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Home My WebLink AboutPermit Building 2005-07-07OF SPRINGFIELD Buildin g/Co mbination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005E)?IRESz 0612712006VALUE: $ 222,600.00 Status: Issued 225 Fifth Street, Springfield, OR 541.:7263753 Phone 541-726-3676Fax 541:7 26-37 69 I ns pe ction Line SITE ADDRESS: 13331ST ST ASSESSOR'S PARCEL NO.: 1703263300544 PROJECT DESCRIPTION: Remodel Care Facility Springfield TYPE OF TYPE OF USE: Care Facility Alteration Commercial Owner: Address: Contractor TVpe Architect General Electrical Mechanical Plumbing # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontlard Setbaclc Side l Setback: Side 2 Sefrack: Rearyard Setback: Solar Setbacla: Street Storm SewerAvailable: Special Instruction: MARQI.IIS HEALTHCARE PROP LLC 4560 SE INTERNATIONAL WAY STE MILWAUKIE OR 97222 Contractor ROBERTSON/SHERWOOD/ARCHITECTS CHAMBERS CONSTRUCTION BUILDERS ELECTRIC INC COMFORT FLOW TWIN RIVERS PLUMBING License Expiration Date Phone 541-342-8077 687-944s 541485-0922 541-726-0100 541-688-1444 REQUIRED PARKNG Total: Handicapped: Compact: in OAR 952-001 114258 4296 460 rough o ost30t2007 12n0t2007 06t2712007urres you u2007 are set forth AR 952-001- Sq Ft Other: nla Occupant Load: t-2 VA Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: %o ofLot Coverage: }IOTICE: COMMET.ICED AI{Y IEO DAY UNDER THIS PERMIT IS NOT 0Fl8"lBllS0l*D toR PEf,F0.routs/Drains DEVELOPMENTINF( Notes: l of 6 ': L('1\ II(AL TUK r1\IryJ 'l: Oreqon Status: Issued 225 Fifth Street, Springfield, OR 541:126-3753 Phone 541-726-3676Fax 541:7 26a7 69 I rc pe ction Line CITY OF SPRINGFIELD Buildin g/Co mbination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005E)GIRESz 0612712006VALUE: $ 222,600.00 Description Estimate Paving Type of Construction Estimate Use Bid Amount $ Per Sq Ft or muhiplier $r.00 $1.00 Square Footage or Bid Amount 217,614.00 4,986.00 Value $217,614.00 $4,986.00 $222,600.00 Date Calculated 06n612005 06n6t2005 Fee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety -Mechanical Issuance Fee- + l0o/o Administrative Fee + 77o State Surcharge Air Handling Unit Up to 10,000 Appliance Not Listed Building Permit Fixture Heat Pump Paving Vent Fan Plan ReviedCom,Ind,Pub Hourly Plan RevieilCom,Ind,Pub Hourly + l0Yo Administrative Fee + 7Yo State Surcharge Fixture Minimum/Adj ustment Plumbing Plan Review/Com,IndrPub Hourly Total Amount Total Value of Project Date Paid Receipt Number 2200500000000000647 2200s00000000000647 2200s00000000000895 2200s00000000000895 2200500000000000895 2200500000000000895 2200500000000000895 2200s00000000000895 2200500000000000895 2200s0000000000089s 2200500000000000895 220050000000000089s 1200s00000000001198 3200500000000000686 1200600000000000106 1200600000000000106 1200600000000000106 1200600000000000106 1200600000000000106 Amount Paid $s78.92 $356.26 $10.00 $129.26 $8s.69 $24.00 $9.00 $949.15 $182.00 $36.00 $68.40 $24.00 $180.00 $90.00 $4.50 $3.1s $28.00 $17.00 $4s.00 $2,820.33 5125105 5t25t05 7t7t05 7l7l0s 7l7l0s 717105 7t7t05 717105 7t7t05 7t7los 7t7t05 7t7t05 8n7t05 r2t7t05 2t3t06 2t3t06 2t3t06 2t3t06 2t3106 f,'ees Paid Plan Reviews 2of6 Valuation Description I CITY OF SPRIN Building/Co mbination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIED: 0512512005E)?IRESz 0612712006VALUE: $ 222,600.00 " Status: Issued 225 Fifth Street, Springfield, OR 541:7264753 Phone 541-726-3676Fax 541:1 2637 69 Inspe ction Line Fire Department Review 0513112005 06/05/2005 OK GRG PIan Review: RemodeUwall relocation. Job #COM2005-00615. Occupancy Classification: I-2. Construction Type: V-A. Maintain fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet of travel distance. The top ofthe extinguisher(s) shall be between 3 and 5 feet above finished floor (2004 Springfield Fire Code 906). If more than 20 sprinkler heads are added or require relocation, submit sprinkler plans and calculations to Springfield Fire Marshal's Office for review and approval. If less than 20 sprinkler heads are relocated, provide submittal showing relocation of sprinkler heads and ensure system maintains compliance with NFPA 13 requirements. Subcontractor shall submit fire alarm addition and relocation plans to Springfield Fire Marshal's Office for review and approval (2004 Springfield Fire Code 901.2). HVAC fire dampers and duct smoke detectors shall be monitored by the fire alarm system. Coordinate between Comfort FIow technician and fire alarm technician to ensure this requirement is completed. Two sets of plans submitted and accepted by John Pearson. No plan review fee was collected. Forwarded to John Pearson Density not to exceed 10 units per acre. No SDCs. No new s.f., Significant REDUCTION in fixtures. 2-year CREDIT balance remains on Sanitary Fixtures. Initial Review Initial Review 05126t200s 0712812005 05/31/2005 05t27t200s 0712912005 0610u200s 06/08i2005 APP APP LLH LLH Planning Review Public Works Review APP APP EMM 0s/31/2005 3of6 SB CITY OF SPRINGFIELD Status: Issued 225 Ftfth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 Inspe ction Line Buildin g/Co mbin ation Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIED: 0512512005 E)(PIRESz 0612712006VALUE: $ 222,600.00 Revised Plan Review - Fire 0712912005 08/08/2005 0K GRG Revised Plan Review - Strr 0712912005 08/03/200s WI JMP Revised Plan Review - Stru Structural Review Structural Review Structural Review Structural Review Structural Review Structural Review SUB Review 10/10/200s 10/10/2005 APP JMP Plans Review: Resubmittal of wall relocation. Job #COM2005-00615. No change in earlier plans review comments dated 6-5-05. Refer to plans review comments on that date. Reviewed 28 pages of revised calculations and 23 revised drawings for value engineered changes. : Received final internal approval. Revisions to Bathrooms 801 and 802 Spoke with Randy Nishimura at RSA about 801 being OK but that 802 is not ADA compliant. I referred him to OSSC 1109.10.10.4 for grab bars and ADAAG Figure 35 for shower size and clearances. He says the clients are attended in the shower and that making 802 ADA compliant is not feasible economically. He will check back tomorrow. Received documentation from Randy Nishimura demonstrating that the budget for accessibility items has exceeded the 25% Iimit requirement. I advised that the City - has made the architect and Marquis Care aware of the potential liability they are assuming by not making tht second Bathtique fully accessible. Left voice mail inquiring about changes to Room 704. Randy Nishimura answered questions about changes to Room 704. Received 5/31/2005. See attached 6 structural comments faxed to Eric Phillips-Meadow. Received response to structural comments. JMP called Eric Phillips-Meadow to request energy code forms and worlsheets for BE and Lighting systems and gave him Jackrs name and number for his additional questions and coordination. 08/09/2005 09t23t200s 12n3t2005 12t27t2005 06n6t2005 0st3u2005 08/09/2005 09128t200s 12t23t2005 1212712005 WE APP WE APP JMP JMP JMP JMP JMP JF 051271200s 06t06t2005 wE JMP 06n6t200s APP 06t06t200s WE APP JFSUB Review 06n3t2005 06n3t2005 4of6 FIELD Buildin g/Co mbin ation Permit F PRIN Status: Issued 225 Fifth Street, Springfield, OR 541:7264753 Phone 541-726-3676I.ax 541:7 2647 69 Inspection Line PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005E)PIRESz 0612712006VALUE: $ 222,600.00 To Request an inspection caII the24 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. Footing: After trenches are excavated. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Drywall: Prior to taping. Structural Concrete: In excess of2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. 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. 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 Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Shower Pan. Prior to covering and including required testing. 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 coyer. SUB Ceiling Grid: Interior Lighting 5of6 l(eoulreo lnsDecuons I Buildin g/Co mbinatio n Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:1 26-37 69 I nspe ction Line PERMIT NO: COM2005-00615ISSUED: 0710712005 APPLIEDz 0512512005E)?IRESz 0612712006VALUE: $ 222,600.00 By signaturer l 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 certiS 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 OCCUPAI\CY 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 wift 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 t the street, that the permit card b located at the front of the property, and the approved set of plans will remain on the site -Z^ 3-oG Owner or Contractors Signature Date 6of6 225 Fifth Street Springfield, Oregon 97 47 7 541-726-3759 Phone nity of Springfield Official Receipt .:velopment Serices Department Public Works Department RECEIPT #: 1200600000000000106 Date: 0210312006 10:25:12AM Job/Journal Number coM2005-00615 coM2005-00615 coM2005-00615 coM2005-00615 coM2005-00615 Description Plan Review/Com,Ind,Pub Hourly Fixture Minimum/Adj ustment Plumbing + 1oh State Surcharge + l0o/o Administrative Fee Amount Due 45.00 28.00 17.00 3.15 4.50 Item Total:$97.6s Payments: Tlpe of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard DAVID BAKKE djb 023648 In Person $97.65 Payment Totat: -Sffi (, '( 'l Ir t( 2/312006 lofl Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-36768ax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIED: 0512512005EXPIRES: 06/0112006VALUE: $ 222,600.00 SITE ADDRESS: 1333 1ST ST ASSESSOR'S PARCEL NO.: 1703263300544 PROJECT DESCRIPTION: Remodel Care Facility Springlield TYPE OF WORIft Care Facility TYPE OF USE: Alteration Owner: Address: Contractor Type Architect General Electrical Mechanical Plumbing ROBER BUILDERS COMFORT TWIN RIVERS {e{.rh(oult0 o\ Expiration Date 0st30t2007 t2nol2007 06t27t2007 031Lu2007 Commercial Phone 541-342-8077 687-944s 541485-0922 541-726-0100 541-688-1444 MARQUIS HEALTHCARE PROP LLC 4560 SE INTERNATIONAL WAY STE MILWAUKIE OR 97222 tes\ gn"; ^n\\eb ",n \o(460 17695 )RMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay # Street Paved D Vo of Lot Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: t-2 VA Sq Ft Sq Sidewalk Type: Downspouts/Drains: REQUIRED PARJ(NG Total: Handicapped: Compact: nla PUBLIC IMPROVEMENTS Notes: Page I of6 1 r\O '\I\'l (tc Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005EXPIRES: 06/0112006VALUE: $ 222,600.00 Description Estimate Paving Type of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 $578.92 $356.26 $10.00 s129.26 $85.69 $24.00 $9.00 $949.15 $182.00 $36.00 $68.40 $24.00 $180.00 $90.00 $2,722.68 Square Footage or Bid Amount 217,6t4.00 4,986.00 Value $217,614.00 $4,986.00 $222,600.00 Date Calculated 06n6t2005 06tr612005 Fee Description PIan Review CommAnd/Public Plan Review Fire & Life Safety -Mechanical Issuance Fee- + l0oh Administrative Fee + 7Yo State Surcharge Air Handling Unit Up to 10,000 Appliance Not Listed Building Permit Fixture Heat Pump Paving Vent Fan Plan Review/Com,IndrPub Hourly' Plan Review/Com,Ind,Pub Hourly Total Amount Paid Amount Paid Total Value of Project Date Paid Receipt Number 2200500000000000647 2200500000000000647 2200500000000000895 2200s0000000000089s 2200500000000000895 2200500000000000895 220050000000000089s 2200500000000000895 2200500000000000895 220050000000000089s 220050000000000089s 2200s00000000000895 1200500000000001198 3200500000000000686 5t25105 5t2Sl05 717105 7t7t05 7l7lo5 7t7t05 7t7t05 7t7t05 7t7t05 7t7t05 7t7t05 717105 8n7105 t2t7t05 Fees Paid Plan Reviews Paee 2 of6 Valuation Descriotion I F Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005EXPIRES: 06/0112006VALUE: $ 222,600.00 Fire Department Review 05/31/2005 06/0s/200s OK GRG Initial Review 07t28t2005 07t2912005 APP LLH 06/08/2005 APP SB Plan Review: RemodeUwall relocation. Job #COM2005-0061 5. Occupancy Classification: I-2. Construction Type: V-A. Maintain fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet of travel distance. The top ofthe extinguisher(s) shall be between 3 and 5 feet above linished floor (2004 Springlield Fire Code 906). If more than 20 sprinkler heads are added or require relocation, submit sprinkler plans and calculations to Springfield Fire Marshal's Office for review and approval. Ifless than 20 sprinkler heads are relocated, provide submittal showing relocation ofsprinkler heads and ensure system maintains compliance with NFPA 13 requirements. Subcontractor shall submit fire alarm addition and relocation plans to Springfield Fire Marshals Oflice for review and approval (2004 Springfield Fire Code 901.2). HVAC fire dampers and duct smoke detectors shall be monitored by the fire alarm system. Coordinate between Comfort Flow technician and fire alarm technician to ensure this requirement is completed. Two sets of plans submitted and accepted by John Pearson. No plan review fee was collected. Forwarded to John Pearson Density not to exceed 10 units per acre. No SDCs. No new s.f., Significant REDUCTION in fixtures. 2-year CREDIT balance remains on Sanitary Fixtures. Initial Review Planning Review 05t26t2005 05/31/2005 0s1271200s 0610U2005 LLH EMM APP APP Public Works Review 05/31/200s Paee 3 of 6 Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005EXPIRES: 06/0112006VALUE: $ 222,600.00 Revised Plan Review - Fir 0712912005 08/08/2005 OK GRG Revised Plan Review - Str 0712912005 08/03/2005 WI JMP Revised Plan Review - Str Structural Review Structural Review Structural Review Structural Review SUB Review 10/10/2005 r0/10/200s APP JMP 0st27t2005 06t06t2005 wE JMP Plans Review: Resubmittal of wall relocation. Job #COM2005-006f 5. No change in earlier plans review comments dated G5-05. Refer to plans review comments on that date. Reviewed 28 pages of revised calculations and 23 revised drawings for value engineered changes. Received linal internal approval. Revisions to Bathrooms 801 and 802. Spoke with Randy Nishimura at RSA about 801 being OK but that 802 is not ADA compliant. I referred him to OSSC 1109.10.10.4 for grab bars and ADAAG Figure 35 for shower size and clearances. He says the clients are attended in the shower and that making 802 ADA compliant is not feasible economically. He will check back tomorrow. Received documentation from Randy Nishimura demonstrating that the budget for accessibility items has exceeded the 25% limit requirement. I advised that the City has made the architect and Marquis Care aware of the potential liability they are assuming by not making thr second Bathtique fully accessible. Received 5/31/2005. See attached 6 structural comments faxed to Eric Phillips-Meadow. Received response to structural comments. JMP called Eric Phillips-Meadow to request energy code forms and worksheets for BE and Lighting systems and gave him Jack's name and number for his additional questions and coordination. 08/09/2005 09t23t2005 06116t2005 05/31/2005 08/09/2005 09t28t2005 0611612005 06t06t2005 WE APP APP WE JMP JMP JMP JF SUB Review 06/13/2005 06n3t2005 APP JF To Request an inspection call the24 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.lyill be made the following work day. Paee 4 of 6 Buildin g/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-36768ax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00615ISSUED: 0710712005 APPLIEDz 0512512005 EXPIRES: 06/0112006VALUE: $ 222,600.00 Reouired fnsnecfions Footing: After trenches are excavated. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. WaIl Insulation: Prior to cover. Drywall: Prior to taping. Structural Concrete: In excess of2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. 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. 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 Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Shower Pan. Prior to covering and including required testing. 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 Paee 5 of 6 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Eax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005EXPIRES: 06i0112006VALUE: $ 222,600.00 By signature, I state and agreeo 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. bil:BJ^*lz-, ^et Owner or Contractors Signature Date Paee 6 of 6 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone r.iry of Springlield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 3200500000000000686 Date: 1210712005 10:34:27AM Job/Journal Number coM200s-00615 Description Plan ReviedCom,Ind,Pub Hourly Amount Due 90.00 Item Total:$90.00 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid DAVID BAKE djb 324618 In Person $90.00 Payment Total : -$90-Id' U ) t t21712005 Page I of I *.tletrto CreditCard l i Status: Issued 225 Fifth Street, Springfield, OR 541:1263753 Phone 541-726-3676Fax 541:7 26-37 69 I nspe ction Line CITY OF SPRINGFIELD Building/Co mbination Permit PERMT NO: COM2005-00615ISSUED: 0710712005 APPLIEDz 0512512005 E)PIREST 0210912006VALUE: $ 222,600.00 SITE ADDRESS: 13331ST ST ASSESSOR'S PARCELNO.: 1703263300544 PROJECT DESCRIPTION: Remodel Care Facility Springfield TYPE OF TYPE OF USE: Care Facility Alteration Commercial Phone 541-342-8077 687-9445 541485-0922 541-726-0100 s4r-688-1444 Owner: Address: Contractor TVpe Architect General Electrical Mechanical Plumbing MARQUIS HEALTHCARE PROP LLC 4560 SE INTERNATIONAL WAY STE MILWAUKIE OR 97D2 tilttY lollow ES Contractor tc Center. Thoseation -ff$oiration Date 0st30t2007 12n0t2007 06t27t2007 03fiu2007 m # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontyard Setbaclc Side l Setback: Side 2 Seback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: t-2 VA # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: %o ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutVDrains DEVELOPMENT INFORMATION Notes: 1of 5 e L tLl CHAMBERS BUILDERS obtain center.(Note: rules bY C0MMENUEU utt-tr ANY 1BO DAY PtHI CITY OF PRIN Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 I nspection Line Buildin g/Co mbination Permit PERMITNO: COM2005-00615ISSUED: 0710712005 APPLIEDz 0512512005E)?IRES: 0210912006VALUE: $ 222,600.00 Description Estimate Paving Type of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 217,614.00 4,986.00 Value $217,614.00 $4,986.00 $222,600.00 Date Calculated 06n6t200s 06n6t200s Fee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety -Mechanical Issuance Fee- + l0Yo Administrative Fee' +7o/o State Surcharge Air Handling Unit Up to 10,000 Appliance Not Listed Building Permit Fixture Heat Pump Paving Vent Fan PIan ReviedCom,Ind,Pub Hourly Total Amount Total Value of Project Date PaidAmount Paid $s78.92 $3s6.26 $10.00 s129.26 $8s.69 $24.00 $9.00 $949.15 $182.00 $36.00 $68.40 $24.00 $180.00 $2,632.68 Receipt Number 2200500000000000647 2200500000000000647 220050000000000089s 2200s0000000000089s 2200s00000000000895 2200500000000000895 2200500000000000895 2200500000000000895 2200500000000000895 220050000000000089s 2200500000000000895 220050000000000089s 1200500000000001 198 5t25t05 5t25t05 7 t7105 7 t7105 717105 717105 717105 717105 717105 7t7105 717105 717105 8n7t05 Fees Paid Plan Reviews 2of5 :r1 ;b Valuation Description I D Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:1 26-37 69 Irspe ction Line BuildinglCombination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005 E)(PIRESz 0210912006VALUE: $ 222,600.00 Fire Department Review 05/31/2005 06/05/200s oK GRG Initial Review 07t28t2005 07t29t200s APP LLH APP SB Plan Review: RemodeUwall relocation. Job #COM2005-00615. Occupancy Classification : I-2. Construction Type: V-A. Maintain fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet oftravel distance. The top ofthe extinguisher(s) shall be between 3 and 5 feet above finished floor (2004 Springfield Fire Code e06). If more than 20 sprinkler heads are added or require relocation, submit sprinkler plans and calculations to Springlield Fire Marshal's Oflice for review and approval. Ifless than 20 sprinkler heads are relocated, provide submittal showing relocation of sprinkler heads and ensure system maintains compliance with NFPA 13 requirements. Subcontractor shall submit fire alarm addition and relocation plans to Springfield Fire Marshal's Office for review and approval (2004 Springfield Flre Code 901.2). HVAC fire dampers and duct smoke detectors shall be monitored by the fire alarm system. Coordinate between Comfort Flow technician and Iire alarm technician to ensure this requirement is completed. Two sets of plans submitted and accepted by John Pearson. No plan review fee was collected. Forwarded to John Pearson Density not to exceed 10 units per acre. No SDCs. No new s.f., Significant REDUCTION in Iixtures. 2-year CREDIT balance remains on Sanitary Fixtures. Initial Review Planning Review 05t26t2005 0s/31/200s 05t27t2005 06/01/200s LLH EMM APP APP Public Works Review 05/3U2005 06/08/200s 3of5 Status: Issued 225 Fifth Street, Springfield, OR 541:7263753 Phone 541-7263676Fax 541:7 26-37 69 Inspe ction Line OF SPRIN Building/Co mbination Permit PERMITNO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005E)GIRES: 0210912006VALUE: $ 222,600.00 Revised Plan Review - Fire 0712912005 08/08/200s OK GRG Revised Plan Review - Stru 0712912005 08/03/200s WI JMP Plans Review: Resubmittal of wall relocation. Job #COM2005-0061 5. No change in earlier plans review comments dated 6-5-05. Refer to plans review comments on that date. Reviewed 28 pages of revised calculations and 23 revised drawings for value engineered changes. Received linal internal approval. Received 5/31/2005. See attached 6 structural comments faxed to Eric Phillips-Meadow. Received response to structural comments. JMP called Eric Phillips-Meadow to request energy code forms and worksheets for BE and Lighting systems and gave him Jack's name and number for his additional questions and coordination. Revised Plan Review - Stru Structural Review Structural Review SUB Review SUB Review 08/09/2005 05t27t2005 08/09/200s 06t06t200s 06fi6t2005 06t06t2005 APP WE APP WE JMP JMP JMP JF 06n3t2005 06n3t2005 APP JF To Request an inspection caII the24 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 foltowing work day. Footing: After trenches are excavated. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Drywall: Prior to taping. Structural Concrete: In excess of2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Buitding Inspector prior to placement. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certilied Spcial Inspector. Provide Inspection results to City Building Inspector. 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 haye been met. Final Building: After all required inspections have been requested and approved and the building is complete.4of5 Reouired Insnecfions 06n6t200s 05/31/2005 225 Fifth Street Springfield, Ore gon 97 477 541-726-3759 Phone nity of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT#: 1200500000000001198 Date: 0811712005 10:19:05AM Job/Journal Number coM2005-00615 Description Plan Review/Com,Ind,Pub Hourly Amount Due 180.00 Item Total:$180.00 Payments: Type of Payment Paid By CheckNumber Autfiorization Received By Batch Number Number How Received Amount Paid Check CHAMBERS CONSTR djb s2760 In Person $180.00 Payment Totat: --5iE6lT- 8/t7/200s I of I iFBilIq'IED OF Buildin g/Co mbinatio n Permit Status: Issued 225 Fifth Street, Springfield, OR 54l:1263753 Phone 541-7263676Fax 541:7 26-37 69 Ins pection Line PERMIT NO: COM2005-00615ISSUED: 0710712005 APPLIEDz 0512512005E)GIRESz 0210912006VALUE: $ 222,600.00 Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Shower Pan. Prior to covering and including required testing. 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 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 certiff that any and all work performed shall be done in rccordance with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAI\CY will be made of any sfructure without permission of the Community Services Division, Building Safety. I further certiff 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 b located at the front of the property, and the approved set of plans will remain on the site at-all times durinpconstruction ,\)^"-J) gJ,l^-0-n'D= Owner or Contractors Signature Date 5()I 5 .__t Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIED: 0512512005 EXPIRESz 0110712006VALUE: $ 222,600.00 SITE ADDRESS: 1333 1ST ST ASSESSOR'S PARCEL NO.: 1703263300544 PROJECT DESCRIPTION: Remodel Care Facility Springfietd TYPE OF WORK: Care Facility TYPE OF USE: Alteration License Expiration Date Owner: Address: Contractor Type Architect General Electrical Mechanical Plumbing MARQUIS HEALTHCARE PROP LLC 4560 SE INTERNATIONAL WAY STE MILWAUKIE OR 97222 05t30t2007 1211012007 06t27t2007 03m12007 Commercial Phone 541-342-8077 687-9445 s4t-48s-0922 541-726-0100 541-688-1444 Contractor ROBERTSON/SHERWO OD/ARCHITECT S CHAMBERS CONSTRUCTION BUILDERS ELECTRIC INC COMFORT FLOW TWIN RIVERS PLUMBING INC 114258 4296 460 r7695 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of $torier: '* '* ! ' i'' ' -r Height of Strueture Type of Heat: Water Type: Range Type: Energy Path: on law requi to dbYtheO Those rules 0 through O Sq Sq Ft Other: nla Occupant Load: t-2 VA Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: REQUIRED PARIflNG Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: PUBLIC IMPROVEMENTS Notes: Pase 1 of5 ."l -)L\L] L('1\ II(ALIUK TI\TUIruJ I,Ult ut l\(, r1\r (rKrvr,{ ullNl Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005 EXPIRES: 01/0712006VALUE: $ 222,600.00 Description Estimate Pavins Fee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety -Mechanical Issuance Fee- + l0o/o Administrative Fee + lYo State Surcharge Air Handling Unit Up to 10,000 Appliance Not Listed Building Permit Fixture Heat Pump Paving Vent Fan Total Amount Paid Total Yalue of Project Date Paid Receipt Number 2200500000000000647 2200500000000000647 2200500000000000895 2200s00000000000895 2200s0000000000089s 2200500000000000895 2200500000000000895 2200s0000000000089s 2200500000000000895 2200500000000000895 2200s0000000000089s 2200500000000000895 Type of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $r.00 $1.00 Square Footage or Bid Amount 217,614.00 4,996.00 Value $217,614.00 $4,986.00 $222,600.00 Date Calculated 06n6t200s 06n6t2005 Amount Paid $s78.92 $356.26 $10.00 $129.26 $8s.69 $24.00 $9.00 $949.15 $182.00 $36.00 $68.40 $24.00 5t25105 st25t05 717los 7t7t05 7t7t05 7t7t05 7t7t05 717105 717105 717105 717105 7t7105 $2,452.68 )aid Plan Reviews Paee 2 of 5 -qt -}-\{ Valuation Descriotion Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIED: 0512512005EXPIRESz 01107t2006VALUE: $ 222,600.00 Fire Department Review 0513112005 06/05/200s oK GRG 05t3U200s 06/08/2005 APP SB Plan Review: RemodeUwall relocation. Job #COM2005-00615. Occupancy Classification: I-2. Construction Type: V-A. Maintain fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet oftravel distance. The top ofthe extinguisher(s) shall be between 3 and 5 feet above finished floor (2004 Springfield Fire Code 906). If more than 20 sprinkler heads are added or require relocation, submit sprinkler plans and calculations to Springfield Fire Marshal's Office for reyiew and approval. Ifless than 20 sprinkler heads are relocated, provide submittal showing relocation ofsprinkler heads and ensure system maintains compliance with NFPA 13 requirements. Subcontractor shall submit fire alarm addition and relocation plans to Springlield Fire Marshal's Office for review and approval Q004 Springfield Fire Code 901.2). HVAC fire dampers and duct smoke detectors shall be monitored by the fire alarm system. Coordinate between Comfort Flow technician and fire alarm technician to ensure this requirement is completed. Density not to exceed 10 units per acre. No SDCs. No new s.f., Significant REDUCTION in fixtures. 2-year CREDIT balance remains on Sanitary Fixtures. Received response to structursl comments. Received 5l31r2OO5- See attached 6 structural comments faxed to Eric PhiIliPs-Meadow' Initial Review Planning Review Public Works Review StructuralReview Structural Review 05t26t200s 05t3U2005 06,161200s 05/27l200s 05t27t200s 06t0u200s 06/16/200s 06/06/2005 APP APP APP WE LLH EMM JMP JMP JF06,131200s APP SUBReview 05/13/2005 Paee 3 of 5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line SUB Review To Request an inspection call the 24 will be made the same working day, day. Building/Combination permit PERMIT NO: COM200S-00615ISSUED: 07t07t2005APPLIEDz 05t25t2005EXPIRESz 0U07t2006VALUE: $ 222,600.00 0st3u2005 06t06t200s wE JF JMP called Eric Phillips-Meadow to request energy code forms and worksheets for BE and Lighting systems and gave him Jack's name and number for his additional questions and coordination. hour recording at 726-3769. AII inspection requested before 7:00 a.m. inspections requested after 7:00 a.m. will be made the following work Footing: After trenches are excavated. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Drywall: Prior to taping. Structural Concrete: In excess of2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. 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. 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 Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Shower Pan. Prior to covering and including required testing. 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. Paee 4 of 5 fll Keoutred lnsnections I F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2005-00615ISSUED: 0710712005APPLIEDz 0512512005EXPIRESz 0ll07lZ00GVALUE: $ 222,600.00 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any coyer. SUB Ceiling Grid: Interior Lighting 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 wiII 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 Iocated at the front of the property, and the approved set of plans will remain on the site at all times during construction. f ^t- ot Owner or Contractors Signature Date Page 5 of 5 225Fitth Street Springfield, Oregon 97477 511-726-3759 Phone ^ity of Springfield Official Receipt ;evelopment Services Department Public Works Department RBCEIPT #: 2200500000000000895 Date: 0710712005 11:50:18AM Job/Journal Number coM2005-00615 coM2005-00615 coM2005-0061s coM2005-00615 coM2005-00615 coM200s-00615 coM2005-00615 coM2005-0061s coM2005-0061s coM2005-00615 Description Air Handling Unit Up to 10,000 Heat Pump Appliance Not Listed Vent Fan -Mechanical Issuance Fee- Fixture Building Permit Paving + 7%o State Surcharge + ljYo Administrative Fee Amount Due 24.00 36.00 9.00 24.00 10.00 182.00 949.15 68.40 8s.69 129.26 Item Total:-$F1750-,- Payments: Tlpe of Payment Check Number Authorization Paid By Received By Batch Number Number How Received Amount paid Check CHAMBERS CONSTRUCTION ddK 05 1869 In Person Payment Total: $ 1,517.50 - $1,517.50 ! 7171200s Page I of I m;r- L oq 6loec>ogg A<, =il tr1!n(n lig frljeoH t l4()il4 Aoo &,*{oIodz U1 Q\()zoaau! t{Htr]oalq 'rl :ao{cEtti <J L E a oo J!o Eu I ! {"a Ia T cl EIaIr m'! Elltrtr s.locg ;Ii G)m N N] n tr frl I N E (o Ioot) l-l v. .lto6ttll!!taFli! u, HI fZ U'a oo 6(, o o .,t,6t <tooitrl. !-:,/t 6r<(JtaldJq qrl to r^r )T*'&trii a!aaDlAI s, Fi. -i,{,I ttr60ool\ nl,O\. '-a O,\.i+ @\r <> ro,o> 8I'4EEEtrELE Ep$lrrry0thdftd4 ,*_T ffi ffi ffi r,H*ffi fmHffiHlYdtiurymo'"o:i@hs' EttsEAtEI[TC!ilEtEUtD rb-rr-oudrtlctsiicoEodnladrhapffkinrE6inrrurrdfts,idtrqti'rbdriilbSr ffiL-"ffi;*it bcq&rtuhtt'tttlrrtH'. . 16E Erd h1qryrtr rtrrgltlfr,fl fro d*i[lrbflilbgo@4ilffiE{td*t*6dfrr1dG' L EiE[rilqudilrfirmamfi& trlbcEdil EIlft o[fErr ltEd' z 1EfutuO$d H0 Ftft rilx EitEtrde!| b tEi,ttdt trFqtl ry cFfie f.gdr.dtBt*lEqdldfi4dorntsbrlblhGvt'b1lfit'lFli ' 1 &etl4d'r.uqLb o'lfiloEllB{Efft{F. dbdr &Gilllry!tu b hryhils4 d +!.glE*trddl Fsifi hdu rqil ts S:hirtlg 6d dill4;dr rdroh, J. BfrIEtf Lrryffi torr76'cry#s9d *dtr1diEil tgrmaruiaraftrp m ory h!fi4 ffElb&til08fi. rn1rrltrfiEl agf,N0Rrl,uGEB,EirIS Clty of8priogfiolil cmruitySrviocsDiYi;im UEfifrSrEi $firuftId'ORYrfl? td+rffi F4Dnoa7re . IE0{I}7!f.r06e h ob.rb - 05 Bdtdng tlF,Itta *-qPH*lFtf,O- . ffiollillp Li Ccrfoe,yEc_ oIlll e(E' t'6oz F,Ert AIo?a, -f5rr H H lr?o 6. tr-i Ect s C F G N cs Gu F !. l'.$ UA F A cr Ho L..) lla H ffi fl*ffi*ci{rtapp-- UgiEltr*tuffiFm(hir.lad) !-[ T6riog lrtonFrylhnr tn '--a V Al;P?rh N N ( GroutReinforced MorlarConcreleGuniteGrout Aqpregate Test of Mix Desigt Reinforcing Test Mix Desicn-Weighmaster Cefi .+ Reinforcing PlacementK Continuous Batch Plant InsPect- Inspect Placingx Cast Samples Samples (Pickup/Delivered) Tcst* Post-Tens Pre-Tens Concrete: Reinforcing Tesh Tsndon Test Mix Desims* Reinforcins Placement Insert Placement Concrctc Batching Concrete Placement Installation Inspcction Cast Sanrples Pick-up Samples Compression Tests SPECIAL INSPECTION AND TESTING SCHEDULE (! CZ o(, Noou I U] 0) l,3 - 1l Fna mnL m -{ u) N JoilN toaprflA GRADING, EXCAYATION, AND trILL Acceptance tests I PSF Establish final grade Fill placement inspection/continuous Soil Density STRUCTURAL STEEL/WELDING: Sample and test (list specifio members below) Shop material identrficarion (mill ce5t) Weld inspection X-SnoP X Rield tlrasonic inspection -Shop -FieldHigh Srength Bolting ShoP -Field A325 _N _XA490 _N _X Metal deck welding inspectton Reinforcing Steel welding inspection Reinforcing steel mill cefiificate Metal stud welding insPection Concrtte insert welding inspection Moment resisting steel frames STRUCTURAL WOOD:" X:-' "'-$;.;,r.ll"nrling inspection ?, " lJil LeD'"&L-rX- Shearwall anchors'-'r- hspection of Glulam fab. * T/C psi Inspection of russ joist fab, Sample and test cornponents Fabrication welding of steel accessories Spcoial inepection sEesses used* f'm ---.-f g Preliminary acceptance tests (masonry units, wall prisms) Subsequent tests (mortar, grout, field wall prisms) Pl acernent inspecti on of units, and reinforcement Masonry, mortar, grout, and reinforcing steel certificates = = MASONRY F -F SMOKECONTROL: _Leakage testing Control Verification FIREPROOFING: _Placement inspection _Dersity tests _Thic*ness te$ts _Inspect batchingROOFING: - krsulation installatiott/R-Valuc* _Test stripVseams Form CompletedADDITIONAL INSRUCTIONS, OTIIER TESTI C NPROVIDE S'TRENGTH REQUIRIiD BY ARCHI'I'ECT OR ENGINEER OR CONTRAC'I' DOCIIMRNT I'OCATION OF VALUES Date a/e/n -o u) \. Piles Claddine Assrcsate Tests ATTACHMENTA C]TY O' -RINGFIELD SYSTEMS DEVETOPMENT CHARGE' {KSHEET JOURN.aI OR JOB NUMBER: COM.-.r5-00615 MARQUIS CARE FACILIry 1333 lSTST NAMEORCOMPANY: I,OCATION: MAP & TAX LOT NUMBER: DE\EIOPMENT TYPE: 17 0326 33 00544 I. STORMDRAINAGE IMPERVIOUS SQ.FT. O 2. SANNARY SEWER{]TY A REIMBURSEMENTCOST: NLIMBER OF DFU's B. IMPROVEMENTCOST: NUMBEROFDFU's (SEE REVERSE SIDE) CONGREGATE NEW DEVEI,OPED AREA (S.F.) EXSTING DE\G,IOPED AREA (S.F.) TOTAL IMPERVIOUS SI'RFACE (S.F.) Y CARE FACIL]TY x $ 0.310 PER SF -81 -81 x $ 18.30 PERTRIP $ 80.72 PER TRIP $ 18.30 PER TRIP x $ 80.72 PER TRIP x ITE: ITE: 1,OT SZE (S.F.): TOTAL STORM DRAINAGE NTF NTF NTF x $ 24.04 PER DFU $ 18.28 PERDru TOTAL I,OCAL SAN-SEWER $ (3,427.e8) 3. TRANSPORTATION BLDGAREATGSF xTRIP RATE x COST PERADTXNEW TRIP FACTOR NEW A REIMBT]RSEMENTCOST: 0.000 x 2.02 B. IMPROVEMENTCOST: 0-000 x 2.02 E>(STING A. REIMBURSEMENTCOST: 0.000 x 0 B. IMPROVEMENTCOST: 0.000 x 0 x x x x x x 0 TOTAL TRANSPORTATION REIMBURSEMENT TOTAL TRANSPORTATION IMPROVEMENT NTF to"'E$ 0 4. SANNARY SEWER - MWMC NEW: A REIMBT]RSEMENT COST: NUMBEROFFELIS B. IMPROVEMENTCOST: NUMBEROFFEU's E)CSTING: A. REIMBURSEMENTCOST: NUMBEROFFEU'S B. IMPROVEMENT COST: NLIMBER OF FEL-rs 0.000 0.000 MWMC CREDIT IF APPLICABLE (SEE REVERSE) TRANSPORTATION 0.000 x $46.88 PER FEU 0.000 x $494.46 PERFEU $O.OO PER FEU $O.OO PERFEU $ INDUSTRIAL STRENGTH INCREASE TOTAL MWMC REIMBURSEMENT TOTALMWMC IMPROVEMENT MWMC ADMIMSTRATIVE FEE: TOTALMWMC SDC:$ SUBTOTAL (ADD ITEMS 1,2,3, &4)$ 5% TOTAL TRANSPORTATION ADMINISTRATION TOTAL SEWER ADMIMSTRATION FEE x x 5. ADMINISTRATIVE FEES : BASE CHARGE (STBTOTAL ABOVE) Stev ew W. eea udrg B a Y wca 6/812005 $=$ $0.00 -$1,947.54 $ $ $ $ $ $ #Dlv/o1 ! NO $ $ $ $ $ $ $ CD{P@mDBIA,IFG&UIS GARE, 1333 1sr sT.xls DATE TOTAL SDC CHARGDS $ 1 JULY 2OO4 :1178 DRAINAGE FXTURE I.]MT (DFLD CALCULANON TABLE NUMBER OF NEW FD(TURES x LNTT EQUTVALENT : DRAINAGE FD(TURE TNITS O{OIE, FOR RE.,TODELS, CALCIThTE ONLY T}D NET MAROUIS CARE FACILITY FD(TTIRES NEW OLD DRAINAGE FD(TTIRE TINITS UMT FD(TURE TYPE BAT}ITUB DRINKING FOLINTAIN FI-,OORDRAIN INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC. INTERCEPTORS FOR SAND/AI.J-TO WAS}I/ETC. LATINDRY TT]B CTOTHES WASHERA,TOP SINK ct THES WASHER-3 ORMORE(EA) MOBILE HOME PARK TRAP (1 PER TRAILER) RECEPTOR FOR REFRIGERATOR/WATER STATIONIETC. RECEPTOR FOR COMMERCIAL SINK/ DISFTWASHER/ETC. SHOWER" SINGLE STALL SHOWE& GANG (NUMBER OF HEADS) SINIC COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIALBAR SINK: WASH BASINIDOUBLE IAVATORY SINK: SINGLE LAVATORY/RESIDENTTAL BAR URINAL, STAIIJWALL TOILET, PUBLIC INSTALI.ATION TOILET, PRTVATE INSTALLATION MISCEII-ANEOUS: -8 -9 0 -16 -6 -42 NIIMBER OF EDU'S'}-81 0 TOTAL DRAINAGE FD(URE TINITS:-81 -mU feq"t""l*t D*"tlt.g Urq tt CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AITERANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY YEAR RATE PER $I,OOO VALUE $1.59 $0.92 $0:00 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXANON DATE) $0.00 J I 3 J 6 2 J 6 12 1 3 2 2 J 2 2 I 5 6 J I -3 0 0 0 0 0 3 0 0 0 0 0 5 4 9 8 0 9 2 2 0 0 x x RATE PER $1,OOO ASSESSED VALI'E YEAR ANNE)(ED 1979 1980 l98l 1982 1983 1984 1985 1986 l 987 l 988 1989 r 990 l99l or before $4.98 $4.80 $4.63 $4.+o $4.07 $3.67 $3.22 $2.73 $2.25 1992 t993 1994 1995 1996 r997 r998 1999 2000 2001 2002 2003 2004 $5.12 .80 $5-29 $5.19 $0.00 s0.00 COM200il0615, lvlARQUlS CARE, 1333 1ST sT.xls CREDIT TOTAL .00 ,I JULY 2OO4 I 1 1