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HomeMy WebLinkAboutMiscellaneous Building 2010-9-7 (2) ( .,J ~-,. -....,.. i City of Springfield Community Services Division 225 fifth Slreet, Springfield, OR 9N17 Telephone: j41.726-37j3 fax: S41.726.3676 Deferred Submittal - Agreement Oregon Structural Specialty Code Section 106.3 allows a permit applicant 10 defer certain submittals If approved by the BuildIng Official. This form is a deferred submittal agreement for the following project: Dnle: "'1-,:/.10 ProjectNamo:J:I'f~". ~-t"",", _ It-l\lr3z.llB.lo ~ Project Addressl ~... \tI~ Il'. ~ 'fW11. Permit Number:Ct:H:!clo~ ClDn Phase: " B,cayallen & {]radlng 0 fonndallon Only 0 Cnmpleffon o Slle UllIllles 0 Shcll )fjenMtlmproycment Design Professlnonlln Responsible Charge: ~ ~.I(. 1-1"", License number: UJ,~ Broall: 1~12\;>e~o..h_a>tn ~~~~;;s~'~;~?k A\hi,Fex~~kW9f~;_ GuJdellnesl I. ADDrOyal: Eaeb deferred submlltRlshall bear fhe Rpproval oflhe deolgn prof..slnnRI In responsible charge. NOlation shall be Included Ihat Ihe deferred .ubmlttal documents have becn reviewed and have been found 10 be In general conformance to thed..lgn oflh. building. 2. '!d1!: Pege 2 of tbls fomlls B IIsl of defened submittals. The deo/gn professional In responsible charge musl.eheck wbleh .ubmltlels e", requested tn be deC.ned and IndlcRlo an anlleipaled snbmltlal dole. 3. fls.!: Mloimum $100.00 (2 hour) for each deterred submlonl. 4. Tlmclln.., Eyery ettempt will be made 10 proylde IImely reylaws of S-IO bllslness day! per dafened submlllol. j. Work ",lIboul "Permll, Work Ihal Js conslrucled 1Yllb0ul baying be.. ,eylewed and appmyed by b01h the design professlonal/n responsible charse and Ihe City of Springfield BulldolS Official Is eonsldered lIS 1Y0lk perfonned wllboula permit. Any pusou or Jlrm porfnlllllng work prior 10 approyalshnll be subjecIlo Ihe penollles ofSecllon 108.2.1 of tho Stele ofOregou Struclural Speolally Code. Acknowledgaments: JII'\W~ OlYner Name (Priolcd) ~~~ Oeneral Conlraelor Firm Name (prulted) ~~AJA' Design Professional I. Responsible Charge(Prinled) ~ . I . 'MI DA\m:> Pue:k1r BuUding OIDelal NlIIlIe (Prlnt.d) >, ' ( i .....,. . City of Springfield Deferred Submittal Agreement Date: .q ;J'll) Project Address: :;,~ Project Name: ~~ az. -1~n ~l- allJlt:.- ~~ Permit Number: Clll1ZD1O-OIOZZ> Phase: o Excavation and Grading o Site Utilities Design Professional In Responsible Charge: Ilems which may be deferred indude. but are not limited to the following: Deten-ed Item Date 0 1. Acouslfcal ceiling suspensron slislem 0 2. Auxiliary power systems 0 3. Awnings 0 4. Bleachers 0 5. Carports 0 6. Curtain walt systems 0 7. Electrtcal call system 0 8. Emergency call system 0 9. Exillllumlnalion '" 10. Fire alarm system ~ 11. Fire sprinkler >( 12. Fire slopping 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 o Foundalion only o Completion >(Tenantlmprovement oShell ~14 ~ , A/~ , Deferred Item Date' 0 19, Plumbing system 0 20. Post-tensioned concrete structural members or panels 0 21. Pre-cast concrete slruclural members Or nanels 0 22, Prefatlrfcaled slair units (0 include steel. aluminum, or nre-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 storace raCks 0 n Signs a 28, Skyllghls 0 29. Smoke and heal vents 0 30. Specialty retaining walls 0 31. Stone veneer 0 32 Terra cotta veneer 0 33, Wooden. sleel. or composfl floor or roof lrusses 0 34. Works of art II( 35.~~~ {1p t1 a;; ." 0 36. FeGs: Minimum $100.00 (2 hr) each for 'he above listed Deferred SubmiUals 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ':~~~~=R WiL~ ' --- ", . "" \ City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 3201000000000000493 Date: 07/30/2010 9:45:06AM Job/Journal Number Descripti.on COM2010-01022 Plan Review ConunJlnd/Public Payments: Type of Payment Check Paid By PEACEHEALTH Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 1,254.34 $1,254.34 Amount Paid KLK 00382294 KLK In Person Payment Total: $1,254.34 $] ,254.34 cReceintl Page 1 of] 7/30/2010