HomeMy WebLinkAboutPermit Plumbing 1988-11-4
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CITY 0, SPRINGFIELD
COMBINATION APPLICATION/PERMIT
EIIERGY SOURCES:
He.t
I~. ter He. ter
.
INFOR/IATlON liNt
726-3753
Sq. Ftg. 1.I.in
~q. Ftg. Access.
Sq. Ftg. Other
Ilew Add Alter Rep.
-Fence Demo Ch.nge/Use
Other - -
'INS~CTION LINE
726-3769
Job Address -q'l9~ O/<:.-'h?..2>/'C
Leg.l De<eription /7-C):2.?c)~C:;c)
.
Address
Phone
Range
V.IUE of Hork:
-::<:f3t~o y.""'O
BuilrifnQ Permit Info: Oescr be Work(i.e.,
Familv nesidence Hith .A.ttached Garaae'
Build Single
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C:#tt.";.K ;<<: /c:~<!:,..,
Owner A~~ /c.A'-Jv j...,./'A-R~' c::.o.
Construction Lender
,;.#.v//yo=, -1f frA'//Y-4'6L= /r::,;q
~r /"577~ .~~1"'/.--.=,; ~/ :'F{'7.
Address Phone
DESIGN TEAl~ (name) (address) (lies. no.l
Prim.ry _ LlppFI' E~/.;V~/~ 696' oo"q""?r~6u2?~2>.
'/') , ;
Structur.l
{exniresl
(ohone no.
b83'-'2&;/8
Electric.l.
Mechanical
CONTRACTORS In.mel
Gener.l /~O~ :ar"":5"'.~....-;r-.
Plumbina
(address) (lies. no, \
(exoires)
(ohone no.)
00',,' ~D
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lOe,,'
Electrical
~'echanical
PLUI1B I NG
ELECTRICAL
MECHANICAL
NO.
FEE CHARGE NO
CCF CHf;IlG.E. NO.
a.L J:HAllG.E.
SQ. FT.
furnace/burner to
BTU's
Each single fixture
Residence of
Relocated building
(new fix. .ddition.l)
INew circuits alts.
or extensions
ISERVICES
I
Floor furnace
and vent
S.F. Residence
(1 b,th)
Duplex (1 b.th) e.ch
Addition.l b.th
I~!ater service
I Sewer
1'12' Storm Sewer
Recessed wall
Sn~~p hp~tpr ~nd vpnt
lTernporary Construction
IChange in existing
re~ j q~nce.
Imultifamily. comm. or
Industrial
"3/. 3t>
amps.l
Appliance vent
seoar~tp.
Stationary evap.
cooler
Vent fan wi th
sinale du~t
Vent system apart from
heatina or A.C.
Mechanical exhaust
hood i1.nd duct
I flood stove/he.ter
I
I
I
TOTAL CHARGES
WHERE STATE LAW REQUIRES
shall not be vali1 until the
IOf
ICDMI'I./IND. FEEDERS I
I Install/alter/relocate I
dic;trih. fppdprs
IOf amps. I
I \Q I
I VI' I" I
I I I ISSUANCF OF PFR/IIT
":? /. '3 c> TOTAL CHARGES I TOTAL CHARGES
that 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
1 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 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 1m OCCUPAI~CY will be made
of any structure without the permission of the Building Division. 1 further certify that my registration with the Builder's
Ooard 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 comoliance with OP.S 701.055 will be used on this p~oject.
IWIE(ple.se print)C'#ARIEC; ~cAe./ . mrMTURE ..?~k-"~~
Far. OFFICE-USE. OIl~Y'- /'
Sq. Ftg. 11.in xC V.lue
Sq. Ftl]. Access x Value
Sq. Ftg, Other~5'5.pM>V/nz:;.:, V.lue;;? &'~Y.' d,.)
TOTAL VALUATION
"',-
q':?7.Cb
DATUI k/!'I
Zone J/ /
Fire Zone
Flood Pl.in
Type/const.~L//~
Bedrooms /
Stories
Units
Occy Lo.d
C.ccy Group
PLUI1B ING PERMIT
Ch.rges .nd..... ?
Surch.rges ~
ELECTR I CAL PERI1IT
Ch.rges .nd
Surcharges
____RL2~_
/.57
Fence
<hI
rl)
~ ,z; Systems Development
/J/~p;r/Y'I ~ Ch.roe (1.5~) ,
'&1-k-r-Y;=es-
I 5",,:rt::> ~//;q.~~
I .' ~
I
I /g~SD
I
I
3/.~
BUILDING PERNIT
Charges and
Surcharges
Pl.n Ck. Comm/Ind
____________..M!/Bldo p.pr Fpp
Pl.n Ck. Res
30%/BldQ Per Fee
..'
D~mo
<.
MECHANICAL PERMIT
Ch.rges .nd
Surcharges
I Sidew.lk
I A/C P.ving
I Curb Cut
I
Tot.' Comb. Permit
TOTAL
':458,0-;;>
1--
7f)(p, 73_".1
.
COMBINATION APPLICATION/PERMIT (CAP)
"
I, Applicant to furnish
A, Job Address
B, Legal Oescription
I. examole- Tax Lot 100, Lane County Map Reference
II OJ 43
2, exam~)e: Lot 1. Block 3, 2nd Addition to
>prlngtleld Estates
C. Name, etc. of owner and construction lender
O. Energy Sources
1: example- heat/electrical ceilinq/or forced air Qas
2. examole- waterheater/electricalJor solar' -
E. Square footage or valuation, etc. -----
1. examole- 1250 sq. foot house, 500 sq. foot garage
2. examole- if new project, check-new - if addition,
check add, etc.
F. Building permit information:
1. exam~le - construct single family house with an
attached garage
2. examole - remodel existing garage into family room
3. examJPle - 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 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 OIVISION STAFF WILL FILL OUT ALL FEES ANO
CHARGES ON THE SCHEOULES
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
-..
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PERMIT VALIDATION
(~?31J
! 1- 7- J f
(C
Permi t Cl erk
~~-
t,. r
.
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
".
PLANS REVIEWED BY:
. name/ .c>;~~~~)signature ac::
,/ "
"? date //-~-8ES
~~ "iequired 'nspecions"
IT IS THE RESPONSIBILITY OF TilE PER.'lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TI!.IE,
THAT EACIl ADDRESS IS READABLE FROM TilE STREET, AND THAT TilE PERMIT CARD IS LOCATED AT TilE 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 NUflBER,
job address, type of inspection requested and \olhen you will be re.1dy for the inspection. Contractors
or owners name and phone number. Requests received before 7:00 Bm;will be ~~de the same day, requests
received after 7:00 am will be made the followin~ work day.
~55C>9~
Job Address: --:::;1./9'f:. V',c1'/:??7rc "'5r
Owner: ~~ 7f/~C=-7
Contractor: /n~~' Lf5~r -'') '_
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Your City Designated Job Number Is:
SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNDERSLAB PLlJHBING, ELECTRICAL
& ~ffiCHANlCAL: 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.
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~ ~ewer~
Water and Drainage lines. fo be
made prior to covering or filling
trenches.
UNDERFLOCR:. 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 she~ting..
FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to installation
of decking or floor sheuting.
MASONRY: Steel location, bond beams
grouting or verticals in accordance
with U.B.C. Section 2415.
ROOF SHEATHI~G A~D NAILING:
to installing any roofing.
Prior
ROUGH PLU~IBING. ELECTRICAL &
MECHANCIAL: No work is to be cover!'!"d
until these inspections have been
made and approved.
')t')
FINAL PLUMBING
o
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Phone:
Phone:
ATIIC DRAFT STOPS & CURTAIN WALLS.
FIREPLACE: Prior tc
materials and before
inspection.
placing facing
framing
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 Oivision.
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STRUCTURAL CONCRETE:
P.S.!. (306 a.l)
In excess of 3000
o
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 nfter the roof,
all framing, fire blocking and
bracing are in place and all pipes,
chimneys and vents arc complete and
the rough electrical, plumbing nnd
heating wires, pipes and ducts arc
approved.
STRUCTURAL WELDS: Preformed on the
job, (2722 f)
HIGH STRENGTH BOLTING: Ouring all .
bolt installation nnd tighting
operations (306 n.S)
SPRAYED ON FIREPROOFING: (U.B.C.
Standards 43.8)
SPECIAL GRADING. EXCAVATION .~D
FILLING: [)o.Jring earthwork. (306 n.ll
& Chapter 29)
:J
GLU-LAM BEMiS: Inspection Certificate,
by an approved agency, furnished to
the City's Building Oivision before
beams are placed. (2S01-U.B.C. STDS.
25-10,11) .
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LATH AND/OR GYPSUM BOARD INSPECTION: ---,
To be mnde after nIl lathing and ~
g)~sum board, interior and exterior,
is in place but before any Plastering:J
is applied or before gyp~um board
joints and fasteners are taped and
finished.
*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 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. must
. b~ com~leted hefore requesting this inspection.
FINAL ELECTRICAL
l"'l
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FIRE & SEPARATION \IAU.: l.ocated &
ccnstructed according to plans.
WQODSTOVES: 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.
C/O <=1/
PARKING LOT: After gravel is in
placc but prior to placing asphalt
or concretc.
FINAL 9lJILIHNG: Must be requested after the final Plumbing, Electrical, Hechnnicnl and Fire
bcpartm~nt inspections arc made and approved. No Occupancy of the premises can be made until
"~~~".. " ,', '"":::: '~~~"" .. ". ,,"",..
FI NAL MECUAN! CAL
o FINAL FIRE DEPARTMHrr
';;',\I.L ~IANIIO!.r:S ANn CLEANOUTS ~'UST Br: .\CCESSIBI.E. AnJUSTMr:NT TO BE MM)E AT NO r.OST TO '111E CoITY.