HomeMy WebLinkAboutPermit Building 1988-8-26
CITY Uf SPRINGfiELD
COMBHIATION APPLICATION/PERMIT
'2'- EilERGY ).CURCES:
Job Address /,1$75' ~"'.N~ /':i4RA'WAY E~ Heat~ # VA-<;:::
I.egal Description Wei aht Loss Cl i ni c' Hater Heat~r~~c7' L5B.
I Range
/7..:'5--Z-.2""':$ /9=. ...:---~..t:::?/ao
Valu, of Hork:~ , ,"",\
Owner Hi ~Ilman Properti es "2'2~",&> ~ ~ '0(".1
Address 900 N Tomahawk l.s'. 0 Port Phone 289 1 .a..iI,iina Pennit Info: Describe Hork(Le., Build Single
r. - ..::tQ.mil) nesidence Hith Attached Garaae)
1'~fjLbr 61
~ v /,,,17J -(]~
flies. no.)
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, ~ t:/ C" 0&> ~ /? /;~.. c:r-G>
TOTAL CHARGES Zz,;S"""'-, TOTAL CHARGES T/~. TOTAL CHARGES /y//# a.
WHERE STATE L,\\/ REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this pemit
shall not be vali1 until the label has been signed by an Electrical Supervisor and returned to the Building Division
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I IrISPECTIOII LINE
1726-3769 .
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Construction lender
Address
DESIGN TEAll
(name)
Phone
(address)
Primary DirM- Hi ckman
Structural
Electrical
Mechanical
CONTRACTORS
(name)
(address)
(lic5.. no.)
General Mckenz; p r.n'lllIlf.rr;. 1 r.nntr.rtnro An~ W ?NIl Avp , Fllgpnp
Plumbina Twi n Ri vers Pl umbilnQ 2050 W Bnoadwav EUQene
Electrical L R Brabham 12-C W "a" Street Sorinafield
~'echanica1 Wi l'l._aodl \I !~ratp 1 v,
PLUlIBING
ELECTRICAL
---.lliL
f f f r HIlBliL JlO.
~~~ r~ARUE NO,
g
Each single fixture
Residence of
7.5'6 -<~.s<=
SQ. FT.
IRelocated building
(new fix. additional)
'"S.F. Residence
, (1 bath)
loup1ex (1 bath) each
IAdditiona1 bath
I Wa ter servi ce
I Sewer
I S to rm Sewer
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. ~ New circu~ts alts.
v or extenslons
"'2...::>~ )>?""~.t:
SERVICES,
'2ZSf!:>
Temporary Construction
Change in existing
rec;. i d..e..nce
multifamily, camm. or
TnrllJc;.triill
/ IOf /~
ICOMfI.,INO. FEEDERS
I Install/alter/relocate
ni c:tritL f~pdprc:.
IOf
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1'2Z:S::>
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amps.
amps.
INFOR/IATION LINt
726-3753
Sq. Ftq, I"ain /~tPI!)fP
~q. Ftg. Access.
Sq. Ftg, Other
~lew_Add_Al ter -,~ep.
fence Demo ChangelUse
AOther~"R.""'T'c:
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C-
...:::.
V\
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rexnir~s)
{ohone no.'
;:,1 <,'J,ntl
,,,In
,
(pxoire,,)
(ohnnp nn
6 ~.5..3,9 A-1 -AQ
20-96PB 6-1-89
20-87C 10-88
163::.,7161
683-1414
MECHANICAL
1=1=1=' r~.q&G[
/
furnace/burner to
il u -, ,BTU' S
IT"Hz.- ....."..,,~
Floor furnace
and vent
t;:,!~t -
Recessed wa 11
~n~~p hp1tpr ~nrl vent
Appl iance vent
f.~':l". r~ ~p
Stationary evap.
cooler
Vent fan with
sinole duct
Vent system apart from I
heatino or A.C.
Mechanical exhaust
hood and dUI"t.
IS'.-G.~O
Wood stovelheater
../ C;:;,4-; ?/r,:" '....~
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ISSUANCE OF PfRlllT
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 Derfonmed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Oregon ~ertaining to the work described herein, and that flO 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 ORS 701.055 will be used on this project.
NAf.lE(please print;-K P.V\..ee.\ VIQ..~ $IGN~~f /~
I fO~ OfFICE USE miL Yf
Zone C:r. TypeIConst,.2l?"~~nits sq.~t . 11ain, Value
Fire Zone Bedrooms Occy load /t.!. Sq. o. Access x Value
flood Plain Stories / Occy Group .!::?-2 Sq. Ft;. Othe~..R'$'rEx/.y"'d""Va1ue_Z2~~
tJJt:N~'/iX4L 1Pf~<.oe 4>/V~......,.... 6=;:l7,-5-~ I Ci TOTAL VALUATION
1l.4bl-/~/~~ Sb;-~/O '2=i--~ '(3.'7'0 _"""
BUILDING PERflIT L--" r-O Plan Ck, Conrn/lnd ~'_.., I _gC J ....f..., Systems Development e:> LI.A
Charges and '" ___ "'_~:.-e~__..22!/Rlda Per ree .:...."IIJ C> V<- <- Charae (1.5~)?~ ,,"2, ~<-'
Surcharges do, " Plan Ck. Res r.t:#'-? ~6V/e __ ~C'
7. &~ 30%/Bldo Per Fee -"""'<"""__ _. _ _ . __ ;Q =-=~
I :;7-9. /3- ~~ ~S';:47:Gr7-
S - - - ::=?/~~/ g- - ::e I' , ..
,/ ~~.......... - 9'Y. 57
____i'~~___ Sidewalk I
Y "::<-:<S-- A/C Paving I
~ ----i~::i?- Curb Cut :
PLU'lBING PERMIT
Charges and
Surcharges
ELECTRICAL PERI~IT
Charges and
Surcharges
MECHANICAL PERMIT
Charges and
Surcharges
DATE P.2-I.-.Ef
Total Comb. Permit
71"6. 7~ _
TOTAL
~O/~';I. 5''1
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
1. Appl icant to furnish
A. Job Address
B. Legal Oescription
1. example- Tax lot 100, lane County Map Reference
17 oj 43
2. examEle- Lot I, Block 3, 2nd Addition to
~prlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceiling/or forced air Qas
2. examole- waterheater/electrical/or solar
E. Square footage or valuation, etc. ------
I. examp1e- 1250 sq. foot house, 500 sq. foot garage
2. example. if new project. check new - if addition,
check add, etc.
F. Building permit information:
1. example - construct single family house with an
attached garage
2. example - remodel existing garage into family room
3. exa~le - convert single family residence into
restaurant (chan"ge of use) ".
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. OESIGN TE~I AND CONTRACTORS
To avoid design or construction delays, Building
Division Staff must be able to contact appropriate
persons regarding design infonmation 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. ---
Ill. 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 penmit is issued.
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V. FOR OFFICE USE ONLY
Permit Clerk
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PROJECT CDNDITIONS TO BE SATISFIED BEFORE DCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
name. L&>JZ7#E /2c::z;;g-?f
Signature~~
date g.3h-&'8
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'jequired
Inspeceons ..
IT IS THE RESPONSIBILITY OF TilE PER.'!IT 1I0LDER TO SEE TIlAT ALL INSPECTIONS ARE MADE AT THE PROPER TIllE.
TllAT EACH ADDRESS IS READABLE FROl1 TI'E STREET, AND T!lAT TilE PER.'1IT CAnD IS LOCATED AT TilE FRO~T OF THE:
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES.
PROCEDURE FOR REQUF.STINr. INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUfffiER.
job .3ddress, type of inspection requested and \olhen you will be re~dy for the inspection. Contracto-:-s
or o\mers name and ohone number. Requests received before 7:00 am will be ~Bde the same day. requests
received after 7:00- am will be ~de the followinh work day.
Your City Desil\nated Job Number Is:_ &J;?O~'7
Job Address: /5? 7-5'" Pt/JN~I:'~ PA."JPc.v~ (5:;1"'7
Owner :ffi~.MA-^, .Ac?o~ .//........ ~ $ ~ Phone: 2"g'9- //7Jb
_con.::.actor:~.N:?/E ~~A-?FA>::"~ _ Phone: '=?~-7/~
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SITE INSPECTION: To b. mad.
after excavation. but prior
to setup cf forms.
UNDERSLAB PLUlIBING, ELECTRICAL
& ~IECHA."'ICAL: To be :nadc before
any ~ork is covered.
CO~CRETE SLAB INSPECTIO~: 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.
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FOOTINGS &. FOUNDATICNS: 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.
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 ir.sulation.
decking or floor sheating;.
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O ROOF S!-tEA'!1n~~G A.'lD NAlLINr.: Prior
to installing any roofing.
~ ROm~1-I PLUMBING. ELECTRICAL &
LLJ ~IECHA.'\CIAl.: No ,,",ork is to be co\'ered
~~ until these inspections have been
-1.6- ma~ and approved.
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o FINAL PLUMBING
IT!
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Q] FINAL ~lEOIANICAL
IAI,,\
~ FINAL FIRE DEPART~lE~IT
FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to inst3112tion
of decking or floor sheating.
~~SONRY: Steel location, bond beams
grouting or verticals in accordance
with U.B.C. Section 2415.
D
ATTIC DRAFT STOPS & CURTAIN WALLS.
.SPECIAl INSPECTIO~S: In accordance ""ith
Section 306 of the 8uilding Code a special
inspector shall be employed by the ~~erl
Contractor during construction of the
following work. A cepy of the special
testi~g reports shall be furnished to the.
Build~ng Division.
FIREPLACE:. Prior to placing facing
materials and before framing
inspection.
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INSULATION & VAPOR BARR!ER: 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.
FRMllNG: 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.
In excess of 300:
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STRUCTIJRAL CO~CRETE:
P.S.1. (30b ..1)
STRUCTUR\L WELDS: Preformed on the
job. (2722 f)
HIGH STRENGTH BCLTI~G: Ouring all
bolt installation and tighting
operations (306 a.S)
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---, SPRAYED ON FIREPROOFING: (U.B.C.
---1 Standards 43.8)
=:J SPECIAl. GRADI~G. EXCAVATION ~~D
L4.m AND/OR GYPSUr-t BOARD INSPECTION: FILLI!\G: During earthwork. (S063.ll
To be made after all lathing and - .
b d' , d .' & Chapter 29)
g)~sum oar . lnterlor an exter~or,
~s in p~ace but before any plastering ---, GLU-LAM BE~tS: Inspection Certificate,
~s.app11ed or before gypsum board ---1 by an approved agency. furnished to
JOlnts and fasteners are taped and 'the City's Building Division before
finished. beams are placed. (2501-U.B.C. SlOS.
WOQDSTOVES: After installation is ---, 25.10.11).
completed. ---1
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.
FIRE & SEPARATION WALL: Located &
constructed according to plans.
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PARKING LOT: After gravel is in
place but prior to placing asphalt
or concrete.
*In addition to the inspections
specified hereon, the Building
Official ~ay make or require other
inspections of any construction
work to ascertain co~pliance with
the Building. City or Zoning Codes.
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CITY'S SITE PLAN REVIEW BO~RD INSPECTION: Must be reGuested 2 days in advance of the date YOI
wish inspectio~. All project conditions such as landscaping. parkint lot striping etc. must
be com~leted before requesting this inspection.
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FINAL ELECTRICAL
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FINAL 9tJ1LDING: Must be requested after the final Plumbing, Electrical. ~Iechanical and Fire
bCp3rtm~nt inspections are made and approved. No Occupancy of the premises can be made until
a Certificate of Occupancy has been issued by the Building Divisicn and postcd on the premise
SICNATURE
DATE
+ ALL ~tA.'1I0LES AND CLEANOUTS ~lUST BE .\CCESSIBLE, ADJUSTl-lENT TO BE ~IADE AT NO COST TO THE cln.