HomeMy WebLinkAboutPermit Building 1988-5-13 (2)
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jlNSPECTION LINE
726-3769
CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
E!IERGY SOURCES:
Heat..s::i-: N'y~
Hater Heater~FC7.'. ~
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Ranqe
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Job Address /8B7 ~N~_ 7>A'R..v........_ C=:-AI'<T
Legal DescriPtion/7""~4'2.~_2~ /9~ 7~ "':f/<::>t!>
Owner jt,c,L.k?,p,N ~P~~6'S .jff..Jf/.
Addres;~ _ / ...,...,...., ;iifo"l:/rst;
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Construction Lender
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INFORMATION LINt
726-3753
Sq. Ftq. "'ain~?.p
~q. Ftg. Access.
Sq. Ftg. Other
Xl/ew Add Alter Pep.
-Fence Dl!IlD Change/Use
~Other..c..-~~
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ValUE of Hark:
~9P.-'"
Builtiina Permit Info: Describe Work{i.e.. Build Single
Familv Residence With Attached Garaael
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~F /'~.A.T""<=- _'5~
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Address Phone
OESHil'i TEAr.:! (name) (address) nics. no.l (i=lxnires)
Primary t4'dn ~~~_~ ?~~ /'22Cl:> A( ~~#r:7€,^, ~;.~.-n
Structural
Mechanical
CONTRACTORS (name) (addr~551 (li~~, no. 1 (pYoirp~\
General M.c..f'cBv2/& /" -'ld'...-,..;I?,,,,_ .:::::;;..,.~.8;;:.~ Jv ~~ G~~
Plumbino~N ??~(' ~~"'.~, """uo>e:> fY. _~""'~w..r~/ B<<,6';1S"
ElectricalL.R 1.?,q~~~~. /L:Ju.~/ ~.:<:-~ p. ~~/~~
Mechanic'al /I,t,.'7?~ .{ ~/4:<? ~. . ~6"" A:h~~r ~r
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Electrical
(ohone no. ~
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PLUI.IBI NG ELECTRICAL MECHANICAL
NO.1 I FE'F '.QjARr.F Nn l I ~IT-l.t..1:1A.Wi[ NO. , I ~~Li..c.l:lAB.G.E
Each single fixture Residence of furnace/burner to
":2 70S.!> /s-- SQ. FT. / B~
""'1/"""" f.-XI'. 6,.-
Relocated building ~ New circuits alts. Flooor furnace
(new fix. additional) or extensions -z:u;;;; and vent
--2 <?R ~&
S.F. Residence SERVICES Recessed wall I
(] bath' ~r'lSre heater and vpnt
Duplex (1 bath) each
Additional bath Temporary Construction Appliance vent
'i~oarat.p
Water service Change in existing Stationary evap.
rp~ j ~P..fl"P r.nnlpr
Sewer multifamily, COI111l. or I Vent - fan wi th ;5.-
Tnrluc;:trial sinole duct
J Of amps. :?2-~ Vent system apart from
Storm Sewer heatino or A.C.
Cor~'I.IINO. FEEDERS Mechanical exhaust
hood and dur-f
Install/alter/relocate Wood stove/heater
rlic:.tdh fpP/"h'rc;:
Of amps. ...... G#.S' p/?/,hZ:, <--
ISSUANCf OF PFR/lIT
TOTAL CHARGES /5: ..0 TOTAL CHARGES 7',<;': -- TOTAL CHARGES ~.N:,t;<;;': ....
WHERE STATE L~H REQUIRES that the Electrical work be done by an Electrical Contractor, the electrical portion of this permit
shall not be val11 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 oerformed 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 rlO 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 ons 7P1.055 will ~d ~iS_prOject. .
IWIE(please print) Lq~ 0L?~et... SIf,IlATURE ~~ DATE ~~~ I
Fon orF I CE USE OIlL Y . ( I
Sq. Ftg. rlainJG/:?.o;t', Value 4~......
Sq. Ftg. Access x Value
Sq. Ftg. Other x Value
,... "" ""IOTAL VALUATION
~//~~,;r>~ r"
. syste.ms Development "-,-
:g:;>.Si'-=3 Charoe (1.5~~ 7&'.O>b
Zone~L
Fire Zone
Flood Plain
BUILDING PERflIT
Charges and .....
Surcharges t?'
PLU'~BING PERMIT
Charges and ~
Surcharges ~
ELECTRICAL PERIHT
Charges and U
Surcharges I
MECHANICAL PERMIT
Charges and J
Surcharges V'
Type/Const.~ ~Units
Bedrooms Oeey Load
Stories / Oeey Groupfi'-:Z
CD
~ Plan Ck. Conmflnd
___ZLeS~__~/RldO P.l'r Fpp
Plan Ck. Res
30%/Bldo Per Fee
-:2 -S"'3
_ _ _ -LS- t>t>
~?S
____115: -
"::?-'25'" I AlC Paving
/ c: ~ . I Curb Cut
----Lv~-7.?-1
Fence
D/jRlO
sldewal k
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ITotal Comb. Permit
/3/ .?8'
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I TOTAL
/SZ.""31
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COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
I. Applicant to furnish
A. Job Address
B. Legal Description
\. example" Tax Lot 100, Lane County Map Reference.
II OJ 43
2. examole" Lot I. Block 3, 2nd Addition to
~prlngtield Estates .
C. Name. etc. of owner and construction lender
O. Energy Sources
1. examole- heat/electrical ceilinq/or forced air Qas
2. examole- waterheater/electrlcal/or solar
E. Square footage or valuation. etc. ------
I. examole" I2S0 sq, foot house, 500 sq, foot garage
2, example- if new project, checklnew - if addition,
check add, etc.
F. Building permit information:
I. examole - construct single family house with an
attached garage
2. exame'e - 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 TEAfl AND CONTRACTORS
To ~void design or construction delays, Building
Division Staff must be able to contact appropriate
.~; per:sons 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.
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V. FOR OFFICE USE ONLY
Permit Clerk
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. PROJECT CONDITIONS TO BE SATISFIED 8EFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's 80ard because:
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Additional Project Information:
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PLANS REVIEWED 8Y:
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name L.1JJeNE h.~6 e:?"f
signature ~~~~~Z..Q date .)-#88
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.. Required Inspections..
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IT IS THE RESPONSIBILITY OF TilE PER.'!IT HOLDER TO SEE TlIAT ALL INSPECTIONS ARE MADE AT THE PROPER TIUE,
TlIAT EACII ADDRESS IS READABLE FROlI THE STRF:ET, AND THAT TIlE PERl'lIT CARD IS LOCATED AT TilE FRONT OF THE
PROPF.RTY, BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIUES.
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PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NU}IBER,
job address, type of inspection requested and when you will be re~dy for the inspection. Contractors
or owners name and phone number. Requests received before 7:00 am will be ~Bde the same day. requests
received aftar 7:00 am will be made tha follovin~ work day.
Your City DesiRnated Job Number Is: R~ =")R::?
Job Address: /~7 .&....",:=R ~"'~.A"'''- ~~
Owner: t5'/LL.h1~~ ;t3;.~7'/',;::z:-'i ' ... Phone: ''';-;:;"''7'''' //3C::;
Contractor: hf~.%'E#~/E~h?r?rC/A-.c.. Phone: :?~"3-7/';I":;>
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SITE INSPECTION: To be made
after excavation, but prior
to setup of forms.
UNDERSLAB PLUMBING, ELECTRICAL
& MECHANICAL: To be ~de before
any work 15 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.
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FOOTINGS & FOUNDATIONS: To be made I]]
after trenches are excavated and
forms are erected, all steel in
JPlace, but prior to pouring concrete.
USDERGROUND: Plumbing, Electrical,
Gas, Sanitary Sewer, Storm Sewer,
Water and Drainage lines. To be
made prior to covering or filling
trenches.
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UNDERFLOCR:, Plumbing, Electrical,
Mechanical. To be made prior to
instal13tion of floor insulation,
decking or floor sheathing.
POST & BEAM: To be made prior to
installation of floor ir.sulation,
decking or floor sheating..
FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to install~tion
of decking or floor sheating.
MASONRY: Steel location, bond beams
grouting or verticals in accordance 0
with U.B.C. Section 2415.
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ROOF SHEATHI~G ~~O NAILING: Prior
to installing any roofing.
ROUGH PLlJ1.ffiING. ELECTRICAL &
~IECHANCIAL: No work is to be covered
until these inspections have been
made and approved. _~~ ?JL I.{ 2:...
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1->'1 FINAL PLUMBING
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~ FINAL ELECTRICAL
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[X] FINAL ~IEOiANICAL
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~ FINAL FIRE DE~AR~ffi~IT
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ATTIC DRAFT STOPS & CURTAIN WALLS.
SPECIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the Owner/
Centractor during construction of the
following work. A copy of the special
testing reports shall be furnished to the
Building Division.
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FIREPLACE: Prior to placing facing
materials and before framing
inspectio,l!,' I a
INSULATlrnI & 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.
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STRUCTURAL COSCRETE: In excess of 3000
P.S.I. (306 a.1)
STRUcnJRU '~ELDS: Preformed on tpe
job. (2722 f)
HIGH STRENGTH BOLTING: During all .
bolt installation and tighting
operations (306 a.S)
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LATH ANO/nR GYPSUM BOARD ISSPECTION: :J
To be made after all lathing and
g)~sum board, interior and exterior,
is in place but before any plastering t
is applied or before gypsum board ---l
joints and fasteners are taped and
finished.
FIRE & SEPARATION WALL:' Located &
constructed according to plans.
SPRAYED ON FIREPROOFING: (U.B.C.
Standards 43.8)
SPECIAL GRADING, EXCAVATION AND
FILLING: During earthwork. (3068.11
& Chapter 29)
GLU-LAM BEMf5: Inspection Certificate,
by an approved agency, furnished to
the City's Building Division before
beams are placed. (2501-U.B.C. STDS.
25-10,11) .
WOODSTOVES:
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.
After installation is
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-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.
PARKING DOT: After gravel
place but prior to placing
or concrete.
is in
asphalt
CITY'S SITE PLAN REVIEW 8O~RD INSPECTION: Must be requested 2 days in advance of the date you
wish inspection. All project conditions such as landscaping, parkin, lot striping etc. must
be com~leted he fore 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 premises
SICNA11JRE
DATE
* ALL MANHOLES :\NO CLEANOUTS ~fUST BE .\CCESSIBLE, AOJUSTIfENT TO BE ~IADE AT NO COST TO TIiE CITY.