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Home My WebLink AboutPermit Mechanical 2007-11-2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-01488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 04/19/2008 VALUE: $ 212,434,907.00 225 Fifth Street, Springfield, OR 54]-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3333 RiverBend Dr ASSESSOR'S PARCEL NO,: 1703220000902 Springfield TYPE OF WORK: Hospital TYPE OF USE: New Commercial PROJECT DESCRIPTION: Riverbend Hospital Owner: Address: PEACEHEALTH PO BOX 1479 EUGENE OR 97440 A~ H:NTlON: Oregon law requires you to 'UIIUVV rule. aooplea oy me urO'~v'l UtilItY Notifllf.~{J1N~m@l1lQJA';1l W~EI1eJNO~h In OAf. """'''''",u ,-uu I U L111 UUY" vl'\n l:10~-U - Contractor 0090. You may obtarn copies of ~fHmj~ by ANSHEN & A~g the center. (Note: the telephone TURNER CONSTRUqf3~r~t'i~~~~^ ~~~~ation E C COMPANY ~~737 . ' SECURECOM INC 117195 CDA ENTERPRISES INC 65967 BOHEMIA PLUMBING & CONSTRUCTION 141468 Expiration Date Contractor Type Architect General Electrical Low Voltage Electrical Mechanical Plumbing 11/09/2007 01/15/2008 09/07/2008 05/09/2008 03/03/2009 Phone 415-882-9500 503 229-6000 503-224-3511 541-988-3585 541-688-9082 541-942-8333 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1-1.1 B IFR # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement:. Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla Frontya,'d Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DWWlij~M:ENT INFORMATION I llll\J n:rUVIII :>Hm!mRE IF THE WORK CAOUTMH.QfilAWdll'lPER THIS PERMIT IS NOT 1~ISNG~GR,l8qtJBANDONED FOR ANY 1I8GdaA\H~E~. . % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Pa2e 1 of27 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction Estimate Estimate Estimate Estimate Fee Description Plan Review CommllndlPublic Plan Review Fire & Life Safety + 1 % Seismic Fee + 10% Administrative Fee + 7% State Surcharge Building Permit + 10% Administrative Fee + 7% State Surcharge Fixture Sanitary Sewer - 1st 50 Feet Special Waste Connection Deposit + 10% Administrative Fee + 7% State Surcharge Plan Review Plumbing (30%) Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtll00' Special Waste Connection Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll00' + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Low Voltage - Commercial Indus Perm ServlFdr 1000 ampslvolts Perm ServlFdr 200 amps or less Perm ServlFdr 201 to 400 amps Perm ServlFdr 401 to 600 amps Perm ServlFdr 601 to 999 amps Plan Review Electrical (25%) + 1 % Seismic Fee + 10% Administrative Fee + 7% State Surcharge Building Permit + 10% Administrative Fee CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-01488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 04/19/2008 VALUE: $ 212,434,907.00 I Valuation Description I $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 212,186,907,00 248,000,00 Value Date Calculated $212,186,907.00 $248,000,00 $212,434,907,00 07/01/2005 06/08/2005 Total Value of Project ~ Amount Paid $443,476.63 $272,908,69 $5,518,79 $55,187,86 $38,631.51 $551,878,72 $21.60 $15.12 $14.00 $90.00 $112,00 $10,000,00 $293,20 $205,24 $1,029,13 $45,00 $560,00 $1,162,00 $45,00 $1,120,00 $14,201.30 $9,940,91 $22,602,00 $63,585,00 $19,125,00 $15,057,00 $18,150,00 $1,375,00 $2,119,00 $41,538.81 $1,379,70 $13,796,97 $9,657.88 $137,969,68 $5,90 Date Paid Receipt Number 2200400000000001481 2200400000000001481 2200500000000000873 2200500000000000873 2200500000000000873 2200500000000000873 1200500000000000955 1200500000000000955 1200500000000000955 1200500000000000955 1200500000000000955 2200500000000000902 2200500000000001132 2200500000000001132 2200500000000001132 2200500000000001132 220050000000000]132 2200500000000001132 2200500000000001132 2200500000000001132 220050000000000121] 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001211 2200500000000001477 2200500000000001477 2200500000000001477 2200500000000001477 3200600000000000057 12/6/04 12/6/04 7/1/05 7/1/05 7/1/05 7/1/05 7/6/05 7/6/05 7/6/05 7/6/05 7/6/05 7/8/05 8122/05 8/22/05 8/22/05 8/22/05 8/22/05 8/22/05 8/22105 8/22/05 9/2/05 9/2/05 9/2105 9/2/05 912/05 9/2/05 9/2/05 9/2105 912/05 9/2/05 10121/05 10/21/05 10/21/05 10/21/05 2/7/06 Pa2e 2 of 27 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line + 8% State Surcharge Plan Review Plumbing (30%) Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll00' + 10% Administrative Fee + 7% State Surcharge . Fixture Special Waste Connection Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll00' Plan Review CommllndlPublic Plan Review Fire & Life Safety :""Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Air Handling Unit 10,000 & Ovr Air Handling Unit Up to 10,000 Appliance Not Listed Appliance Vent Backflow Device Evapol'ative Coolers Exhaust Hoods Fixture Furnace - more than 100,000 Furnace - Unit Heater Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Heat Pump Inspection - Preliminary Medical Gas Base Fee Medical Gas Each Inlet/Outlet Medical Gas Plan Review Not Covered Mechanical Plan Review Electrical (25%) Plan Review Mechanical (25%) Plan Review Plumbing (30%) Plan Review Plumbing (30%) Sanitary Sewer - 1st 50 Feet Sewage Ejector Pump Special Waste Connection Trap or Waste not Conn to Fixt Vent Fan Water Line - 1st 50 Feet Water Line - Each Addtll00' + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Temp Power 201 - 400 amps $4,72 $159,30 $45,00 $14.00 $14.30 $10,01 $56,00 $14,00 $45.00 $28,00 $125,58 $77,28 $10,00 $10,748.00 $7,523,60 $435,00 $112,00 $28,260.00 $288.00 $210,00 $72,00 $90,00 $37,450.00 $90.00 $300.00 $18,804.00 $4.00 $6,00 $264,00 $45,00 $219.00 $14,625.00 $4,453,20 $540.00 $-6,035.53 $12,334.50 $-149,53 $12,992,40 $45,00 $112,00 $4,172.00 $1,260,00 $18,00 $45.00 $14.00 $9.00 $7.20 $21.00 $69.00 2/7/06 2/7/06 2/7/06 2/7/06 3/9/06 3/9/06 3/9/06 3/9/06 3/9/06 3/9/06 3/10/06 3/10/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22106 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22106 3/22/06 3/22/06 3/22/06 5/15106 5/15/06 5/15/06 5/15/06 Pal!:e 3 of 27 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2004-01488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 04/19/2008 VALUE: $ 212,434,907.00 3200600000000000057 3200600000000000057 3200600000000000057 3200600000000000057 2200600000000000287 2200600000000000287 2200600000000000287 2200600000000000287 2200600000000000287 2200600000000000287 1200600000000000285 1200600000000000285 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000602 2200600000000000602 2200600000000000602 2200600000000000602 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line + 10% Administrative Fee + 8% State Surcharge Low Voltage - Commercial Indus Plan Review Electrical (25%) Refund - Admin Fee Refund - Electrical Refund - Surcharge + 10% Administrative Fee + 10% Administrative Fee + 10% Administrative Fee + 7% State Surcharge + 8% State Surcharge + 8% State Surcharge Fixture Not Covered Plumbing Plan Review Plumbing (30%) Plan Review Plumbing (30%) Plan Review Plumbing (30%) Refund - Admin Fee Refund - Plumbing Refund - Surcharge Sanitary or Storm Sewer Cap Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtll00' Special Waste Connection Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll00' + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus Plan Review Electrical (25%) + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus Plan Review Electrical (25%) + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus $900,00 $720,00 $9,000,00 $2,250.00 $-2,10 $-21.00 $-1.68 $11.50 $11.80 $137,20 $96,04 $9,20 $9.44 $1,344.00 $28,00 $34,50 $35.40 $481.57 $-137.20 $-1,853.57 $-96.04 $45,00 $45,00 $28,00 $42.00 $45.00 $28,00 $13.50 $6,75 $10,80 $135.00 $274,50 $137,25 $219.60 $2,745.00 $144,00 $72,00 $115,20 $1,440,00 $360,00 $603,00 $301.50 $482.40 $6,030.00 $1,507.50 $490.50 $245,25 $392,40 $4,905,00 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: cOM2004-01488 ISSUED: 05/1812006 APPLIED: 12/06/2004 EXPIRES: 04/19/2008 VALUE: $ 212,434,907.00 5/18/06 5/18106 5/18/06 5/18/06 5/19/06 5/19106 5/19/06 6/8106 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 8/9/06 8/9/06 8/9/06 8/9/06 1214/06 1214106 1214/06 1214106 12/12/06 12/12/06 12/12/06 12112/06 12112/06 2115/07 2/15/07 2/15/07 2/15/07 2/15/07 3/19107 3/19/07 3/19/07 3/19/07 1200600000000000678 1200600000000000678 1200600000000000678 1200600000000000678 VOUCHER #104418 VOUCHER #104418 VOUCHER #104418 1200600000000000829 1200600000000000829 1200600000000000827 1200600000000000827 1200600000000000829 1200600000000000829 1200600000000000827 1200600000000000827 1200600000000000829 1200600000000000829 1200600000000000827 VOUCHER # 105568 VOUCHER # 105568 VOUCHER # 105568 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000001228 1200600000000001228 1200600000000001228 1200600000000001228 1200600000000001719 1200600000000001719 1200600000000001719 1200600000000001719 2200600000000001684 2200600000000001684 2200600000000001684 2200600000000001684 2200600000000001684 2200700000000000210 2200700000000000210 2200700000000000210 2200700000000000210 2200700000000000210 3200700000000000157 3200700000000000157 3200700000000000157 3200700000000000157 Pa2e 4 of 27 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plan Review Mechanical (25%) + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Plan Review Plumbing (30%) Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtll00' Special Waste Connection Storm Sewer - 1st 50 Feet Storm Sewer Each Addtll00' Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC SanitarylStorm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus ~Mech Iss 2+ Appliances~ + 1 % Seismic Fee + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Boiler/Comp Up To 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Plan Review Mechanical (25%) Total Amount Paid Initial Review Public Works Review Structural Review $1,226,25 $67,80 $33,90 $54,24 $203.40 $45,00 $28.00 $224.00 $45.00 $336,00 $172,729,80 $10,00' $768,682.48 $72,795.91 $33,130.87 $87,265.55 $853,215,71 $282,168,90 $258,325,56 $5,00 $2.50 $4.00 $50,00 $40,00 $1.04 $10,40 $5,20 $8,32 $96,00 $8,00 $4,00 $26,00 $4,467,544,71 3/19/07 4/20/07 4/20/07 4/20/07 4/20107 4/20/07 4/20/07 4/20/07 4/20/07 4/20/07 6/22/07 6/22/07 6/22/07 6/22/07 6/22/07 6/22/07 6/22/07 6/22/07 6/22/07 7/27/07 7/27107 7/27/07 7/27/07 11/2/07 11/2/07 11/2107 11/2/07 11/2/07 11/2/07 11/2107 11/2/07 11/2/07 I Plan Reviews I 03130/2006 03/30/2006 06/21/2007 06/20/2007 06/19/2006 06/19/2006 10 LLH 10 JLP APP AC Pa2e 5 of 27 CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: cOM2004-01488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 04/19/2008 VALUE: $ 212,434,907.00 3200700000000000157 2200700000000000563 2200700000000000563 2200700000000000563 2200700000000000563 2200700000000000563 2200700000000000563 2200700000000000563 2200700000000000563 2200700000000000563 1200700000000000802 1200700000000000802 1200700000000000802 1200700000000000802 1200700000000000802 1200700000000000802 1200700000000000802 1200700000000000802 1200700000000000802 2200700000000001194 2200700000000001194 2200700000000001]94 2200700000000001194 2200700000000001665 2200700000000001665 2200700000000001665 2200700000000001665 2200700000000001665 2200700000000001665 2200700000000001665 2200700000000001665 2200700000000001665 Received permission from Philip Farrington to recycle old plans, Added SDC fees provided by Ken, Processed info into cashier as provided by Les in amount of $2,528,324,77 check #00291969. Fee's are for Hospital 7-01488, Central Utility Plant 5-01358, and OHVI4-01488. ASI 95 - Approved with note to inspector CITY OF SPRINGFIELD - Building/Combination Permit Status Issued PERMIT NO: cOM2004-01488 225 Fifth Street, Springfield, OR ISSUED: 05/18/2006 541-726-3753 Phone APPLIED: 12/0612004 541-726-3676 Fax EXPIRES: 04/19/2008 541-726-3769 Inspection Line VALUE: $ 212,434,907.00 Structural Review 06/19/2006 06/19/2006 APP AC ASI 106R.l - Approved with Conditions Structural Review 06/19/2006 06/19/2006 APP AC Proposal Request #35R.3 and #35R.4 - Approved with Conditions Structural Review 06/19/2006 06/19/2006 APP AC Proposal Request #52 - Approved Structural Review 06/19/2006 06/19/2006 APP AC Proposal Request #63 - Approved Structural Review 06/19/2006 06/19/2006 APP AC Proposal Request #80 - Approved with Note to Inspector Structural Review 07/01/2006 07/03/2006 APP AC Deferred Submittal No, 0485-05510-DFO - Stair No.7, 9,10, and 11 - 1st Back Check - Approved with Notes to Inspector Structural Review 07/01/2006 07/03/2006 APP AC Deferred Submittal No, 0625-03450-DFO - 3rd Floor Precast Bracket Panel Reinforcing Drawing5 wi Calculations (APS) - Approved with conditions Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No, 0707-03450-DFO - 3rd Floor West Elevation Sills (between bracket panels) reivsion (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No, 0624-03450-DFO - Connection RDE-l and RDE-3 for panels SPl and SP3 (west elevation) (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No, 0557-03450-DFO-l - Parapet and Bay Windows - Hospital (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No, 0675-03450-DFO - Corner Window sills reinforcing, Level 4 Hospital - including shop drawings (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No. 0676-03450-DFO - Precast Window Sills Reinforcing - OHVI - shop drawings (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No, 0632-15000-DFl - Seismic Bracing - Level 2. (Previously submitted plans for this submittal were taken and stamped by KPFF and returned to CLAIR 7/11/06 for the back check t( our first review of this submittal) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Proposal Request #37 - Approved Pa2e 6 of27 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: cOM2004-01488 225 Fifth Street, Springfield, OR ISSUED: 05/18/2006 541-726-3753 Phone APPLIED: 12/0612004 541-726-3676 Fax EXPIRES: 04/1912008 54]-726-3769 Inspection Line VALUE: $ 212,434,907.00 Structural Review 07/01/2006 07/1712006 APP AC Proposal Request #97 - Approved Structural Review 07/01/2006 07/17/2006 APP AC Construction Change Directive #52 - Approved with Conditions Structural Review 07/01/2006 07/17/2006 APP AC Construction Change Directive #10 - Approved Structural Review 07/01/2006 07/1712006 APP AC Construction Change Directive #53 - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Construction Change Directive #70 - Approved with Conditions Structural Review 07/01/2006 07/17/2006 APP AC Construction Change Directive #55R2 - Approved Structural Review 07/01/2006 07/1712006 APP AC ASI #111 - Approved Structural Review 07/01/2006 07/17/2006 APP AC ASI #61 - Approved Structural Review 07/31/2006 08/01/2006 APP AC ASI #62 approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC ASI #115Rl, 115R3, adn 115R4 - Approved on 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC ASI 120 - Approved 7/31/06 Structural Revie.w 07/31/2006 08/01/2006 APP AC ASI 130 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC ASI 134 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC ASI 133 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 12 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 13 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 71 - Approved with notes to inspector 7/31/06 Structural Review 07/31/2006 08/01/2006 . APP AC CCD 48 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2~06 APP AC CCD 28 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC PR 65 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC PR 34 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC Deferred Submittal #0704-03450-DFO - 1st Floor Precast Sills (plan and reinforcing) - OHVI . Approved 7/31/06 Structural Review 08/01/2006 08/03/2006 APP AC Deferred Submittal #0777-08810-DFO - West Elevation Window Systems Floors 1-3- Approved with conditions Structural Review 08/01/2006 08/09/2006 APP AC ASI 122 - Approved Structural Review 08/01/2006 08/09/2006 APP AC ASI 91 - Approved with Notes to Inspector Structural Review 08/01/2006 08/09/2006 APP AC ASI 123 - Approved Structural Review 08/01/2006 08/0912006 APP AC CCD 46 - Approved Structural Review 08/01/2006 08/0912006 APP AC CCD 81 - Approved Structural Review 08/01/2006 08/0912006 APP AC PR #21 - Approved Structural Review 08/01/2006 08/0912006 APP AC PR 42 - Approved Structural Review 08/01/2006 08/09/2006 APP AC Deferred Submittal Package No. 0373-15000-DFl - Larsen VR-1818 Fire Hose Valve Cabinet - product datalcut sheets - Approved Pa2e 7 of 27 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-0 1488 COM2004-0 1488 COM2004-01488 COM2004-01488 COM2004-0 1488 COM2004-01488 COM2004-01488 COM2004-0 1488 COM2004-01488 Payments: Type of Payment CreditCard cReceiot I City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200700000000001665 Date: 11/02/2007 11:30:19AM Description Boiler/Comp Up To 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ ~Mech Iss 2+ Appliances~ Plan Review Mechanical (25%) + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee + I % Seismic Fee Amount Due 96.00 8.00 4.00 40.00 26.00 5.20 8.32 10.40 1.04 $198,96 Paid By BLAKE PETERSON Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid D18 301114 In Person Payment Total: $198.96 $198.96 Page I of I 11/2/2007 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2004-01488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 04/19/2008 VALUE: $ 212,434,907.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Special Inspection: Reinforcing Steel Mill Certificate Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield, Special Inspection: Masonry, Mortar, Grout, and Reinforcing Steel Certificates Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield. Structural Welds: To be done during construction by State Certified Special Inspector, Provide inspection test results to City Building Inspector, Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector, Low Voltage: Prior to cover. Low Voltage: Prior to cover. 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 of 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. ~ -- .;; Owner or Contractors Signature ~ -'-- //.- .2 - D "7 Date Pa2e 27 of 27