HomeMy WebLinkAboutPermit Building 1987-10-27
CITY OF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
E!lERGY SOURCES:
Meat
l'later Heater
Range
Valu€ of Work:
Phone
I name I (addres~) f1;c~. no.l (exn;res)
/:Z~~/lI, (;/~n<py,J/"""L=--~Y.JO
, Primary "f},dwn ,t,/.vA'h>i.IVk~ ,#=/~ P--!??l<A-t<'l? ~~. <??2{.7
'- ' . ..,' '-2"" ;;r.<F. jh/~<~ :S7:"
Structural}lJ,-R'<.-'/M","'E.-:? E~ /~4. .~Z2"'L"'^'L?~h'.97~Z
Electrica; M. f:/.A /H.c l::~.!D#~.~'2/4'
,
,rI
Appliance vent
Sfloaratp
S'tationary evap.
cooler
Vent fan wi th
sinale duct
Vent system apart from I
heatino or A.C.
Mechanical exhaust I
hood and dUr't
I \'/ood stove/heater I
137.~ '26 ~:s 4YM!<=7~
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TOTAL CHARGES /75:- TOTAL CHARGES / '3:5:"-'" TOTAL CHARGES /6"9 A&>
WHERE STATE L'\W REQUIRES that the Electrical work be done by an 'Electrical Contractor, the electrical portion of this permit
shall not be vali~ until the label has been signed by an Electrical Supervisor and returned to the Building Division
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1 INSPECTION UNE
726-3769
Job Addresslg+'/_/~9 R~~.R"""'-Y CAx7'"
Legal DescriptionI7."'~'24''23 /'9""".'2-':>" '2/~
Owner /I/L.LMAN J1?e>:P N"""'THs-vE:aT
Address~ "or ,_ 'T> Phnne
7A1!> nt, /...."-..."",,V ,., - L/:z;(', ",:::s?- ';'1:/
~&?r, ..~"., I'?R 977,/7
, ' -;;
Construction lender
Address
Ut~IGN rEM
Mechanical , '
CONTRACTORS In~1
General f.LA~n ,Hu""X'<!"
(address)
U~7',
,
Plumbina
Electrical
Mechanical
1't.m1lI1NG
NO.
IT" CHARGE-"o
Each single fixture
Residence of
Relocated buildiR9
(new fh. adllHional)
S. F. P.es i .....,
(1 bath)
Duplex (I batlJ) each
New circuits alts.
or extensions
SERVICES
Additiooal bath
,
INFORlIATlDN liNt
726-3753
Sq. Ftg. I"ain
~q. Ftg. Access.
Sq. Ftg. Other
New Add Alter Rep.
Fence_Demo _ Changel Use
_Other
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Builtiino Permit Info: Describe Work(i.e., Build Single
Familv Residence With Attach~d G~r~o~)
C..-:?N"i7'7'<'''_~.''' <:".{. 9""<<=' 15.:!ll,.,r:r. G5.~
~N7~__",~<<-/<.-:-.,,--,_~ e;;~..F"
(ohone no_}
-:?~:<r'--::;>-::>~
? :!..'-O?/7
"7"'3 V-O~".r$4
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n leS. no.)
(pxoirps)
(ohnnp M, )
(~)~.7E'-~l,/~V
/))1 vfliOU
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ELECTRICAL
MECHANICAL
CC~...c.HARG.E. "In
eer 1..c.J:iARG.E.
SQ, FT.
furnace/burner to
'2~ ""~~ BTlI's
Floor furnace
and vent
:;.-15(;.. '
Recessed wa 11
~n~rp hp~tpr ~nrl vpnt
,
''Ia' I/ater service
~.o J Sewer
/tJ~
70
Temporary Construction
Change in existing
rpc;. j de.nr:p
multifamily, comm. or
TndlJc;.trii'll
/
Of /'2"0_
Storm Sewer
CDMM,/IND. FEEDERS
amps.1
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(175<:
I
l'Install/alter/relocate
dic;.trin_ fppdprc;.
/ IOf '2 Z") amps.1
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ISSUANCF OF PFR!lIT
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 .antl the Laws of the State of Ore1]on pertaining to the work described' -.....:.;". drill... UO OCCUPAUCY will be made
of any structure without the permission of the Building Division. I further cer. . registra ion ~. h the Builder's
Board is in full force and effect as required by ons 701.055, that if exempt e ba is for exemption 's 6 ed hereon, and that
only subco~tractors and employees who are in compliance with ORS 701.055 . 1 be use on this pr je
SIGtlATU r --:I< ~
FOP. OFFICE USE ~ - ./' '
Sq, Ftg. Ilain ~. "9c!J.e:>
Sq. Fta. Access
Sq, Ftg. Other
NAI,'E(please print)
F~vf.",k
Ut<.--e
Tvoe/Const. 31'.. ~ Units
Bedrooms Occy Load
Stories / Occ'y Group 8-2,
t/::;;c- c.-sz:>.:: ?<> 7
_ I "'" Plan Ck, ConmlInd
~~JL'?.B-~:'__ 65%1Bldo Ppr Fpp
Plan Ck. Res
~;7e>"~G> 3D%/Blda Per Fee
L Z5"."'" I Fence
---- 8~'-i5-1 D~mo
1'35:...e> I Sidewalk
I-j. _n_ -:i.-;75--1 A/C Paving
/62..'-:> I Curb Cut
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Zone
~~
Fire Zone
Flood Plain
BUILDING PERMIT
Charges and
Surcharges
PLU!~BING PERMIT
Charges and 5
Surcharges
ELECTRICAL PERmT
Cha rges and
Surcharges.
HECHANICAL PERMIT
Charges and
Surcharges
DATE /tJ-.Z'7'~:
x
Value
Value
Value
x
x
r
(5<0"6 ,/08 ~
9?.e?"''''L>
\ -
"" TOTAL VA)rUATION
Systems Development ~"'::;~b'C)
Charae (1.5%) \ 9;:>0<:"90
,
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~~\ ----
L: ~ Total
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I TOTAL
Comb. Permit
502.7S
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COMBINATION APPLICATION/PERMIT (CAP)
I. Applicant to furnish
A. Job Address
B. Legal Oescription
1. example- Tax Lot 100, Lane County Map Reference
1/ uj 43
2. example- Lot I. Block 3, 2nd Addition to
sprlngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
"I. 'exam~le- heat/electrical ceiling/or forced air Qas
2. examDle- waterheater/electrlcal/or solar
E. Square footage or valuation, etc. ------
1. examole- 1250"sq. foot house. 500 sq. foot garage
2. example- if new project, check new - if addition,
check add 1 etc. ' .
F. Building pennit information: .
1. exam~le - construct singlE! family house with an' .
attached garage
2. example. remodel existing garage into family room'
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, 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
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 anp return it to the ..'
appl icant at the time the actua'l 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 per.mit.is issued. .
V. FOR OFFICE USE ONLY
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
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If'
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PERMIT VALIDATION
10 Lh__3
t o--;)'7-~1
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Permit Clerk
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information: e:t)cd;:r 4.4?#:!??C>b"?D .re..??
~7TA'C#e=''z:> ~7:~J.i-___;; '7" ~~?rCF:.
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PLANS REVIEWED BY:
name LtJP.Ntf:" l::c&:iEiR
Signatur~-"""'_~~ date /C)-S--8-;>
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I ...,~"LD
Lit-.
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, '/ IT IS THE RESPONSIBILITY OF TilE PER-'lIT HOLDER TO SEE THAT ALL INSPECTIONS ARE MADE AT TilE
THAT EACII ADDRESS IS READABLE FROII THE STREET. AND THAT TIlE PERl'tIT CARD IS LOCATED AT TIlE
PROPERTY. BUILDING DIVISION APPROVED PLANS MUST BE ON JOB SITE AT ALL TIllES.
..quired
.. 73v/(,2)//y=;' ;1-'
Inspec.ns ..
PROPER TUlE,
FRONT OF THE
PROCEDURE FOR REQUESTING INSPECTIONS: Call 726-3769 (recorder) state you CITY DESIGNATED JOB NUMBER.
job address, type of inspection requested and when you will be reedy for the inspection. Contractors
or o\mers name and phone n~~ber. Requests received before 7:00 am will be ~ade the same day, requests
received after 7:00 am will be ~de the followin~ work day.
Your City Designated Job Number Is: 9"/072 &
Job A<!drcss: u:?Y'/-1.!?&9 f}f?~Z? A~V"W-A-~ ~d, T
Owner:#~,{.J'~ "" ~~7/.E!'> /(/.IC/. Phone:~SX_<;I///
Contractor:L.UWD 7bw~.c( c::;~~. Phone:hCl!:')g;>8-~~~~
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CONCRETE SLAB INSPECTION: To be
made after all inslab building
service equipment, conduit, piping,
accessories and other ancillary
equipment items are in place but ~
beforo any concrete is poured. ~
FOO~S a FOU~ATIONS: To be made
after trenches are excavated and
forms are erected, all steel in
place, but prior to pourinr co~c~ete.
USDERGROUND: P~lng, ~lectrrt'k:r, I:;)...
Gas, Sanitary Sewer. Storm Sewer, Ix I
Water and Drainage lines. To be
made prior to covering or filling
trenches. Ixl
UNDERFLOCR: , Plumbing, Electrical. to
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..
~~SONRY: Steel location. bond beams
grouting or verticals in accordance I _vi
with U.B.C. Section 2415. ~
ROOF S~ATHI~G ~~D NAILING: Prior
to installing any roofing. ~ ~
ROUr.1I PLU~mING. ELECTRICAL 8- ~ J I
MEC!lANCIAL: No work is to b covered
until these inspections hav( been
made and approved. /
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F?:1L PLU~IBING (f\:;J CIT.Y"~ITE PIAN REVIEW BOARD INSPECTION: Must be requested 2 days in advance of the date you
~-,wiSh inspection. All project ~onditions such as landscaping, parking lot striping etc. must
be com~leted hefore requesting this inspection.
O StTE INSPECTION: To be made
after excavation, but prior
, to setup of forms.
f"Vl/UNDERSLAB PLUlIBING. ELECTR1CAL
l.!ld & ~lEC~~'ilCAL: To be made before
/ any loo'ork IS covered.
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FLOOR INSULATION & VAPOR BARRIERS:
To be made prior to install~tion
of decking or floor sheating.
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FINAL !HJILDING: 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 Divisien and posted on the premises
FI~AL ELECTRICAL
L{q
lxl FINAL MECHANICAL
~
I )'1 FINAL FIRE DEPARTIIENT
SICNA11JRE
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ATTIC DRAFT STOPS & CURTAIN WALLS,
,qPF.CIAL INSPECTIONS: In accordance with
Section 306 of the Building Code a special
inspector shall be employed by the O~~er/
Contractor during construction of the
fellowing work. A copy of the special
testing reports shall be furnished to the
Building Division.
FIREPLACE: Prior to placing facing
materials and before framing
ins~ction. /
INSULATION & VAPOR B~R!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.
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.
In excess of 3000
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STRUCTURAL CONCRETE:
P.S.I. (306 a.')
STRUCTUR~L WELDS: Preformed'on the
job. (2722 f)
HIGH STRENGTH BOLTING: During all ~
bolt installation and tighting
operations (306 a.S)
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LATH AND/OR GYPSUM BOARD INSPECTION: :J
To be made after all lathing and
g)~sum board, interior and exterior.
is in place but before any Plasteril18:J
is applied or before gypsum board
joints and fasteners are taped and
finished.
FIRE G SEPARATION WALL: Located &
censtructed according to plans.
SPRAYED ON FIREPROOFING: (U.B.C.
Standards 43.8)
SPECIAL GRADING, EXCAVAT!ON AND
FILLING: During earthwork. (3068.11
& Chapter 29)
GW-LAM BEAHS: Inspection Certificate.
by an approved agency, furnished to
the City's Building Division before
beams are placed. (2S01.U.B.C. STOS.
25-10.11) .
WOODSTOVES: After installation is
completed. q '"
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SIDEWALK & DRIVEWAY: ~qUired 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.
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*10 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.
PARKING LOT: After gravel
place but prior to placing
or concrete.
I
is in
asphal t
OATE
. ALL ~tA.'HOLES !INO CLEANOUTS ~lUST BE ACCESSIBLE. ADJUSTIlENT TO BE MADE AT NO COST TO TIlE CITY.