bath
~Jater service
~' Sewer
I Storm Sewer
New circuits alts.
or extensions
Floor furnace
and vent
SERVICES
Recessed wall
So~rp hp~tp~ ~nrl vpnt
Of
amps,
I Appl lance vent
<;,~oaratp
I Stationary evap.
coolar
I Vent fan wi th
sinale duct
I Vent system apart from I
hea t i no or A. C.
IMechanical exhaust
hnnd and durt
I flood stoye/heater
I
I
I
Temporary Construction
Change in existing
rps i dJ'Jlrp
multifamily, conn. or
Ind""trial
CO~~./IND. FEEDERS
Install/alter/relocate
rli"trih fppdpr"
Of
amps.
I
TOTAL CHARGES 30 TOTAL CHARGES TOTAL CHARGES
WHERE STATE L\H REQUIRES that the Electrical work be done by an Electrical 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
~I
?-q
IV'}
ISSUANCF OF PFRilIT
I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon ;s 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 ng fi e 1 d and the Laws of the Sta te of Oregon perta i ni ng to the work descri bed herei n, and that UO OCCUPAUCY 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 OPOS 7~1.055 will be used on this project.
SIGIIATURE~,('./.11:?~ k /i5+U DATE,-J-9-f?K
IlAI.1E(please print)
GAIL
DEB LE.R
FOr. OFF I CE USE DIlLY
Sq. Ftg.
Sq. Ftg.
Sq. Ftg.
Zone..NL.
Fi re Zone
Flood Plain
Type/Const~ y/~
Bed rooms '
Stories
Un; ts
Occy Load
Occy Group
t1ain
BUILDING PERmT
Charges and
Surcharges
It)
Plan Ck. Comm/Tnd
65%/Bldn Ppr F~p
------------ Plan Ck. Res
30%/Blda Per Fe.
x Value
x Value
/.$32."", Value /~,&:JaO. -..
TOTAL VALUATION
~ ~..q-;::]#
.c~ F/tO ~//. Systems Development /C""~ ~
!./LoR<€> :7,.".-'&.D Charae ()'5~) ---1.', JI "---,,
d?
Access
Othe~.V/~
PLUMBING PERMIT ;;>c:> ....
~~~~~;~g:~d ~ ------/~.-5~-
ELECTRICAL PERIHT
Charges and ------------
Surcharges
/lECHANICAL PERMIT
Charges and
Surcharges
Fence
Dl1R1o
I I
I I
91 ~ So ITota' Comb. Permit
I
I TOTAL
II?.=-
.Sidewalk
A/C Payi ng
I Curb Cut
I
:2&2. ""'c:>
,
COMBINATION APPLICATION/PERMIT (CAP)
'.'
I. Applicant to furnish
A. Job Address
B. Legal Description
1. examole- Tax lot 100, Lane County Map Reference
17 oj 43
2. exam~le- Lot 1. Block 3, 2nd Addition to
.' sprlngtield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources .
1. examole- heat/electrical ceilinq/or forced air Qas
2. examyle- waterheater/electrical/or solar'
E. Square footage or valuation. etc.
1. examole- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, checknew - if~addition, "
cnecK add, etc. '.
F. Building pennit information:
1. examele - construct single family house with an
attached garage
2. example - remodel existing garage into family foom
3. example - 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
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:
,
I
-'-#
'"
PERMIT VALIDATION
. .
.-
. ..
'.
\ b~ \ \q
frb \)
~
Permit Cl erk
L4~
'--./
Permit applicant exempt from registration with the Builder's Board because:
Additi ona 1 Project Infor.mati on.:
PLANS REVIEWED BY:
name-.L"PIII',.:: "?C~~ signature4~ --- i'~ .' ,'" date '2 - '77f!r.s
,.