HomeMy WebLinkAboutMiscellaneous Application 2009-2-27
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City of.Springfield
'CommunhyServicesDivisiori
225 Fifth Street; Springfield; OR97477
-Tel<:phoiie: 541C726-3753, Fax: 54V726-3676.
DefetredSubmittal - Agreemen.t
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Or.egoriStiuCtlliaj SP:t:lChllty qo~eSC?~.S>J:fl()6;311.jWws'aperri1itapplicarino'defer' certain
slibmiftiils if apptoved.by-theBuilding0fficiij, This'form is a defell'ed submittal
agi~elll.ent"f6rtl1.e f6U()wmgproject:,
Ijate:zJz.";j-ib9. l'rOJI'l;(Name:~Ji.tlA.l<A..J~~. .... \1,,,, l.~""-'-J~'.r (-"'~
ProjeCt AddresS:~ "",-h'''.,-h:,Jd,..,L -t)i,t>i(...rennitNulIlller:
Phase: o ExCavation &Graclirig o Foundation OriIy ,0 Completion
U Site Utilities 'O'Shell . u:renaiit hriprovemenl'
Desigii.rrofe~ionalin,R.~ponsibll!Cbarge:
License number:. Email:
Phone: '-W,,;"'. -"'1 "" 0 i:u<.:
AddresS: 4L.D E:.,...I, "'-:>lnD"""\
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4100) . "3 407- '
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Guidelines:
I, ADDrnv.1: Eacitde(crredsUbtnittalsbailbe.rrtheal>Provaloftbe~ign professional inrespouSil:J1e
,chatge.Not;otion sball!:>e jnc1uqedihat thedeferredsu!:>tni~ldOcumeillsbaveheen reviewed and'llave
. beenfoundtobeingenetlll confo,nnance. to the design, oflbeliuUding:
2. List: Pages 2andXor thisforirtisalistofd~ferred submitt;ols.'fhedesignprofesslonal ["responsible
ebargenmstcbeck wbicb subrriitt;olsa,rerequested tri!:>edefei'red and'indicatean anii6ipatedsubmitt;ol
date.
3. Fees::.Minimuin $1 00.OO(2bour) ,frireacbdeferredsuhmittill:
4. Timellllt;s:,Eyeryatt~ri1pt"111 ~e mad~toproy;de.timel)' revieWsof5:10busi,nes,sd~YSp'er'clefetted'
subrillttal: .
5. Work without. Perml,t'," jV"rk:ibatis cOn.<trucied 'Wi1ho~tbavingb"eI1reviewe~an(lapproved by
botbthe designprof~ssiOl"'Jin resp()nsilllech8Ige~()d the 9ty ofSpringfi~ld Bni\dingQf!icialis:
. eOnsidere4as worlc~rforme,j;\Vitb"ut~,pe!",itJ\nyp~oo Orfiflll ~".,;~",Jng w"rkpj;,orto.
approval' shallb,<,sUbjectto the penaltieS of ~ciion 108;,2.: I. otme State:of Oregon Slrllctul1il'SpeciaIty'
,Code;
ACknowiedgel1lents:. -- ~
O~~;~"(Pifut~\~ I .' p--'ntL- ~~
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General Contractor Firm Name (Primeq) .
.~'^ ;:~~~.'4 1\. .
Design Professio' . sible Chalge(printed)
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Bull(ull~ vwclalName (Pnnted) Buddmg,Officlal Signature'
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City of Springfield
Deferred Submittal Agreement
Date: -z.1~"t 104 \ proJectName:~I.W.~ \1.:.\\"11 (.A~'~'tw-
Project Address: ?l':>, ~ ~ ,l'I',rb,...uA, \J.r';;v'l.,.. Permit NUlIlber: l ,
Phase: 0 Excavation and Grading 0 Foundation o~ly 0 Completion
o Site Utilities 0 Shell ?slTenant Improvement
Design Professional in Responsible Charge:
Deferred ltem
Items which may be defemld Indude. but are not limited to the loDowing:
Deferred Item
c ,. Acoustical ceiling suspension
system
o 2; Auxiliary power systems
o - 3. Awnings
10 4, Bleachers
10 5, Carports
10 6. Curtain wall systems
10 7. Electrical call system
10 8. Erru:rgency call system
log,. Exit illumination
I\J. 1'0. Fire alann system
I\;. 1'1, Fire sponkler
10 12. Fire-stopping
10 13; Glass guardrails
10 14. Glazing systems
I" <5. HVAC syslem
10 16. Intercom syst~m
10 17. Iniga,tiOn system
10 18. Metal guardrails 8?d handrails
Date
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t\(M D1 I
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~16 01
~ 1'9. Plumbing system
o 20. Post-tensioned __.....""~'" structural
members or panets
10 21. Pre.<:ast cOncrete structural
members or panels
10 22. Prefabricated stair units to include
steel. aluminum. or pre-cast concrete
o 23. Prefabricated wall panel
o 24. <?r&streSSed.concrete structural
members or panels
c 25. Raised floor systems
c 26. Shelving systems andsteef
storage racks
o 27. Signs
o 28. Skylighl$
o 29. Smoke and heat vents
o 30, Specialty retaining walls
o 31. Stone veneer
o 32 Terra cotta veneer
o 33. Wooden, steel, or composlt
"oar or roof trusses
o 34, Worksofart
/'
p"'35, J I
. "€~ "'~....
o 36,
~-S' "1il~
~ Minimum $100.00 (2 hr) each for' the above listed Deferred Submittals
Date, I
.,18/611
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Deferrad !tam
o 1. C02 System
o 2. Emergency and Standby Power
1013, Fire Alarm and De~on SySlems
1014. Fire PumPs
10 S. Gas leak and Chemical Leak
Detection .
10 6. Halon Systems
10 17 . Kitchen Hood Suppression
System
1018. Portable ExtInguishers
1019. Private Fire Service Mains
10 10., Private Water Tank Systems
I~ 11, Fire Sprinkler Systems 13, 13R
& 130 (more than 20 heads) ,
10 12, Fire Sprinkler Systems 13. 13R
& 130 (less lhan 20 heads) $60lhr
10113:StandPipe and Hose Cabinets
10114. Water Mist System
10115, High-piled Storage
0116, Clean Agent Systems
0,(17< Clean Agent Systems
ID 118. Paint Booths
Fire Protection and Life Safety Systems
(Date
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Deferred Item
o 19. Underground Fuel Tanks
o 20. Above9round Oulslde Fuel Tanks
o 121. Aboveground Fuel Tanks and
P'lPinO '
o 1'22. Aboveground Fuel Tank and
Day Tank
0'123. Fuel Dispensing Station
o 124. LPG. Aboveground Installations
o 125. Cryogenics, Exterior Installation
o 126. SIlane Gas
o '2:1. Ozooe System
o 28. HPM Semiconductor Workstation
o 29. Gas CablnetslExhausled
enclosures
9130. Hazardous MaterIal Inventory
. IStatement
o 131. Special Hazard Delectlon
and SUpprasslon
o 132. MedicalGases
o 133. VESDA System
, 0 134. Emergency Lighting
0135.
0136.
. Date-
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Fire Protection and Life Safety Systems fees are based on 3% of the total valuation of the work to be penormed for the system
up 10 the system's contract value of $50,000,00, An additional $3,00 will be charged for eacl1 additional $1.000,00 in value or
portion thereof. The minimum charge shall be no less tha~, $12Q.OO Additional staff time for work performed in excess of 2 hours.
will be chargad an additional $15.00 for every 15 minutes of review time or portico thereof.
Work without a Parmlt: Work thaI Is constructad wilhoul havJog been reviewed and approved by both tha design
professional In respol1$ible charge and th_8 Building Official will be considered as work pe.rfonne<fwithout a permit.
Any person or firm pertorming wor1< prior to approval shall be subject 10 the penaltias of Section 108,2,1 of the
Stale of Oregon Structural Specialty COde,