HomeMy WebLinkAboutMiscellaneous Application 2010-3-10
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SPRINGFIELD
City of Springfield
Community Services Division
225 Fifth Street, Springfield, OR 97477
Telephone: 541-726-3753 Fax: 541-726-3676
Deferred Submittal - Agreement
Oregon Structural Specialty Code Section 106.3 allows a permit applicant to defer certain
submittals if approved by the Building Official. This form is a deferred submittal
agreement for the following project:
Date:3--/.;;;. L0 Project Name: ~~ ~....h.,~ -i'!.
Project Address: 1t>97.2. f.'\M"-l <;;t J Permit Number:47.A1'~ -'151'6
Phase: 0 Excavation & Grading 0 Foundation Only .ll(Completion
o Site Utilities 0 Shell OTenant Improvement
Design Professional in Responsible Charge: ~jJ~~b~~A--.:r.A.
License number: 6R ~c.,"q Email: M ....___ ._ 11"4.. t
Phone:l7ltl.t..."'~'9(.,"( eJCt2Fax: "'l~- Il'!><.o
Address:
Guidelines:
I. ADDroval: Each deferred submittal shall bear the approval of the design professional in responsible
charge. Notation shall be included that the deferred submittal documents have been reviewed and have
been found to be in general conformance to the design of the building.
2. List: Page 2 of this form is a list of deferred submittals. The design professional in responsible charge
must check which submittals are requested to be deferred and indicate an anticipated submittal date.
3. Fees: Minimum $100.00 (2 hour) for each deferred submittal.
4. Timelines: Every attempt will be made to provide timely reviews of 5-1 0 business days per deferred
submittal.
5, Work without a Permit: Work that is constructed without having been reviewed and approved by
both the design professional in responsible charge and the City of Springfield Building Official is
considered as work performed without a permit. Any person or firm perfonning work prior to
approval shall be subject to the penalties of Section 108.2.1 of the State of Oregon Structural Specialty
Code.
Acknowledgements:
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Owner Name (Printed) ,
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General Contractor Firm Name (Printed)
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Design Professional in Responsible Charge(Printed)
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Building fficial Name Printeo)
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City of Springfield
Deferred Submittal Agreement
Date: '2 ( '2-(.. flo
Project Name: ,&,FI'f^ N'AR-TMeI'lT5>
Project Address: I oe/2.. M~dN '?Tfe.te:f
Phase:
o Excavation and Grading
o Site Utilities 0 Shell 0 Tenant Improvement
Penn it Number: COM UJo<J -OII:54{.,
o Foundation only
o Completion
Design Professional in Responsible Charge: ANt\lE. PI::; l PI N e '(
Items which may be deferred include, but are not limited to the following:
Deferred Item Date
0 1. Acoustical ceiling suspension
system
0 2. Auxiliary power systems
0 3. Awnings
0 4. Bleachers
0 5. Carports
0 6. Curtain wall systems
0 7. Electrical call system
0 8. Emergency calt system
0 9. Exit Illumination
0 10. Fire alarm system
~ 11. Fire sprinkler t'!-(L '1/ 'Zc II)
0 12. Fire stopping
0 13. Glass guardrails
0 14. Glazing systems
0 15. HVAC system
0 16. Intercom system
0 17. Irrigation system
0 18. Metal guardrails and handrails
Deferred Item Date
0 19. Plumbing system
0 20. Post-tensioned concrete structural
members or panels
0 21. Pre.cast concrete structural
members or panels
0 22. Prefabricated stair units to include
steel, aluminum, or pre-cast concrete
0 23. Prefabricated wall panel
0 24. Ore-stressed concrete structural
members or panels
0 25. Raised floor systems
0 26. Shelving systems and steel
storage racks
)( 27. Signs (IJ~$-~ .-c- 9/z0(0
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0 28. Skylights I
0 29. Smoke and heat vents
0 30. Specialty retaining walls
0 31. Stone veneer
0 32 Terra cotta veneer
~ 33. Wooden, steel, or composit '1/~/D
floor or roof trusses
0 34. Works qf art
~ 35. hJ";~ frI{2010
0 36.
~ Minimum $100.00 (2 hr) each for the above listed Deferred Submittals
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Fire Protection and Life Safety Systems
Deferred Item Date
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0 1. C02 System
0 2. Emergency and Standby Power
0 3. Fire Alarm and Detection Systems
0 4. Fire Pumps
0 5. Gas Leak and Chemical Leak
Detection
0 6. Halon Systems
0 7. Kitchen Hood Suppression
System
0 8. Portable Extinguishers
0 9. Private Fire Service Mains
0 10. Private Water Tank Systems
'p( 11. Fire Sprinkler Systems 13, 13R "'/7-0ID
& 130 (more than 20 heads)
0 12. Fire Sprinkler Systems 13, 13R
& 130 (less than 20 heads) $60/hr
0 13. Standpipe and Hose Cabinets
0 14. Water Mist System
0 15. High-piled Storage
0 16. Clean Agent Systems
0 17. Clean Agent Systems
0 18. Paint Booths
Deferred Item Date
0 19. Underground Fuel Tan~s
0 20. Aboveground Outside Fuel Tanks
0 21. Aboveground Fuel Tanks and
Piping
0 22. Aboveground Fuel Tank and
Day Tank
0 23. Fuel Dispensing Station
0 24. LPG, Aboveground Installations
0 25. Cryogenics, Exterior Installation
0 26. Silane Gas
0 27. Ozone System
0 28. HPM Semiconductor Workstation
0 29. Gas Cabinets/Exhausted
Enclosures
0 30. Hazardous Material Inventory
Statement
0 31. Special Hazard Detection
and Suppression
0 32. Medical Gases
0 33. VESDA System
0 34. Emergency Lighting
0 35.
0 36.
Fire Protection and Life Safety Systems fees are based on 3% of the total valuation of the work to be performed for the system
up to the system's contract value of $50,000.00. An additional $3.00 will be charged for each additional $1,000.00 in value or
portion thereof. The minimum charge shall be no less than $120.00 Additional staff time for work performed in excess of 2 hours,
will be charged an additional $15.00 for every 15 minutes of review time or portion thereof.
Work without a Permit: Work that is constructed without having been reviewed and approved by both the design
professional in responsible charge and the Building Official will be considered as work performed without a permit.
Any person or firm performing work prior to approval shall be subject to the penalties of Section 108.2.1 of the
State of Oregon Structural Specialty Code.