HomeMy WebLinkAboutMiscellaneous Application 2010-3-4
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City of Springfield
Community Services Division
225 Fifth Street, Springfield, OR 97477
Telephone: 541-726-3753 Fax: 541-726-3676
SPRINGFIELD
Deferred Submittal - A~reement
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:r.:::dt~ Project Name: key; ArlrYl d(lLc\'~r)\(:~\r\t (-{HI 0, .. ..
Project A dress: 4\02 FrClf\\::'hn . -Permit Numbeh::::<J,117~t-e-~ tJl6
Phase: 0 Excavation & Grading 0 Foundation Only 0 Completion
o Site Utilities 0 Shell kfenant Improvement
Design Professional in Responsible Charge: -r~G
License number: Email:
Phone: Fax:
Address:
Guidelines:
I. Approval: 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 iu general conformance to the design of the building.
2. List: Page 2 oflhis 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 $1D0.00 (2 bour) for each deferred submittal.
4. Timelines: Every attempt will be made to provide timely reviews of 5-10 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 performing work prior to
approval shall be subject to the penalties of Section 108.2.1 of the State of Oregon Structural Specialty
Code. .
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Owner Signature .
General Contractor Signature
arge Signature
Design Professional in Responsible Charge(Printed)
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Building Official Name (Printed)
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City of Springfield
Deferred Submittal Agreement
Date: 2-. \ \.10
Project Address:
Phase: 0 Excavation and Grading
o Site Utilities
Design Professional in Responsible Charge:
Project Name: \0@dro. daM"- rugttCtaJu..;
Per~~ Numbe'r:
o Foundation only
oShell
o Completion
o Tenant Improvement
Items which may be deferred include, but are not limited to the fo((owing:
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Deferred Item Date Deferred Item Date
1. Acoustical ceiling suspension Plumbino system
0 svstem IJ.- 19.
20. Post-tensioned concrete structural
0 members or oanels
0 2. Auxiliarv Dower svstems
21. Pre-cast concrete structural
.I 3. AwninDs 0 members or oanels
22. Prefabricated stair units to include
0 4. Bleachers 0 steel, aluminum, or ore-cast concrete
.
0 5. Caroorts 0 23. Prefabricated wall panel
24. Ore-stressed concrete structural
0 6. Curtain wall systems 0 members or oanels
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0 7. Electrical call system 0 25. Raised floor svstems
8. Emeraencv call system 26. Shelving systems and steel
0 0 storaQe racks
0 9. Exit IlIuminatian 0 27. Sians
0 10. Fire alarm system 0 28. 'SkyliQhts
0 11. Fire sorinkler 0 29. Smoke and heat vents
0 12. Fire stoooina 0 30. Soecialty retainina walls
0 13. Glass auardrails 0 31. Stone veneer
.
0 14. Glazina systems 0 32 Terra cotta veneer
I.,.... 15. HVAC system 33. Wooden, steel, or composit
0 fioor or roof trusses
0 16. Intercom system 0 34. Works of art
0 17. Irriaation system 1!1" 35. f.M~~
0 18. Metal auardrails and handrails 0 36.
Fees: Minimum $100.00 (2 hr) each for the above listed Deferred Subinittals
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;.. re Protection and life Safety SyS ems
Deferred Item Date Deferred Item Date
0 1. C02 System
0 19. Underoround Fuel Tanks
0 2. Emeroencv and Standby Power 20. Aboveground Outside Fuel
0 Tanks
3. Fire Alarm and Detection 21. Aboveground Fuel Tanks and
0 Systems 0 Pipino
0 4. Fire Pumos . 22. Aboveground Fuel Tank and
. 0 Day Tank
5. Gas Leak and Chemical Leak
0 Detection' - 0 23. Fuel Disoensino Station
0 6. Halon Systems 0 24. LPG, Aboveoround Installations
7. Kitchen Hood Suppression
0 System 0 25. Crvonenics. Exterior Installation
0 8. Portable Extinouishers 0 26. Silane Gas
0 9. Private Fire Service Mains 0 27. Ozone System
28. HPM Semiconductor
0 10. Private Water Tank Systems 0 Workstation
11. Fire Sprinkler Systems 13, 13R 29. Gas Cabinets/Exhausted
0 & 130 (more than 20 heads) 0 Enclosures
12. Fire Sprinkler Systems 13, 13R 30. Hazardous Material Inventory
0 & 130 (less than 20 heads) $60/hr 0 Statement
31. Special Hazard Detection
0 13. Standnioe and Hose Cabinets 0 and Suppression
0 14. Water Mist System 0 32. Medical Gases
0 15. Hioh-oiled Storaoe 0 33. VESDA System
0 16. Clean Aoent Systems 0 34. Emeroencv Liohtino
0 17. Clean Aoent Systems 0 35.
0 18. Paint Booths 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.