HomeMy WebLinkAboutPermit Building 1983-11-3 (3)
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.. RESIDENTIAL'.
APPLI~A~IQN/PERMIT
225 ~orth 5th Street
Sp~;r.gfieZdJ O~egon 97477
auiZd~ng V-;vis~on
726-3753
'7'" aLl
Job !.oc~:i()n.. ~ -, n
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Tc= Lot #
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:Jescribe !lork: '-..
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/6 -2-6 - f!; 2 Value $7. '1tJ'1 .-.r
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Ac!di :icn
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Dcrt;: of ..t,?plicc::icn
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Phone: 7:2-'" -S""I'tM?
Zip: c['7?/ /(
Add....es3
C"".""L '~'_.f) 41 '\1\ ~ y--
Ftumi>ir.g tl VII'- ...........vv\ tt...:t ~.t<:."A.
~lectrical ( f
Mechar.ic::l I ,
Const~~cti~ ~~qr
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Sigr..d:
Date:
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E=:;irocs
Phone
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It i4 ths respcmDibiZity of' ehB per'r.'ri: itoUd!" tc see that aU inDpectiortB are r.:ade at the ;;roper timc# t}-.at &:.cn ::d.t:1Jo6S8 is l"Ba.::.a,;:"
frcnr eM streat, c:nd that ths pC1':'lTi.e ccrrd 1.8 t...x!J.ted at the front of the =,roperty.
"~ui.!.di!"..g J:.vi=i.o:-: 9F:ro!:ed Fl..an sr.c!.Z. rer.t:l:::n on t~ Su";Wing $f.t~ at aLl' times.
?'!?OC~!)Op.~ FOR !,'.'SP!C':'I'll R!'CUES7':CALL 726-3769 (recorder) state your City desigr..:zted J.ol; nur.:bel'~ job adC.zocss~ type of in.3pe:::icn
Z03q'LUl's'Cca a......d :.I.::8'n i'ou :.1i.l.l. be ready for ir.apc::ction, Cont:7"ac:crs or Ot..'ne::'"S 11Cme end phone number. Requ.i:8~8 r6ceit.:.a cs;czot:J 7:00 (:':":
:..~LL be rrcae the same dt::f, reques:s m~ afta' 7: 00 ~ wn:n be r.nde t.1te nat :Je1'kin.; day.
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,'.tECH.~.:I;C,J"i.o' ':'0 be meas :,e;'o1'+4 c:.ny
wr< ::s .:ovcrea.
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.:OCO':'!.';C ; FOV:!D.tTIC:lo' To:,e r:cds
af:er crenches =re a:~atdd ar~
ferms are lrec:~d~ but pri.vr eo
pc:J.rirJ] cC7lcre t..
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V.'.ID?:iG.~'JIJ.'!() P:.t.;\CI::':,
DRA.;.-:IAG2o' ;o:;e r.r:.;e
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um:ER:~cC.q ?~,:','.~r.:G ,'1!."CH).NIC:,:,:
To be ~e J~ZO :0 ~r.3~~L~t~cn ~f
floor ir.suz.C:icn or deckir.g.
PQST .J.,vD 3EA.r.'1: To be r.".aCc pr-:..?r ea
instaL':':ti.cn of l'1oor ir.st;l.a:::on: or
dec<i"t; .
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l..!J ..idrc..:.r.o' :/0 '.JO:"O: ia ;0 :,C a~n:e:"~a
~=i~ =r.C$~ ~r~~ec=i$r.s ~~U€ =~er.
made ;;r.d ~?!""J"ed.
O F;~2?U.CZo' ?!o--;or ~ ?k~;"'.; .~::.r..g
mc=03!""~i.d ~r.d :,cjore lr~r4 ir.spec-
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; ~r F~~~I5r.: ~~3: ~~ re'f~~~:2d af:03zo .
! G?pro:J"::~ of rou~11 ,?LLtr.'';)t.r.IJ~ ~t2C::t"':.~
caL & ~ec;..:v:~aL. AL!. ,:,oo....ir..;
br:z.C"';roo] ~ c;rur:TU;YS~ et..:. .~st .;e
coI'f'1DL.a::cd. :.'0 '.Jar< is :0 oe ccn-
. cea'!~ un::iL :l:i3 1.nsr:ecticn r.as
. been .~~ and apPl"'JTled.
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:71 '.....IA' pr'I~<I:Ir"G
I .I.. w .."'..U~.,
lour City.Desigr~tcd Job lVumb~ Ioo'
0"1NSi..TLri'!'ION/VAPOR 8A.QRIZP. I.~'SP::CTIONo'
To be !T.ade after aLL insuL.::::i."n ct"'..a
. _ required tJapor bar!'iers are in p lacs
Cut befors any Lath. gypfl'l.4r.J board or
wLZ. covering is C?pli.ed~ and befol'B
ar..y inculation fa conceaLed.
r::I,,'ORY".JALI; nlS?::CTIi);I: Tc be roods
L:::::J aft€l' .aZL dl';{wal.Z is in pLace~
but prior to any tapir.g.
O NASONt?Y: SteeL location~ boiui
beam3~ arou;-ina or vezo~icc.!s in
ac~o~ce with V.B.C. Section
2415.
~ODSTOV::o' Aftezo instaLlation i8
ccmpZ.at~d...,.
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o
CURB & n'PROACP. AP.~N: After' forms
are ere~ted but ?M.or to POU1"";ng
.::on::reta.
SIDEr'ALK & JRnT'tt"A:!o' For all ccn-
~ete pavi~ wit~in ~trect right-
oI-wcy~ to O~ ma~e a;tar aZ! e:ca-
vati.r.Q' ocrrrotete ,j ;"'o~ work & ZuD-
base .::.:cte~;aL in pla::e.
I02.'-.'Qc".iTIO!! OR .~:Ov=; 3UI:'DI:J.CS
~ Sani ~ Be'..Jer capped ::: r:.opo:rt-~. Li:-:e ,
~ Septi~ ~k ;r.J?d a:-.d f~Lla.d vieh ~;"J~
:J Pin;:L - :IJum ~~e -::~e.':'lS ar~ C::$.~t.tcd
ar~ ~hen d~l~t~or. t.a c~~.te or st~~~-
ture movea and pr~3es cle~r.ed ~?
I NobiZe Hc.-r:es
~ alocki~.g and Sat-:J.p
~ PLumbing connections B&Wer and wa;-.r
~ ElectricaL Ccnr.ection - BLockir4~ set-up
---1 and ~Z.W1lbir.c ccnr.ections nr..:st =8 Q~r~l.'.c
before l'equest~r.g e!ec:JM;c!J.l. ir.B?ec:io~
=:J Ac::essoro:,. sui !ding
] Fi~..:1.L -' ~1ft~-r ;:;rcr.es ~
etc. .are c~ple;.d.
skirtir.g~ ~ec;".s.
o
o
ITIVC'2: Wher. c::ompL.t€ -- Provida
gates or movabLe sections through
P.U.;;.
o
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-;:1 :;or'",
~ ...."'-
ALL project cor.di=ions~ auc~ as :he ~r.s:a~Zct~on of street :rees. ca~!at::o" ~f :hs
required :.an:::.'3oc:pir.q~ etc. ~ must :;e saci.sliad bo::jol'Q :r... 3UIL::INC FI:!AL ::an !;e r.2lf'.l6st:d.
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~Lacc~~aLJ and Necna~~c~~
Sui~ir4 :napea:ion .~.lst be !"equ6Gtad af:ar :r.a F::nal ?!~~illJ
Ir.spec::i.ona ;~a been mad~ and cpprou~i.
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....- '.""Rl"'r::-<:" I'VD C'"AVQU'f'~ "V". 3" 'C....:-S.-3L:- ''''J''S':'''''<:;-''''' ""03" "1C::- .'~ "0 ^'ST .. rr""v I ::I......
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I HAVE CAiiE~I;'VU,Y EXA.'1L'IED t.~ compZeted appu'catw" f01" ?eZ"mi:~ c:nd do
hereoy certi.fy thet al.Z. in,""o:'r.'"ation hereon. is true ar.d CCl"!'CC:, and I I
f.JJ'tl:er oer<ij"y tl:at any ar.d aLl ,,;ark perfo=ed shaLl b. do"e i" co'or- '~
danc9 :.rith ena Ordin....'7tCes of' ths City of Spl"";n.gfid.d~ and tit: La-..;s oj th3 ; j
St.:lta of Oreg"" p~r':.::ining to the work desC'!""~bcd hel'ein~ a'.d ;r.a::: .va OCC:1- 'Ii
P.~!I~l :.1iU o.a ,~.:e of W:Yf. 3t:uCt"'..tr~ !J7ithou.t parmi3J~Cn "L the ::1J.~Zding r::- f;.t
~~~~~nc; ~~~ '~~Sc~~~~O~/~~ft~BYU~~~t~~:;~: ~oj~ ~yee3 ~r~ ere U~ \:
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Data
.
.. RESIDENTIAL'.
APPLICATION/PERMIT
225 North 5th Street
Springfield, Oregon 97477
Building Division
726-5753
Job !.oc",ion: 72- e:r A f) IA /'.( V
A....om Xap N \1 ('{) ~~ ~L.\'
SzdJdioi.icn: fU c/.cJ'1 Z I .p -I-/. I i I. <:
f
SPRINCFlEl.C
.
Rece";:;)t .ii
B&/C? C/q
:
Ta: Lot 6 ? u,(Y')
",~-n..: S i -L\.Je g lA. V K.-e..t+
Addrm: '/).. "( ~ yJ oU~ y
I I'
City: ~/'n "K;.-fl e. let>
Describe r-'ork: .........
~~.
n.o~. ~ I
~/~_..,~
~~
~~
IrJ-;u, -~2 Value 417. 7"1 .-r
n
n
"1......1
At!d~:iCl1
~RGmOdllt
n ....z '
,.ao.... II ..O~3
Dccell of A?plicaticn
(;o7l:raC:O:'8
Pr.one: 7-;;"~ -S''1tbR'
Zip: cr '7Q'1 ')
Add."'es3
GcrntraZ ~ ~1) l() 111 ~ y--
PZumbing /).11 fI.~ t,c;( ~~ ~
Electrica l { (
",'a"hm:ic" Z I /
CO'lStl'"'..IctiC?t !.~tl7'
o~j,,&~ ,qL\q
\j \\'~ t\ f; to
~
Siqr,ed:
Dato:
Iv
1/. ~~S<<
Liac..ii
E--:iircs
PhOl1~
!~ is ':h8 r8sponaibilit:y of ehs pe~t: holde to 886 that aLZ i1U1pections are r.:adfil at ;hs proper ;i.m~, that ~c;, .::ddres8 is r5'a.:::a.;~"
,li*cm eM serest, end that the permit card is z.xated at the frene of ells property.
.3ui!.dir'.q jit)'i=w~ ~p1"O'I;ed plan sr.c.H l'ma-::n on tho Buf.Zding Sit:; at all times.
P.WCED('P.~ ?,OR INSPEC'!'I~" REQUEST:CALL 726-3769 (recorder) stata your City iesigr.:J.ted job 1t"~berJ job wid:!'css, typs of in.7pi'c:icn
1"':JqUs8ted a......d :.;::en you :.;iLl be ready foro ir.spcction, Contractcrs at' Q.,'nsrs ncms av1. ~hone rru.wa. Requ.~8:8 receil;llfi ce,;cre 7:00 c::
:.'iZl. be rraao the sarr:s deb requests mt:de afta' 7:00 an wizz. b:z r.ru18 t.":e n='t ~rkin.; da-:j.
<631..-.\"13
~Rm!i~P1 T~~~~~~~~~
r:-:::y"SITE !!lSP!~IO:l: To-b.-ncd_ -J.'.....
~ ~~~,-~u~.p~0?~.8e~.up.of
f:mns.
O UNDERSr.AB ?!.l','.{BI.'IG, ZLZC":.'?IC,lL 1
j'{ECHA:IICAL: To be made beJortl any
1J01",lc is .;ovcred.
o
FOOTING ~ .:'OU:!DATIC.'I: To be ."rade
aftsr :renc~e3 ~9 e:cavat~d ar~
ferm:; a.re erectad, but pz-:..vl' to
pcurir.g ccncret~.
o
U."!OS?iG.'o/JU.'.'D P:,r..;,\f3I;'l~. S-U"F:R, ;.T.l?'!'.=:',
fJRA....-.'JAGE: 7'0 ae r:r:.is ?ri.or :0 /i~-
l.ir.g :rencr..8s.
O UNDtRF!.CC.q P!U.'.S~:G ~ :'.fECHANIC:o!.:
To be mads prier =0 in3t.=l.Zat-:;on of
J100r insui:cticn or dtlcking.
D PaST AND 3E:AN: To be r.-.aCc P"r"';Ol' to
; instaLl-aticn of j"7.oor ir.sz.:Lation 01'
deckin,;.
I. .Jt~r.'-'CH ?'!.~~f3!.'}C_ ?1:EC"':'_l?!C;'~ ~ .'.fEe.!/.-
., ANTO.r.: ;'10 '.JO!''': ia :0 bc cOt.'e:oea
~:~~ thcs~ :r~~ec:icr.s h=v~ =eer.
r.:aCB iInd =??:O:i"Jed.
D F_".'."". ['C_".' .""". '-r '.
_ _M .......... ?tc:i"'.g tc.C";r.g
ma:aMai.d :1ro.d b&f'orB frcr.ri.r.g inspec-
tiol':.
[2]~l).ur'Ir.. ',,",_... 1.a -ac:".'-ed a:' r
. t1I" ...:."Io.~. ... ,.,........ >J . -.... J ",Ol
i approv.::! of rough p1.L.r.-.bing, Ollecer-i.-
cal & mechanical. All !'Oofing
braain.g & ch~ys, et.;. .':T'..St .!iB
caf1TD lated. ;':0 '..JOric ~8 to os con-
. cBc:ZQd un:-=: l this insoec:icn r.as
'b40e'1 madQ a.nd approved.
~I.'.r p'U'<Dr"G
~ ~.~~ w '~~_;'
~!:IAL NE':EA.'IICAL
~~AL ![.EC':'RICAr.
lOW" City. Dssigr.ated Job Numb...'" In:
r:;:t"1'NSULATIO.Y/VAPOR BA.qRIER INSP-=CTIOlI:
~ To be rr.ad.a (lfter aL1. insul.;;,ti."n w.a
'. l'cqu~red vapor ca:1"1""';ers are in p lacs
cu,t before any lath. gyptr.ml bccrrd or
r..t:lz,z covering is applied, and befors
any irwuZation fa conceaZed.
r-::I--'DR.Y"....ALl; INSP::C'!IO,'/: Ta eft ,"!!ade
l!:J after aLL Cr;/lJaLL is in place,
but prior to c:ny tapir.g.
O ''!ASONRY: 5:0:8l location~ bcmd.
oeam3, grou..~ng or verticcls in
accordance with (j. 3. C. Section
241$.
WOODSTO"IE: After installation is
acmplet€d. ....
D
o
CURB & APPROACH AP'=!f)rl: After' forms
are erected but prior to pouring
.::on.crete.
SIDEr/ALK & [JRI'/Ffr'A"!: Fo'!' all con-.
crete owing !Jithin street nah:-
o[->.Xy: to be mads a;~ter aU e:.ca-
vatir.g ct71TpZeta & fo~ t.XJ'!'k & ,nw-
base :~teri.al. in p~e.
r DEt.1OLITIOH OR .~:QV=; 3UILD!iiGS
=:J Sarti:ary 86"..1er ::a:pP6C .::t ;n:.opcrt'i ti!';Q
:=J Septi~ tank ~~.d ~~ f~1.lad wieh ;r=~J~
=:J F-:.nal - :l'um c.Xve ite.":'ls are cc-"m:Ilatcc
. .J '.' '. 4 ~. ~
ar~ when _e.~c1.~..~on ~8 coept..s..e or s...~~-
turs mouea and pr~3ss c1.Qanea U?
Nobi. 1.6 Hc:":,;es
~ alocking and Sat-~p
~ Plumbing connecticns sC:Jsr and watOlr
~ Electrical Canr.ection - Blocking, set-u;
..-J and rJlumbina connections m-~st cs o~rct:.c
befo~c request~r.g s1.ec:M.cal ir.SPBC"::io~
=:J Accesso:r:,.' 3uit.d~ng
---, fir~l ....t.ft~'I' ;''I'e~es,
~ etc. are c~le:.d.
skirting, decy.s,
D
D
:'E,'VCE:: When aomp1..te ...- Provida
gates or movable sectui71s through
P.U.E.
D
All project aor.di:ions, JUC~ cs :he ~ns=a~Lct-:.on of s=1'eet :rees. ac-~Za;~~n of ehe
required landscc;piro4, ~tc., must ;;e sat-:.sfied oO!jore t;..6 3[,1ILDING FI:!~L ~an be rZq'.Isse.:d.
D
~'1Ar. ~:JILDING:. Th~ F~na~ Buil.ding !ns?eation ,':;Ust be requ.Qnted c:.t":ar ehe Final nur:bing
'C.J !lecc'M.cal, ana NQcnar:....cat.. Inspecti.::ma hava besn made and approved.
,
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10-...
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"A;C NANHCLES AND CLeANOUT5 ,'tUST 3e ACCSSS:3LE, ..tD,jt/S7'::~:I'!' :0 Be ".~1CS :tT .':0 :-:ST 'I") CI'J'!
of 2
I JOB NO~~?\'l"5
1,O>':e: V-t.
ILet Sq. F"d.
: ,jf l..:;;t; C.:roerc:qi:
.~ of StOl""';es
Total .:IeiGht
I
Topoqra;:hy
jif"'lr;''.J
I~~:~
I S~. F~G
l~aC'R
I
I Car:,cl'~
I .' I
1.-lCCCSS.:J!'''.J
'Ill!.:l'~\\ "~"'0Cl. <:>",I.Jl. \~-:>-.
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TOT.~L VALUE
Is. D.C.
II.'Ct.;.U;)
1.5 =
Sui 'Ldir.g p~ t
State Sla'charge
Total cr;,a.:"ge3
I 17I.~ .
!'i--r:ures
I ReswantiaZ f1 beth)
I Sanit~ry Se'lJel'
I ;';c:.tu
It>.f\c\'~\r" \\:>.\ ~
PliJl1fbing Pe1'r.':i t
State Surcr.a...~e
T~tal. C1u='!'oes
~ :'1'::.\1
.~es. Sa. fto.
Ncw/E:::tend CirC"J.its
Temporary Service '.
I
Ele~triaa! Permit
State Surcilarae
Total O.arces
I ITI.~
F'urr..::tCB ETU'S
E=haust Hood.
I V07tt F:::n
I .
I iloodsto:JB
Mecr.anic.::.l Permi t
State Swocht:::!'ai;
'!'nt;(':l Chz!o'U!s
SOLAR aESS
OCC"J.::ar.C:J G~J.=': '\) - b
x
I NO. ,
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FIT
LCT:'fP~
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~ .r.:en.cr
Corner
Panhandle
CUl-ae-sac
Value j
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I....\~."\U> ,.
C;':AR.GE
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\ I\(),CP I \D. CO
I\D.CO
1 .L..\[)
I \().40
I.va., FII I
1\~.dJ I \S. cC
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-- 2tJCRCACHNE::T --
I ;Ie. i ?SS
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'~~\-'t'lI., 1\ 1(0,00 I (" .00 I
~~\\}\\<to\llI\J)>IlIli,\- IO.llOl
r \C).DO I
"-\t> I
\C\ . L\C:> I
! Sec.cI"";tlJ
IStort:.qrz
Da=:03i t
Maintenar...:11il
P~t
To"tal. C'''.al'~CS
I C'..a-,;c-.l:
I side!Ja.l~
I :cn:::e
I
I Elea~l'ica l r.;.oe z.
! :>lobi Ze Home
I Z'QTAt ANOU.'lT DU~:"
CHARGe
\~.OD
,(.,0
\'::\. bb
CHAR.;JE
':\ .00
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REQ~=~e~. ~. I ~.
T:r:JeICo~.st: ~- '" Eec.roorr:s: ~
Cot Foces . ~ ~,\ \?r.\'T" - I r Iner""" 5our=ese~ Of" r
Setb:2cks I J .~'ea:
I House I Caraae I A.ccess. ! I /lateI' 111'_'1":;0.'"
I I Range
I 1 I F~l'eolc.ce
I : : Wooaooo"e
L -CO G";:
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I P,L
If/ol'tit
IEasr;
S01O.tn
West
Tu-:.e
Fees
Building Value & Permit
This perm-:.t i3 gran.ted on the express condition tr.a.: the said, constl'Uction
shall. in all 1'8S?CCtS3 conjcnm to the Ordinance ~dopted by the C~ty of
Spr>";.,...afield. inc!ud--:'na the Zonina Crd::.nance. l'eaiilc.:ir:a =r:8 ccr.str'~~c::cn
and u;~ of buiZdingsJ~and m~y ~e~suopended or r~vokac ~t cr.y ti~e upon vie-
lation ot' any pl'ovi:sions ol said Ordir.ances.
I Plan Check
I Date Paid:
IReceipt #:
!Sig>:ed:
Plumbing
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Permit
Fee:
No person shall construct, instalZ, a!ter or ehangs GnY r~ cr e--istir.g
plumbing or dr~inage system in ~hole or in part, ur.less su~h ~erson is tr~
legal possessor of a valid plumber's licenss, except tr~t a pe~son may do
plumbing work to proper"t":I which is owned, LQa8~d. or operated :,y thQ appli-
cant.
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Electrical Perm it
Where State La:LJ requires tr.at the eLectrical work be dene by an SZectrical
Contractor, the electrical portion of this p8~t shaLL r~t be valid untiL
the labeL has been signed by the Eleetrical ~ontractor.
Mechanical Permit
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I HAt/!" CAREFULLY EXA.I1IN~D the completed application fol' ?e~i~. C?Ui do
hereby certify that aLl. i,-;fo;"r.'.ation hel'eon is true and C01"1'cct, and I
fother certi{y that any ar.d all I;;ork perf'omred shaLL be do718 in ac~or-
dan.c9 :.lith the Ordin:;maes of ths City of Springfield, and t:h~ Lc..,:s of tr.a
State of Oregon psr~ining to the :.x:lrk desc:-;bcd herein, c:nd :r.a:; .vo OCC:J-
P.~;'lCl :..rill be ,~.:ie of any st:-uctuz>e without parmisJion. of the 3ui.!ding Di-
vision. I fu:t'"';her cel'tif~ th.at o:-t~y ~ontra~;or8 ar.d e:::p?..;yees r.:r.o ars in
~Z~nce with cns 101.055 wiZl be used on this projzct
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