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Home My WebLink AboutPermit Building 2019-12-20OREGON Web Address: www.springfi eld-or.9ov Building Permit Commercial Structural Permit Number: 811-19-OO2831-STR IVR Number: 811011919171 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 Email Add ress: permitcenter@springfield-or. gov SPRINGFIELD €rt Permit Issued: December 20,2OL9 TYPE OF WORK Category of Construction: Commercial Submitted Job Value: $2,000.00 Description of Work: Install partition in exam room Type of Work: Tenant Improvement JOB SITE INFORMATION Worksite Address 5781 MAIN ST Springfield, OR 97478 Parcel 1702334103500 Owner: Address: CARRINGTON FRANCIS L PO BOX 1328 EUREKA, CA 95502 LICENSED PROFESSIONAL INFORMATION Business Name BURT WALTER CONSTRUCTION INC - Primary License ccB License Number L90704 Phone 503-5 16-8786 PENDING INSPECTIONS Inspection 1999 Final Building 1260 Framing 1540 Gypsum Board/Lath/Drywall Inspectaon Group Struct Com Struct Com Struct Com Inspection Status Pending Pending Pending SCHEDULI NG INSPECTIONS Permits expire if work is not started within 180 Days of issuance or if work is suspended for 180 Days or longer depending on the assuing agency's policy. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Granting of a permit does not presume to give authority to violate or cancel the provlsions of any other state or local law regulating construction or the performance of construction, ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-OO1-OO10 through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (503) 232-t987. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O (Structural/Mechanical), ORs 479,540 (Electrical), and ORS 693.01o-o20 (Plumbing). Printed on: 12120119 Page 1 of 2 C:\myReports/reports//productaon/01 STANDARD h Various inspections are minimally required on each project and often dependent on the scope of work. Contact the issuing jurisdiction indicated on the permit to determine required inspections for this project. Schedule or track inspections at www.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811011919171 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permit Number: 81 1-19-002831-STR Page 2 of 2 Fee Description Technology Fee Structural building permit fee State of Oregon Surcharge - Bldg (l2o/o of applicable fees) Printed on: 12l20l19 Quantity Total Fees: Fee Amount $s.10 $ 102.00 $r2.24 $119.34 Page 2 of 2 C : \myReports/reports//production/01 STAN DARD PERMIT FEES SPRINGFIETD ni OREGON www.springfield-or. gov Worksite address: 5781 MAIN ST, Springfield, OR 97478 Parcel:'l 7023341 03500 Transaction Receipt 811-19-002831-STR IVR Number: 81 l0ll9t9171 Receipt Number: 473345 Receipt Date :'l2l20l 19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 permltcenter@spri ngfield-or.9ov Fees Paid Account codeTransaction Units date 12120119 1.00 Ea 12t20t19 1.00 Ea Description Structural building permit fee State of Oregon Surcharge - Bldg (12o/o ol applicable fees) 224 -00000- 425602- 1 030 821 -00000-21 5004-0000 204-00000-425605-000012t201'19 1,00 Automatic Technology Fee Fee amount $102.00 $12.24 $5 10 Paid amount $102.00 $'t2.24 $5.1 0 Payment Method: Credit card authorization: 004060 Payer: Daniel Klute Payment Amount:$1 19.34 Cashier: Chris Carpenter Receipt Total:$119.34 Printed: 12120/19 9:46 am Page 1 of 1 F I N_Tra nsactionReceipt_pr Structu ral Permit Application ffi -5225 Fitlh Street o Springfield, OR 97477 . PH(54t)726-3153 . FAX(54 I )726-3689 This permit is issued under OAR 918-460-0030. Permits expire if work is not started within I80 days of suspended for 180 days. This proiect has final land-use approval Signature:Date: This pro.ject has DEQ approval Signature:Date: Zoning approval verified: ! Yes n No Property is within flood plain: ! Yes ! No E Residential ! Government fi Commercial JOB .lob site address: 5781 Main St. City: SPringfield State: OR ZIP:97478 Subdivision:Lot no.: Reference:Taxlot. I 7023341 -03500 11ams. Nova Health Address: 91302 Coburg Industlial Way Suite 122 City: Coburg State: OR 2rc97408 Phone: 54 1.799. I I 50 Fax: E-mai I : jdowns@rlovahealth.con-r Building Owqer-.or Owner's agent authorizing this application'' \ Sign here: l, / .*. ; 'ilt: Owner's agen E This instaltation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010. TOR ON Business n311s. Burt Walter Construction Address: 12586 SE l62nd Ave City: HaPPY ValleY State: oR ZlPt97086 Phone: 503-516 -8786 Fax [-p3i| ; burlwalter@mac.corn CCB license no.' 190704 Print name: Burt Walter Signature:( ,.),,*:f U, Contractor's agent or ls DEPARTMENT USE ONLY Permitno: 511_ 263 Date: //.,//2 /l q (a) .lob description Partition existing roolr to create t$,o exam room Occupancy B, clinic Construction type: 5B Square f-eet: No ProPosed charrge Cost per square foot: NA Other inlorrnation: NA Type of He at: NA Energy Path: NA ! nerv ffialteration E addition (b) Foundation-only permit? [ Yes E No Total valuation $ 500.00 (a) Permit fee (use valuation table)$ /n2/ (b) Investigative fee (equal to [2a]):s (c) Reinspection ($ per hour): (number ofhours x fee per hour)$ (d) Enter I 27o surcharge (. I 2 x [2a+2b+2c]):$ (e) Subtotal offees abovc (2a thro $ (a) Plan review (65% x permit fee [2a])$ (b) Irire and litb saf'ety (65% x permit lee [2a]):$ (c) Subtotal offees above (3a and 3b):S (a) Seismic flee. l% (.01 x permit f'ee [2a])$ (b) Tech fee,5o/o (.05 x perrnit fee[2a]+PR fee [3c])$ JOTAL fees and surcharges (2e+3c+4a+b) .7e S //q,J PhoneNameCCB License # Electrical TBD Plum bing TBL) Mechanical NA Last edited 5-5-2019 BJones LOCAL GOVERNMENT APPROVAL CATEGORY OF CONSTRUCTION PROPERTY OWNER SUB.CONTRACTOR INFORMATION FEE SCHEDULE 1. Valuation information 2. Building fees 3. Plan review fees 4. Miscellaneous fees City of Springfield Development Services Department 225 Fifth Street Springfield , OR 97477 SPRINGFIELD h, Planning Division Information Sheet for Building Permits Commercia l/Ind ustrial/ M ulti-Fa mily Residentia I The Planning Division requires the following information for all building permit submittals on properties zoned Medium Density Residential, High Density Residential, Commercial, or Industrial, including new construction, expansions, and changes of use. New construction, expansions, and changes of use to any building, parking, or development area in these zoning districts requires either Minimum Development Standards-MDS review (SDC 5.15-100) or Site Plan Review (SDC 5.17-100) by the Planning Division. Overlay District Development review (SDC 3.3-100) may also be required, depending on the site. NOTE: It is prudent to make sure your use is permitted in the applicable zoning district. Building Permit, Police or other permit approvals or inspections are not Planning approval. Applicant Name: Daniel P' Klute, AiA phone: 54L.344.9157 Companv; GMA Architects Fax: 03500 Address: 860 W. Park St. Suite 300 ASSESSOR,S MAP NO: 17o2334L TAX LOT NO s ProPertY Address: 5781 Main St Description of the proposed work to be completed under this building permit: Partition existing room to create two exam rooms Has this development proposal been reviewed by the Planning Division through an application process (i.e. MDS or Site Plan Review)? If yes, Case #: If no, is this a change in use? E ves E no Prior Approved Use: NA Proposed Use:NA Eves Euo Zonin TOTZ:Ove s Does the use necessitate the use of any chemicals or substances that are hazardous or and Data Sheets YesMSDSto be ke on site?re uire Material S No The proposed project requires submittal and approva! of the following Planning application prior to building permit approval: E OWp Overlay District Development E Statement Letter Regarding DWP Exemption E t{oS tr MDS Land Use Compatibility Statement E site Plan Review E other: Reviewed bv:Date: Reguired froject Information (Appticant: complete this section) nirF'a Staff:this siCtion) SPRINGFI ELD b OREGON City of Springfield Building Safety/ Community Services Division Development Services Deparlment 225 Fifth Street, Springfield, OR97477 ph: (541) 726-3753 fax: (541) 726-3689 Permit #8ll-SPR20 Commercial Building Permit Submittal Requirements / Checklist Check each box to verify requirements are met. Submit 3 full sets of plans with the following applicable information (Submit only 2 sets of specifications, engineering calculations, product listings, etc...) I. Planning- Project Approval -Yes X No II. Public Works- Project Approval -Yes -[N,III. Site PIan REQUIRED FOR ALL APPLICATIONS, INCLUDING INTERIOR REMODELS flegible & drawn to scale (such as l ":20') and include North arrow frfiInclude property line locations & existing public and private easements (utility, driveway, etc.) with dimensions Nl Include the location of public and private utilities (water, electric, sewer, gas) [[_lf on septic system, show tank and drain field locations M Indicate any water ways & wet lands areas on property N[ Show existing and proposed finished grade based on spot elevations and contours over entire site liShow adjacent street names |4 Perimeter outline of existing & proposed structures with distances to all property lines & between structures, setbacks shall be identified with written dimensions as well as to scale M Indicate height ofall structures IttA Sho* building & garage entrances as well as driveway & access location fi'om street [{ Parking lot layout with required spaces (including disabled) NA Building surface coverage calculations (square footage oflot, offootprint & percentage oflot coverage) [Show site drainage using arrow to indicate direction of flow, also indicate square footage of impervious surfaces which will include asphalt, concrete, roofing, etc. III lndicate all projections from exterior walls, including overhangs, awnings. etc. [For additions / remodels, indicate area on footprint to be altered IV. Plans \Legible and drawn to scale (such as %": t'-0") Wny building resulting in the /botprint o1 4,000 square Jbet or greater OR with a ceiling height 20' or more above grade needs to have an Engineer's or Architect's seal and signature. $14"t-tig,rature Stamped Engineering, Design Criteria, Calculations and Specifications, including energt path N* Engineering specifications and construction details must be transferred to the plans t* DeJbrred Submittals must be listed on the cover sheet of construction documents. A DeJbrred Submittal Forrn must be completed prior to permit issuance- http://www.springfield-or.gov/dsd/Building/Forms.htm \_Code Analysis Layout including Fire and Life Safety plan review 6[_Civil Drawings, all sheets to include parking, fire service lines, water lines, etc. phFoundation Plan 4ndicate size & location of all footing types, posts, girders, hold-downs & straps and under floor access openings & vents TJnclude details (with scale indicated) of each footing type & retaining wallto be used showing size, reinforcing, wall heights & framing connections 4rovide design calculations for retaining walls and/or special footings \k tt"rotions (l /br eaci side of building) y\Typical cross sections [-The main sections shall show alI foundation & framing components including but not limited to: floors, walls & ceiling, main structural members, sheathing, siding, roofing and bracing [L For two story structures: inciude a complete stair section indicating stair rise & run, headroom clearance, framing & support members and handrail/guardrail details !_Include any additional framing section needed to demonstrate any unique framing condition not shown by the main section |,fu!,at era I b r ac ing detai I s {OetaiUa Toor plans with square.footage & systems layout &Show entire floor plan of new construction [lndicate existing and/or new square footages lldentify & label use of each room, space or area { Indicate dimensions of all building sides & interior wall locations f, Indicate all window & door sizes & locations fShow system layout of all plumbing, heating & air conditioning, mechanical equipment, etc (indicate electric or gas) include non-residential energy forms (energy forms can be printed from www.energy.state.or.us) fllStrow electrical layout including room lighting, outlets, fans, exhaust vents, etc. @Floor.iraming./ Provide a plan for each framed floor /lndicate location & sizes of all posts & beams; show joist sizes & spacing ./lndicate Dost & beam connections Nk noul Ji*ing (iJ'using Roof Trusses provide engineeretl details oJ'all trusses to be usecl, including a layoul indicating the placement of each tru,ss)/ lndicate location, spacing & sizes ofrafters & ceiling joists or rooftrusses ftndr"ut" location, size & type of suspended ceiling system ,/Show camiertrusses & type of hurricane clips to be installed at each truss rlndicate solid blocking between rafters at point of bearing and truss bracing /Indicate headers sizes for door & window locations Nlr gtectricol Plan Reviewfor Complex Structures 4f the scope of electrical work meets the definition of complex structure in OAR 918-3 I l-0040, an electrical plan submittal meeting the requirements of OAR 918-3 I l-000 shall apply. V. Medical Gas Plans "Medical Gas" means any gas and vacuum system or equipment intended for medical and dental procedures in heulth care and non-health carefacilities (i.e. Oxygen, Nitrous Oxide, Medical Air, Medical Vacuum, etc.) N[ Vtedical Gas System (Engineer stamped plans, specifications, and calculations are required) |.L{iLevel 3 Dental Air and Dental Vacuum Systems (Plans designed to equtpment manufacturer's installation standard are required) All Plctns to include'. !f,Location of all piping, valves, vacuum pumps and compressors flA Size and type of all piping and fittings pA Location and type of all alarms and outlets NA Location and volume of all supply gas x{Specifications of vacuum pumps and compressors NfVentilation requirements for equipment, supply, and storage areas VI. Self-Preservation - Medical and Dental Facilities Will there be use oJ'prctcedures that render a patient incapable of'unas.tisted se(-preservation? _Yes VII. Address [Vutia physical adclress is required on application. Proper building or suite number must be provided to the building division prior to permit issuance. Provide 8 l12" by 11" floor plan for proper suite number assignment andlor, if more than one building on lot, provid e 8 I12" by 1 1 " site plan for s" proper building number assigmnent. VIII. Special Circumstances - Demolitiorl (separate demolition application must be filled out) Demo work to take place?f,Yes -No lAny commercial prclect requiring demolition is requiretl to submit an inspection by a certified inspeclion compan.t,slating lhul asbeslos hus been removed properl.v,) IX. Special Inspections Special inspections required? _Yes f,No ,lr.r commercial proiect requiring special inspection.r requires suhmittal of a complere Special Inspection Forn be.fore permit i.s.suunce-'http://wunu.springfield-or.gov/dsd/Building/Forms.htm X. Special Circumstances - Grading An.y comnrerc:iul projecl increasing ./botprint square.fbotage, an1' neu'or modilied impervious surlace will reqnire Grading.sign ol/ lbr plan qeviau'and sirc in.sltcction prior ro./inal huilding inspection. Applit'ant shall ,rubnit grading plan to Puhlic l|'orks. NA Project requires Grading sign off XI. Special Circumstances - Waste Water The Following Bustnesses May Require ll/qste Water Review: Auto Body Repair & Paint Shops, Auto Repair (Mechanical) Engine & Transmission, Auto Wash, Breweries, Blue Printing/Photocopying, Chemical Manufacturing, Electroplating/metal finishing, Laundries, Leather Tanning, Machine / Sheet Metal Shops, Medical/Dental Vacuum System Equipment Drainage, Millwork, Pharmaceutical Manufacturing, Photo Processing, Plastic / Synthetic Manufacturing, Print Shops, Service Stations, etc... |'{[_Project requires waste water review The Following Businesses May Also Require an Oil/Water Separator: Auto Body Repair & Paint Shops, Auto Repair (Mechanical) Engine & Transmission, Auto Wash, Service Stations NA eroi.ct requires oiliwater separator All Restaurants & Food Sertice Establishments (lncluding Small Deli Types) Require Grease Interceptors NL Proj..t requires grease interceptor XII. Special Circumstances - Food-Related Activities N& Will there be any food- or beverage-related activities? pft_Food Service (i.c. rcstaurant, dcli, cat6, coft'cc shop, brew pub, catcring opcration, mobile food vendor, etc) pI Food or Beverage Processing, Manufacturing, Sales, Warehousing/Distribution (i.e. grocery store, convenience store, home-based food business, beverage production and/or sales; includes wine, nonalcoholic beverages, bottled water, brewery, etc.), food products warehouse, bakery, meat market, food processing (includes the manufacture and/or handling ofany food product). XIII. Egress Lighting If there is a requirement to complete an egress lighting inspection, we offer this service after hours for those customers interested in not having to 'black-out' the facility for inspection. Additional fees are required for after- hours inspections. Note: Additional fees may be charged for phased construction, deferred submittals and proiect revisions. I tlo hereby cerlify that sll information hereon is true und accurste and that I am responsible for submittittg the applicable items to the appropriate departntents. D*tt6 L ?UTE hLcHtr7cI Sigttuture (Design Professional, Builder or Properfit Owner)/ Pritrt Name/Association with Pntiect ot_Nf.p *heru r