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Home My WebLink AboutPermit Building 2007-6-29 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2007-00764 ISSUED: 06/29/2007 APPLIED: OS/29/2007 EXPIRES: 12/29/2007 VALUE: $ 760,500.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 123 INTERNATIONAL WAY ASSESSOR'S PARCEL NO.: 1703154001101 SPRINGFIE TYPE OF WORK: Interior TYPE OF USE: Remodel PROJECT DESCRIPTION: Interior Tenant improvement - Facilities Management, Section F and G Commercial Owner: PEACEHEAL TH Address: 123 INTERNATIONAL WAY SPRINGFIELD OR 97477 Phone Number: 541-793-7144 Contractor Type Architect General Electrical Mechanical Plumbing I CONTRACTOR INFORMATION I Contractor License ANDERSON DABROWSKI ARCHITECTS JOHN HYLAND CONSTRUCTION INC 46071 OREGON ELECTRIC CONSTRUCTION INC 203 FM SHEET METAL INC 89710 TWIN RIVERS PLUMBING INC 17695 BUILDING INFORMATION I Expiration Date 07/11/2008 01/01/2008 03/15/2009 03/11/2008 Phone 503-239-7377 541-726-8081 503-234-9900 541-726-3000 541-688-1444 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: B # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: lIB n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATIO~IIJTICE: THIS PERMIT s""Et?~r"tmlNWYOR1< Overlay Dist: AUTHORIZED UNOOiJH1S PERMIT IS NOl # Street ~rees Rqd: COMMENCED OWI8lJ\~OONED FOR Paved Dnve Rqd: ANY 180 DAY pemmJ~ct: % of Lot Coverage: ATTENTION: Oregon law requires you to f""l........ .. .n..... ...."l'p.Atf hy tho ~n Iltlllty Notification 'jJ]!{QlLIfflIM'~~~ in OAR 952-vu .-uu IV .I..v...~. ~Nl II! Mt. 0090. You may obtain copies oftherul81 by Sidewalk Type: calling the center. (Note: the telephone Downspouts/Drains: number for the Oregon UtIlity NotIftcatIora Center is 1-800-332-2344). Street Improvements: Storm Sewer Available: Special Instruction: Notes: Paee 1 of3 Status Issued 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: COM2007-00764 ISSUED: 06/29/2007 APPLIED: OS/29/2007 EXPIRES: 12/29/2007 VALUE: $ 760,500.00 I Valuation Description I Description $ Per Sq Ft or multiplier $1.00 Estimate Type of Construction Estimate Square Footage or Bid Amount 760,500.00 Total Value of Project ~ Value Date Calculated $760,500.00 $760,500.00 OS/29/2007 Fee Description Amount Paid Date Paid Receipt Number Plan Review CommlInd/Public $1,764.04 5/29/07 3200700000000000352 -Mechanical Issuance Fee- $10.00 6/29/07 1200700000000000844 + 10% Administrative Fee $292.99 6/29/07 1200700000000000844 + 5% Technology Fee $146.50 6/29/07 1200700000000000844 + 8% State Surcharge $234.39 6/29/07 1200700000000000844 Building Permit $2,713.90 6/29/07 1200700000000000844 Fixture $98.00 6/29/07 1200700000000000844 Miscellaneous Mechanical $45.00 6/29/07 1200700000000000844 Miscellaneous Plumbing $45.00 6/29/07 1200700000000000844 Plan Review Fire & Life Safety $1,085.56 6/29/07 1200700000000000844 Sewage Ejector Pump $28.00 6/29/07 1200700000000000844 Total Amount Paid $6,463.38 I Plan Reviews I Fire Department Review 06/01/2007 06/23/2007 Fire Department Review 06/26/2007 06/26/2007 Initial Review Plan Review Comments 05/30/2007 05/30/2007 06/15/2007 Plannine Review Public Works Review 06/01/2007 06/04/2007 06/04/2007 06/04/2007 Structural Review 05/30/2007 06/12/2007 Structural Review SUB Review 06/28/2007 06/01/2007 06/28/2007 06/26/2007 WE GRG OK GRG APP LLH 10 JMP APP EMM APP JHJ WE JMP APP JMP APP JF Paee 2 of 3 Waiting on fire alarm device information. See attached document for Fire Department Plans Review comments. WI. Steve Spitzer delivered the responses. Forwarded the set requested for SUB to Jack Foster. Attched SDC Worksheet. No New SDC's. (JHJ) See attached documents for 4 structural comments faxed to Elaine M. Dabrowski. Received final internal approvals. Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: cOM2007-00764 ISSUED: 06/29/2007 APPLIED: OS/29/2007 EXPIRES: 12/2912007 VALUE: $ 760,500.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line To Request an inspection call the 24 hour recording at 726-3769. 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 work day. I Reouired InsDections I Framing Inspection: Prior to cover and after all rough in inspections have been approved. Ceiling Grid: After drywall approval but prior to cover. High Strength Bolting: To be done during construction by a State Certified Special 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. SUB Final: After all required energy inspections have been requested and approved. 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 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 fnspections 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 timesd~ ,~ _ f/:;J1- . J{,4r { f ( Owner~r ContracUors Signature Date Page 3 of 3 City of Springfield Community Services Divisiqll 225 Fifth Street Springfield, OR 97477 Telephone: (541) 726~3759 Fax: (541) 726-3689 .c..o~ ~\' CJ:)lb~ lc::o- (8 -01 Building Permit # Date ~.H- ~ep..., f"~tL.lllE-S M~~'t. f cl c., Project Title l2.:, l~'t' ~~~"'tlO~""L W f\.--<' Project Address Special Inspection and Testing To applicants of projects requiring special inspection or testing as per Section 1704 of the Oregon Structural Specialty Code. Please review the information below. When you have finished, acknowledge an understanding of the information by signing below, and return this form to the City. , BEFORE A PERMIT CAN BE ISSUED: The owner or owner's representative, on the advice of the responsibie Project Engineer or Architect, shall conlplete, sign, and submit to the City for review and approval this form completed on both the front and back. The oWner and General Contractor, where applicable, shall also acknowledge the following conditions applicable to Special Inspection and/or Testing. 1. Contractor is responsible for proper notification for the Inspection or Testing ofItems listed. 2. Testing laboratory shall take appropriate samples and trailsport them to their laboratory for proper evaluation or testing. . Copies of all laboratory reports and inspections are to be sent to the City by the Testing Agency. 3. Special Inspection Agency is to submit Dames and qualifications of on-site Special Inspectors to the City for approval. 4. Special Inspector shall provide inspection reports to the building official of all inspection activities. 5. Contractor is responsible to review the City approved plans for additional inspection or testing requirements that may be noted.. BEFORE A CERTIFICATE OF OCCUPANCY WILL BE ISSUED: The Special Inspection Agency shall submit to the Building Official a statement that all items requiring inspection have been fulfilled and reponed and were to the best of the inspector's knowledge, in confonnance with the approved plans, specifications and applicable workmanship provisions. Those items not tested andJor inspected shall be noted in the statement. The report is to be submitted to the City plior to a request for final inspections. ACKNOWLEDGEMENTS 1L-_' -~ Jj~'oJJ.tt ~'<fV-pI< ~ ~ Owner Name (Printed) Owner~~e t4l'\tJ(i'YJOVl tM.bk7Wrl=4'~. -r,/M ~n . eer or Architect Finn (Printed) Eniineer ~r Arc t gnature ~M <.,.'Cc.< I~,h. -2"-;-- esting Laboratory Name (printed) Test~Labora~ Rep. Signature . Jtth/1l{k/ W"f'/' ~/ Gen. Contractor Firm Name (Printed) ~( Co~ctor Signature G\"'~~,.ML 4.a.JItC 1~ ~ ~-r- y ~Sj)eCial Inspectio~e (printed)(J1~~~:.s~ . \'--~~~ \.J~. - . Building Official Name CPr"h1ted) Building Official Signature SPECIAL INSPECTION AND TESTING SCHEDULE Reinforced Concrete, Gunite, Grout and Mortar: Concrete Gunite Grout Mortar ~ --- /l~ ----~. Precast/Pre-stressed Concrete: Piles Post- Tens Pre- Tens /' i /J '-....... / II rr- -r----. ( / I ~______ I SMOKE CONTROL: Leakage testing Control Verification ROOFING: Insulation installation/R -Value * Test strips/seams -~ Aggregate Test of Mix Design Reinforcing Test Mix Design-Weighmaster Cert.* Reinforcing Placement Continuous Batch Plant Insoect. Inspect Placing Cast Samples Samples (Pickuo/Deli vered) Compression Test* Cladding Aggregate Tests Reinforcing Tests Tendon Test Mix Designs* Reinforcing Placement Insert Placement Concrete Batching . ______ Concrete Placement ----. _Installation Inspection C~ples Pick-up SiiiIrt>les Compression Tests FIREPROOFING: XJ Placement inspection Density tests Tbickness tests Inspect batching ADDITIONAL INSRUCTlONS, OTHER TEST, & INSPECTIONS: I} BrAelVlS k. AOVl- .ffyz,,~ ~ c;.ov;..por. ~rJ ,:( GRADING, EXCAVATION, AND FILL Acceptance tests * PSF Establish final grade Fill placement inspection/continuous Soil Density STRUCTURAL STEEL/WELDING: Sample and test (list specific members below) Shop material identification (mill cert) Weld inspection Shop Ultrasonic inspection Shop High Strength Bolting Shop A325 _N A490 _N Metal deck welding inspection Reinforcing Steel welding inspection Reinforcing steel mill certificate Metal stud welding inspection Concrete insert welding inspection Moment resisting steel frames Field Field Field x X F F STRUCTURAL WOOD: Shear wall nailing inspection Shear wall anchors Inspection ofGlu-lam fab, * T/C psi Inspection of truss joist fab. Sample and test components Fabrication welding of steel accessories MASONRY Special inspection stresses used* f'm f'g Preliminary acceptance tests (masonry units, wall prisms) Subsequent tests (mortar, grout, field wall prisms) Placement inspection of units, and reinforcement Masonry, mortar, grout, and reinforcing steel certificates ., Form Completed by:, PIP01~ ,nrt'. f,n/1^ /,,...r anA , /, .. Date C~ ('/lh7 *PROVIDE STRENGTH REQUIRED BY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION OF VALVES CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER C0M2007-00764 NAME OR COMPANY: PeaceHea1th LOCATION: 123 International Way MAP & TAX LOT NUMBER: 17031540 01200 DEVELOPMENT TYPE: PeaceHealth FM Interior Remodel NEW DEVELOPED AREA (S.F.): EXISTING DEVELOPED AREA (SF): TOTAL IMPERVIOUS SURFACE (S.F,): I. STORM DRAINAGE IMPERVIOUS SQ. FT. x $ 19.79 PERDFU TOTAL LOCAL WASTEWATER SDC:' $ 3. TRANSPORTATION No New Building Square Footage BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW: A. REIMBURSEMENT COST: ~OO x 0 B. IMPROVEMENT COST: 0.00 x EXISTING: A. REIMBURSEMENT COST: 0.00 x 0 B. IMPROVEMENT COST: ~OO x 0 2, SANITARY SEWER-CITY (see reverse side) A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's o Interior Remodel Change In Use Paid Previously COMl005-00429 ITE: ITE: LOT SIZE (S.F.): x No New Impervious Area $ 0.336 PER SF TOTAL STORM DRAINAGE SDC:' No New Fixtures (Net) o $ 26,03 PER DFU x o x $ 19.81 PER TRIP x o NTF $0.00 I $0.00 I x $ 87.39 PER TRIP x o NTF x $ 19.81 PER TRIP $0,00 I o NTF x x $ 87.39 PER TRIP x 0 NTF $0.00 I TOTAL TRANSPORTATION REIMBURSEMENT SDC: TOTAL TRANSPORTATION IMPROVEMENT SDC: TOTAL TRANSPORTATION SDC:I $ 4. SANITARY SEWER - MWM( No New Building Square Footage NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU $0.00 I B. IMPROVEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU $0.00 I EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU $0,00 I B. IMPROVEMENT COST: NUMBER OF FEU's 0.00 x #N/A PER FEU $0.00 I MWMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: TOTAL MWMC SDC:I $ SUBTOTAL (ADD ITEMS 1,2,3, & 4) r I $0.00 I 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) $ x 5% , $0,00 TOTAL SEWER ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: $ TOTAL SDC CHARGES Jesse Jones Civil Engineer, EIT 6/4/2007 DATE $0,00 I DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) PeaceHealth FM Interior Remodel FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN, FLOOR SINK INTERCEPTORS FOR GREASE/OIL/SOLIDS/ETG. INTERCEPTORS FOR SAND/AUTO WASH/ETG. LAUNDRY TUB CLOTHES W ASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERA TOR/W A TER ST A TION/ETG. RECEPTOR FOR COMMERCIAL SINK! DISHW ASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLELAVATORY/RESIDENTIALBAR URINAL, STALL/WALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: FIXTURES UNIT NEW OLD EQUlV ALENT 3 I 3 3 6 2 3 6 12 I 3 2 2 3 2 2 1 5 6 3 NUMBEROF EDU'S* DRAINAGE FIXTURE UNITS o o -3 o o o o o o o o o o 3 o o o o o o o TOTAL DRAINAGE FIXTURE UNITS = , 0 *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 YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 RATE PER $1,000 ASSESSED VALUE $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 RATE PER $1,000 ASSESSED VALUE $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 $0.00 $0.00 $0.00 CREDIT FQR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) x x CREDIT TOTAL $0.00 $0.00 $0.00 225 'Fifth Street Springfield, 'Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-00764 COM2007-00764 COM2007-00764 COM2007-00764 COM2007-00764 COM2007-00764 COM2007-00764 COM2007-00764 COM2007-00764 COM2007-00764 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200700000000000844 Date: 06/29/2007 Description Plan Review Fire & Life Safety Building Permit Fixture Sewage Ejector Pump Miscellaneous Plumbing Miscellaneous Mechanical -Mechanical Issuance Fee~ + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By PHILIP FARRINGTON Item Total: Check Number Authorization Receiyed By Batch Number Number How Receiyed djb 012690 In Person Payment Total: Page I of I 11:47:40AM Amount Due 1,085.56 2,713.90 98.00 28.00 45.00 45.00 10.00 146.50 234.39 292.99 $4,699.34 Amount Paid $4,699.34 $4,699.34 6/29/2007