HomeMy WebLinkAboutPermit Building 2014-7-7 •
SPRINGFIELD • 225 Fifth St •
CITY OF SPRINGFIELD Springfield,OR 97477 •
"``O EGON Phone: 541-726-3753 -
Building I Commercial Permit Inspection Phone: 541-726-3769 •
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01245 _
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/07/2014 EXPIRES: 01/02/2015 •
STATUS DATE: 07/07/2014 APPLIED: 06/09/2014
SITE ADDRESS: 3333 RIVERBEND DR,Springfield,OR 97477 SCOPE: Interior
. ASSESOR'S PARCEL NO: 1703220004102 TYPE OF STRUCTURE: Commercial
r
PROJECT DESCRIPTION: Build out radio surgery suite
OWNER: PEACEHEALTH Phone Number:
ADDRESS: 1115 SE 164TH AVE
VANCOUVER WA 98683
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor GREENBERRY CONSTRUCTION LLC CCB 166612 09/26/2015 541-752-0381
INSPECTIONS REQUIRED
Inspections
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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.
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1550 Firewall Firewall: Located and constructed according to plans.
1560 Firestop Assemblies •
1600 Ceiling Grid Ceiling Grid: After drywall approval but prior to cover.
1710 Fire Sprinklers
1740 Fire Alarm Final
1800 Emergency Egress Lighting
1999 Final Building Final Building: After all required inspe Triov,have been requested and approved and
the-building is complete. AA N11ON: Oregon law regttirP� yo.,
to
t�l{uw rules atlopted by the Oregon Utility
8999 Fi al r
��L/ rtE. SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
THIS P RMIT , nn77 In OAR 852-0 1-00
By si nature �n�p�T a �x� Tfetl the completed a lic Ibscmgh OAR 952-001-
y s u IT tlt i°•�,,111 E14 (H18 P PP S dA �R4d� tf tfine rules b
information e 1 rr&���i tt�fNterC�pr(eRy that any and all work perforrr Rp e by
Ordinances;ofit{1jtt I D .4 •n�AnriCi ee Laws of the State or Oregon pertaining ttl�F�`p, es Iier li �)11 dtti'iaat phone
OCCUPANCY-Iwiltlbn r(g G4tructure without permission of the Community Services'Di`�}si �i �jl ic9graatl;tytilitytgittification
certify that only contractors and employees who are in compliance with ORS 701.005 will be us`!S8'OWYthl�p-r QQ-Qte432li284 e
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 th front of the property, and the approved set of plans will remain on the site at all times during
construction.
/r7 it( •
Owner or Contractor Signature Date
Springfield Building Permit 7/7/2014 10:27:16AM Page 1 of 1
,r SPRINGFIELD CITY OF SPRINGFIELD '
-'�° 225 Fifth St
LO EGON TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2014-01245
•
www.springfield-ar.gov 3333 RIVERBEND DR permitcenter@springfield-or.gov
RECEIPT NO: 2014001452 RECORD NO:811-SPR2014-01245 DATE:07/07/2014
,.
DESCRIPTION�,`G S`�",;>'s�hr.a��f�!�iT �` ���'����1"xU:ACCOUNT CODEISRANS CODE,ag2,.°_tingAMOUNTaDUE.a
, Building Permit Fee 224-00000-425602 1002 2,312.00
Continuing Education 224-00000-425606 2.50
Fire, Life, Safety Plan Review 224-00000-425602 1077 924.80
SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 1183 1,569.50
SDC: Total Sewer Administration Fee 719-00000-426604 1175 116.78
Special Occupancy Fee 224-00000-425602 1097 23.12
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 277.44
Technology fee(5%of permit total) 100-00000-425605 2099 115.60
TOTAL DUE: 5,341.74
PAYMEN aTTYP-E ,.. P,AXORi asiliTe: RSON COMMENTS _...- z -�' , Wilc.),YNAPAPICIMMOV
Check GREENBERRY CONSTRUCTION LLC 5,341/4
22515
TOTAL PAID: 5,341.74
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SPRINGFIELD--- CI Y 225 Fifth St OF SPRINGFIELD
�9 _ -'-
z , TRANSACTION RECEIPT Springfield,OR97477
OREGON 541-726-3753
811-SPR2014-01245
www.springfield-or.gm, 3333 RIVERBEND DR perrnitcenter @springfield-or gov
RECEIPT NO: 2014001248 RECORD NO: 811-SPR2014-01245 DATE:06/09/2014
DESCRIPTION =„:'- __:ACCOUNT!CODEITRANSCODE,__ ' •-__, T.AMOUNT_DUE
Structural Plan Review Fee Commercial 224-00000-425602 1060 1,502.80
TOTAL DUE: 1,502.80
_ `'
LPAYMENT TYPE PAYOR CASHIER:CCARPERiER' COMMENTS AMOUNT PAID. -
Credit Card William Shaw 1,502.80
07327c
TOTAL PAID: 1,502.80
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY;
"-rtn*141'8 -CITY OFeESPRNGF[ELD OREGON 4:i T% i �/,//2�ic
.., .i: _ C i s,____ ,_.a _. . .., ? .s r-;'-tc "�.1 ;7aP Permit no.: �(y
225 Fifth Street♦Springfield,OR 97477 4 PH(541)726-3753♦FAX(541)726-3689 OREGON
Date: 6/q776-/
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days.
:"+e `_`,LOCACGOVERNMENT APPROVAL „ _e?-1 :'u, „zr., =jyF.EE,SCHEDULE ryn ,X0i'isl.i.
This project has final land-use approval. .l Valuation information r, , - ,? ,n - ti ik ..: ,'f-=^ .
Signature: Date; (a)Job description:' er
This project has DEQ approval. � - SI)
�U7fJ�
Signature: Occupancy / — 2-,
ignature: Date:
Zoning approval verified: El Yes ❑No Construction type: 1
Property is within flood plain: ❑Yes ❑No Square feet: 2C1' 1 L
`{� ::CATEGORY OF_CONSTRUCTION i_�-i'. .i?; Cost per square foot
❑Residential - ❑Government Commercial Other information:
! 'z,r JOB SITE:INFORMATION AND L''OCATION CI;f,>,7";:i Type of Heat:
Job site address:3'7) 5 14 l(uE b Qk 1 U6 Energy Path:
City: SI'.(tletGFEU) State: •07-- ZIP: 1NT ❑new ❑alteration ❑ addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No
Reference I7? 3 ZZao Taxlot 0 Q, Total valuation: $ ICA 0 6 O
Yt uy 1 3r t r ;PROPERTYiKOWNER ' .kr.',Xif =:2 Bmlding fees u- i.u. -:% a;, .`. h iz,t14.:r'
��.sk�..u� v,.3
Name: Perkg-1/-Q'L/11 fi 6JIM- ET N” (a)Permit fee(use valuation table): $23/2 di----
Address: (22) ,$( /t*
d✓ - W 4A71 (b)Investigative fee(equal to[2a]): $
City: 9)2(,46r Fe(-20 State: op.- I ZIP: f 717 (c)Reinspection($ per hour):
Phone: ( - 7 3` 477c Fax - ,y, - (number of hours x fee per hour) $
E-mail: J i tiJeIteut C. ?tote(Ae`at l t. , o . "1 (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $
J (e)Subtotal of fees above(2a through 2d): s
Building Owner or Owner's agent authorizing this application: -3 Plauvevtew fees + ` i ?'_ ,C' _rr ; t`.11y --�' n;?
8"
a O Plan review(65% permit fee I 2a ll $ /562
Sign here:
(b)Fire and life safety(40%x permit fee[2a]): $ q710"3
❑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 4 Miseel,laue0uslfees±+? "4 .' t;. sp i q a1, {r Y rr+ ` ;` :`
requirements under ORS 701.010. - " '
I,y, P �� ,i ix� (a) Seismic fee, 1%(.01 x permit fee [2a]): S. �jJ-
k 7,; CONTRACTOR INSTALLATION,f, rf >' i ,i,% °
(b)Technology fee,5%(.05 x permit fee[2a]): $ i/S—/'O
Business name: G/27-1/1jEfL(2,-( G07.1S'('_ (c)Continuing Education Fee$2.50 $2.50
Address:
City: ,¢LLc $ State: ZIP: TOTAL fees and surcharges(2e+3c+4a+4b+4c): $ 575i a
Phone: - - Fax: - -
E-mail:
CCB license no.: _ 51)6,
Vi
-'&% F
Print name: 2, / /Cri) �� "
Signature:
' $ `SUB CONTRACTOR{INFORMATIONS xfa} ` c...„„'[ vx-_
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical -