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Home My WebLink AboutPermit Building 2014-4-23 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 ♦\ Phone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00571 www.springfield-or.gov permitcenter @springfieltl-or.gay PROJECT STATUS: Issued ISSUED: 04/23/2014 EXPIRES: 10/20/2014 STATUS DATE: 04/23/2014 APPLIED: 03/18/2014 SITE ADDRESS: 1980 MARCOLA RD,Springfield,OR 97477 SCOPE: Tenant Infill ASSESOR'S PARCEL NO: 1703251301500 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Tenant improvement for phlebotomy clinic-Group B occupancy OWNER: TRI-W GROUP LTD PARTNERSHIP Phone Number: ADDRESS: 100 SE CRYSTAL LAKE DR CORVALLIS OR 97333 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type • Lic No Lic Exp Phone General Contractor DORMAN CONSTRUCTION INC CCB 68801 08/31/2014 541-984-0012 INSPECTIONS REQUIRED Inspections 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. 1600 Ceiling Grid Ceiling Grid: After drywall approval but prior to cover. 1710 Fire Sprinklers 4999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the . Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street,that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. ATTENTION: Oregon law requires you to 4. 2-3- Zieftiflow rules adopted by the Oregon Utility I Owner or Contractor Si afore Notification Center. Those rules are.set forth 11-11b Ytlilul anALL EXPIRE IF THE WORK Date in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). .Springfield Building Permit 4/23/2014 10:32:42AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD • 225 Fifth St �` EGON TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-S P R2014-00571 www.springfield-or.gov 1980 MARCOLA RD permitcenter @springfield-or.gov RECEIPT NO: 2014000896 RECORD NO: 811-SPR2014-00571 DATE:04/23/2014 [DESCRIPTION ACCOUNT CODE/TRANS CODE ; ,_. . AMOUNT;DUE. Building Permit Fee 224-00000-425602 1002 711.77 Fire, Life, Safety Plan Review 224-00000-425602 1077 284.71 Planning-Minor Review-City 100-00000-425002 1231 119.00 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 417.83 SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 856.09 SDC: Total Sewer Administration Fee 719-00000-426604 1175 63.70 State of Oregon Surcharge(12% of applicable fees) 821-00000-215004 1099 85.41 Technology fee(5%of permit total) 100-00000-425605 2099 35.59 TOTAL DUE: 2,574.10 PAYMENT TYPE_ PAYOR CASHIER:JLARSON _ _ COMMENTS AMOUNT PAID Credit Card Peace Health 2,574.10 002852 TOTAL PAID: 2,574.10 Structural Permit Application SPRINGFIELD � DEPARTMENT,USE'ONLY S1a .,ma,, , n CITY OF SPRINGFIELD, OREGON ta °"'' Permit no.: 9/40- 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 QRIiGON Date: 3'ss) This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days ofuance or if work is suspended for 180 days. 1,.,' 51 rt2,2 LOCAL GOVERNMENT AP„P,ROVALrg if fie . This project has final land-use approval: ;1"Valuattortitnf0�mation, ",xwt, ,v�'', ^"q, ,re ?""„ Signature: . Date: (a)Job description: i?jT /M". This project has DEQ approval. 7' Occupancy Signature: Date: Zoning approval verified: ❑Yes El No Construction type: Property is within flood plain: ❑Yes ❑No Square feet: ,,T '°""'""`"" ""'""°'" -r` "7i`s^' Cost per square foot: `j1,; ` '� ,,: CATEGORY OFI,CONSTRUCTION s ,,?,�1 P s9 ❑Residential ❑Government ,mil Eommercial Other information: N ';'2_-, „JOB SITE�IyNF�O7RMATION ANDuLOCATIONI"�-�; •r Type of Heal: Job site address: /€9 O!/ atez_94- Energy Path: _ i Ctty: S P�� I State:��, ZIP:974`7 7 ❑new Ericeration ❑addition Subdivision: I Lot no.: (b)Foundation-only permit? ❑Yes ❑No Reference: 17O? Z Si 71 Taxlot: O I ) 00 Total valuation: - $qa7-70 t,PROPERTY QWNER"'vzS"',',--'.z; ' '„+�.:.'t`t7,2l, �,A , �yr �� Name: �i/ -Al/ /�,ed-r1° Z-77) (a)Permit fee(use valuation table): S • Address: MO fe ZA'�t kn.- (b)Investigative fee(equal to[2a]): $ City: �J721 'Lt /-1 State: (0--- I ZIP: rysei (c)Reinspection(S per hour): (number of hours x fee per hour) $ Phone: Fax: - - -. E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ 16-iY (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: • (a)Plan review(65%x permit fee[2a]): _ $yG2i Sign here: (b)Fire and life safety(40%x permit fee[2a]): $?Y 71 ❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): $ me or a member of my immediate family,and is exempt from licensing requirements under ORS 701 010 (a)Seismic fee, I%(.01 x permit fee'[2a]): $ :::r..W. a_ „ 2-.CONTRACTOR2IIJSTALLATION " 3h 114't • 2 7S SP • - 7 II - (b)Technology fee,5%(.05 x permit fee[2a]): _ $y J Business name: flna H (:finStL UC t'IC� TOTAL.fees and surcharges(2e+3c+4a+4b): $ 53-01 Address: 633 S. 5 36 City: SPpi PX'IG t\ State:6rj ZIP:Crj lc?' _(�-�// /�,{"�w..�� Phone:5'y[ -�1-�(b 20 Fax: l -%q- cc l' �.��b?. ??t .' S5 3 G ei- E-mail: busst or-w%co- - [nisi . 4:t-w }� j CCB license no.: (no�j [ -) `7'� —3y�3 7,) Z Print name: 0E0 I�uS 5 Signature: a/LJ i',�---- ;,l _, SUB'°CONTRACTOR INFORMATION u�y, „rA Name CCB License# Phone Number • Electrical V fEtLI t` Plumbing • BrebtLnc) P(t,fMioe bs Mechanical SPRINGFIELD - CITY OF SPRINGFIELD 225 Fifth St _______ii TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 OREGON 811-SPR2014-00571 www.springfield-orgov 1980 MARCOLA RD permitcenter@springfield-or.gov RECEIPT NO: 2014000582 RECORD NO: 811-SPR2014-00571 DATE:03/18/2014. [DESCRIPTION , , _ % ACCOUNT CODE/TRANS,CODE; . : __ AMOUNT DUE Structural Plan Review Fee Commercial 224-00000-425602 1060 462,65 TOTAL DUE: 462.65 PAYMENT TYPE • _,_P_AYOR__ CASHIER:CCARPENTER -..1 COMMENTS_ • •- .`AMOUNT PAID - - • . I Credit Card ARBOR SOUTH ARCH 462.65 06159z • ` TOTAL PAID: 462.65 • Structural Permit Application SPRINGFIELD DE TM EN fib—ST' L CITY OF SPRINGFIELD, OREGON x -- Permit no S/4" S9 / 225 Fifth Street♦Springfield,OR 97477•P11(541)726-3753•FAX(541)726-3689 OREGON Date: 3/i q y This permit is.issued under OAR 918-460-0030.Permits expire if work is not started within 180 days of{'ssuaneeee or if work is suspended for 180 days. TT'-211 _.ae.+srvq -w. ..p.m.o-w a :fe=e j 2AL:L t ...o.a. -.'S"•�: y�Y4 d..av�?�+Y, a".��xt LOCAL�,GOVERNMENT�{AP„PROVAL '- .. �r,,�?,,.-:« ,t��;.;sf�EE�SCHEUULE�y,�;y�� .a;,J;;� This project has final land-use approval. Lld`,UaI alto rnrn informal of o _,, '''3d '= y ?< Signature: Date: (a)Job description: 7-1..A.0,-"F /4/-i . . This project has DEQ approval. - Occupancy`.'� '� Signature: - Date: � 1� Zoning approval verified: ❑Yes El U No Construction type: Property is within flood plain: ❑Yes ❑No Square feet: 0,,FairtnrcearobliteiraWeaglik UCT101∎IM a' Cost per square foot: El Residential El �/ Government al Eommercial Other information: 4SoWOB SITEfINFf,ORMATION„„AND, LTOCATION .; ,3 Type of Heat: . Job site address: 7z9 O Ci / P—.OZ'9'- (.� Energy Path: City S en_)) State:gf— ZIP: 97Y77 ❑new alteration ❑addition Subdivision: �7 �7 Lot no.: (b)Foundation-only permit? ❑Yes ❑No ,1,v.,,, Reference: X70 J j,�t J Taxlot: 0 f ) 00 - Total valuation: $�U tei fa- -12 C',P'r''` ..:d"MPROPERT,Y,;("OWNER t `*de, eal „2 ,`Buiiii g fees £' . `'g'.+` 'a” ,u�'i? _ g " j d k d Name: �/—1- o,&)z/'0 (i (a)Permit fee(use valuation table): $ 77/x`77 Address: MO Ser 4%�J�-e-i ZA-- t` pri.- y (b)Investigative fee(equal to[2a]): $ / City: 72�P 1 t-C i.-) State: (/0— ZIP: 7 79'/ (c)Reinspection($ per hour): Phone: Fax: - - (number of hours x fee per hour) $ E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: 3'rIPlan}vtew fee ' A '"r:`" r 4;'t"x3 (a)Plan review(65%x permit fee[2a]): 1.1112„fi Sign here: (b)Fire and life safety(40%x permit fee[2a]): S ❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above on and 3b): $ me or a member of my immediate family,and is exempt from licensing ,= '" ="'s"` .. ;� '''-� ''°4.'-' "'x' y e"g' g �4 Miscellaneous fees. , ,„,, ;,tis ,� �'��'„�-°g� requirements under ORS 701.010. o T 1 ,,,,,,,, �_ ,n-r-, (a)Seismic fee, 1%(.01 x permit fee[2a]): $ „Eir . CONTRACT,OR WSTALLATIONe r .- h ', .a.,m ° .. (b)Technology fee,5/°(.05 x permit fee[2a]): $ Business name: 0 TOTAL fees and surcharges(2e+3c+4a+46): $ Address: City State: ZIP: Phone: - - - Fax: - - ��/f c5737'g ei,y E-mail: CCB license no.: �.-`7 `fl-/3 7�z Print name: . Signature: E', ,,ttnEllai-Hr ONTRACTOR INFQRMA.TION - Name CCB License# Phone Number • Electrical . - Plumbing ,. - .• Mechanical - .