HomeMy WebLinkAboutPermit Building 2014-07-28CITY OF SPRINGFIELD
Building / Commercial Permit
PERMIT NO: 811-SPR2014-01394
mm.springfieldor.gov
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permflcenter@spdngfield-ocgov
PROJECT STATUS: Issued ISSUED: 07/28/2014 EXPIRES: 01/23/2015
STATUS DATE: 07/28/2014 APPLIED: 06/27/2014
SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477 SCOPE: Hospital
ASSESOR'S PARCEL NO: 1703220004102 TYPE OF STRUCTURE: Commercial
_--PROJECT
OWNER: PEACEHEALTH
Phone Number:
ADDRESS: 1115 SE 164TH AVE
VANCOUVER WA 98683
CONTRACTOR INFORMATION
Contractor Type Contractor
Name Lie Type Lic No Lie Exp Phone
General Contractor GREENBERRY CONSTRUCTION LLC CCB 166612 09/26/2015 541-752-0381
INSPECTIONS REQUIRED
Inspections
8999 Final Fire
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.
1999 Final Building
Final Building: After all required inspections have been requested and approved and
the building is complete.
1550 Firewall
Firewall: Located and constructed according to plans.
1560 Firestop Assemblies
By signature, I state and agree, that I have czrg(�d the completed application and do hereby certify that all
information hereon is true and correct, Wil, }[[tt,� t ,l any and all work performed shall be done in accordance with the
Ordinances of the City of S ri (�gld�a �8'$�of,1A to or Oregon pertaining to the work described herein, and that NO
OCCUPANCY will �in�ftx yj a��t�r-Nwn f�o�{lgoa ' of the Community Services Division, Building Safety. I further
certify that(�0h�op/.ana�terQjyt3ye��a'Y "I�Sh`�nce with ORS 701.005 will be used on this project. I further agree
I ensure t al}.tris ne�iEfd� y�,n �yl� �-j{t®_{q�`oo�er time, that each address is readable from the street, that the
permit cart o gtt tb® eft jt �etj�'r� "Roved set of plans will remain on the site at all times during
construction OP�9
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Owner or ontracior Signature Dale
- a�•itcE'. \'SSNP���NSPE��®FpF�
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Springfield Building Permit 7/28/2014 3:13:55PM ��'��,\ �g0 Page 1 of 1
SPRINGFIELD --
RECORD NO: 811-SPR2014-01394
crrY OF SPRINGFIELD
6- {
TRANSACTION RECEIPT
225 Fifth St
8pnngfie1d,0R97477
"� OREGON
811-SPR2014-01394
541-726-3753
mm.spnngfield-or.gov
3333 RIVERBEND DR
permitcenter@spdngfieid-or.gov
RECEIPT NO: 2014001621
RECORD NO: 811-SPR2014-01394
DATE: 07/28/2014
Building Permit Fee
224-00000-425602
e-
1002
a
779.00
Continuing Education
224-00000-425606
2.50
Fire, Life, Safety Plan Review
224-00000-425602
1077
311.60
SDC: Reimbursement Cost - Local Wastewater
442-00000-448024
1183
142.68
SDC: Total Sewer Administration Fee
719-00000-426604
1175
7.13
Snecial Occunancv Fee
224-00000-425602
1097
7.79
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 93.48
Technology fee (5% of permit total) 100-00000-425605 2099 38.95
22711
TOTAL PAID: 1,383.13
SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth Sl
TRANSACTION RECEIPT Spdngfield,OR97477
OREGON 541-726-3763
811-SPR2014-01394
lm"v.spdngfield-or.gov 3333 RIVERBEND DR permitcenter@spdngeeld-or.gov
RECEIPT NO: 2014001395 RECORD NO: 811-SPR2014.01394 DATE: 06/27/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE; i
Structural Plan Review Fee Commercial 224-00000-425602 1060 506.35
TOTAL DUE: 506.35
:PAYMENTTYPE PAYOR CASHIER:QCARPENTER ' COMMENTS AMOUNT PAID
Credit Card PEACEHEALTH 506.35
063690
TOTAL PAID: 506.35
Structural Permit Application
225 Fifth Street It Springfield, OR 97477 ♦ PH(541)726-3753 4 FAX(541)726-3689
E
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within I
suspended for 180 flays.
LOCAL GOVERNMENT APPROVAL
This project has final land -use approval.
Signature:
Date:
This project has DEQ approval.
Signature: I
Date:
Zoning approval verified: ❑ Yes ❑ No
Properly is within flood plain: ❑ Yes ❑ No
CATEGORY—OF—CONSTRUCTION
❑ Residential I ❑ Government I XCommercial
JOB SITE INFORMATION AND LOCATION
Job site address: 3333 RiverBend Drive
city: Springfield State: OR zip: 97477
Subdivision: I Lot no.:
Reference: 17-03-22-00 Taxtot:04102
PROPERTY OWNER
Name: PeaceHealth Sacred Heart Medical Center
Address: RiverBend Annex 123 International Way
City: Springfield
State: OR ZIP: 97477
Phone:541.228.6926
Fax:
E-mail: jiweston@peacehealth.org
Building Owner or Owner's agent authorizing this application:
Sign here:HdAt , 7.2,9
❑ This installation is being made or residential or farm property owned by
me or a member of my immediate faunily, and is exempt from licensing
requirements under ORS 701.010.
CONTRACTOR INSTALLATION
Business none: Greenberry Construction
Address: 2273 NW Professional Drive, Suite 200
City: Corvallis
State: OR ZIP: 97330
Phone: 541.752.0381
Fax: -
E-mail: kwillis@greenberryconstruction.com
CCB license no.: #166612
Print name:
Signature:
$
SUB -CONTRACTOR INFORMATION
Name
CCB License #
Plrone Number
Electrical
S !0
(c) Subtotal of fees above (3a and 3b):
Plumbing
4. Miscellaneous fees
Mechanical
S 7
(b) Technology fee, 5% (.05 x permit fee[2a]):
;`; DEPARTMENT USE ONLY
Permitno.:96( / 3
Date:
or if work is
FEE SCHEDULE
Y. Valuation information
(a) Job description: Infill shelled space with Pediatric Treatment Room
Occupancy
12
Construction type: Type IA- Fully Sprinklered
Square feet:
237 sf
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
❑ new ❑alteration ❑ addition
(b) Foundation -only permit? ❑ Yes XNo
Total valuation:
$ $100,000
2. Building fees
(a) Permit fee (use valuation table):
S•
(b) Investigative fee (equal to [2a]):
$
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
$
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
S Y
(e) Subtotal of fees above (2a through 2d):
$
3. Plan review fees
(a) Plan review (65%x permit fee [2a]):
S
(b) Fire and life safety (40%x permit fee [2a]):
S !0
(c) Subtotal of fees above (3a and 3b):
S
4. Miscellaneous fees
(a) Seismic fee, 1% (01 x permit fee [2a]):
S 7
(b) Technology fee, 5% (.05 x permit fee[2a]):
S %S
(c) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (2e+3c+4a+4b+4c):
$ /23