The URL can be used to link to this page

Home My WebLink AboutPermit Building 2004-6-11 . " 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~ . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06/11/2004 APPLIED: 04/15/2004 EXPIRES: 12/11/2004 VALUE: $ 326,800.00 Status Issued SITE ADDRESS: 6364 MAIN ST ASSESSOR'S PARCEL NO.: 1702344204100 Springfield TYPE OF WORK: Church TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add 4,000 sf Multipurpose room. Owner: CHARITY BAPT CHURCH SPFLD Address: PO BOX 1393 SPRINGFIELD OR 97477 Phone Number: 541-746-5556 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone General OWNER Electrical ROBS ELECTRIC INC 156678 08/14/2005 541-686-5444 Engineer SS & W INC - ENGINEERS 541-485-8383 Mechanical J CO ENTERPRISES INC 156807 09/09/2005 541-689-1667 Plumbing SUSAN JANE ARNOLD 49561 12/16/2004 541-484-3787 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 1 26.50 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: 4,000 A-3 nla , DEVELOPMENTINFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: FuIlv Improved Yes Sidewalk Type: Downspoutsillrains: Setback 5' To Storm Sewer Notes: Paee 1 of5 ,- Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Churches Pavine VN Use Bid Amount Fee Description Plan Review CommlIndlPublic Plan Review Fire & Life Safety -Mechanical Issuance Fe.... + 100/0 Administrative Fee + 7% State Surcharge Backflow Device Building Permit Encroachment Permit Fixture Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Paving Plan Review CommlIndlPublic Plan Review Fire & Life Safety Planning Final Occy Inspection Sanitary Sewer - 1st 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement Sanitary Sewer Each AddtllOO' SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Storm Sewer Each AddtllOO' Vent Fan Water Line - 1st 50 Feet Water Line - Each AddtllOO' + 10% Administrative Fee + 7% State Surcharge . I Valuation Descrintion I $ Per Sq Ft or multiplier $71.20 $1.00 Square Footage or Bid Amount 4,000.00 42,000.00 Total Value of Project )?pp< PIilIJ Amount Paid $758.49 $466.76 $10.00 $203.88 $120.04 $14.00 $1,166.90 $120.00 $252.00 $60.00 $4.00 $1.00 $323.85 $88.72 $54.60 $143.00 $45.00 $946.55 $1,245.20 $14.00 $10.00 $244.83 $359.58 $238.58 $183.23 $2,769.80 $627.86 $2,232.42 $45.00 $28.00 $12.00 $45.00 $28.00 $13.50 $9.45 Date Paid 4/15/04 4/15/04 5/14/04 5114/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 6/1lI04 6/1lI04 Paee 2 of5 . CITY OF SPRINGt<mLU Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06/1112004 APPLIED: 04/15/2004 EXPIRES: 12111/2004 VALUE: $ 326,800.00 Value Date Calculated $284,800.00 $42,000.00 $326,800.00 04/1512004 04/2312004 Receipt Number 2200400000000000368 2200400000000000368 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000754 2200400000000000754 . - Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Add, Aller, Extend Circ Ea Add Curbcut Permit Perm Serv/Fdr 201 to 400 amps PW Mull Disc - 2nd Permit Sidewalk Permit Total Amount Paid Fire Department Review Initial Review Plannin!! Review Public Works Review Structural Review . 04/16/2004 04/16/2004 04/16/2004 04/16/2004 05/06/2004 $60.00 $75.00 $75.00 $-30.00 $75.00 $13,140.24 6/11104 6111/04 6/11104 6/11104 6/11104 I Plan Reviews I 04/21/2004 04/16/2004 04/23/2004 04/23/2004 05/06/2004 OK APP RJB APP EMM APP SB APP JMP Pa!!e30f5 . CITY OF ~rK11'1uJ<1J!,LJJ Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06/11/2004 APPLIED: 04/15/2004 EXPIRES: 12111/2004 VALUE: $ 326,800.00 2200400000000000754 1200400000000000895 2200400000000000754 1200400000000000895 1200400000000000895 GRG Plan Review: Construction of a detached 4000 sq. ft. multipurpose activity room. Job #COM2004-00428. Occupancy Classification: A-3. Construction type: V-No Fire extinguisher location shown on Sheet lIAl Floor Plan. The fire extinguisher shall have a minimum rating of 2-A:IO-B:C. The top of the extinguisher(s) shall be between 3 and 5 feet above flnisbed floor (Springfield Uniform Fire Code 1002.1). Exit/egress lighting shown on Detail lIEI. Will verify on inspection. Bollards and chain with public works lock called out in Sheet C5. Will verify on inspection. Approved as per Final Site Plan and Conditions of Site Plan Review Applicant has submitted an encroachment permit application fOl 61t tap to 8" sewer main. A section of the 8" pipe is proposed to be removed and a 6 x 8 x 8 Tee is required. Received from Roger Tiller information for PW, SUB, and plumbing inspector and distributed to all. Brian Tiller called to review mechanical equipment for inspections. . . CITY OF,~rKll'1ut<1ELU Building/Combination Permit Status Issued PERMIT NO: COM2004-00428 225 Fifth Street, Springfield, OR ISSUED: 06/11/2004 541-726-3753 Phone APPLIED: 04/15/2004 541-726-3676 Fax EXPIRES: 12/11/2004 541-726-3769 Inspection Line VALUE: $ 326,800.00 Structural Review 04/16/2004 04/19/2004 WE JMP 4/19/2004 See attached fax to Ralph Wilson requesting Special Inspection forms. Also called Raiph and asked for the list of contractors and the written vaiue of the building and of the site work itemized separately. 4/20/2004 See attached faxed structurai review to Raiph with 8 points to be addressed. 4/23/2004 received response from John Stapleton and processed. Called for John Stapleton and sent attached fax with a progress update with information request for PW, SUB, and plumbing inspector. 5/3/2004 updated Roger Tiller, ofthe Church, on the progress. He wants to start construction next week. 5/4/2004 spoke with John Stapleton and he said he would try to supply all missing information this week. He referred me to Ted Essner for mechanical equipment questions. Ted referred me to Brian Tiller of Jayco who said he would call back al a time more convenient for him. SUB Review 04/16/2004 04/30/2004 WE DH 4/30/2004 See fax sent by JMP to John Stapleton requesting missing information. 5/7/2004 Envelope and Lighting pass energy code review. HV AC fails plan review. DH will contact Roger Tiller. SUB Review 05/12/2004 05/12/2004 APP DH HV AC passes plan review. To Request an inspection call the 24 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. Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: After all erosion measures are in place. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Paee40f5 . . CITY OF ~rKll'1u.l'lELU Building/Combination Permit Status Issued PERMIT NO: COM2004-00428 ISSUED: 06111/2004 APPLIED: 04/15/2004 EXPIRES: 12111/2004 VALUE: $ 326,800.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Roofing: Prior to installing any roof covering. Drywall: Prior to taping. Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection 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 Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Underground Plumbing: Prior to mling the trench and including required testing. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. 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. 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 Plumbing: Following City Rough Plumbing inspection approval and prior to cover. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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 701.005 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. 2 1t~ t,- If -0(/ Owner or Contractors Signature Date Pal!e 5 of5 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00428 COM2004-00428 COM2004-00428 Payments: Type of Payment Check 6/11/2004 . 8!1~IN_'!,PI~- ...------- l lilt. : ~ . . '.' i JiiilY of Springfield Official Receipt .elopment Services Department Public Works Department RECEIPT #: 1200400000000000895 Date: 06/11/2004 Description Sidewalk Pennit Curbeut Pennit " PW Mult Disc - 2nd Pennit Item Total: Cbeck Number Authorization Paid By Received By Batch Number Number How Received THURSTON COMM BAPTIST vrj 1108 In Person CHURCH Paymeot Total: Page I of I 2:47:38PM Amount Due 75.00 75.00 (30.00) $120.00 Amount Paid $120.00 $120.00 . . CITY 01< ~rKll,\(lJNELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06111/2004 APPLIED: 04/15/2004 EXPIRES: 12111/2004 VALUE: $ 326,800.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 6364 MAIN ST ASSESSOR'S PARCEL NO.: 1702344204100 Springfield TYPE OF WORK: Church TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add 4,000 sf Multipurpose room. Owner: CHARITY BAPT CHURCH SPFLD Address: PO BOX 1393 SPRINGFIELD OR 97477 Phone Numher: 541-746-5556 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone General OWNER Electrical ROBS ELECTRIC INC 156678 08/14/2005 541-686-5444 Engineer SS & W INC - ENGINEERS 541-485-8383 Mechanical J CO ENTERPRISES INC 156807 09/09/2005 541-689-1667 Plumbing SUSAN JANE ARNOLD 49561 12/16/2004 541-484-3787 BUlLlJOU"-' ",FORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Constrnction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 1 Lot Size: 26.50 Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: nla Occupant Load: 4,000 A-3 I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS. A I I ~NTI9l;j: Oreaon law requires you to Fullv Improved follow rule~ cl'8'&'YiEbB~the Oregon UtililySetback 5' Yes Natificatiorre\mllpllulStDiliiiis!es are S'fhfS'f.\\Jm Sewer I OAR 952..Q01-OO1 0 through OAR 952-001- ~90. You may obtain copies of the rules by calling the center. (Note: the tele~ho~e Iilumber far the Oregon Utility Notification Center Is 1-800-332-2344). .' NOTICE: NotestH1S PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Pal!e 1 of5 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06/11/2004 APPLIED: 04/15/2004 EXPIRES: 12/11/2004 VALUE: $ 326,800.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Churches Pavine VN Use Bid Amount $ Per Sq Ft or multiplier $71.20 $1.00 Square Footage or Bid Amount 4,000.00 42,000.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $284,800.00 $42,000.00 $326,800.00 04/15/2004 04/23/2004 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review CommlInd/Public $758.49 4/15/04 2200400000000000368 Plan Review Fire & Life Safety $466.76 4/15/04 2200400000000000368 -Mechanical Issuance Fee- $10.00 5/14/04 2200400000000000579 + 10% Administrative Fee $203.88 5/14/04 2200400000000000579 + 7% State Surcharge $120.04 5/14/04 2200400000000000579 Backflow Device $14.00 5/14/04 2200400000000000579 Building Permit $1,166.90 5/14/04 2200400000000000579 Encroachment Permit $120.00 5/14/04 2200400000000000579 Fixture $252.00 5/14/04 2200400000000000579 Furnace - up to 100,000 btu $60.00 5/14/04 2200400000000000579 Gas Outlets 1-4 $4.00 5/14/04 2200400000000000579 Gas Outlets 4+ $1.00 5/14/04 2200400000000000579 Paviog $323.85 5/14/04 2200400000000000579 Plan Review CommlInd/Public $88.72 5/14/04 2200400000000000579 Plan Review Fire & Life Safety $54.60 5/14/04 2200400000000000579 Planning Final Occy Inspection $143.00 5/14/04 2200400000000000579 Sanitary Sewer - 1st 50 Feet $45.00 5/14/04 2200400000000000579 Sanitary Sewer - Improvement $946.55 5/14/04 2200400000000000579 Sanitary Sewer - Reimbursement $1,245.20 5/14/04 2200400000000000579' Sanitary Sewer Each AddtIIOO' $14.00 5/14/04 2200400000000000579 SDC MWMC Administration $10.00 5/14/04 2200400000000000579 SDC MWMC Improvement $244.83 5/14/04 2200400000000000579 SDC MWMC Reimbursement $359.58 5/14/04 2200400000000000579 SDC Sanitary/Storm Admin $238.58 5/14/04 2200400000000000579 SDC Transpo Admio $183.23 5/14/04 2200400000000000579 SDC Transpo Improvement $2,769.80 5/14/04 2200400000000000579 SDC Transpo Reimbursement $627.86 5/14/04 2200400000000000579 Storm Drainage Impervious Area $2,232.42 5/14/04 2200400000000000579 Storm Sewer - 1st 50 Feet $45.00 5/14/04 2200400000000000579 Storm Sewer Each AddtIIOO' $28.00 5/14/04 2200400000000000579 Vent Fan $12.00 5/14/04 2200400000000000579 Water Line - 1st 50 Feet $45.00 5/14/04 2200400000000000579 Water Line - Each AddtIlOO' $28.00 5/14/04 2200400000000000579 + 10% Administrative Fee $1.40 6/ll/04 2200400000000000755 + 10% Administrative Fee $13.50 6/ll/04 2200400000000000754 Paee 2 of5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line + 7% State Surcharge + 7% State Surcharge Add, Alter, Extend Circ Ea Add Curbcut Permit Perm ServlFdr 201 to 400 amps PW Mult Disc - 2nd Permit Sidewalk Permit Storm Sewer Each AddtllOO' Total Amount Paid Fire Denartment Review Initial Review Plannine Review Public Works Review Structural Review . 04/16/2004 04116/2004 04116/2004 04116/2004 05/0612004 $0.98 $9.45 $60.00 $75.00 $75.00 $-30.00 $75.00 $14.00 $13,156.62 6/1lI04 6/11104 6/11104 6/ll/04 6/11104 6/11104 6/11104 6/11104 I Plan Reviews I 04/2112004 04/16/2004 04/23/2004 04/23/2004 05/06/2004 OK APP RJB APP EMM APP SB APP JMP Paee30f5 . CITY OF ~rK1j"l,jld<lELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06/1112004 APPLIED: 04/15/2004 EXPIRES: 12/11/2004 VALUE: $ 326,800.00 2200400000000000755 2200400000000000754 2200400000000000754 1200400000000000895 2200400000000000754 1200400000000000895 1200400000000000895 2200400000000000755 GRG Plan Review: Construction of a detached 4000 sq. ft. multipurpose activity room. Job #COM2004-00428. Occupancy Classification: A-3. Construction type: V-No Fire extinguisher location shown on Sheet VAl Floor Plan. The fire extinguisher shall have a minimum rating of2-A:IO-B:C. The top of the extinguisher(s) shall be between 3 and 5 feet above finished 1100r (Springfield Uniform Fire Code 1002.1). Exit/egress lighting shown on Detail llEl. Will verify on inspection. Bollards and chain with public works lock called out in Sheet C5. Will verify on inspection. Approved as per Final Site Plan and Conditions of Site Plan Review Applicant has submitted an encroachment permit application fOJ 6" tap to 8" sewer main. A section of the 8" pipe is proposed to be removed and a 6 x 8 x 8 Tee is required. Received from Roger Tiller information for PW, SUB, and plumbing inspector and distributed to all. Brian Tiller caUed to review mechanical equipment for inspections. . . CITY OF SPRIl~ld<lJ!,L1J Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 0611112004 APPLIED: 04/15/2004 EXPIRES: 12/1112004 VALUE: $ 326,800.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Structural Review 04/16/2004 04/19/2004 WE JMP 4/19/2004 See attached fax to Ralph Wilson requesting Special Inspection forms. Also called Ralph and asked for the list of contractors and the written value of the building and of the site work itemized separately. 4/20/2004 See attached faxed structural review to Ralph with 8 points to be addressed. 4/23/2004 received response from Jobn Stapleton and processed. Called for John Stapleton and sent attached fax with a progress update with information request for PW, SUB, and plumbing inspector. 5/3/2004 updated Roger Tiller, ofthe Church, on the progress. He wants to start construction next week. 5/4/2004 spoke with John Stapleton and he said he would try to supply all missing information this week. He referred me to Ted Essner for mechanical equipment questions. Ted referred me to Brian Tiller of Jayco who said he would call back al a time more convenient for him. SUB Review 04/16/2004 04/30/2004 WE OH 4/3012004 See fax sent by JMP to John Stapleton requesting missing information. 5/7/2004 Envelope and Lighting pass energy code review. HV AC fails plan review. OH will contact Roger Tiller. SUB Review 05/12/2004 05/12/2004 APP OH HV AC passes plan review. To Request an inspection call the 24 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. Site Inspection: To be made after excavation but prior to setting forms. ErosionlGrading Inspection: After all erosion measures are in place. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framiug Inspection: Prior to cover and after all rough in inspections have been approved. Walllnsulation: Prior to cover. Ceiling Insulatiou: Prior to cover. Pal!e 4 of5 . . \...11 f VI< ~rKll~uI<IELD Building/Combination Permit Status Issued PERMIT NO: COM2004-00428 ISSUED: 06111/2004 APPLIED: 04/15/2004 EXPIRES: 12/1112004 VALUE: $ 326,800.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Roofing: Prior to installing any roof covering. Drywall: Prior to taping. Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Structural Concrete: In excess of2500 psi. To he done during construction by a State Certified Inspector. Provide results to City Buiding Inspector High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection 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 Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Underslah Plumhing: Prior to filling the trench and including required testing. Underground Plumbing: Prior to filling the trench and including required testing. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to hackfill. Rough Plumhing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Water Line: Prior to mling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. 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. SUB Insulation Vapor Barrier: To be called for at the same time as tbe SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Plumbing: Following City Rough Plumbing inspection approval and prior to cover. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior Lighting Curbcut - Standard: After forms are erected but prior to placement of concrete. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. 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 ofthe Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will he 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 ofthe property, and the approved set of plans will remain on the site at all (", ...m?es U ri=truction. ~ ~ rk1!.L.. t,- ) 1- <-{ , Owner or Contractors Signature Date Paee 5 of5 225 Fiftl.I Street . ' Springfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2004-00428 COM2004-00428 COM2004-00428 Pnyments: Type of Payment Cash 611112004 RECEIPT #: Description Storm Sewer Each Addtl 100' + 7% State Surcharge + 10% Administrative Fee Paid By THURSTON COMMENITY BAPTIST CHURCH 6 SIiY of Springfield Official Receipt .elopment Services Department Public Works Department 2200400000000000755 Date: 06/11/2004 Item Total: l:heck Number Authorization ReceIved By Batch Number Number How Received dIm In Person Payment Total: Page I of I 3:01:04PM Amount Due 14.00 0.98 1040 $16.38 Amonnt PaId $16.38 $16.38 ~" ~~D~" lin1JU=. I) submitted has the fallawing . . ..... squire specific I~nd use 225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . f~~~I)726-3689 ELECI'RICALI(~#ICATION' Dat"ZOning CIty Jab Numb~r ~ Date Mumorized Signaturo L ~'DO,GA~OdiOitmSTAE'ffi"OM:~~:. -"'"""~~~.~.,~, -'::.::9!~~~ ~?1ro _ ~(\' - .. . ., _) 3. l8?J!J&!it;..T.K;f.&gf.~9.ffiPPJ;E~~LOl'W ;';C ..f',,~ ~ LE<"t~\{]) '",~tr~ JOBDESC~ION . 1000 sq. ft. arless $106.00 !MJ A 6{))(\) -\' W C'lJ\(\U\T-::) ~~~a~:~~:~ 500 sq. ft ar $ 19.00 CL t,:'" 4- elL- _ '~ PermitS are nan-transferable and expire if wark is nat started within 180 days af issuance or if work is Suspended for 180 days: . ~,' ~:;,':~~,'~~, :\.o>J'~~",',ffi,~~,'~,-\ 2.Co.~q.c;O~I!:!iil";:J.J:.?~[ION{01'YP."}ir Electrical Cantract . ., (l~. Each Manufacfd Harne ar Madular Dwelling Service ar Feeder $50.00 L&i;~~J~""~;l~~~_~H~"~:i',j""t(.~~~~ B. ~~eS&eedefs~allat~.A1r~rat!q'ns'ar,~elacati't.,l:-' ~ ~~, ,~" ~,"'(~ ,_~~U!l>-~_,_.~ . 200 Amps ar less $ 63.00 201 Amps to. 400 Amps .\ $ 75.00 401 Amps to. 600 Amps $125.00 LC'I_r'l///t1 601 Amps to. 1000 Amps $163.00 Phane t:..lfJ-:-7t:l:ifE Over 1000 AmpsIValts $375.00 ENTlOl\ReC\llBell ~)',..,...o-... $ 50.00 follow rules a80 dhu .-"wH....VOIHo L/71///0Notlficationee .0' _~(\'l-~mr~'-'''$....;t~~,..:" ~h ?>?>.~ .....,,'~..Jt\l " Supervisar License Number '7 It"'!) IROAR ~1r's~,~~;lI.~ / / 952-001-o010throl!q,h OARe I Expiratian Date / D ~'C2I-() y- 0090.. You ma~~!lpOO"OtMn o~btian - - - ~ull,ng the ,....R.....AI........... e ru""s bv /'1:::/ 1_ /.--, eJJ number for t~~---......",.me telephono $ 50.00 Canstr. Cantr. Number ~)V? Ie> C ''2!l'\''!'$fi\l1t~~ncatlon $69.00 o ente'41Y11__.aasoo~~ $100.00 Expiratian Date () --I4---f) c::; Over 600 Amps ar 1000 Valts see "B" abave. . ""-'''''''7','''''''',~'~''~'!l:~l>'o:?oi~,',''''"~"'-'''',''.,-'''','''ilf:'', .~\P"l(~""4 D. ~Bt.~l)f~~~r,f.1:!~ ~~~~"r~':.'~~i...tc~~t~.~~~.~tP.'~~-:... ....r-.. yt~~ ~.* .., ("l - ~. ~~"~'~~'':1~~r'~;;';''3;r;~~~~~','-~~.~'''~''~~~ .~V\.. ' E. ft~!I~,@'$m!t.(~~I&S%!~~~J:.!:i~2.'!!Ei~Ltl~f}1~i$~~'il~~Jj!!Ati.~ -.~ Pumparirrigatian '$50.00 ' :;.... Sign/Outline Lighting S 50.00. .' Limited EnergylResidential S 25.00 Limited Energy/Cammercial ' S 45.00 Address Jhm 2AzJ City_~ u ,Signature af Supervising Electrician New Alteration ar Extension Per Panel One Circuit Each Additianal Circuit ar with Service ar Feed~ Permit $ 43:00 '-1D.. $ 3.00 .,~.U? foOcP '0--- The installatian is being' made an property I awn which is nat intended far sale, lease ar rent. ' Minimum Electric Permit Inspectian Fee is $45.00 + Surcharges NOTICE: ' ~!ii?''''""'';''''~''''~','''''--)t,'-" -'~'"'''',''W<:'Jij~: ?'""""',' \n.t><.. I'lf) Owners Signature: THIS PERMIT SHALL EXP\Ht:~~}$?"~~~~~~ 'Oc) \IV AUTHORIZED UNDER THIS P~BM!J.J~ NOT " ~ G8::!..C;~~~ 8R IS ABANDON'l:il1-'\ttfrc'harge . '!t. , ANY 180 DAY PERIOD. 10% Administrative Fee \J.~ .'(J~ Inspectian Request: 726-3769 TOTAL ~I ""\ J Shared Drive(T:YBuilding Forms/Electrical Permit Applicntion l..Q3.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06/1112004 APPLIED: 04/1512004 EXPIRES: 12/11/2004 VALUE: $ 326,800.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 6364 MAIN ST ASSESSOR'S PARCEL NO.: 1702344204100 Springfield TYPE OF WORK: Church TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add 4,000 sf Multipurpose room. Owner: CHARITY BAPT CHURCH SPFLD Address: PO BOX 1393 SPRINGFIELD OR 97477 Phone Number: 541-746-5556 I CONTRACTOR INFORMATION I Contractor Type ~Iutor License Expiration Date Phone \/u .~ General 1~," . .. Electrical AR:~B ~t!E(fiRit':ilItsEXP/RE IF THE WORK 156678 08/14/2005 541-686-5444 Engineer S' ~ WIiN8J.ENG E 541-485-8383 C'J"'r"~-iWu .l1ll.~m>PERMIT IS NOT Mechanical J eo ENffE ,I'!R~\I~GJDON 156807 09/09/2005 541-689-1667 Plumbing AS'i!fsWNlJA:N&-"'4R1f9~Dr" ED FOR 49561 12/16/2004 541-484-3787 I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type, Energy Path: Sprinkled Building: 1 Lot Size: 26.50 Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: n/a Occupant Load: 4,000 A-3 ATTENTION: Oregon I~'I?~ll6I'MENIlINFORMATION I follow rule$ adopted by the Oregon U{l~fy Frontyard Setba~kDtification Center. Those rUles~MI!n';' S~de 1 Setback: I~ OAR 952-001-001? thra~gh QfSl~~~ U; Rqd: SIde 2 Setback: 0090. You may obtain caples O~, Vl.qd: Rearyard Setback: calling the center. (Note:.t~e%1~verage: Solar Setbacks: b for the Oregon Utility NotlflcatiOl'l num er . - - ra' "\ (;enter Il> 1'~vl P(}OLIbf.n>ROVEMENTS I REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Fullv Improved Yes Sidewalk Type: DownspoutslDrains: Setback 5' To Storm Sewer Notes: Pal!e 1 of5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Churches Pavin!! VN Use Bid Amount Fee Description Plan Review CommlIndlPublic Plan Review Fire & Life Safety -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Backl10w Device . Building Permit Encroachment Permit Fixture Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Paving Plan Review CommlIndlPublic Plan Review Fire & Life Safety Planning Final Occy Inspection Sanitary Sewer - Ist 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement Sanitary Sewer Each Addtll00' SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC SanitarylStorm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - Ist 50 Feet Storm Sewer Each Addtll 00' Vent Fan Water Line - Ist 50 Feet Water Line - Each Addtll00' + 10% Administrative Fee + 7% State Surcharge . I Valuation Descriotion I $ Per Sq Ft or multiplier $71.20 $1.00 Square Footage or Bid Amount 4,000.00 42,000.00 Total Value of Project Fppo tIilLI Amount Paid $758.49 $466.76 $10.00 $203.88 $120.04 $14.00 $1,166.90 $120.00 $252.00 $60.00 $4.00 $1.00 $323.85 $88.72 $54.60 $143.00 $45.00 $946.55 $1,245.20 $14.00 $10.00 $244.83 $359.58 $238.58 $183.23 $2,769.80 $627.86 $2,232.42 $45.00 $28.00 $12.00 $45.00 $28.00 $13.50 $9.45 Date Paid 4/15/04 4/15/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14104 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 6/11104 6/11/04 Pa!!e 2 of5 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06/11/2004 APPLIED: 04/15/2004 EXPIRES: 12/11/2004 VALUE: $ 326,800.00 Value Date Calculated $284,800.00 $42,000.00 $326,800.00 04/15/2004 04/23/2004 Receipt Number 2200400000000000368 2200400000000000368 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000754 2200400000000000754 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Add, Alter, Extend Circ Ea Add Perm ServlFdr 201 to 400 amps Total Amount Paid Fire Department Review Initial Review Plan nine Review Puhlic Works Review Structural Review . 04/16/2004 04/16/2004 04/1612004 04/16/2004 05/0612004 $60.00 $75.00 $13,020.24 6/11/04 6/11/04 I Plan Reviews , 04/2112004 04/16/2004 04/23/2004 04/23/2004 05/06/2004 OK APP RJB APP EMM APP SB APP JMP Paee30f5 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 06111/2004 APPLIED: 04/15/2004 EXPIRES: 12111/2004 VALUE: $ 326,800.00 2200400000000000754 2200400000000000754 GRG Plan Review: Construction of a detached 4000 sq. ft. multipurpose activity room. Job #COM2004-00428. Occupancy Classification: A-3. Construction type: V-No Fire extinguisher location shown on Sheet lIAl Fioor Plan. The fire extinguisher sball bave a minimum rating of2-A:10-B:C. The top oftbe extinguisher(s) shall be between 3 and 5 feet above finished floor (Springfield Uniform Fire Code 1002.1 ). Exit/egress Iigbting sbown on Detail lIEl. Will verify on inspection. Bollards and chain witb public works lock called out in Sheet C5. Will verify on Inspection. Approved as per Final Site Plan and Conditions of Site Plan Review Applicant has submitted an encroachment permit application fOI 6" tap to 8" sewer main. A section oftbe 8" pipe is proposed to be removed and a 6 x 8 x 8 Tee is required. Received from Roger Tiller information for PW, SUB, and plumbing inspector and distributed to all. Brian Tiller called to review mecbanical equipment for inspections. . . CITY OF ~.rK1NGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2004-00428 225 Fifth Street, Springfield, OR ISSUED: 06/11/2004 541-726-3753 Phone APPLIED: 04/15/2004 541-726-3676 Fax EXPIRES: 12/1112004 541-726-37691nspection Line VALUE: $ 326,800.00 Structural Review 04/16/2004 04/19/2004 WE JMP 411912004 See attached fax to Ralph Wilson requesting Special Inspection forms. Also called Ralph and asked for the list of contractors and the written value of the building and of the site work itemized separately. 4/20/2004 See attached faxed structural review to Ralph with 8 points to be addressed. 4/23/2004 received response from John Stapleton and processed. Called for John Stapleton and sent attached fax with a progress update with information request for PW, SUB, and plumbing inspector. 5/3/2004 updated Roger Tiller, of the Church, on the progress. He wants to start construction next week. 5/4/2004 spoke with John Stapleton and he said he would try to supply all missing information this week. He referred me to Ted Essner for mechanical equipment questions. Ted referred me to Brian Tiller of Jayco who said he would call back al a time more convenient for him. SUB Review 04/16/2004 04/30/2004 WE DH 4130/2004 See fax sent by JMP to John Stapleton requesting missing information. 5/7/2004 Envelope and Lighting pass energy code review. HV AC fails plan review. DH will contact Roger Tiller. SUB Review 05/1212004 0511212004 APP DH HV AC passes plan review. To Request an inspection call the 24 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. ~r.."T~ Site Inspection: To be made after excavation but prior to setting forms. Erosion/Grading Inspection: After all erosion measures are in place. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Pal!e 4 of5 . . CITY OF ~nuNGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2004-00428 ISSUED: 06/11/2004 APPLIED: 04/15/2004 EXPIRES: 12/11/2004 VALUE: $ 326,800.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541, 726-3769 Inspection Line Roofing: Prior to installing any roof covering. Drywall: Prior to taping. Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection 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 Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Underground Plumbing: Prior to filling the trench and including required testing. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Fiual Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 Plumbing: Following City Rough Plumbing inspection approval and prior to cover. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. SUB Ceiling Grid: Interior Lighting SUB Exterior 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 will be made oCany structure without permission of the Community Services Division, Building Safety. I further certify tbat 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 ofthe property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Paee 5 of5 1 .225 F.ifth Street SP.ringfield, Oregon 97477 541-726-3759 Phone . Job/Journal Number COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 Payments: Type of Payment CreditCard 6/11/2004 RECEIPT #: ~ Jii.ty of Springfield Official Receipt .velopment Services Department Public Works Department 2200400000000000754 Date: 06/11/2004 Description Penn ServlFdr 201 to 400 amps Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By ROBS ELECTRIC Item Total: Check Number Authorization Received By Batch Number Number How Received llh 000407 011828 Phone Payment Total: Page 1 of 1 2:37:08PM Amount Due 75.00 60.00 9.45 13.50 $157.95 Amount Paid $157.95 $157.95 ,J. . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ~ . CITY OF SPKll'i\.ot<!J!.,LD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 05/14/2004 APPLIED: 04/15/2004 EXPIRES: 11/14/2004 VALUE: $ 326,800.00 , Status Issued SITE ADDRESS: 6364 MAIN ST ASSESSOR'S PARCEL NO.: 1702344204100 Springfield TYPE OF WORK: Church TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Add 4,000 sf Multipurpose room. Owner: CHARITY BAPT CHURCH SPFLD Address: PO BOX 1393 SPRINGFIELD OR 97477 Phone Number: 541-746-5556 I, CONTRACTOR INFORMATION I Contractor OWNER SS & W INC - ENGINEERS J CO ENTERPRISES INC 156807 09/09/2005 SUSAN JANE ARNOW, 49561 ....CI1./16/2004 '* r' BtHLDING INFORMATION I fb"\\)".:F~O~'~ ~'" ~. ~ . :. ~~ ~~ tOt- 9JrS>"Q"\ # of Units: ~ ~ 9::-~ ~ <<. # of Stories: ..rP(j-'lJ '#.0$l7@'" 0 Primary Occupancy Group: f,'NgQ.'<; ~~<.(; Height of Structure ~~'50:,.~ ::s8'F0't'~~~ Secondary Occupancy Group: ,,~"-~ ~ Type of Heat: ff."Q"\ !I> ~ !f ~~i"t~l)Iiior: Primary Construction Type ~~ fi3:' V~ Water Type: ~,j> 4:$'0 !..~. 0<S~~'-~ment: Secondary Constructipn T~: ~ ~ ~~. Range Type: O~.,p~!... '\:; ~ vo~:~il'~~ge/Carport # of Bedrooms: #"9::-~ ~ 'S (;;)<:(- # Energy pat~: rP ~0~ s:.'\:;" ;q~ ~~Sq)rr?her: ~ q,'<; $ ~ q,'<; Sprinkled B 1~1f ~v-!:)~ efil !...~"d}c~ant Load: ~ .c... {',,- ,C~ r~ . ..l.,_['I.,I:$.\ ~'lj ,.,,,,~<::l ~'f~-$:-~~'V' I DEVELOPMENt<IN~;(T.ro~i:'0~~ ~v ,,~;l..,.....f.- ol ..... ,,~. ~.~ ~ ~"'~ ,.,<:-'<I!..~ ~ ~ Overlay Dist: ~- #.~'lj " # Street Trees Rqd: ~. Paved Drive Rqd: % of Lot Coverage: Contractor Type General Engineer Mechanical Plumbing License Expiration Date Phone 541-485-8383 541-689-1667 541-484-3787 4,000 REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Fullv Improved Yes Sidewalk Type: Downspouts/Drains: Setback 5' To Storm Sewer Notes: Pal!e 1 of5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Churches Pavin!! VN Use Bid Amount Fee Description Plan Review Comm/IndlPublic Plan Review Fire & Life Safety -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Backflow Device Building Permit Encroachment Permit Fixture Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Paving Plan Review CommlIndlPuhlic Plan Review Fire & Life Safety Planning Final Occy Inspection Sanitary Sewer - 1st 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement Sanitary Sewer Each Addtl 100' SDC MWMC Administration SDCMWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Storm Sewer Each Addtl 100' Vent Fan Water Line - 1st 50 Feet Water Line - Each Addtl 100' Total Amount Paid . I VaIL ,ItiOD DescriotioD I 1...11 III I $ Per Sq Ft or multiplier $71.20 $1.00 Square Footage or Bid Amount 4,000.00 42,000.00 Total Value of Project F PP., PlIilLI Amount Paid $758.49 $466.76 $10.00 5203.88 $120.04 $14.00 $1,166.90 $120.00 $252.00 $60.00 $4.00 $1.00 $323.85 $88.72 $54.60 $143.00 $45.00 $946.55 $1,245.20 $14.00 $10.00 $244.83 $359.58 $238.58 $183.23 $2,769.80 $627.86 $2,232.42 $45.00 $28.00 $12.00 $45.00 $28.00 $12,862.29 Date Paid 4/15/04 4/15/04 5/14/04 5114/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 5/14/04 Pa!!e 2 of5 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 05/14/2004 APPLIED: 04/15/2004 EXPIRES: 11/1412004 VALUE: $ 326,800.00 Value Date Calculated $284,800.00 $42,000.00 $326,800.00 04/15/2004 04/23/2004 Receipt Number 2200400000000000368 2200400000000000368 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 2200400000000000579 . . CITY OF ~rK11'1liJ:<l.l!,L1J Building/Combination Permit PERMIT NO: COM2004-00428 ISSUED: 05/14/2004 APPLIED: 04/15/2004 EXPIRES: 11/14/2004 VALUE: $ 326,800.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Plan Reviews I Fire Department Review 04/1612004 04/2112004 OK GRG PlaD Review: CODstrDctioD of a detached 4000 sq. ft. multipurpose activity room. Job #COM2004-00428. Occupaucy Classification: A-3. Construction type: V -N. Fire extinguisher 10catioD shown OD Sheet IIAI Floor PlaD. The fire , extiDguisher shall have a minimum ratiDg of 2-A:10-B:C. The top ofthe extiDguisher(s) shall be betweeD 3 aDd 5 feet above finished floor (Springfield UDiform Fire Code 1002.1 ). Exit/egress lighting showD OD Detail IIE1. Will verify on inspectioD. Bollards and chaiD with public works lock called out iD Sheet C5. Will verify OD inspectioD. Initial Review 04/16/2004 04/16/2004 APP RJB PlaDDiD!! Review 04116/2004 04/23/2004 APP EMM Approved as per FiDal Site PlaD aDd CODditioDs of Site PlaD Review Public Works Review 04/16/2004 04123/2004 APP SB ApplicaDt has submitted aD eDcroachment permit application fOI 6" tap to 8" sewer main. A section of the 8" pipe is proposed to be removed and a 6 x 8 x 8 Tee is required. Structural Review 05/06/2004 05/06/2004 APP JMP Received from Roger Tiller information for PW, SUB, and plumbing iDspector and distributed to all. Brian Tiller called to review mechanical equipment for inspections. Pa!!e 3 of5 ' . . CITY OF SPKll'l\..ot<1Jj,LD Building/Combination Permit Issued PERMIT NO: COM2004-00428 225 Fifth Street, Springfield, OR ISSUED: 05/14/2004 541-726-3753 Phone APPLIED: 04/15/2004 541-726-3676 Fax EXPIRES: 11114/2004 541-726-3769 Inspection Line VALUE: $ 326,800.00 Structural Review 04/16/2004 04/1912004 WE JMP 4/19/2004 See attached fax to Ralph Wilson requesting Special Inspection forms. Also called Ralph and asked for the list of contractors and the written value of the building and of the site work itemized separately. 4/20/2004 See attached faxed structural review to Ralph with 8 points to be addressed. 4/23/2004 received response from John Stapleton and processed. Called for John Stapleton and sent attached fax with a progress update with information request for PW, SUB, and plumbing inspector. 5/3/2004 updated Roger Tiller, ofthe Church, on the progress. He wants to start construction next week. 5/4/2004 spoke with John Stapleton and he said he would try to supply all missing information this week. He referred me to Ted Essner for mechanical equipment questions. Ted referred me to Brian Tiller of Jayco who said he would call back al a time more convenient for bim. SUB Review 04/16/2004 04/30/2004 WE DH 4/30/2004 See fax sent by JMP to John Stapleton requesting missing information. 5/7/2004 Envelope and Lighting pass energy code review. HV AC fails plan review. DH will contact Roger Tiller. SUB Review 05/12/2004 05/12/2004 APP DH HV AC passes plan review. To Request an inspection call the 24 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. ~Irt In~,nlP:l"~ I Site Inspection: To be made after excavation but prior to setting forms. 2 Erosion/Grading Inspection: After all erosion measures are in place. 27 Rough Mechanical: Prior to Cover 28 Final Mechanical: When all mechanical work is complete. 29 Rough Electric: Prior to Cover 30 Final Electric: When all electrical work is complete. 31 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. 32 SUB Final: After all required energy inspections have been requested and approved. 33 SUB Plumbing: Following City Rough Plumbing inspection approval and prior to cover. 34 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. Paee40f5 . . CITY OF :srK11~lJ"U",LU Building/Combination Permit . Status Issued PERMIT NO: COM2004-00428 ISSUED: 05/14/2004 APPLIED: 04/15/2004 EXPIRES: 11114/2004 VALUE: $ 326,800.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 35 SUB Ceiling Grid: Interior Lighting 36 SUB Exterior Lighting 3 Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor foundation inspection. 4 Footing: After trenches are excavated. 5 Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 6 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 7 Wall Insulation: Prior to cover. 8 Ceiling Insulation: Prior to cover. 9 Roofing: Prior to installing any roof covering. 10 Drywall: Prior to taping. 11 Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. 12 Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector 13 High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector. 14 Final Fire Department. After all requirements of the Fire Department have been met. 15 Final Building: After all required inspections have been requested and approved and the bnilding is complete. 16 Rough Grading: After gravel is in place but prior to placing concrete. 17 Final Paving: After paving is complete. 18 Underslab Plumbiug: Prior to filling the treuch and including required testing. 19 Underground Plumbing: Prior to filling the trench and including required testing. 20 Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. 21 Rough Plumbing: Prior to cover and including required testing. 22 Shower Pan. Prior to covering and including required testing. 23 Water Line: Prior to filling trench and including required testing. 24 Sanitary Sewer Line: Prior to filling trench and including required testing. 25 Storm Sewer Line: Prior to filling trench. 26 Final Plumbing: When all plumbing work is complete. 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 fnrther 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. Q~ ~O~ Owner or Contractors Signature <:;~I~,q Date Pa2e 5 of5 . ATIACHMENTA CITY OF GFIELD SYSTEMS DEVELOPMENT CHARGE W.HEET JOURNAL OR JOB NUMBER C0M2004-00428 NAME OR COMPANY, THURSTON COMMUNITY CHURCH LOCATION: 6364 MAIN ST MAP & TAX LOT NUMBER: 17023442 04100 DEVELOPMENT TYPE: CHURCH ADDmON NEW DEVELOPED AREA (S.F.): 4.000.00 EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVlOUS SURFACE (S.F.): 560 lTE: lTE: LOT SIZE (S.F.): o I STORM ORAINA.Qf; lMPER VlOUS SQ. IT. $ 0.290 PER SF TOTAL STORM DRAINAGE SDq $ 2,232.42 1070 , 7,698 x . ~ ~ ... ~~~: - = = OO~, 2 SANITARY SEWER-CITY A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) . . .i II ~~ . 0 "'" 55 x $ 22.64 PER DFU I $ 1,245.20 I $ 1,245.20 1091 55 x $ 17.21 PER DFU I $ 946.55 I $ 946.55 1092 TOTALWCALWASTEWATERSDC:I $ 2,191.751 .. - -.-- 3 TRANSPORTATION BLOG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 4.000 x 9.11 x $ 17.23 PER TRIP x NTF 1$ 627.86 I B. IMPROVEMENT COST: 4.000 x 9.11 x $ 76.01 PER TRIP x NTF 1$ 2.769.80 I EXISTING A. REIMBURSEMENT COST: 0.00 x 0 x $ 17.23 PER TRIP x 0 NTF 1$ B. IMPROVEMENT COST: 0.00 x 0 x $ 76.01 PER TRIP x 0 NTF 1$ TOTAL TRANSPORTATION REIMBURSEMENT SDC:' $ TOTAL TRANSPORTATION IMPROVEMENT SDC:' $ $ TOTAL TRANSPORTATION SDq $ 3,397.66 ~ 627.86 2,769.80 3,397.66 4 SANITARY SEWER. MWMC NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 4.000 x $89.89 PER FEU 1$ B. IMPROVEMENT COST: NUMBER OF FEU's 4.000 x $61.21 PER FEU 1$ EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.000 x $0.00 PER FEU 1$ B. IMPROVEMENT COST: NUMBER OF FEU's 0.000 x $0.00 PER FEU 1$ MWMC CREDIT IF APPLICABLE (SEE REVERSE) 359.58 I 244.83 I I $ TOTAL MWMC REIMBURSEMENT FEE: $ TOTAL MWMC IMPROVEMENT FEE: $ MWMC ADMINISTRA TTVE FEE: $ TOTAL MWMC SDC:' $ 614.41 ~ SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ $ 8,436.24 ~ 5 ADMlNlSTRA TTVE FEES' BASE CHARGE (SUBTOTAL ABOVE) $ 8,436.24 x 5% $ 421.81 TOTAL TRANSPORTATION ADMlNlSTRATION FEE:I $ TOTAL SEWER ADMlNlSTRA TION FEE:' $ 1054 359.58 1054 244.83 1055 10.00 1056 183.23 1078 238.58 1079 1093 1094 steve.... W. 1!.e.u,,'1::J 1!..YI'\.t$ 1SllillO~~003.xls TOTAL SDC CHARGES 8,858.05 4/23/2004 DATE , $ 1 JULY 2001 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FlXTIJRES x UNIT EQUlV ALENT - DRAINAGE FIXTURE UNITS (NOTE: E9R REMODELS. CALCULATE ONL Y mE NET ADDmONAL FIXTURES) THURSTON COMMUNITY CHURCH FIXTURE ITPE BA THTIJB DRINKING FOUNTAIN FLOOR DRAIN lNTER\..u 'V~ FOR GREASFJOllJSOLIDSIETC. lNTER\..cr' v~ FOR SAND/AUTO WASHlETC. LAUNDRY TUB CWTIlES WASHERlMOP SINK CWTIlES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRlGERA TORIW A TER ST A TIONIETC. RECEPTOR FOR COMMERCIAL SlNKI DISHW ASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASINIDOUBLE LA VA TORY SINK: SINGLELAVATORYIRESIDENTIALBAR URINAl, STALllWALL TOILET, PUBLIC INSTAlLATION TOILET, PRIVATE INSTAlLATION MISCEU.ANEOUS: FIXTURES NEW OLD UNIT EOUIVALENT 3 1 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 5 2 1 2 1 3 I 3 NUMBER OF EDU'S. TOTAL DRAINAGE FIXTURE UNlTS= -EDO (Equivalent Dwcllin~ Unit) is a discbarlze equivalent to a sinldt family dwellinR (20 DFU) set 81167 ~Ions ocr day DRAINAGE FIXTURE UNITS o o 15 o o o 3 o o 2 3 4 o o o 2 3 5 18 o o o o 55 CREDIT CALCULA TION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFfERANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY YEAR RATE PER $1,000 YEAR RATE PER $1,000 ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE = 1979 or before $ 5.04 1992 $ 1.52 1980 $ 4.95 1993 $ 1.38 1981 S 4.88 1994 $ 1.19 1982 $ 4.75 1995 S 1.03 1983 $ 4.58 1996 $ 0.87 1984 $ 4.41 1997 $ 0.68 1985 $ 4.20 1998 $ 0.46 1986 $ 3.88 1999 $ 0.27 1987 $ 3.50 2000 $ 0.09 1988 $ 3.07 2001 $ 0.04 1989 $ 2.60 2002 $ 1990 $ 2.14 2003 $ 1991 $ 1.71 2004 $ CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE $0.00 X 0.000 $0.00 IMPROVEMENT (IF AFTER ANNEXATION DATE) X $0.00 CREDIT TOTAL $0.00 1SteveCOMBuildSDCdec2003.x1s JULY 2001 . ~! ~ of Springfield Official Receipt .lopment Services Department Public Works Department .225 Fifth Street . Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 COM2004-00428 Payments: Type of Payment Check 5/1412004 RECEIPT #: 2200400000000000579 Date: 05/14/2004 Description Planning Final Occy Inspection Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC SanitarylStorm Admin SDC Transpo Admin Encroachment Permit Building Permit Paving Plan Review CommlInd/Public Plan Review Fire & Life Safety Furnace - up to 100,000 btu Vent Fan Gas Outlets 1-4 Gas Outlets 4+ -Mechanical Issuance Fee-- Backflow Device Fixture Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtl 100' Water Line - 1st 50 Feet Water Line - Each AddtllOO' Storm Sewer - 1st 50 Feet Storm Sewer Each Addtl 100' + 7% State Surcharge + 10% Administrative Fee PaId By THURSTON COMMUNITY BAPTIST CHURCH Item Total: Check Number Authorization Received By Batch Number Number How Received jmp 1106 In Person Payment Total: Page 1 of 1 3:07:06PM Amount Due 143.00 2,232.42 1,245.20 946.55 627.86 2,769.80 359.58 244.83 10.00 238.58 183.23 120.00 1,166.90 323.85 88.72 54.60 60.00 12.00 4.00 1.00 10.00 14.00 252.00 45.00 14.00 45.00 28.00 45.00 28.00 120.04 203.88 $11,637.04 Amount Paid $11,637.04 $11,637.04