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Home My WebLink AboutPermit Building 2005-4-25 II I . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00304 ISSUED: 04/25/2005 APPLIED: 03/17/2005 EXPIRES: 10/25/2005 VALUE: $ 186,087.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 3306 Gateway St ASSESSOR'S PARCEL NO,: 1703222001700 Springfield TYPE OF WORK: Retail TYPE OF USE: New Commercial PROJECT DESCRIPTION: Brenner's tennant infill, Owner: NEWGA TE LLC Address: 840 BELTLINE RD STE 202 SPRINGFIELD OR 97477 Phone Number: 541-746-8444 " Contractor Type Architect General Electrical Mechanical Plumbing ,t\\\.)\"{ I CONTRAGTORINFORMATION I <(. \' ~\ \. ~ Contracto~ yf~~ Q,<8:,\y') <;;\J AFFOL TER-WESf' &.:JONES ",'-,,\1' ~(l' . "'-\V ,,1{:MEILFCONSTRUCTION CO 63771 02/12/2006 ~,\'\ ,.rnYNOIlDS idiCTRIC 17252 02108/2007 \~~s 'X.iioMEsol\iFiIRT HEATING & AIR 84164 0.;)'0 l).6/25/2007 ,,\)\\'~o.~IN.S9NPLUMBING INC 107124 ..0" ~_ \)~'mf1'9/2005 ,,\)~ \'6'" I BUILDING INFORMATION'I"OS\0<!lu~0 "~~<i:()()~'\ ';': 1;\ 'v ;;s.0 "/.,0" ~ 5?0 '" "/.,0" # of Stories: O\0<!l~O X)... ,,0 \V ~ O~ ~~~~iiC? ~ Height of SY=!!'tt~5V" ,\~o ~0.;)Cf,0" o'SvqW~~s'P'FIoor: Type ot.I,It~Y~" ~ ~,0\' ,() ~ (p~' .;;s.0 S~<Ft 2nd Floor: Watf\"~~~ ~v0 ,SJ() "/,..iJ;<:< ~0'0.~~S~J1't"'Basement: Ran~~Tlg.~~o b'/P() ~ oX) 0\. ~ 0<:< \j ~~q Ft Garage/Carport Enerf,lxc1'a~,"'~.;) ~'/j. 00<:<" 0\0CS ';)r;y~ Sq Ft Other: SprinkIe!i:Building'..'(\0 ;;s.0. IlIa'/) Occupant Load: \\. ~o.\J::.",:u.._/....~ ~.l ,? I DEVELOPMENT INF0RM>\TION I ,- License Expiration Date Phone 541-342-6511 541-485-1417 541-343-7297 541-345-2838 541-345-6909 # of Units: . Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: M VB REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutsIDrains: Notes: Paee 1 of4 . . . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Estimate Tvpe of Construction Estimate Fee Description Plan Review CommlIndlPuhlic Plan Review Fire & Life Safety -Mechanical Issuance Fee- + 10% Administrative Fee + 70/0 State Surcharge Add, Alter, Extend Circ Ea Add Addressing Assignment Building Permit Fixture Furnace - more than 100,000 Gas Outlets 1-4 Perm Serv/Fdr 200 amps or less Plan Review Comm/Ind/Pnblic Plan Review Fire & Life Safety Vent Fan Total Amount Paid Fire Department Review 03/18/2005 Initial Review 03/18/2005 PlanninllReview Public Works Review 03/18/2005 03/18/2005 I Valuation DescriDtion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 186,087.00 Total Value of Project Fpp< PI1lLl Amount Paid Date Paid $526.11 $323.76 $10,00 $127,94 $89.56 $96.00 $31.00 $848,40 $154,00 $45.00 $4,00 $126,00 $25.35 $15.60 $6.00 3/17/05 3/17/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 4/25/05 $2,428.72 I Plan Reviews I 04/06/2005 OK GRG 03/18/2005 APP LLH 03/29/2005 04/06/2005 APP EMM APP SB Palle 2 of4 . CITY OF ~rKll~hl<lt!:LD . Building/Combination Permit PERMIT NO: COM2005-00304 ISSUED: 04/25/2005 APPLIED: 03/17/2005 EXPIRES: 10/25/2005 VALUE: $ 186,087.00 Value Date Calculated $186,087,00 $186,087,00 04/13/2005 Receipt Number 2200500000000000301 2200500000000000301 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 2200500000000000489 See attached document for Fire Department Plans Review comments. Left message for Reynolds Electric requesting approval to use their signed electrical permit application, Gerald caUed back in p,m, witb approval and information for permit, No SDCs. Residual credit from Hotel. . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2005-00304 225 Fifth Street, Springfield, OR ISSUED: 04/25/2005 541-726-3753 Phone APPLIED: 03/17/2005 541-726-3676 Fax EXPIRES: 10/25/2005 541-726-3769 Inspection Line VALUE: $ 186,087.00 Structural Review 04/13/2005 04/13/2005 10 JMP WE, Received a response from David Jones to the structural comments. Called David to let him know that we are still waiting for items 5 and 6 to he completed, Structural Review 04/1412005 04/14/2005 10 JMP WE, Received a fax from David Jones with the Special Inspection and Testing forms, Still waiting for the Seismic design for RTUs, Structural Review 04/21/2005 04/2112005 IO JMP WE. Received fax from Wally Elling with Home Comfort giving a sketch and notice of change from th, HV AC ducting system shown on the plans to a supply and return drop system. Structural Review 04/25/2005 04/25/2005 APP JMP Received fax from Andy Renfro requesting the permit be issued with a deferred submittal for the HV AC seismic calculations. Structural Review 03/1812005 04/01/2005 WE JMP See attached documents for 8 structural comments faxed to David Jones, SUB Review 03/18/2005 03/28/2005 APP JF To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. ~ptl Tn~nections I SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection, SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping, Ceiling Grid: After drywall approval but prior to cover, Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met, Paee30f4 . . CITY U1< ISrK11~lj1<mLD Building/Combination Permit PERMIT NO: COM2005-00304 ISSUED: 04/2512005 APPLIED: 03/1712005 EXPIRES: 10/2512005 VALUE: $ 186,087.00 Status Issued 225 Fifth Street, Springfield, OR 541.726.3753 Phone 541-726-3676 Fax 541-726.3769 Inspection Line Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete, Rough Gas: After line is installed and required testing and capped if not attached to an appliance, " Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete, . Final Mechanical: When all mechanical work is complete, Rough Electric: Prior to Cover Final Electric: When all electrical work 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 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, O~~ J//,Z.S-/65" Date Page 4 of 4 "',...L,', VJtT; ....C:' I. "c 1'" . ~ -- -.\,,',-:~ ".' . - ..~....... ... .' .,.J. '::,.~:, ~ < .r:,n"o-:,.:-.\".CI1"':Y-.OFSPRINGFIEfrD OREGON' '.. ": ,~{.., " '~~>.,..:-.-r..' r'-~'~!."-'r ..-~(."''''''.> 't ;.r..,. ".,-"~ 1-' ., "_"~'_,"..'.~.^h'",.~'.< . r. 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)72~9 ~.,."O ELECTRICAL PIf~I1fr4.ePA1CATION "''0 ~ 't", City Job Number ~)<"iJ\ Date '04- c..:S - OS"'L \ :....".,0:.0'0. ":l~=>l'T"J~"""""""":"1:'l~ ,., . ~~.'" . ~<r tt...,.....-:>:.,.""F,..""..'''..,~~...,,~, .}. ~~, o~~~":i;.t:"_~"~"'-'_~ 1. ~ LOeA'l'ION OEtINSTALi!ATIONft{'f-t'~~;.;c:; 3. 'j-COMPLETE'FEE.'&ijh "",,,,1< B _"'0:;"'_~\@'\'~ ,~";'-"~~lil 1{A~n~" ~.~~--" - '..: ~~.:-,,~.>;;aj '&'=., ..~.=.-. '-."-"....~"f' . ;'-C=."'.""H'" .. "i~".C.'-'~- ""'''''''. '~-:~"~.' '.' ."'):') )lO l ^ lLL..Il....J:;!.. __ ., . .... ~._ . ~ 9<,;;~ .~. . LE~~1{rX1t) ~\1DD \J A':!~!~~~:~~~i~i~1~gt~!~~~~.:~.~~!~~1ITjim JO~( , 1000 sq. ft. or less ~ $106:-oo-G~, c. C\~ I\\\~_'t\" Each additional 500 sq. ft. or ~"c 0:-..,,"'1, J "\\ \ 1\ 1 " 1.1 UUL. portion thereof \. J. .00 ~ Permits are Don-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days, :\.....,.,~./.<"/,"i,-.,j"':..'.r'I':A:a!".:"",);,O\<..."';;,,;\'.:...;c--",:,;-"_...i1,....""...!;,;t,i,&...~.........-":,~ \'feONTIDfCTOIVINSTAEHA.TIOMONLy':~ 2. ;Ji~;~;;~-"""J;"""~"""":'~\'- '~"~..'!"'\..."..", ..".w..;_..'''''.....,..,'''...,~..;%,~;~/;;;''>1.~'--.,j S?RINOFI:E.LD ~.".l ~ . . ~ i. !\;I, ..,..'___ . ~~ ~.-.~. .."-,,,;.;.~~ r"?x(t ~~~,..... ~~"'" ...-"'J3!..,...t';/~ '''If.~''' J~:.<;!7!l_-*'~ ... ~ Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 '~-I"'>\-- ."'".. ,.. ,.__..~,,~,~n..,. ...... '.' ,_... ,._ B. }~s~y~!6~1F:~a~~i:.fttilrrii~ri}fAlt~ftih..~~V~iR1lli~.i6~.1}~.0d .'.\"....~.;'.:..,''',.,,' ,.,."n,'~~.;;);;;;,."""'""~:ii&1,';"'>:7~~rlh-';,-..:.".."',...,"':..!~~~.."',.:~.,'-."-;;,..,..,,,....'f..-";;"'~-.r;,.;;!.:::]1 JaleED Electrical Contractor L(;" nt. In~, F\':r-I-Y ,(' 200 Amps or less A $ 63.00 I - ._ _. = ._ '-'0. , . ",<,'201 Amps to 400 Amps $ 75.00 Address ~..l \ I ; (;I...;.x AI; " . ...-I-\t. ~':.'001 Amps to 600 Amps $125.00 C \\ . ...- \S \' _'_ c.'~S!\'?'o'- c?'~\, ?- 601 Amps to 1000 Amps $163.00 City r--- l i',$O\',k' ~, Phon~,";'+:)".Sl:;pidi) \$ Over 1000 Amps/Volts $375.00 J \\I:)\\~~~~\\S~~\)\~ ~~\>.~\)\J'- Reconnect Only . $ 50.00 :5.1-\\S ,,,?-\1~ . Q;3 ~ <'<. ' .,'"."m."',~<~"",,,.,~<'''''~,,,o;~."'''''~,;'''"'"''i'".'''"''''*~''i;ol~'-'''..""~"'jI Supervtsor LIcense ~\:\~~~(::'~;~ ",-\\.l~ C, :X:\!'empor~ry,.se""'c..,o~~~:~~~~~'1j'.!);'ili{".""'J~'r\'l'i"~W'-"~ Expiration Date i 'fR1t';,,!>ry ,)00 J Installation, Alter~DI'6~~~i!,tt8l\.'I:(}(}\' \'<,. I 200Ampsor~~{\ 'O,\~e J.e",'3'tQ..~? ."..",'0150.00 Constr. Contr. Number Il ~ S ~ 201 ~~ ~~e \ Q,'(\ 0 ~ .'(\~ \V~o{\%,(i9.00 . . ~~~Sl~~&-3.\\OoJ. e'" 0 '0\e~: r~~'S100.00 Expiration Date CJ<;J.-/03/;).t/:J \ ~,(~ c&~~(\\ <:pQ~ .~~~. ~.- , ~~.OP.Q.~ii.~~VP.lWSe~~ Luye. S,.gnature of SuperYJ.s\.ng Electn.ct'an \9.'J.m~;;';I2~~~!;;{t.~~;;:i>S'~~' ,J:;iroft'\!\,:;'l!:{"""i"J<<!"1;j~!i.'~ ~\'o' ~~~'JiiQr--~ .'\' +, .",.~,\" '" ~~c;,," '~1:s.\.\;~~,Il""..-..,-<-......a::-""-:'~':';r ...,;:~,~i\j~J:~ '" ~ ~\' e\'. e.,,=, ! ~w'""'-.. \~~.~at{!i.i1 <ii~~~l9D<:lper Panel ~~~~'i'~\O\ ~e\~ $43.00 Each CX~~n'ltififcUlt or wIth f\ " III _. r.::lCO SerYJ~orFeederPennit ....,~$ 3.00 ~ The installation is being made on property 1 own which is not intended for sale, lease or rent. Owners Signature: Inspection Request: 726-3769 '.....r~,.-.-.....,~,__" ......___.. ....-..7(,''"'''_... n_....___ ,_,'~__ , .." E. ;:'j'Mi~~~i'i~:i~t)irr(S~~~1Vf~~'d.~~rt~ili~liId.;a"i+E~~li1Iil~tiiii~ti6f1':~ J~;;":':''-'','F'.~'~..",w:;~~~'A;::'''' ~"''-'''C;i!:.iii;.~~W;;~~~k~'' .:' o_-_..".-.I'......";4~;i'~,~ Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited EnergylResidentiaI $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges :fi~"ft:;~-:'~ ""'''''''';..";.'''!JI:::ltl .-.,!".."..,;J;;:1~~-:,'".;"0'~~f'--; T...li''ii:~ Ilov"'I 4. 1;SUBTOTAL'OEABOVE:::~'B..t':;:~'f'>:;~;~, .(;;-J lA../ I. ~'."i T" ",-,'..., 'J'_-"~....;J;''''<i',_ -".}l~,~,: '1.",,~<'>:l'~~ . ~~~te surc;'~: . \ ~. 5t 10% Admlnlstratlve Fee ~ TOTAL ~ C;;~ -. '1.+ Shared Drive(T:)/Building forms/Electrical Pennit Application I-03.doc _A_. AlTACHMENT A CITY '::W"..!:'GFIELD SYSTEMS DEVELOPMENT CHARGE A:.sHEET JOURNAL OR JOB NUMBER: C0M2005-000304 -- NAME OR COMPANY: BRENNER'S FURNITURE LOCATION: 3306 GATEWAY ST MAP & TAX LOT NUMBER: 1703222001700 DEVEWPMENT TYPE: New Furniture Store attached to Best Buy NEW DEVELOPED AREA (S.F.): 5800 EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURFACE (S.F.): Already included in J lTE: lTE: LOT SIZE (S.F.): 822 See Best Buy LSIQRM DRAINAGE Alreadv included in ] IMPERVIOUS SQ. FT. 0 $ 0.310 PER SF x TOTAL STORM DRAINAGE SDq 2 ~ANTTARY SEWER-CITY Second credit from prior hotel. A. REIMBURSEMENT COST: . NUMBER OF DFD's B. IMPROVEMENT COST: NUMBER OF DFD's (SEE REVERSE SIDE) -2246 x $ 24.04 PER DFU x $ 18.28 PER DFU .2246 TOTALWCAL SAN-SEWER SDC:' $ -$54,002.11 ^ TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A REIMBURSEMENT COST: 5.800 x 67.91 x $ 18.30 PER TRIP x 0.45 NTF 1$ 3,243.28 I B. IMPROVEMENT COST: .5.800 x 67.91 x $ 80.72 PER TRIP x 0.45 NTF 1$ 14,307.69 I EXISTING A REIMBURSEMENT COST: Second'credil from prior hotel. 0.000 x 0 x $ 18.30 PER TRIP x 0 NTF 1$ (3,560.04)1 B. IMPROVEMENT COST: 0.000 x 0 x $ 80.72 PER TRIP x 0 NTF 1$ (15,705.10) 1 PAID BY BEST BUY LSANTTARY SFWER - MWIill: NEW: A REIMBURSEMENT COST: NUMBER OF FEU's 5.800 B. IMPROVEMENT COST: NUMBER OF FEU's 5.800 TOTAL TRANSPORTATION REIMBURSEMENT SDq $ TOTAL TRANSPORTATION IMPROVEMENT SDq $ TRANSPORTATION SDq $ ~ $ 1$ 272.48 1 2,872.77 I x $46.98 PER FEU x $495.30 PER FEU 1$ EXISTING: A REIMBURSEMENT COST: NUMBER OF FEU's 0.000 B. IMPROVEMENT COST: NUMBER OF FEU's 0.000 MWMC CREDIT IF APPLICABLE (SEE REVERSE) Second credit from prior hotel. x $0.00 PER FEU I $ (34,867.09)1 $0.00 PER FEU I $ (16,842.82)1 $ $ $ $ ~ $ ~ x TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: PAID BY BEST BUY TOTALMWMCSDC:I $ (34,594.61) (13,970.05) (48,564.67) SUBTOTAL (ADD ITEMS 1,2,3, & 4) I $ 5 ADMfl\T1STI? ATIVE FEES' BASE CHARGE (SUBTOTAL ABOVE) $ x 5% $ TOTAL TRANSPORTATION ADMINISTRATION FEq TOTAL SEWER ADMINISTRATION FEE:' #D1V/O! #DIV/O! '1'<'-'j ,.1078.. ;,'107'\ J~ ^ . . steve v.. w. "E.e.uartj "E..rv..es 4/612005 J,\lSo'O~ER':S FURNITURE, 3306 GAT~JJ ST.xls TOTAL SDC CHARGES , NONE 1 JULY 2004 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FlXTIJRES x UNIT EQUIVALENT = DRAINAGE FIXTIJRE UNITS (NO"IE: FOR REMODELS. CALCULA "IE ONLY THE NET ADDmONAL FIXTIJRES) BRENNER'S FURNITURE FIXTURE TYPE BATI-lTUB DRlNKJNG FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASFJOILISOLIDSIETC. INTERCEPTORS FOR SAND/AUTO WASWETC. LAUNDRY TUB CWTIlES WASHER/MOP SINK CWTIlES WASHER - 3 OR MORE (EA) MOBD..E HOME PARK TRAP (I PER TRAlLER) RECEPTOR FOR REFRlGERA TOR/W A TER ST A TIONIETC. RECEPTOR FOR COMMERCIAL SlNKJ DlSHW ASHERlETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK; COMMERCIAL, RESIDENTIAL KlTCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIDOUBLE LAVATORY SINK: SINGLE LA V A TORY /RESIDENTIAL BAR URINAL, STALUWALL TOD..ET, PUBLIC INST ALLA TION TOD..ET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDU'S' FIXTURES NEW OLD 234 o 0 o 0 2 160 2 234 UNIT EQUNALENT 3 I 3 3 6 2 3 6 12 1 3 2 2 3 2 2 I 5 6 3 o TOTAL DRAINAGE FIXTURE UNITS~ $ff)U (EQuivalent DwellinJ!: Unit) is a discharJ!:e equivalent to a single family dwelling (20 DFU) set at 167 J!;3llons per day DRAINAGE FIXTURE UNITS -702 o o o o o 3 o o o o o o 3 o o -158 O' -1392 o -2246 o o -2246 I 'CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 RATE PER SI,OOO ASSESSED VALUE $5.29 ,$5.19 $5.12 . $4.9B $4.BO $4.63. $4.40 $4.07, $3.61' $3,22 . $2.73 $2.25 $1.80 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) com2005-00304, BRENNER';S FURNITURE, 3306 GATEWAY ST.xls YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 RATE PER SI,OOO ASSESSED VALUE $1.59 ,$1.45, " $1.25 ' , $1.09 $0,92 $0.72 $0.48 .:$0.28, , $0.09 $0.05 $0.00 , $0.00 $0.00 x X CREDIT TOTAL SO.OO SO.OO . SO.OO 1 JULY 2004 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . ~f -- . <!-~, ~ty of Springfield Official Receipt .velopment Services Department Public Works Department . Job/Journal Number COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 COM2005-00304 Payments: Type of Payment CreditCard 4/2512005 RECEIPT #: 2200500000000000489 Date: 04/25/2005 Description Addressing Assignment Perm Serv/Fdr 200 amps or less Add, Alter, Extend Cire Ea Add Fixture Furnace - more than 100,000 Vent Fan Gas Outlets 1-4 . -Mechanical Issuance Fee- Plan Review ComrnllndlPublie Plan Review Fire & Life Safety Building Permit + 7% State Surcharge + 10% Administrative Fee Paid By DENNIS W MElLI Item Total: Check Number Authorization Received By Batch Number Number How Received jmp 06360 I In Person Payment Total: Page I of I 2:02:23PM Amount Due 31.00 126.00 96.00 154.00 45.00 6.00 4.00 10.00 25.35 15.60 848.40 89.56 127.94 $1,578.85 Amount Paid $1,578.85 $1,578.85 SPRINGFIEl.D. I' 'A ~- ~~".(X)~ Building Permil R ~\r'1/~ Oile ~~~ ~\.tV~ - .' :"OJCel-:.:t~. ~ bA&WM 4'(': \ Pnljecl Address Cily ofSpdngfield Corr:::u3lr;o Si:.a-:~~~5 D_i~~iVi' nHifth Su.el Springraeld, OR 97477 Telephone: (541) 726:)759 Fax: (541) 726-3689 Specialln.peelion And Tesling - '," ': , '" .... , to..:~ ''"'. IS... <1", ..... ...0 <1en '" <1... '" '" ... ..... '" G " ~ Gen '" ... . '" co en ... '" co '" c . -> -", ('-< '> 0'" ,C"l ,= .... ~:;j &C"l .>-3 rV> .~ BEFORE A CERTIFICATE OF OCCUPANCY WILL BE ISSUED: The Special Inspection AgeDcy shall submit 10 lile Building Official a slalemeOllila! all items requiring inspeclion have been fulfilled and reported and were 10 lbe best oflhe inspector's knowledge, In conformance wilb Ibe approved ptans, specificalions and applicable workmanshiP provisions. Those ilems nollesled and/or inspecled sball be DOled h Ihe slllemenl. The rcport is 10 be submitted 10 Ihe City prior 10 a requesl for f.r,al inspeclions. To applicanlS ofprojeclS requiring special insPeclion or lesling as per Seclion 1701.5 ofllle Oregon SINCIun' Specialty Code. Please review.lbe information below. When you have fmnhed. acknowledge an underslanding oflbe informaliOll by signing below, and rehlm Ihis fonn 10 Ihe City. BEFORE A PERMIT CAN BE ISSUED: Tho oYlner or owner's represenlalive, on lIIe advice of !he responsible Projtcl Engineer or ArChilecl. shall compl~e, sign, 8J1d submil 10 Ihe City !9r review and approval this form compleled on bOlh lIIe fronl ~nd back. ~ Own...."'d General Conrraelor, wileR applicable, shan aim ackoowlecige1J\e following condillDIU applicable 10 Speciallaspection and/nr TeSling. I. Conlrador is responsible for proper noliflCation for Ihe Inspeclion or Teslillg of itenu listed. 2. Telling Iabornlory .hlIlIlake ,.,., ,. '.Ie samples and rransport them 10 Iheir Iaboralory for proper evaluation or ICSling. . Copies or.n'labor-alory reporlS and Inspections are 10 be senl 10 die City by Ihe Testing Agency. J. Speelnllnspeclioll Agency is 10 submit names and qualifications of on-site Special In.peclors 10 lbe Cily for approval 4. Speciallnspcelor shall provide iIlspeclioo report! 10 Ihe building official orall inspection activities. 5. Conlroclor is respOllSible 10 review IIN: City approved pl~os for addilional inspection or leJlint requiremenl.llhlt may be nOled. ACKNOWLEDGMENTS /2-.114 ~ - 0\\A.. ~mubl6'(e&J~ 'tJ'ltt'\7f.64. kL Owner Name (Prinled)' . Owne uni 1- - t ~,\N~~Jo~ Engineer or Archileel Finn (Prinled) Engi~~e~ oeil ~ignalure /12. ~d7w-..:.- . <<';b,g L8~tP Signat~re .EI;J TF..!>i/N t:. -t-INsP Tesling Laboralory Name (Prinled) . . ~&tl,l c.t).f'(DH ~____~.___---7"'" ~ ---- Jion~a;l::~~~; ( G~r,a;~ Speciallnsp.~on. a ll"osy tl_- ~d) '~iall~~CY Rep s~.gD. r C-- ~. " ~ c- r- .......... 0......., \ ~l ~)-f" ,\ U. 'c..\ J ~. . \ -'=') \. ~ . Building Official 'Name (Printed) ~Cial SlgnSlUre !:: . . :', . 0 o '" Reinforced Coneret.. Gunil.. Grouland MOrl...: Concrete Gun.i1r- GQHlI M;w:Dr P",cssl/Pre-slrused Conerele: _Pil.. Pos!- TeM Pre-Tens Clnddine SMOKE CONTROL: Leal!ai:e lesting Control vuifuliIIn ROOFtNG Insulation in<lallalionIR-value' Tesl slripslseams STRUCTURAL STl!:EIJWELDING: SImple Ind.ksl (lisl specilic members below) a:w,u- Shop material identilicalion linin ce~./ .~ ~. Weld inspeclion ~ Shop Y Field Ulll~onic ins(lCclion Shop Field High strenglh bolt;ng Shop Field ADS N X F A490 N X F Meilll deck welding iMpeelion Reimorclng Sloel welding insp<:Clion Reinforcing sleel mill certiliea/e Metal slud welding inspeclion Concrete insert weldlng inspKtion Momenl resisling sleel frames SPECIAL INSPECTION AND TESTING SCHEDULE J\grre~ate Te~t ,,(Mix Oesi,m Reinrortin~ T~d Mi. DesillD-Wei\11mstr Cm ' Reinfocior Plaeeme'" Con\inuous Balch Plantln.n Insned PlaWI: ~... Sampl... Samples lPickuplDelivereOl CM1pression T.... GRADING, EXCAVATION, AND FILL A~tance ICS1.5 .' PSF Estahlish linal grade. Fill placemml inspeclion/continuous Soil Densily Aurerate Ted' Reil'farcine T..c.t. Tendon Tf!d Mi. J:lc.lI&n.' Reinfarcin, Placement Insert Platemenl ~I]ncrele Balchil'lit;J ermer-de Plar:emenl In'lallation Inspection Ca,t Sanmks Piek-up S8mpl.. rnrnpreslion Tem STRUCTURAL WOOD: Shear wall oailing inspecli<Jn Sh~r wallllllChors hl3peclion of GIu-lam rob. . T/C psi lnspcclion OrlNn joist rab, Sample and le,l components Fabrication welding orslCel accessories. FIREPROOFING: Plal:emenl inspeclion Density Tc,lS Thickness !csb Inspect bat ching MASONRY: 4i1iie ~. Special inspeclioo slresses used' rm _rg Preliminary acceptance 1<><1$ (masonry uoits. wall prisms) Subsequenllesls (mortar, grolll, rleld wall prisms) Placemenl illSjl<<lion of uniu. and n:illron:emenl Masonary, mortar, groUl, and reiarorcing slUl certilicates Form com"pleled by: OM)\O .\~ Oalc-'_26 ADDmONAL INSTRUCTIONS. OTHER TEST, & INSPECfIONS: ~~ ~~, ~~, · PROVIDB STREI'lGTH REQUIRED DY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION 0\1' VALUES C l o . '0 .... 0, 0.... ""' , o .", " . l.... "' '" '" . o l ~ 0'" ... .... eE .... ... '" "' ( . -> -., c'"' '> 0'" ,'" ,;:; S;J ~'" .'"' 0'" e~ , 1 G o ~ -0 o "' , o o "'