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Home My WebLink AboutPermit Building 2002-02-11ctTY oF sPRtrvGFtELq OREGON SPRINGFIELD Job# 00-01325-01 COMMERClAL PERMIT City Of Springfield Community Services Division Building Safety Page 'l of 4 225 Fifth Street Springfield, OR97477 Location Of Proposed Site: 101 00030th St Spr AssessorsMap#: 17023100 Lot: Block: Addition: Job Number: 00-01 325-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot #: 00703 Subdivision: Owner: Goodwill lndustries Phone Number: 541-345-1801 Address: 855 Seneca City/State/Zip: Eugene, OR 97402 Scope Of Work: Retail Addition Value: $453,000 Expansion to existing buildings Adult & Family Services Center - Construct 50 x 101 addition on north end and 20 x 101 addition on sorrlh end of existino Adrrlt & Familv Services brrildino, See .lob #00-0'1 325-04 for narkino lot Contractor Type Contractor Registration # Expiration Date Phone General Contr Soft Tech Building Systems Llc 52008 10119102 541-726-3922 1655 N 32Nd St, Springfield, OR 97478 Electrical Contr Alert Electric lnc 12772 _ - _5122103 541-747-2213 1970 N 28Th St, Springfield, OR NOTICE:97477-3401 TH1S pERMtT SHALL EXptRE TFTHEWORK Engineer lnternational Resources AUTHORIZED UNDER THls PERMIT lS NOT 541-344-9454 PO Box 11017 , Eugene, OR 974406ON1MENCED OB lS ABANDONED FOR Mechanical Contr Harvey & Price Co ANY 1BODAY PERIOD. 10131102 541-746-1621 Po Box 1910, Eugene, OR 97440-1910 Plumbing Contr Twin Rivers Plumbing 17695 3111103 541-688-1444 PO Box 40397,oR 97404 - office use - Quad Area: Land Use: Other RetailTrade # Of Units: Zoning Code: CC Constr. Type: Bedrooms: Water Heater: Range: # Of Buildings: Occupancy Group Heat Source: Sq. Footage: To request an inspection call the 24 hour recording at726-3769. All inspections 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 working day. Required lnspections Site Footing Slab Framing Drywall -To be rade afte#ting forms. -After trenches are excavated. -To be made after all inslab building service equipment, conduit piping, and other equipment iter - Prior to cover. -Prior to taping. StructuralWelds Structural Concrete Bolts installed in concrete Ceiling Grid High Strength Bolting SUB - lnsulation/Vapor Barrier SUB - Final Fina! Fire Final Site Plan Final Building Rough Electrical Electrical Service SUB - Exterior Lighting Final Electrical Underfloor Plumbing Rough Plumbing FinalPlumbing Rough Gas Rough Mechanical Gas Service SUB - Mechanical FinalGas FinalMechanical Zoning: CC FloodPlain? [l Wetlands? [ ] Journal numbers 1:2000-06-0127 2: Comments: Job# 00-01 325-01 Page2 oI4 Required lnspections Building I -To be done during construction by State Certified Special lnspector. Provide inspection test res -lnexcessof2500psi. TobedoneduringconstructionbyaStateCertifiedlnspector. Provider -To be done by a State Certified Special lnspector. Provide inspection test reports to City Buildir -To be done during construction by a State Certified Special lnspector. Provide inspection resul -To be called for at the same time as the SUB framing inspection. -When all Fire Department requirements have been met. -After all requirements have been met for Minimum Development Standards or from the Develop -When all required inspections have been approved and the building is complete. Electrical - Prior to cover. -Must be approved to obtain permanent power -*n"n all electrical work is complete. Plumbi - Prior to insulation or decking. - Prior to cover. -When all plumbing work is complete. Mechanical - Prior to cover. -After line is installed and line has been connected to a minimum of one appliance. Pressure tet -When all gas work is complete. -When all mechanicalwork is complete. Overlay District: # of Street Trees: Land Use: Other RetallTrade Pave Driveway? fl Planner: Jim Donovan Urban Growth Boundary?! Glenwood Area? [ Quantity Of Fill: Supplier: Drainage: Floodway FEMA: 3 Additional Requirements Required Attachments: Source Locn: Material: Flood Plain FEMA: Job# 00-01325-01 Page 3 of 4 Area (Sq. Main:Accessory: # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total: Fee Paid On Receipt# Value/Quantity Fee Amount Plan Check CommercialPlan Check Hourly Plan Review Total Plan Check 09/01/2000 02t11t2002 3093 8012 453,000 2 $797.71 $80.00 $877.71 Building Permit State Surcharge For Building Permit Building Administrative Fee Total Building Building 02t1112002 0211112002 0211112002 8012 8012 B0'12 453,000 $1,227.25 $85.91 $36.82 $1,349.98 Permanent: 201 to 400 Amps Branch Circuits With Feeder or Service State Surcharge - Electrical Administrative Fee - Electrical Total Electrical Electrical 02t1112002 02t11t2002 02t11t2002 02t1112002 8012 8012 8012 8012 3 53 $180.00 $106.00 $20.02 $8.58 $314.60 Minimum Plumbing Permit Fee Number of Fixtures State Surcharge - Plumbing Administrative Fee - Plumbing Total Plumbing PIumbi 0211112002 02t1112002 02t11t2002 02t11t2002 8012 8012 8012 8012 12 $.oo $120.00 $8.40 $3.60 $132.00 Hood and Exhaust One to Four Outlets Minimum Mechanical Permit Administrative Fee - Mechanical Less than 100,000 BTU Vent Fan to One Duct Mechanical lssuance State Surcharge - Mechanical Total Mechanical Mechanical 02t11t2002 02t1112002 02t11t2002 02t11t2002 02t11t2002 0211112002 0211112002 0211112002 8012 8012 8012 8012 8012 8012 8012 8012 1 1 b 2 $4.50 $2.00 $.00 $1.46 $36.00 $6.00 $10.00 $3.40 $63.36 Sanitary Sewer MWMC Administrative Fee SDC Administrative Fee General Office Building - Transp General Office Building Totat System Development System Development 02t11t2002 02t11t2002 02t11t2002 02t11t2002 02t11t2002 8012 8012 8012 8012 8012 30 1 7 7 $1,495.80 $10.00 $402.79 $5,296.s4 $1,253.37 $8,458.50 Grand Total $11,196.15 Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? [ Plan Check Type lnitial Review-C/l/P lnitial Review-C/l/P Engineering-C/l/P Planning-C/l/P Structural-C/l/P Structural-C/l/P Fire Marshal-ClllP Checked By Lisa Hopper Lisa Hopper Pam Ownby Jim Donovan Lorne Pleger Don Moore AlGerard Job# 00-01325-01 Date Completed 0813112000 1110512001 1011812000 1010412000 1112612001 11126t2001 09/1 3/2000 Page 4 of 4 Comment Per Dave Puent, project revisions include only energy and ADA for permit to be issued. Charge per hour for plan revisisions then okay to issue original permits. Checked for changes in ADA requirements to plans that were approved. OK. Need Mfgd Bldg. drawings, specifications and engineering.documents Plan review - Addition to existing structure TypeVN,sp[rinkled, 7000sq ft, B-occ 1. Provide sprinkler plans 2. provide extinguisher 3. HVAC detectors installed accordance to listing 4. HVAC detectors to be tested according to listing in FM presence SUB - Comm/lnd David Harris 1112812001 New Energy Forms forwarded for review under new energy codes for construction. 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 701.055 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 ap pf on the site at all times during construction 2 OL Signature ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER NAME OR COMPANY: LOCATION: TAX LOT NUMBER DEVELOPMENT TYPE: USE#I USE#2 Coodwill Industries 00-0 I 325-0 l l0l 30th Street 17-02-31-00 00703 General Office Building NEW DEVELOPED BUILDING AREA (S.F.): NEW DEVELOPED BUILDING AREA (S.F.): EXIST DEVELOPED BUILDING AREA (S.F.): TOTAL DEVELOPED BUILDING AREA (S.F.): 5050 TYPE OF USE: TYPE OF USE:2020 LOT SrZE (S.F.): I. STORM DRAINAGE IMPERVIOUS SQ. FT.0.00 x $0.240 PER SQ. FT $0.00 2. SANITARY SEWER-CITY NUMBER OF PFU's (SEE REVERSE SIDE) x $49.86 PER PFU30 $ 1 ,495 .80 3. TRANSPORTATION BLDG AREA TGSF X TRIP RATE X COST PER PM PEAK HOUR TRIP USE # I 5.05 x 1.49 x $502.79 PER TRIP USE#2 2.02 x 1.49 x 5502.79 PER TRIP TOTAL TRANSPORTATION SDC $s,296.s4 $3,783.24 $ 1.s 13.30 to1 3 107 ? 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: USE # I NUMBER OF FEU's 5.05 USE#2 NUMBER OF FEU's 2.02 B.IMPROVEMENT COST: USE#I NUMBER OF FEU's 5.05 USE#2 NUMBER OF FEU's 2.02 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE 163.3 8 PER FEU PER FEU$163.38 $I3.90 PER FEU $I3.90 PER FEU TOTAL MWMC SDC x x $825.07 s330.03 $70.20 $28.08 $0.00 $ 10.00 $1,263.37 tt75J., lq56 x x suBTorAL (ADD ITEMS 1,2,3, & 4)s8,0ss.7l 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE)x 0.05 $402.79 DATE TOTAL SDC CHARGES t673 Pamela J. Ownbeyffi tU28l0t $8,458.50 PLUMBING FIXTURE UNIT (PFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = PLUMBING FIXTURE LTNITS (NOTE: FOR REMODELS.CALCULATE ONLY THE NET ADDITIONAL FIXTURES) FIXTURES NEW OLD UNIT IVALENT PLUMBING FIXl-URE TIIiITSFIXTURE TYPE BATHTUB DRINKING FOLINTAIN FLOOR DRAIN INTERCEPTORS FOR GREASE/OIL/SOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB/CLOTHESWASHER/MOP SINK CLOTHESWASHER - 3 OR MORE MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERATOR/WATER STATION/ETC. RECEPTOR FOR COMMERCIAL SINK/ DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: BAR, COMMERCIAL, RESIDENTIAL KITCHEN UzuNAL, STALL/WALL WASH BASIN/LAVATORY, SINGLE OR DOUBLE TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: 24 TOTAL PLUMBING FIXTURE CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATEL YEAR ANNEXED RATE PER $I,OOO ASSESSED VALUE YEAR ANNEXED RATE PER SI,OOO ASSESSED VALUE 1979 or before 1980 l98l 1982 I 983 1984 1985 I 986 1987 1988 1989 4.74 s 4.6s $ 4.59 $4.46 $ 4.30 s 4.14 s 3.93 $ 3.63 $3.26 $ 2.8s s2.40 I 990 t99t 1992 '1993 1994 I 995 1996 1997 r 998 I 999 s 1.96 $ t.s5 $ t.36 $ r.23 s 1.05 $ 0.90 $ 0.7s $ 0.s7 $ 0.35 $0.ls 0 2 I 2 J 6 2 6 6 I 3 2 I 2 2 I 6 4 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2 2 2 4 0 0 0 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) x x CREDIT TOTAL $0.00 $0.00 s0.00 ao70s Multi-Family per drvelling unit. Serryice Included: Items Cost ft. or less $ 106.00 Each additional500 portion $ 19.00 $ 50.00 S PER not in ction Fee is S45.00 + '4"1"o '' DESCRIPTION Permits are if lvork is zoninS of issuance 180 days. Electrical' work is within 180 Manufd Home or Au$r'rrtzeo Slgnatule Service or Feeder TALLATION ONLY B. Services or Feeders InstaIIntion, Relocation: 200 amps or 201 amps to 401 amps Electrician Over "Bt'a AUIHOfl 'l/ c0&t ANY 1 4.S Date 7Yo 8Yo TOTAL gl tf -a has I \ rtr ATTACHMENTA CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER NAME ORCOMPANY: LOCATION: MAP & TAX LOT NUMBER: DEVELOPMENT TYPE: GOODWILL INDSUTRIES 00-0 1325-0 I IOI 3OTH STREET t7-02-23-00 00703 NEW DEVELOPED BUILDING AREA (S.F.): EXISTING DEVELOPED BUILDING AREA (SF): TOTAL DEVELOPED BUILDING AREA (S.F.): X $ 0.273 PER SF 7,070 ITE ITE LOT SIZE (S.F.) TOTAL STORM DRAINACE SDC 7',10 $ 8,458.50 I. STORM DRAINAGE IMPERVIOUS SQ. FT 2. SANITARY SEWER.CITY A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU'S (SEE REVERSE SIDE) 30 30 4. SANITARY SEWER - MWMC NEW: A. REIMBURSEMENT COST: NUMBER OF FEU'S B, IMPROVEMENT COST: NUMBEROF FEU's MWMC CREDIT IF APPLICABLE (SEE REVERSE) x TOTAL LOCAL WASTEWATER SDC: TOTAL TRANSPORTATION REIMBURSEMENT SDC: TOTAL TRANSPORTATION IMPROVEMENT SDC: TOTAL TRANSPORTATION SDC: 7.07 $163 38 PER FEU PER FEU7.07 $ 13.90 TOTAL MWMC REIMBURSEMENT AND IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: TOTAL MWMC SDC SUBTOTAL (ADD ITEMS 1,2,3,&4) 0.0s rll28/01 x $ 28.42 PER DFU S 21.44 PER DFU 3. TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 7.07 x 1.49 * -$_!Q.;!L PERTRIP B, IMPROVEMENT COST: 7.07 x 1.49 x $ 412.29 PER TRIP x x 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) PavweLaJ. owwb eu SDC COORDINATOR 1,495.80 953.38 343.1 6 953.38 1 1 55.1 0 98.27 402.79 I@ ComBuildSDC200l x DATE TOTAL SDC CHARGES JULY 2OO1 GENERAL OFFICE t09r rw2 DRAINAGE FIXTURE TINIT (DFU) CALCULATION TABLE NLA4BER OF NEW FIXTURES x UNIT EQUIVALENT: DRAINAGE FIXTURE TINITS (NOTE: FOR REMODELS, CALCULATE ONLY TT{E NET ADDITIONAI FIXTURES) FIXTURES NEW OLD I.INIT DRAINAGE FIXTURE UNITSFIXTURE TYPE BATHTUB DRINKING FOTINTAIN FLOORDRAIN INTERCEPTORS FOR GREASE/OIL/SOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB CLOTHES WASHER/MOP SINK CLoTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERATOR/WATER STATION/ETC. RECEPTOR FOR COMMERCIAL SINK/ DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLE LAVATORY/RESIDENTIAL BAR URINAL, STALLNVALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDU'S* ALENT J I 3 3 6 2 J 6 t2 I J 2 2 J 2 2 I 2 6 J 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2 2 4 2 24 TOTAL DRAINAGE FIXTURE UNITS:30 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE. CALCULATE CREDITS SEPARATELY 0 0 0 0 YEAR ANNEXED RATE PER $I,OOO ASSESSED VALUE YEAR ANNEXED RATE PER $1,OOO ASSESSED VALUE I 979 or before 1980 l98l 1982 1983 1984 1985 1986 1987 I 988 r 989 s 4.92 $ 4.83s 4.77 s 4.64 $ 4.47 s 4.30 s 4.09 $ 3.78s 3.41 $ 2.98 $ 2.s2 I 990 t99t 1992 1993 1994 1995 1996 1997 r 998 1999 2000 s s $ $ s $ $ $ $ $ $ 2.06 1.64 1.45 1.3 I 1.13 0.97 0.82 0.63 0.41 0.22 0.04 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) x x $0.00 $0.00 $0.00CREDIT TOTAL ComBuildSDC200l JULY 2OO1 Oct-Ia-O1 O1:43P 22j FIFTH STREET zoning and S PRINCFTELD. ORECON ryA?YA I iNSPECTTON REQUEST: ?26-i?62oning oFFICE. 726-J759 Date YAL I. LOCA oF Iris LEGAL DESCRI.PTIO\ JOB T'ESCRIPTION Pernrits ilrc llori-trilnsft.rrable a if nork is rial sl:rrtcd ryitliin I ol issuiucc or if n'ork rs su I80 days. 2 CON1RACTOR TNSTAII-A,TIOhI Electrical Contr:rcto Alert tlectri cin S rr_n fi Supe rv isor Expiration Constr Contr. '- The lollowing project as submifted has the followin!- does not reguie specific land ESEC.I-RICAL pERj\,IIT APPLiCATION EELCW Nerv Rcsi drnti;tl-Single or l\'Iu lti -Frrmil;" pi:r drvell in g unil. Sen icc lncluilcrl lii00 sq.[t. or less Each addirronal 5L)0 sq. R or portion therecI En:ir }"larruld liornc or Il,lodular Dwelling Sen ice or Feeder 2.ll I 1o 4()l ilnlps to 600 amps tr,.,, ,lur.1:s tO lC{}0 a::ips Over Iil(r0 ampVl'oits Cnly or Fcerlel's r'n or Relocutlrrn t'r less P. O1 itenrs Cos( Strrn _ $t2i.0c ---- st63.oo .-_ s375.oo __ $ 5o.oo -_ *_ $50.00 -*- -. $69.00 --.$lc0 00 @--/ 'irr,lut,N,,-tnrr. fr-OJ ?Lf :Q/ '-- $10(r 00 - -- $ l9.oo _ $ ii).0t) Feulcrs on, Altcnrtions or $ 53.00 anps ..? s@o JEos 'a4 Explrilrion Dlttc_-22-5 Signatun: ol Supcn'ising Ekrctr.iciarr Orvners to 400 amps d0I to 600 ar.ps Over 600 amps or 1000 lolts scE "8" abc:r,e D. Branch Circrrits Netv Alteration or Extensiorr i):r Panel Orre Cirsuit E. l\{iscellirncous (Scrr iccifecdcr not ir c I u dedi -Each instailaiion Punrp or irrigotion SiglulO,illirre Lighiing Linitsd Energl',T.es Li uri Lr,d Energ.v/(lonrm {. SUBTOT.{L OF ABOVE ?Yo Stltc Surchnrgc J'$izo Adnrinislr'ative Fce :'v ra*.r, 855 ,Diz()M -- c ir,- fu.. 22{0LPh,," ZlS - / gO/ OWNER INSTALLATION The irrsurllatron is bcing rrmde on propeAl'i owrr which is lot intcnded for s.rle, leirse or rent Orvncrs Signature: $43.00 ._ Each Additional Circuit or *'iih Service crr F*edcr Pcrrnil 5? $a$o /ob,6o l'linirnuiu Elcclric Permlt Inspccr;nn fec is S-1i.0(] = Surchitrge r $50.00 $50,00 s25.00 s4i.00 z%,a--zzrvz _____-b& TOTAL 34!! SPRI^JGFIELD G o o, d*r',ll lfxtu-srcre s of Ownerlriarne fPrinted) Lqrre Ca, t^ternd\a*-t t eso.rrces U.ttd Enginccr or Architecr Flrrn (printed) ?SI UorVz.Sp/ Building Permh # AtrS Burr--ort-l& Eyo*r.rCity of Springf reld Corn:.':uaiiy !ci:'i::s Divi::g;, l,z) f rtrn Srreet Springfield, OR 9?477 Tel ephon e : (54 l) 726-l'? 59 Fax: (541)726-3689 1/8€4 Date aOoq3Op.t<UP P: Io:o: (, o;..O (d10: D o o F s 10N Spccial Inspection And Tcsaing nlvc lrr6hcd, !cknorvt.dgcell und.Rhnding of tht inform.lion by signing b.low, lnd r.Nm this fom ro thr City, BEFORE A PERMITCAIi BE ISSUED: Th. owncror owncr's r.prcs.ilativr, or !h. rdvi.cofthc rcsporiblc Project Erio..r o. Arihirccr, sh all complcra, lign, .nd sob1itto lha Ciry lorrlviawand lpproval this fom comgl.lad on both rhc a.olt llld baak, Th.Ow',r lndGlrc l conioclor, wh.r. rpp licttl., rhalllko rckflowt.dgr lhr foltowinB c.n{tition3 .pp licrbl. !osplcill tolplction nndo. Tcaling. l, Cor t.rcto r is rcspon3iblc for pmp.r noaific ion for th. Insp.clion or T.itjng of it m3 listcd. 2. T.sllng ,rboratory shalt lakc approprirtc srmpl.s rnd tn.lpon ri.,n o (hci. labon!.ry for prop.r aveluatior or tastio& . Copic! ofall laborabry rEpons rnd inltcciions rl! to b. scnt to th! City by the T?stinE Agcncy. i. Splcirl ln spcct io 'r Agc ncy i! to 3ub t it n!m.s .rd qurlific. tio,ls of on.dta Spccial lDlpcctors ro rhc Chy fo. .pprovrl. 4, Sp.clal lrlpcctor sh rll prbvid. inspcction lEports lo th? bu [dilg ofrr. ia I o f !ll iNpacrior, .ctlvjrica, 5 Contractorii rcsponsiblc to rcvicw ftc cily lfrprovad phn! for additjonll iosp.ctior o.lcating r.quirchcnt! th.a mty ba notEd. EEFoRE A CERTIFICATE OF occUPANcy wtLL 8E IssUE-D: TIrc sp..ial lrspccrioo Ag.ary.hrll submil ro rh. BuildiDg offici.t r srarcm.or th.t a1 iremr rcquidng provrsront' I nosc (rms nor tcslcd lrxUor inspcct.d shlll bc noGd ir lh. stlll.mcni Thc rrport i3 to ba ssb(oir.d to th. cit pior ro a rcqucst for liral inspcciions. ACIG'{OWLEDGMENTS l'i'cieci i ;itg Address S Gen. Contracror Finn (Printed)Ceneral Signalure U- Special Inspectlon Agency Narne (Prinred) Spcci Agency P Sign. v oooo€ H T T HzI o{ I- 0) f o F @ 0 o o 0) a t+ Owncr S (POL Lt}*l- e €, Engineer or Architect Signature \) .! o.'No o N Testing Laboraiory Narne (printed)r:ltory Rep r€Building Oflicial Name (Prinred)Building O(ficial Signarure oocrele Cunite Grorrt Monar I SPtrCIAL INSPECTION AND TESTING SCHEDULE uOoa3c? P.t<rdqHf I8i U o;.,o UJol D oo "= forced Conc rete, Gunite, Grout and Morlar: P recast/Pre-st ressed Conc rete: SI\TOKE CONTROL: Leakale cesting CoorroI uerificition Sacrple and resr (list specific mernbers below) Shop malerial idenrificarion (niil cen) Weld inspection Shop _ Fietd Ul(rasonic inspcctiorr Shop -.- Ficld High strength bolring Shop -- FieldAi25 _N x F Meal deck welding inspecrion Reinforcing Steel rvelding inspect ioo Reioforcing steel rnill certlfi cate Mecal stud welding inspection Concrete insen weiding inspecrion Moment resisting steel frames a x Accepunce lests r pSF __-:_ Esrablishfinalgradi-,: Fillplacernentinspection/continuous x Soil Density GRADING, EXCA VATION, AND FILL STRUCTURAL STEELINVELDING : + '. STRUCTURAL WOODI Shear wall nailing ir:spection Shear wall ancliors Inspectlon of Clu-larn fab. . TiC osi Inspecrioo ofcrussjoist fub. -- Sarnple aod (esr cornponen(s Fabrication welding of steel accessor.iesFIREPROOFING: Placement inspection Densig. Tesu Thickness resrs Inspect barching oooo EHrT HzI 0+ r 0)l o F a 0 6 o !) a .+ 1' !tJ o)LJo o (/) ROOFING Insulation iosrallat ion/R_valu.-r Tesl stripsiscarrrs ADDITI0NAL INSTRUCTIONS, orHER TEST, & tNspECTIoNS: MASONRYT lpecial inspection stresses used+ _f m _flgPrellminaryacceD(ar,c€r.rrs1.r@Giu,w.attprr-rsri'sy Subsequenttests(rno(oqgroul.ficld-rvalJprisnx)' Piacernen( inspcctiorr of units, arrcl rcin!-orccmcnt Masonary, mor(ar, grout, and rcinforci ng srcel certilicarcs Form completcd by: _ nare i g6 ,PRovIDE sTRENGTH REQUIRED By ARCHITECTOR ENG INEER OR COI.I?RACT DOCUft1ENT LOCATION OF VALUES Job# 00-01325-04 COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety SPFINGFIELD Page 1 of 2 TRffNE*: 01-0001415 DATE:I]IT 06 TOOO At{T RE[D:? $ 401.00 [HAli6t: [ASHIER:004 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 101 00030th St Spr AssessorsMap#: 17023100 Lot: Block: Addition Job Number: 00-01 325-04 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 00703 Subdivision: ctTY oF sPRltvGFlELq OREGON Owner: Goodwill lndustries Phone Number: Address: 855 Seneca City/State/Zip: Scope Of Work: Retail Addition Paving & site utilities for addition This is a copy with a new Sequence Number 541 -345-1 801 Eugene, OR 97402 Value: $60,000 Contractor Type GeneralContr Plumbing Contr Contractor Soft Tech Design & Construction lnc 1655 N 32Nd St, Springfield, OR 97478-5530 Braun Excavating lnc 26361 Perkins Rd, Veneta, OR 97487 Registration # 52008 Expiration Date 11t25100 Phone 541-726-3922 541-935-32511 01 3BB 10117103 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection callthe 24hour recording a1726-3769. All inspections 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 working day. Required lnspections Electrical Underground Electrical Rough Electrical Final Electrical Sanitary Sewer Line Storm Sewer Line Final Plumbing Rough Grading Final Paving - Prior to cover. - Prior to cover. -When all electrical work is complete. -Priortofiringtr.#l - Prior to filling trench. -When all plumbing work is complete. Permits w/o Srchg ] -After gravel is in place but prior to placing concete. -After paving is complete. Job# 00-01325-04 # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total: Page 2 of 2 Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main:Accessory: Fee Paid On Receipt# Value/Quantity Fee Amount Plumbi Minimum Plumbing Permit Fee State Surcharge For Plumbing Permit Sanitary Sewer Footage Storm Sewer Footage Plumbing Administrative Fee Total Plumbing 1 0/06/2000 10/06/2000 10/06/2000 10/06/2000 10/06/2000 000341 5 000341 5 000341 5 000341 5 000341 5 140 140 $.00 $5.60 $40.00 $40.00 $2.40 $88.00 Permits w/o Srchg 10/06/2000 0003415Paving Total Permits w/o Srchg 60,000 $313.00 $313.00 Grand Total Plan Check Type Engineering-C/l/P Planning-C/l/P Structural-C/l/P Signature Checked By Pam Ownby Jim Donovan Lorne Pleger Date Completed 10/03/2000 10/03/2000 10/03/2000 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 701.055 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 ap set of plans will remain on the site at alltimes during construction $401.00 Comment Will collect SDC fees with building permit, Job #00-01 325-01 /o d e,/"/f*?+Date/