HomeMy WebLinkAboutPermit Signage 1988-8-31
I..
j1"
'-<
.
CITY UF SPRINGFIELD . INFORltATlON LINt
COMBIIIATlON APPLICATION/PERMIT 726-3753
EIIERGY SOURCES: Sq. Ftg. 1.1. i n
~e.t ~q. Ftq. Access.
I~ater Meater Sq. Ftg. Other ~
lIew Add Alter Rep. ~
Range -Fence Demo Change/Use ~ 11
ValuE of Hork:;:2 m Dther- - I::::>
BuilriinQ Permit Info: Describe Work(;~e.. Build Single .~
Familv nesidence IHth Attached Garaael ~
IAA.-r~~ !<:!'t.--~//~ + C ~ ~
-1'"~G~"'>/'"F:;r- ~nv /N.~
Phone ")/e::;..v. .4-..........:.'j' //<=e\- --:;~ ~-...
(address) - , . l1ies. no.1 (exnirf(s) (ohane no.)
1~7S J,}, 6',P1 Ave.., ~'':'':nI'' d....&1""He :5~:.u,'S
E.
~
jINSPECTION LINE
726"37 6g ,
~~b Address ,:)Jl,<::( 'B:nYleeY' J~.y.L"llf
legal Description
I
Owner ~;+y. "t Sf'~'OH/j~:Pt1
Address :J hi b )/ !')' fl<J
Phone
Construction lender
Address
UC" uN ICAI1
(name)
- I.cLA '
l:mp>('(j ,,'11 I I>\ll>
V
t,<?7.o:r38
Primary
Structural
Electrical
Mechanical
CONTRACTORS Inamel
Genera 1 f l<< e I"n lrl.
Plumbino
h.w.... :.j
(address 1
"1.2,7"> \J.~,/",-.
(lies. no.)
r~)(nirp,'
(nhonp nn_ 1
,
.~n"'" E7"'''>.5?~
?,'i{ 7-()~31
PLUI1BING
l,_yt I
ELECTRICAL
0,1
t::;'7, or>
Electrical
~'echanical
MECHANICAL
NO.
FFE fHARGE Nn
~~~ f~ARUE Nn_
SQ, FT.
furnace/burner to
BTU's
I=n' fl:iAR.G..E.
Each single fixture
Residence of
Relocated building
(new fix. additional)
S.F. Residence
11 bath \
Duplex (1 bath) each
Additional bath
New circuits alts.
or extensions
Floor fu rnace
and vent
SERVICES
Recessed wa 11
Sn~rp np~tp~ ~nrl ~pnt
Storm Sewer
Of
amps.
Appliance vent
s.eoaratp
Stationary evap.
cooler
Vent fan wi th
sinole duct
Vent system apart from I
heatina or A.C.
Mechanical exhaust
hond ~nd durt
Wood stove/heater
Sewer
Temporary Construction
Change in existing
rp'j-j4e.nrp
multifamily, corrm. or
Industrial
~Iater service
COMM./IND. FEEDERS
Install/alter/relocate
rli~t~i~ fpprlpr~
Of
amps.!
ISSUANCF OF PFR!IIT
TOTAL CHARGES TOTAL CHARGES TOTAL CHARGES
WHERE STATE L'\~ REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this pemit
shall not be valiJ 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 Ore~on pertaining to the work described herein, and that NO OCCUPAr~CY 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 701.055 will be used on th:t project.
IW1E(p1ease print) :l7 WI... I'I1tH'a 1:11 SIGrl^TURE Y~J ...._fln/l~G DATE 51-3/-:1':J
V - FOr. O(FICE USE mItt: 4
Units Sq. Ftq. llain
Occy Load Sq. Ftq. Acces5"'5't""......
Occy Group J'S.- -=? Sq. Ftg. Other d'-".A/f ~
6)
~.
Zone_P-L
Type/Canst.
Bedrooms
Stories
BUILDING PWlIT
Charges and
Surcharges ~
PJ an Ck.
___-;::<.&~~~__ ...Q.2!'Blda
Plan Ck.
30%lBl do
::J1~3
,-z,.3o~
q ff(['
x Value
x Value a"=--
x Value /?~. -
TOT^L VALUATION ~_....
Fi re Zone
Flood Plain
.' /- y~
Conm/lnd
Pyr Fpp
Res
Per Fee
Systems Development
Charoe (1.5~) .
#'.~.
PLUt1BING PERMIT
Charges and..-'
Surcharges
Fence
D~mo
ELECTRICAL PERIHT
Cha rges and
Surcharges
'Sidewa 1 k
MECHANICAL PERMIT
Charges and
Surcharges
A/C Paving
___ _ __ _ _ ___ _I Curb Cut
I
ITotal Comb. Permit
I
I TOTAL
799'<7
J/,
\
.
.
,/ ~
.
'.
{
-
.
.
COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
I. Applicant to furnish
A. Job Address
B. Legal Description
1. example- Tax Lot 100, Lane County Map Reference
11 03 43
2. example- Lot I. 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. example- waterheater/electnca(/or solar
E. . Square footage or valuation, etc. -
1. example- 1250 sq, foot house, 500 sq. foot garage
2. example- if new project. check:ruew - if addition,
check: add, etc.
F. Building pennit information:
1. exa~le - construct single family house with an
attached garage
2. example - remodel existing garage into family raam
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
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. ---
III. Applicant to sign and date
Whenever possible. the initial application will be used as
a worksheet only. Where possible. Building ~ivision Staff
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
signa ture.
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
payaple when the permit is issued.
f /-5 c(3
1~~/O~6~
V. FOR OFFICE USE ONLY
Permit Cl erk
C{/
.
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
'.
"
PLANS REVIEWED BY:
name
L4R#E 7}E6Y~
Signature~
"
~.e-?
,
date '7'-/S-.es
. ....,H.
..
....h,.:..D=t
e~
..~quired
'nspeciWns ..
IT IS THE RESPONSIBILITY OF THE PER!lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT THE PROPER TI1.1E.
THAT EACH ADDRESS IS READABLE FROM TIlE STRF.ET. AND THAT THE PF.R.'lIT CARD IS LOCATED AT TilE FRONT OF THE
PROPF.RTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES.
PROCEDURE FOR REQUF.STING 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 reade the same day, requests
received after 7:00 am will be ~de the following work day.
Your City Designated Job Number Is:. ~
Job Address: '27.',. jZ}C>IY~~ ~...v~6""" -;-I;"...--.,
;~;'r7 .6'~r4~ ~n-;-~ Phone: .
Contractor: F~~ ~A?./""""'-::: Phone: ~....,...'..,......,.
D
D
D
D
D
o
D
D
D
D
D
~ITE INSPECTION: To be made
after excavation. but prior
to setup of forms.
UNDERSLAB PLUHBING, ELECTRICAL
& ~ffiCHANICAL: 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
D
D
~
~
FOOTINGS & FOUNDATIONS: To be made
after trenches are excavated and
forms are erected, all steel in
place, but prior to pouring concrete.
l~DERGROUND: Plumbing, Electrical.
Gas, Sanitary Sewer, Storm Sewer,
Water and Drainage lines. To 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 sheating.',
FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to installation
of decking or floor sheating.
o
D
o
o
MASONRY: Steel location, bond beams
grouting or verticals in accordance 0
with U.B.C. Section 2415.
ROOF SHEATHI~G ~~D NAILING:
to installing any roofing.
Prior
ROUGH PLU/offiING. ELECTRICAL &
~~CHANCIAL: No work is to be covered
until these inspections have been
made and approved.
D FINAL PLUMBING
~ FINAL ELECTRICAL
~ FINAL MECHANICAL
~ FINAL FIRE DEPAR~reNT
o
l~
IE]
o
ATTIC DRAFT 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 are
approved.
:=J
LATH AND/OR GYPSUM BOARO INSPECTION: ---,
To be made after all lathing and ~
g)~sum board~ interior and exterior,
is in place but before any Plasteri~--,
is applied or before gypsum board ~
joints and fasteners are taped and
finished.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
WOODSTQVES: 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
asphalt
'SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the ~~erl
Contractor during construction of the
following work. A copy of the special
testing reports shall be furnished to the
Building Division.
:=J
:=J
~
STRUCTURAL CONCRETE: In excess of 3000
t.S.I. (306 a.l)
STRUCTUR~L WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BOLTING: During nil,
bolt installation and tighting
operations (306 a.S)
SPRAYED ON FIREPROOFING: (U.B.C.
Standards 4348)
SPECIAL GRADING, EXCAVATION AND
FILLING: During earthwork. (306 a.11
'& Chapter 29)
:=J
GLU-LAM BEMts: 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 you
wish inspection. All project conditions such as landscaping. parkinc lot striping etc. must
be com~leted before requesting this inspection.
FINAL BUILDING: Must be requested after the final Plumbing. Electrical, ~lechanical 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 premises
SIGNATURE
DATE
* ALL MANHOLES AND CLEANOUTS ~rusT BE .\CCESSIBLE, ADJUS~reNT TO BE MADE AT NO COST TO THE CITY.