HomeMy WebLinkAboutPermit Building 1988-4-11
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ItISPECTdON UIIE CITY UF SPRINGFIELD INFORlIATlON LINe
726-3769 COMBINATION APPLICATION/PERMIT 726.3753
J b Add "'2/frr'? tLI. ~ EIIERGY SOURCES: Sq. Ftg. 1.lain
o ress :.; 7 VV v- 1/J'1..1. LJ..lA.-, Heat ~q. Ftg. Access.
Legal Oescription 17-CJ2--'-- />~. ---q/9~/' I~ater Heater Sq. Ftg. Other ~
7~~., <--7 ~ New Add Alter Rep.
~ tw..~ ~:~:: of Work: S; tJ1Jf) ~~~~~_Oem(Uhange/Use I a
&~1-1if .1 Ph Builtiino Permit Info: Describe Work(i,e., Build Single ~
f/'IIIA)Y/i.,/lf'/' /.?P97?1? one Familv Residence Uith Attached Garaoel 'Y
~~A"I /Y!!.~"'n -:?~-'1~:%" vf2J1hJ)~::!:~?'T 0'V~ ~
Construction Lender 1.. r- ~ /7--="
~ - 0, /~ Y~R/.67-? ____ 6. .~'" ;/...-. k. ~ r'
..~~W> / ...
{namel'~~'" -- - PhOtaeddressl ~/&-/Y~ ~;.~~~/.,...yr:x~f~~ (ohane no.'}
Owner
Address
Address
UeSUjN TEAr~
Primary
Structural
li tI.:'J I ~CO
lA' \1,
Electrical
Mechanical
CONTRACTORS
(name) __'address'
W~/-' ('~.--
;!
~
flies. no.)
(exoires) )ohnnp nQ._ \_,
<W'6:?=:! -5?'t' /
# --;tY-=? -~/</
General
Plumbino
Electrical
~lE;chan;cal
PLUIIBING
ELECTRICAL
MECHANICAL
..liQ..,.
FFF r.HMU~F ~m
ccc ru~ Nn
crt:" "'~ARG.E.
Each single fixture
Residence of
SQ. FT.
furnace/burner to
BTU's
Relocated buildin9
(new fix. additional)
INew circuits alts.
or extensions
ISERVICES
I
Floor furnace
and vent
S.F. Residence
II bathl
IDuPlex (1 bath) each
IAdditional bath
Water service
Recessed wall
~n~~p hp~tpr ~nrl vpnt
Sewer
ITempOrary Construction
IChange in existing
rec;.j4rflcp,
Imu1tifamily, comm. or
Indll(,tri~l
IOf amps.
ICOffi~./IND. FEEOERS
I Install/alter/relocate
cti<:.tri h fpprlprc;
IOf amp~
I
I
I
Appliance vent
~poartl.tp
Stationary evap.
cooler
Vent fan with
sinole duct
Vent system apart from
heatino or A.C.
Mechanical exhaust
hood tl.nd durt
Storm Sewer
Wood stove/heater
ISSUANcr OF PFRIIIT
TOTAL CHARGES 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 HAVE CAREFULLY EXM1INED 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 oerformed 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 rm OCCUPA[~C,( 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 7nl.055 will be used on this project.
NAI.IE(please print) 5 I GtIATURF. (1/ y~ r ~ ~ DATF .I../-I/-F'i..
FOr. OFFICE USE O;l~~ . 7
Zone M I'.
Fire Zone
Flood Plain
Tyoe/Const. 02 A/
Bedrooms
Stories /
Units
Occy Load
Dcc.y Group
Sq.
Sq.
Sq.
Ftg. t1ail'l )f Value
Fta. Access )f Value
Ftg. Other~~;"'",?.".. Valu.
TOTAL VALUATlm'
."')eoa "'-
BUILDING PERllIT
Charges and "'
SurCharges d-
~ Plan Ck.
_ _ _uc:;?~5?2_ _ 65%/Bldo
~ Plan Ck.
-::2....v:;.> 30%/Bldo
Fence
ro
ConmlI nd
P.rr F,:op
Res
Per Fee
2.7..,'1>3
1ll...40 lj+'6~
Systems Development
Charoe (1.5%) .. ~
C:::f)
I
75-:...-.::>
PLUr1BING PERMIT
Charges and
Surcha rges
I DBRlO
___________J Sidewalk
I A/C Paving
___________J Curb Cut
I
ITota1 Comb. Permit
I
I TOTAL
5:?.o:a
/28. 0 '3
ELECTRICAL PERIHT
Cha rges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
.J
.
.
I
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Oescription
I. example- Tax Lot 100, Lane County Map Reference
II oj 43
2. example- Lot I. Block 3, 2nd Addition to
sprlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceilinq/or forced air qas
2. examyle- waterneaterjelectrical/or ~
E. Square footage or valuation, etc.
I. examole- 1250 sq. foot house. 500 sq. foot garage
2. example- if new project. check-new - if addition.
check add. ete.
F. Building pennit information:
1. example - construct single family house with an
a ttached garage
2. examele - remodel existing garage into family room
3. examele - 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 OSE ONLY
Permi t Cl erk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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c~ _,
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PERMIT VALIDATION
I ( ;J.-f1
Cf-i{-rl
CL-.
.
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information: <~r=- A-siP /~;;;? ;t%E~ o/~
. PLANS REVIEWED BY:
L~~ '7t~~ signature.~.-<>'?~- J?
,,]:'-- p-
name
date
7";"7'-~
~~
IT IS THE RESPONSIBILITY OF THE PER-'lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TUlE,
THAT EACH ADDRESS IS READABLE FROM THE STRF:ET. AND THAT THE PERJoIIT CARD IS LOCATED AT THE FRONT OF THE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES. .
"
.. .uired
Inspect"s ..
PROCEDURE FOR REQUESTINr. INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER,
job address. type of inspection requested and \olhen you will be ready for the inspection. Contractors
or owners name and phone number. Requests received before 7:00 amjwil1 be ~Bde the same-day, requests
received after 7:00 am will be made the following work day.
Your City Designated Job Number Is: RRr:?2.s=?2
Job Address: '=6 sr:< '2 a y.---,"~/,~ ~7"=
Owner: K~g;e 'A'"......~ ?ErC Phone:
/"' I. /' /': W-~8;f~S 7~/
Contractor:! ..L/F~ VWC:>P,cE'ir' c...o~. ]hone:;.I. -.,</,:?-:i:U:./l/
~
FOOTINGS & FOUNDATIONS: To be made
after trenches are excavated and
forms are erected, all steel in
place. but prior to pouring concrete.
UNDERGROUND: Plumbing, Electrical.
Gas. Sanitary Sewer, Storm Sewer,
Water and Drainage lines. To be
made prior to covering or filling
trenches.
FLOOR INSULATION & 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
SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNOERSLAB PLUIlBING, ELECTRICAL
6 ~ECHANlCAL: To be made before
any work is covered.
CONCRETE SLAB INSPECTION: To be
made after all ins lab building
service equipment. conduit, piping,
accessories and other ancillary
equipment items are in place but
before any concrete is poured.
o
o
o
UNDERFLOQR:, Plumbing, Electrical.
~lechanical. 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 shesting.'.
o
o
o
o
o
ROOF SHEAllIING AND NAILING:
to installing any roofing.
Prior
ROUGH PLUIlBING. ELECTRICAL &
f.lECHANCIAL: . No work is to be covered
until these inspections have been
made and approved.
o FINAL PLUMBING
~ FINAL ELECTRICAL
o FINAL IIEClIANICAL
o FINAL FIRE DEPARTMENT
o
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~
o
o
o
o
o
o
o
o
ATTIC ORAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior to placing facing
materials and before framing
inspection.
INSULATION G 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.
~
LATH AND/OR GYPSUM BOARD INSPECTION: ---,
To be made after all lathing and ~
g)~sum board. interior and exterior,
is in place but before any plnsterlllll---,
is applied or before gypsum board ~
joints and fasteners are taped and
finished.
FIRE G SEPARATION WALL: Located &
constructed according to plans.
WOODSTOVES: After installation is
completed.
SIDEWALK G DRIVEWAY: Required for
all concrete paving within street
right-of-way, to be made after nIl
excavating complete & form work &
sub-base material in place.
CURB AND APPROACn APRON: After forms
are erected but prior to pouring
concrete.
PARKING LOT: After gravel
place but prior to placing
or concrete.
is in
asphalt
SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code 0 special
inspector sholl be employed by the Owner/
Contractor during construction of the
following work. A copy of the special
testing reports sholl be furnished to the
Building Division.
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STRUCTURAL CONCRETE: In excess of 300
P.S.I. (3060.1)
STRUCTURAL WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTll BOLTING: During all .
bolt installation and tighting
operations (306 n.S)
~
SPRAYEO ON FIREPROOFING: (U.B.C.
Standards 43-:8)
SPECIAL GRADING, EXCAVATION AND
FILLING: During earthwork. (306 n.ll
& Chapter 29)
GLU.LA.M BENtS: Inspection Certificate.
by an approved agency, furnished to
the City's Building Division before
beams are placed. (2S01-U.B.C. STDS.
25-10,11) .
* In addition to the inspections
specified hereon, the Building
Official may make or require other
inspections of any construction
work to ascertain compliance with
the Building, City or Zoning Codes.
CITY'S SITE PLAN REVIEW BOARD INSPECTION: Must be requested 2 days in advance of the date YOI
wish inspection. All project conditions such os landscaping. parking lot striping etc. must
be com~leted before requesting this inspection.
FINAL BUILDING: Must be requested nfter the final Plumbing, Electrical, Hechanical nnd Fire
Department inspections are made nnd approved. No Occupancy of the premises cnn be made until
a Certificate of Occupancy has been issued by the Building Division and posted on the premise:
SIGNATURE
DATP
* ALL ~lANltOLES :\NO CLEANOUTS MUST BE ACCESSIBLE. ADJUSTMENT TO BE MADE AT NO COST TO TIfE CITY.