HomeMy WebLinkAboutOccupancy Temporary 1985-4-2
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SPRINGFIELD
CITY OF SPRINGFIELD
, :iDepartment of Public Works
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*NOTI CE*
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CERTIFICATE OF TEMPORARY OCCUPANCY
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..' ~'Wi nstons Department Store
.,'.,1040 Harlow Road
.-' . .City Job #850075
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Occupancy Group.B.2
Construction Type V-N, Spr.
April 2, 1985
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remporary Occupancy has been granted at.the above address for a period of 30 days
. from the date of this notice.. This certificate is issued pursuant to the requirements
.' of Section 307 (d) of the Springfield Building Safety Codes, certifying that the por-
...tions of ~he building may be. used prior to completion of the items described below.
The .fo 11 owi ng items shall be completed wi thi n the granted 30 day peri od, after
.:' which a pennanent certificate of occupancy will be issued:
STRUCTURAL
1. Provide applicator's certificate for exterior stucco after completion.
2. Complete the roof structure and flashings, in accordance with the approved drawings.
Repair damaged roofing and tiles where.necessary.
3. Provide the required special inspection report for field welding.
4. Complete the installation of roof drains.
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. 5. Complete the installation of.the building signs.
..6. Complete exterior landscaping and irrigation modifications.
Please note that the overhead crane work will not be allowed in areas. of public
access subsequent to granti ng thi s temporary occupancy certHi cate. In addi ti on,
. areas of publ ic access shall be protected from roof construct.ion activity at all.times.
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David J. Puent
Acting Superintendent of Building
Building Official
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Don Moore
Building Inspector
225 North 5th Street . Springfield. Oregon 97477 · 5031726.3753
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WSPECTlON LINE CITY OF SPRINGFIELD
i 726-3769 COMBlilATlON APPLICATION/PERMIT
Job Address / tJ 'It;, iIARl..t:!JW Jl?:> ~~:~r,Y SOURCES:
Legal De<cription / /~-:;:'2-O~ t";,.~ -s~-~ Ilater Meater
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NFORltATIDN ll,'l
726-3753
Sq, Ftg. 1.lain
~q. F'tg. Access.
Sq. Ftg. Other
New Add Alter ~ep.
Fence_Demo _Change/Use
_Other
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Owner .~/~NM/J?r ..uv~L6p~€Alr
Address ?~.~X ~t..-..:./ Phone
.~"':f"-/.lVc;. CA.. 1''9/'')-:Z~.&7/;)' ~lI/~~~/Al6.
Construction Lender . ~D!'j~ p/N4 .
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ValUE of ,I~f . ()O~
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BuilGina Pernli~ Info: Oeser be Work(i~e.. Build Single
Family nesidence With Attached C,araae)
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Address Phone
Ut:.~lliN TtAr.' lname) (address) .flies. no.) Jexnires
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Primary 7~_/' /.... -'^"LA~ ... ~c. /NC. ,~ u Z! ~ LJ~;::::'. c:::AL.
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Electrical
Mechanical
CONTRACTORS
(name)
(address)
nin. nn.}
(pxo;rpc;.\
(ohnnp nn \
Genera 1
Plumbina
Electrical
Hechanical
PLUI1BI NG
ELECTRICAL
MECHANICAL
..J!Q...
FEF rHARr.F ~JO
Each single fixture
Residence of
~~~ r~;RGE ......tlO......
SQ. FT.
furnace/burner to
BTU's
I..E.E..E-. (HARr,f
Relocated building
(new fix. additional)
New circuits alts.
or extensions
Floor furnace
and vent
S.F. Residence
(] bathl
Duplex (1 bath) each
SERVICES
Recessed wa 11
~n~rp hp~t~r ~nrl v~nt
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II
II
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Storm Sewer
V" ~~.P~~~
57N/NK'~~-=';~; 'B7J
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Of
amps.1
Appliance vent
seoa ra. tp
Stationary evap.
cooler
Vent fan wi th
sinole duct
Vent system apart from I
heatina or A.C.
Mechanical exhaust
hood and rlUr"t
j I-Iood stove/heater
Additional bath
Sewer
Temporary Construction
Change in existing
rpCj j qp'.nc:p
multifamily, comm. or
Tnnuc;tritlT
\-later service
COffi1./IND. FEEOERS
I Install/alter/relocate
rlhtl"ih fpl'>rlprc:
10f amps.
ISSUANCf OF PFRIIIT
TOTAL CHARGES
WHERE STATE L~H REQUIRES
shall not be vali1 until the
/It/,- TOTAL CHARGES TOTAL CHARGES
that the Electrical work be done by an Electrical Contractor, the electrical portion of this pemit
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 oerfonmed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Oregon pertaining to the work described herein. and that rlC OCCUPAI~CY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builderls
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 ed t~iS p~. . .
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HAI.IE(please print) c/5?2(.q~_, LL/~P,r_# SIr,rlATU~ (._. _<" ~. OATE :5'-1.7-.$:5'
FO~ OFFICE USE~
So. Ftg. l1ain
Sq. FtlJ. Access
Sq. Ftg. Other
Tvoe/Const.l/f""~
Bedrooms
Units
Occy Load
Occy Group
x
Valut'
Value
Value
TOTAL VALUATION
Zont'
Fire Zone
Flood Plain
x
Stories
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BUILDING PERHlT
Charges and
Surcharges
Plan Ck. Comm/lnd
____________ 65%/BldC1 Ppr Fpp
Plan Ck. Res
30%/Bldo Per Fee
Lt? - I Fence
---- -~ljcP-1 Oemo
ELECTRICAL PERtm
Cha rges and
Surcharges
Sidewa 1k
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Systems Development
Charoe tI.5~)
PLU'1BING PERMIT
Charges and
Surcha rges
11ECHANICAL PERMIT
Charges and
Surcharges
A/C Pavi ng
____________1 Curb Cut
I
ITotal Comb. rermi t
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I TOTAL
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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 uj 43
2. examole- Lot I. BlocK 3, 2nd Addition to
spr,ngtield Estates
C. Name. etc. of owner and construction lender
D. Energy Sources
1. example- heat/electrical ceilinq/or forced air Qas
2. examclew waterneaterjelectrlcal/or solar
E. Square footage or valuation, etc. ~ .
I. examole- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check-new - if addition. '
chee k add. etc.
F. Building permit information:
1. example - construct single family house with an
a ttached garage
2. examyle - remodel existing garage into family room
3. examOle - 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 ANO 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. BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO
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
Pennit Clerk
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PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Infonnation:
PLANS REVIEWED BY:
name Ltf:!!?iV~ H~si~natur~. ~.'~ ..., date3"S"-8"_~