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Home My WebLink AboutPermit Building 2020-03-10CitY of SPringfie\d D ev ero Pm ent'1I T,[ H'X1 Soringfield' OR97477 541-726-3753 SPRINGFIELD OREGON Web Address: www springfield-or'gov Building Permit Commercial Structural Permit Number: 811-2O-OOO282-STR IVR Number: 811007803506 Email Address: permitcenter@springfield-or'9ov Permit Issued: March 10, 2020 Structural Specialty Code Edition: 2019 Category of Construction: Commercial Submitted Job Value: $260,000'00 Type of Work: Tenant ImProvement Description of Work.TI 4th floor ICU Pt' rooms Worksite Address 3333 RIVERBEND DR Springfield, OR 97477 Parcel t703220004L02 Owner: Address PEACEHEALTH 1115 SE 164TH AVE VANCOUVER, WA 98683 PROFESSIONAL INFORMATIONLICENSED Business Name ANDERSEN CONSTRUCTION COMPANY OF OREGON LLC - Primary License CCB License Number 2L8297 Phone 503-283-67L2 PENDING INSPECTIONS Inspection 1999 Final Building 1260 Framing 1540 Gypsum Board/Lath/Drywall 1500 Ceiling Grid Inspectaon Group Struct Com Struct Com Struct Com Struct Com Inspection Status Pending Pending Pending Pending SCHEDULING INSPECTIONS 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: 811007803506 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work is not started wlthin 18O Days of issuance or if work ls suspended for 18O Days or longer depending on the issulng 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 provisions 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 rul€s are set rorth in oAR gs2-ool'oolo throush oAR 952-oo7-oo9o. You may obtain copies of the rules by calling the Center at (503)232-7987. a'l persons or entities perfoming work un.ler this permit are required to be licenserl unless exempted by oRs 7ol.o1o(structurar/Mechanicat), oRs 479.540 lelectricat;,-and oRs 693,olo-o20 (plumbing). Printed on: 3/7O/2O page 1 of 2 C: \myReports,/repo rts/ / production/ O 1 STANDARD ,/ ,tfi TYPE OF WORK JOB SITE INFORMATION Permit Number: 8t t_20_OO0282_sTR Fee Description Technology Fee SDC: Total Sewer Administration Fee SDC: Reimbursement Cost _ Local Wastewater SDC: Improvement Cost - Local Wastewater Seismic Review - Essential Facilities Structural building permit fee Structural plan review fee State of Oregon Surcharge - Bldg (t2o/o of applicable fees) Note: This may not include att the fees required for this project. Printed on: 3/10/20 Quantity 89.o7 1193.5 587.93 Page 2 of 2 Fee Amount 9153.54 989.07 $ 1,193.s0 $587.93 $ 18.s0 $1,849.90 97,202.44 922t.99 $5,316.87Total Fees: C:\myReports/reports//produdion/o1 STANDARD Page 2 of 2 PERMIT FEES Transaction ReceiPt 81 1-20-000282-sTR IVR Number: 81 1007803506 Receipt Number: 474060 Receipt Date: 3/10/20 CitY of SPringfield Development and Public Works 225 Fifth Street Springfield, OR97477 54t-726-3753 permitcenter@sprin gfield-or. gov Paid amount $1,849.90 $18.s0 $221.99 $'153.54 $1,193.s0 $587.93 $89.07 OREGON www. springf ield-or. gov Worksite address: 3333 RTVERBEND DR, Springfietd, ORgt477 Parcnl: 1703220004102 SPRINGIIELD th Transaction Units date 3l1ol20 1.00 Ea Description Structural building permit fee Payer: Andersen Fees Paid Account code 224-00000 _425602_ 1 o3o 204-00000 _425605-0ooo 3t10t20 '1.00 Ea 3t10t20 1.00 Ea 3t10t20 1.00 Automatic Technology Fee 3t10t20 3110t20 3t10t20 Payment Method: Check number: 32.,0 SeismicReview-EssentialFacilities 224_00000-425602_1030 State of Oregon Surcharge _ Bldg (12o/o of applicabte fees) 82 1 -00000-2 1 5004-0ooo $221 .99 1 ,193.50 Amoun SDC: Reimbursement Cost _ Local Wastewaler 6 t 1-00000-448024_8800 $1,193.50 587.93 Amount SDC: lmprovement Cost _ Local Wastewaler 61 1 -00000-448025-8800 $587.93 89 07 Amount sDc: Totar sewer Administration Fee 719-00000_426604_8800 Fee amount $1,849.90 $18.50 $153.54 $89.07 Payment Amount:$4,114.43 Cashier: Katrina Anderson Receipt Totat: $4,114.43 Printed: 3/10/20 8:38 am Page .l of 1 FIN_Tra nsactionReceipt_pr -.y' 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. NTI This project has final land-use approval. Signature:Date: This pro.ject has DEQ approval. Signatrgc-Date: Zoning approval verified: E Yes E No Property is within flood plain: f] Yes E No OF CONSTRUCTION ! Residential I Government [} Commercial JOB SITE INFORMATION AND LOCATION Job site address: 3333 Riverbend Drive City: Springfield State: OR ZIP:97477 Subdivision:Lot no Ref-ercnce Taxlot: 17032200 - 4102 Name: Peacehealth Address: ll 15 SE l64th Ave Citv: Vancouver State: WA ZIP: 98683 Phone: (541) 344-9157 Fax E-mail : jhollou,ay@peacehealth.org :i::,:::- "" n "ryri1113Yp n' i c a' i o n an i, instfitKnis ueirii maoe on residential or farmlproperty owned by me or a merfrber of my immediate family, and is exempt from licensing requirements under ORS 701.010. CONTRACTOR INSTALLATION Business name: Andersen Construction Address: W 4th Ave City: Eugene State: OR ZIP:97401 Phone: 54 I -735-3525 Fax E-mail : .ihubbard@andersen-const.com CCB license nq:J,65612-> a Print name: Joe Hubbard Signature:lg utr' lw A/L Structural Permit Application 225 Fifth Strcet I Springfield,OR9741'7 .PH(54t\726-3'753 o FAX(54t)726-3689 SUB.CONTRACTO Name CCB License #Phone Number Electrical OEG 203 (s4t) 747-081 l Plumbing Harvev + Price Co 77 (54t) 7 46-t621 Mechanical Harvey + Price Co 77 (s4t) 746-1621 ffi (g(.-*u^ (Jd s4er'*{ so€- N\-\=^.c q 6fr-v..e-3 q)Ca DEPARTMENT USE ONLY Permit no.2-a7- out.' }.\\3\>O C (e) (r) (') Pttut ,fiUP FEE SCHEDULE (a) Job description: Equipment replacement ,1, Occupancy: I-2 (Hospital) Construction type: lB - Fully Sprinkled {c Square feet: 552 SF Cost per square foot: Other information: 'fype of Heat: Energy Path: fl new @alteration n addition (b) Foundation-only permit? [ Yes E tlo Total valuation $2 00 (a) Permit fee (use valuation table):$ (b) Investigative fee (equal to [2a])$ (c) Reinspection ($ per hour): (number ofhours x fee per hour)$ (d) Enter I 2%o surcharge (.12 x l2a+2b+2cl):$ (e) Subtotal offees above (2a through 2d):$ 3. Plan review fees $(a) Plan review (65% x permit fee [2a]): (b) Fire and life safety (650lo x permit fee [2a]):$ and 3b) fee [2a]) S $ (c) Subtotal offees above (a) Seismic fee, l% (.01 x 4. (b) Tech fee,5%o (.05 x permit lee[2a]+PR lee [3c])$ (c) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (2e+3c+4a+b+c+d):s Last edited 5-5-201 7 BJones e,\\J\/\.A a 6l-c- PROPERTY OWNER \ 1. Valuation information a,Lte 2. Buildine fees CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER NAMEORCOMPANY: LOCATION: MAP & TAX LOT NUMBER: DEVELOPMENT TYPE: 8l 1-20-000282-STR Peacehealth 3333 Riverbend Dr 1703220004102 100 LOT SIZE 1.00 MWMC I ITE: SURFACE .F EXISTING DEVELOPED AREA (S.F.): TOTAL IMPER TOTAL STORM DRAINAGE SDC: x Cost SQ. FT REIMBURSEMENT COST: IMPERVTOUS SQ. FT IMPROVEMENT COST: SQ. FT, $0.00 $0.00 X $ 0.303 PER SF $ 0.437 PER SF sF= $ 0.740 $I 781.43 REIMBURSEMENT COST: NUMBER OF DFU'S IMPROVEMENT COST: NUMBER OF DFU's x $ 83.99 PER DFU $ 254.49 TOTAL LOCAL WASTEWATER SDC: reverse 7 7 x $ 170.50 PER DFU I $0.00 AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR s0.06 $r.06 $ 397.26 x x x x x NTF x S 19.86 PER TRIP S 377.40 PER TRIP S 19.86 PER TRIP NTFx TOTAL TRANSPORTATION NTF NTF x $ 377.40 PER TRIP TOTAL TRANSPORTATION REIMBURSEMENT TOTAL TRANSPORTATION IMPROVEMENT REIMBURSEMENT COST: 0.00 x 2.81 IMPROVEMENT COST: 0.00 x 2.81 REIMBURSEMENT COST: 0.00 x 2.81 IMPROVEMENT COST: 0.00 x 2.81 #N/A $.43 #N/A #N/A #N/A #N/A #N/A #N/A #N/A SUBTOTAL ITEMS I 0.00 x 0.00 x x0.00 #N/A PER FEU x x x TING: REIMBURSEMENT COST: IMPROVEMENT COST: COMPLIANCE COST: CREDIT IF APPLICABLE (SEE REVERSE) TOTAL MWMC SDC: &4 REIMBURSEMENT COST: NUMBER OF FEU's IMPROVEMENT COST: NUMBER OF FEU's COMPLIANCE COST: NUMBER OF FEU'S PER FEU PER FEU #N/A PERFEU #N/A PER FEU #N/A PERFEU NUMBER OF FEU's 0.00 NUMBER OF FEU's 0.00 NUMBER OF FEU's 0.00 TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: TOTAL MWMC COMPLIANCE FEE: MWMC ADMINISTRATIVE FEE: IU@ I@ IIEE 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE)|,78t .43 x 5o/o STORM DRAINAGE ADMINISTRA SEWER ADMINISTRATION TRANSPORTATION ADMIN ISTRATION LOCAL MWMC ADMINISTRATION $89.07 0.00 89.07 0.00 0.00 $ 1.870.50 $ 211312020 TOTAL SDC CHARGES 1 I I I DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES X UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS,CALCULATE ONLY THE NET ADDITIONAL FIXTURES) #REF!DRAINAGE FIXTURE UNITS UNIT FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN. FLOOR SINK INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB CLOTHES WASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARKTRAP (1 PERTRAILER) RECEPTOR FOR REFRIGERATOR/WATER STATION/ETC. RECEPTOR FOR COMMERCIAL SINIV DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBEROF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLE LAVATORY/RESIDENTIAL BAR URINAL, STALUWALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: 0 0 NUMBEROF EDU'S* *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day FIXTURES NEW OLD ALENT 0 0 0 0 0 0 0 0 0 0 4 3 I 3 3 6 2 3 6 t2 I 3 ,, ) 3 2 2 I 5 6 3 4 0 0 0 0 0 3 0 CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY YEAR ANNEXED CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) RATE PER $1,OOO VALUE $1.4s $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.0s $0.00 $0.00 $0.00 x x $0.00 RATE PER $1,OOO ASSESSED VALUE YEAR ANNEXED 1979 r 980 r98I 1982 1 983 1 984 1 985 I 986 198'7 I 988 I 989 l 990 I99r or before $5.29 $5.r9 $5.1 2 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.2s $1.80 1992 1993 1994 l 995 1996 1997 l 998 1999 2000 2001 2002 2003 2004 CREDIT TOTAL t $ooo TOrAL DRATNAGE FrxruRE lrNrrs = lT SPRINGFIETD ,b Transaction Receipt 81 1 -20-000282-STR IVR Numben 8l I 007803506 Receipt Number:473808 Receipt Date:2113120 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54L-726-3753 permitcenter@spri n gfi eld-or. govOREGON ww.springf ield-or.gov Worksite address: 3333 RIVERBEND DR, Springfield, OR97477 Parcel: 1 703220004102 Fees Paid Account codeTransaction Units date 2113120 1.00 Ea Description Structural plan review fee 224-00000-425602-1 030 Fee amount $1,202.44 Paid amount $1,202.44 Payment Method: Credit card authorization: 001351 Payer: daniel klute Payment Amount:$1,202.44 Cashier: Katrina Anderson Receipt Total:sl,202.44 Ptinted: 2113120 1 1:28 am Page 1 of 1 F I N_Tra nsactionReceipt_pr o" ,/