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Home My WebLink AboutPermit Building 2010-11-17 . , 5gI.U.N.,. GF.IE.~.D'. k~ >',71>;;- l':~ ,'>'7J !~}'F~"OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD ' Building I Commercial Permit PERMIT NO: 811-SPR2010-00257 IVR Number: 811103996914 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone. 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield,or.us PROJECT STATUS: STATUS DATE: Issued 11/17/2010 ISSUED: APPLIED: 11/17/2010 09/08/2010 EXPIRES: VALUE: 05/16/2011 $4,500,000,00 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477-7708 ASSESOR'S PARCEL NO: 1703220002219 PROJECT DESCRIPTION: SCOPE: Tenanllnfill WORK INVOLVED: Alleralion TYPE OF STRUCTURE: Commercial Remodel existing space for Cabela's MI $-11 B occupan'cy Phone Number: OWNER: ADDRESS: GATEWAY MALL PARTNERS PO BOX 617905 CHICAGO IL 60661-7905 Contractor Type # of Unils: Construction Type Occupancy Comments Occupancy Type Occupancy 'Comments Occupancy Type ,Construction Type # of Bedrooms: Sprinkled Building: Fire Alarms: . Energy Path;. Sq FI 1 sl Floor: Sq FI 2nd Floor: Sq Ft Basement: Sq FI Garage: ^:-if~-;:11~I><1N,I:0riJ 'goo 'I~\~ ~~g~\Pg~:yoU to; fn I "''' UI, Sq H Olher:Jn Uti lit yo f~\I\bv:iVr(iles:adopted by ,t,c~,~~, --'.f rt"" l'N!!i~l~atlon-Center.. Th.cgE~4pancy, ~oa~,: 0 ;i-52 , IIy q,?,~.qi!J~ii'!OO:l ~(jOl,r2b08Jugh OAR 95~e~~b(ff .' ." d Ed' 'I' . "w'm-'a'y.'obtam caples of the ru , . Sprin.~'~'f.i~I~' ~ 0 eJ _ )_Ion:uu~ '. .. I hone:! , ",,,"',"c,,,",H,,, 'enteI'Y, (Note, ,the te ep , .' ..Meih.~ni';~. .ally COdeIEd,"on:c,.;, ,"'~ 20071 Uiility Notlflcatlon1 rfol\ffll!iliifHir,'t"e'0r8\jul. \ ,'Muni,fo~~lf.! opmenl COde:~fjl!jtli$SrHi0o.-332.2.344)., .p.lul11bin~,1y Code Edilion: 2008 Re~idential Specialty Code Edition: Structural Specialty Code Edition: o CONTRACTOR INFORMATION ~ Contractor Name Lie Type HOWARD S WRIGHT CONSTRUCTORS LIMITED PARTNE ceB BERGMEYER ARCHITECTURAL, PC ARCHITECT BUILDING INFORMATION ~ # of Stories: Lie No 164711 3710 Lie Exp OS/24/2011 06/30/2012 Phone 206-447-7654 617-542-1025 Type liB 50,000 sJ., fully sprinklered, anchor at mall M r 25,428 sJ. ,fully .sp.r!nklered, anchor at mall S-1 Type liB Height of Structure: Type 01 Heal: , - Waler Type: Range Type: Hazmat: Lot Size: 2007 Engineered Fill: Fill Volume: Flood Hazard Area; Land Hazard Area: Retaining Wall: Soils Report Required:. Springfield Building Permit Yes. ' Yes Site Information I 1 " ,~., NOTICE: E IF THE WORK THIS PERMIT SHALL ETXH\~ PERMIT IS NOT AUTHORIZED UNDER R COMMENCED OR \S ABANDONED FO ANY 180 DAY PERIOD, 11/17/201 11:41:49AM Page 1 of7 SPRI.N..G. flE,l~ .~ ,~~,~ ....."^,.....~. OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00257 IVR Number: 811103996914 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 11/1712010 ISSUED: APPLIED: 11/1712010 09/08/2010 , EXPIRES: VALUE: 05/16/2011 $4,500,000.00 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477.7708 ASSESOR'S PARCEL NO: 1703220002219 SCOPE: Tenanllnfill WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Remodel existing space for Cabala's MI S~11 B occupancy DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: 498 Downspout/Drains: Valuation Description ~ Description Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value Springfield Building Permit 11f17f201 11:41:49AM Page 2 of7 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00257 IVR Number: 811103996914 www.ci.springfield.OLUS PROJECT STATUS: STATUS DATE: Issued 11/17/2010 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield.or.us ISSUED: APPLIED: 11/17/2010 09/08/2010 05/16/2011 $4,500,000.00 EXPIRES: VALUE: SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477-7708 ASSES OR'S PARCEL NO: 1703220002219 PROJECT DESCRIPTION: SCOPE: Tenant Infill WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial Remodel existing space for Cabela's Mf 5-1/ B occupancy FEES PAID ~ DescriDtion Structural Plan Review Fee Commercial Fire, Life, Safety Plan Review ~uilding Permit Fee SDC: Administrative Fee - MWMC Regional ~ast,:water ! sac: Total Transportation Administration Fee SDC: Total Sewer Administration Fee SDC: Compliance Cost - MWMC Regional Wastewater SI SDC: Improvement Cost - MWMC Regional Wastewater ~ SDC: Reimbursement Cost - MWMC Regional WastewatE SDC: Improvement - Transportation SDC sac: Reimbursement M Transportation SDC sac: Improvement Cost M Local Wastewater SDC: Reimbursement Cost - Local Wastewater Water heater Electrical Plan Review (25% of electrical fee) Storm Sewer Storm Sewer M Each additional 100 feet or portion of Miscella~eous copies Mechanical Permit fee (based on value of work) First copy Hose bibb Water closet -- Urinal ~ink/basinllavatory Floor drain/floor sink/hub Drinking fountain Branch circuits with service or feeder each circuit ~=~~ices 201 to 400 amps Services 200 amps or le~ Fixture Technology fee (5% of permit t<:tal) State of Oregon Surcharge (12% of applicable fees) Deferred Submittal Admin fee (10% of applicable fees) Technology fee (5% of permit total) Total Amount Paid Springfield Building Permit Amount Paid $12,100.69 $7,446.70 $18,616.75 $10.00 $492.55 $94.28 $11.59 $682.79 $52.21 $7,231.78 $1,984.24 $578.60 $1,185.46 $209.00 $803.00 $76.00 $76.00 $222.00 $1,929.75 $0.75 $19.00 $114.00 $38.00 $133.00 $57.00 $1900 $2,022.00 $380.00 $810.00 .._-~ $76.00 .~-~ $1,228.78 $2,949.06 $226.00 $22.80 $11.40 $61,912,38 Date Paid 09/09/2010 09/09/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 11/17/2010 Receipt # 374259 374259 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 --~~ 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 374913 --.--- 374913 .-.-.----- 374913 374913 374913 374913 11/17/201 11:41:49AM Page 3 of7 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00257 IVR Number: 811103996914 www.cLspringfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: Issued 11/17/2010 09/08/2010 11/17/2010 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97471.7108 ASSESOR'S PARCEL NO: 1703220002219 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541.726-3676 permitcenter@ci.springfield,or.us EXPIRES: VALUE: 05/16/2011 $4,500,000.00 SCOPE: Tenant Infill WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Remodel existing space for Cabela's MI $-1/ B occupancy Plan Review I Application Acceptance 09/08/2010 09/08/2010 09/08/2010 Application Accepted Kip Kaufman Comments: Received Fed Ex plan documents and application. r:ir~T~eYi~V{ -. _n', '~'?J:',L-L'~:>'. :~8BLQ8120,1~O. ',' '09/08/2?,1 P;",19W1.[2~6j Oc',;-' '(\pp'r9~~3'~;' "",0, % ',~'". GltbertGOrdO~~-----:._ : "tbm~/~lt~:c6~d;~;cJmer;t'f6r,l:irel~~p~rti1ifi!:plins ,Reyt~~:99iri:~e~t~:~~~2:1.f '~?<0 <,'5:.' 5,J :~"b,:; "e;.' ,. Structural Review 09/14/2010 09/08/2010 11/17/2010 Approved Kip Kaufman Deoartment Electrical Review Received Due Date 09/08/2010 09/08/2010 Comoleted 09/14/2010 Result Approved Energy Code Review 10/04/2010 09/08/2010 09/08/2010 Approved Reviewer Bryan Richardson David Harris '~ "J .., .'" ! Structural Review 09/14/2010 09/08/2010 11/10/2010 Add'llnfo Required Comments: Phone call with architect, 11/9/10, he will finish responding to 4 items. Kjp Kaufman Planning Review 09/21/2010 09/08/2010 10/04/2010 Approved Liz Miller Comments: To be constructed per approved Minor Site Plan Modification review and Final Site Plan Typ110-00001. Please call Andy' Springfield Building Permit 11/17/201 11:41:49AM Page 4 of7 SPRI.NGF.IEL~ \'1.-" ' ~ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00257 IVR Number: 811103996914 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 11/17/2010 ISSUED: APPLIED: 11/17/2010 09/08/2010 EXPIRES: VALUE: 05/16/2011 $4,500,000.00 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477-7708 ASSESOR'S PARCEL NO: 1703220002219 SCOPE: Tenant Infill WORK INVOLVED: Alleration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION:. Remodel existing space for Cabela's MI S-11 B occupancy INSPECTIONS REQUIRED ~ Inspections 1920 Miscellaneous Building 1110 Footing 1120 Foundation Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. 1150 SlablFlatwork Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Post and Beam: Prior to floor insulation or decking. 1170 Post & Beam 1180 Pilings/Caissons Piling, Drilled Piers/Caissions: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1260 Framing 1400 Perimeter Slab Insulation 1530 Exterior Shearwall 1540 Gypsum Board/LathlDrywall Drywall: Prior to taping. Lath/Plaster: To be made after aI/lathing and gypsum board, interior and exterior are in place, but prior to plastering. Firewall: Located and constructed according to plans. 1550 Firewall 1560 Firestop Assemblies 1600 Ceiling Grid 1630 Roof Sheathing 1620 Roofing 1710 Fire Sprinklers 1800 Emergency Egress Lighting 1829 Special Inspection 1999 Final Building Ceiling Grid: After drywall approval but prior to cover. Roof Sheathing Roofing: Prior to installing any roof cove~ing. Final Building: After all required inspections have been requested and approved and the building is complete. 2115 Exhaust Duct 2120 Water Heater 2180 Fire/Smoke Damper 2250 Gas Piping 2300 Rough Mechanical Rough Mechanical: Prior to Cover Springfield Building Permit 11/17/201 11:41:49AM Page 5 of7 www.cLspringfleld.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00257 IVR Number: 811103996914 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 11/17/2010 09108/2010 EXPIRES: VALUE: 05/16/2011 $4,500,000.00 11/17/2010 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477-7708 ASSESOR'S PARCEL NO: 1703220002219 SCOPE: Tenantlnfill WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Remodel existing space for Cabela's M/ 5-1/ B occupancy 2310 Rough Gas Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 2500 Smoke Detection Systems 2995 Final Gas Final Gas: When alf gas work is complete. Final Mechanical: When all mechanical work is complete. 2999 Final Mechanical 3130 Footing/Foundation Drains 3131 Site Drainage-Roofdrain/foundation 3150 Underslab Plumbing 3170 Underlloor Plumbing 3200 Sanitary Sewer 3400 Storm Sewer Underslab Plumbing: Prior to filling the trench and including required testing. Underfloor Plumbing: Prior to insulation or decking. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Rough Plumbing: Prior to cover and including required testing. Grease Trap: Prior to Cover. Final Plumbing: When all plumbing work is complete. Rough Electric: Prior to Cover Final Electric:. When all electrical work is complete. 3500 Rough Plumbing 3610 Grease Trap Interceptor 3999 Final P(umbing 4500 Rough Electrical 4999 Final Electrical 8670 Sprinkler Alarm 8750 Fire Alarms 8999 Final Fire 9012 SUB Final 9508 Sidewalk SUB Final: After all required energy inspections have been requested and approved. Special Inspection Form Receive Structural Welds High Strength Bolting Epoxy Anchors Hold Downs Installed Bolts Installed in Concrete Springfield Building Permit 11/17/201 11:41:49AM Page 6 of 7 SPRINGFIEL.~. . ~.- ~^..~ . ::~i v,, OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2010-00257 IVR Number: 811103996914 225 Fifth St Sprin9field,OR 97477 Phone: 541-726-3753 Inspeclion Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@d.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 11/17/2010 09/08/2010 EXPIRES: VALUE: 05/16/2011 $4,500,000,00 11/17/2010 SITE ADDRESS: 2800 GATEWAY ST, Springfield, OR 97477-7708 ASSESOR'S PARCEL NO: 1703220002219 SCOPE: Tenant Infill WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Remodel existing space for Cabela's MJ 5-11 B occupancy By signature, I state and agree, that I have carefully examined the completed appli.cation 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 or 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 contr ctors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all req ired i pections are requested at the proper time, that each address is readable from the street, that the permit card i cate at th front of the property, and the approved set of plans will remain on the site at all times during construction. 1\ -1 to Owner or Cont actor Signature Date Springfield Building Permit 11f17f201 11:41:49AM Page7of7 i. I I .'t -I '" III I > "1= po .~ l-' t-' :- ;l n= $'01 ~, m1..~ ~ ~ 31'l -'I'l ~ 0 n q'll it n '" '" -l 9 ~ ~ 33 0 I I It !i'o f U'jil a ~ ;;= ~ . ;; lI> ~ ~. . 5' q il ~p .. n !l ~~ >- g~ >lI> Sl i J r ~ ... a.. OJ ;l ~ ~ = iQ g' >> ". Cl '" .0 :r )> :!' -~ j i ~ 9 l~ II ~ i.o 1 n 1:). [~3 ~ .", !.. :ll=i :z: !l ::T t .. !l ~;:::;.: 1"1 ~ )> ~ ., a~ 3: ~:!:I~ I " .~ ~. !i . l e, li' iI n ~ #~; ft " ;; ~2 ~ r' a ~ i :r !10'= " .......c: t '~ Ii < .,. 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City of Springfield Conimuriity Services Division . 225 Fifth Street, springfield,0R 91417 Telcpbolie: 541'126-3753 Fax: 541C126-3676 Deferred Submittal- Aueement Oregon SttucturalSpec:ialty Code SectionJ'06.3 a1lowsapennitapplicantto defer. certain submittliisif approved by1he Building Official Thisfonn isadeferred submittlil agreementfor the folloWfugprojeGt: Dale: 1 Of131201 0 Project Name: Pr<iJect Add.....: 3000 Gatewl\}' Sl PhaSe: o Excavation &G!ading 'J Site Utilities Cabala's Gatewav Mall ~e.?flO() . l'erDlit'Number'811.SPR2010-00257 o FOlIIid;ltion0I11y0 <;ompletion (J Sholl 'XTori8IItlmprovomont Design Pnifwlonalin Respomible Cilarge:David TubricIV AlA License nlimbet:3710 Einail:dtubridvliilberamever.com .!'hone: 617_'>4?10?5 Fax:617~fi4?-1n?6 Address: BergmEl)'erArchiteclural P.C!51 Sleeper Street. Boston MA 02210 Guldell..es:. 1. ADDl'Oval: :Eachddorrodsubmittal shall hear tho approval of the design professional inRlSpODSiblt cIuuJe; 1\Iota!joluhall\:Jo"iilc!udod lhilt thodefeaod submiltaldocumoJIlshavobeon revi.wed and have b<ien.touod tq.boin.gonCn!I confoimimcotoihedosign of1hebuilding. .2. :!J1t: :Page 2.ofthi~ form isalist.ofdefeuedsubmitta\s. The. design professiooal illresponsihloehaIge _ eheCkwbicluubmittals 8l;e rolj1!eSledlo hedetmed allilindicate an an6cipateil-subntitl3l.dat.; 3. t...: MiniDlll1llS1 00.00 (2 hour) for eacb lleferred submittal 4. -Tlmelln..: BY\'fY:att"ll1pl will.l><\J>ia<Ww pmvide-.timcly review. Of 5.1 ObuSi_daySper. d!'fClm!l aubmittal . S. WorkwlfhollU Penidt; Worlc-lhalisconstruct<d.withont hav~been reviewed andapprovod by I>oth the designproCelolibnalin ~I.charge aIld the:City ofSprinijfi.ld Building Official i. "onliiderod....workp.rformod -without.. permit: Any pen;on at t\nnpelfonningwOl'kJ>tiorlo approval shaiI be subjecttoll1cpeoalties.ofSectio.. 108.2..1 ofth. State ofOregQI1 Sttuctura\ Specially COde. ; I , I f .' o < . . ~~ City of Springfield Deferred Submittal Agreement Date: 10/13/2010 Project Name: Cabela's Gateway Mall Project Address: 3000 Gatewav Sl.. Ste 2800 Phase: o Excavation and Grading o Site Utilities .. Pennit Number: 811-SPR2010-00257 o Foundation only o Completion oShell I)( Tenant Improvement Design Professional in Responsible Charge: David Tubridy AlA Items which may be deferred ,include, but are not limrted to the following: Deferred Item Date 0 1. Acoustical ceiling suspension system 0 2. Auxiliary power systems 0 3. Awnin~s 0 4. Bleachers 0 5. Carports 0 6. Curtain wall systems 0 7. Electrical call system 0 8. Emergency call system 0 9. Exit Illumination 0 10. Fire alarm system 0 11. Fire sprinkler 0 12. Fire stopping 0 13. Glass guardrails 0 14. Glazing systems 0 15. HVAC system u 16. Intercom system u 17. Irrigation system 0 18. Metal guardrails and handrails Deferred Item Date 0 19. Plumbing system 0 20. Post~tensioned concrete structural members or oanels 0 21. Pre-cast concrete structural members or panels 0 22. Prefabricated stair units to include steel, aluminum, or Dre-cast concrete 0 23. Prefabricated wall panel 0 24. Ore-stressed concrete structural members or panels 0 25. Raised floor systems J( 26. Shelving systems and steel storage racks 0 27. Signs 0 28. Skylights 0 29. Smoke and heat vents 0 30. Specialty retaining walls 0 31. Stone veneer 0 32 Terra cotta veneer 0 33. Wooden, steel, or compos it floor or roof trusses 0 34. Works of art 0 35. 0 36. Fees: Minimum-$100.00 (2 hr) each for the above listed Deferred Submittals .,~".:. . Fire Protection and Life Safety Systems ~ Deferred Item Date 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 0 11. Fire Sprinkler Systems 13, 13R & 130 (more than 20 heads) 0 12. Fire Sprinkler Systems 13, 13R & 130 (less than 20 heads) $60/h, 0 13..Standpipe and Hose Cabinets 0 14. Water Mist System 0 15. High-piled Storage 0 16. Clean Agent Systems 0 17. CleanAgent Systems 0 18. Paint Booths Deferred Item Date 0 19. Underground Fuel Tanks 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 $15.00 for every 15 minutes of review time or portion thereof. Work without a Pennit: Work that is constructed without having been reviewed and approved by both the design professi,?nal in responsible charge and the Building Official will be considered as work perlormed without a permit. Any person or firm performing work prior to approval shall be subject to the penalties of Section 108.2.1 of the State of Oregon Structural Specialty Code. DEPARTMENT USE ONLY - '.n.. . "..' -i' g l.L - S"pt<( z.ej.e- Permit no.: 2-5"7- Date: q ~ to- This permit is issued under OAR 918-460-0030. Permits expire if work is not started within ]80 days of issuance or if work is suspended for 180 days. Structural Permit Application LOCAL GOVERNMENT APPROVAL This project has finalland~use approval. Signature:. Date: This project has DEQ approval. Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: DYes 0 No CA TEGORYiiO~'CPN5'TRUCTION o Residential E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.0 lO: Sign here: CONTRACTOR [INsTALtA TION h :. Business name: Address: City: Phone: E-mail: CCB license no.: State: Fax: ZIP: Print name: Signature: ~<.':f . sUB'CONTRAqOR{(N~08IV1ATION. ;_'}?.3:: Name CCB License Number Phone Number Electrical Plumbing Mechanical FEE SCHEDULE' ';E';Ya~ua!io'n..inform~tio~ (a) Job description: Occupancy Construction type: Square feet: Cost per square foot: Other information: Type of Heat: Energy Path: D new 0 alteration (b) Foundation-only permit? ~ ~ Total valuation: ;.~~~fiitdilIg:fe~S'j (a) PeI'J11it fee (use valuation table): (b) In~estigative fee (equallo [2a]): {cfReinspection ($ per hour): (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): (e) Subtotal of fees above (2a through 2d): \~3rsltl~jWr~yiewfees (a) Plan review (65% x permit fee [2a]): (b) Fire and life safety (40% x permit fee [2a]): (e) Subtotal offces above (3a and 3b): . ;tf4:~rMj~1=~JUfn)~()'us. fees (a) Seismic fee, 1% (.01 x permit fee [2a]): TOTAL fees and surcharges (2e+3c+4a): o addition DYes DNo 00 $ $ $ $ $ '~'1 ,1fO $ , $ '0,5"41-S,? S:1:.~=-. fl.E~ ~$'i' ~O-RfGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00257 2800 GATEWAY ST CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541-726-3753 permitcenter@ci.springfield.or.us RECORD NO: 81 I-SPR2010-00257 DATE: 11/17/2010 ; /7'2 if:::,: t~~~:~~.:'\ E':: :~;"~;;.~;".:. -, -~-~, 'J;'~~~~6.(fN1tlc.oOE~ ~~: ~-:,+ /~-; :,",;~i\!9J:t~J~Qll~,-'-: ~~ ~ "- ',' ,:' 224-00000-425602 $18,616.75 611-00000-426604 $10.00 ~._------- 719-00000-426604 $492.55 ~~-~ 719-00000-426604 $94.28 444-00000-426607 $11.59 445-00000-448025 $682.79 444-00000-448024 $52.21 447-00000-448027 $7,231.78 446-00000-448026 $1,984.24 443-00000-448025 $578.60 442-00000-448024 $1,185.46 224-00000-425603 $209.00 224-00000-426102 $803.00 224-00000-425603 $76.00 * -,.- *--- 224-00000-425603 $76.00 224-00000-425602 $222.00 224-00000-425604 $1,929.75 224-00000-425602 $0.75 224-00000-425603 $19.00 224-00000-425603 $114.00 224-00000-425603 $38.00 224-00000-425603 $133.00 224-00000-425603 $57.00 224-00000-425603 $19.00 224-00000-426102 $2,022.00 224-00000-426102 $380.00 224-00000-426102 $810.00 224-00000-425603 $76.00 -'------'"-'"-- 100-00000-425605 $1,228.78 821-00000-215004 $2,949.06 224-00000-425602 $228.00 224-00000-426605 $22.80 100-00000-425605 $11.40 TOTAL DUE: $42,364.79 1;,-4PAYMENT T,'t.F'E;_;;'.,~~ipAYOR~C:e-SHIER?CCAR"ENl'ER{:(;:QMMgrHS'-,;,';-'\,.f', ;:<.'; : :./,. AMOUNi~~.ID _ . _ . RECEIPT NO: 2010000853 fPEsCRrF':t19N,,~.#.w~",'>n, Buildin~ Permit Fee SDC: Administrative Fee - MWMC Re~ional Wastewater SDC SDC: Total Transportation Administration Fee SDC: Total Sewer Administration Fee SDC: Compliance Cost - MWMC Regional Wastewater SOC SOC: Improvement Cost - MWMC Regional Wastewater SDC SDC: Reimbursement Cost ~ MWMC Regional Wastewater SDC SOC: Improvement - Transportation SOC SOC: Reimbursement - Transportation SOC SOC: Improvement Cost - Local Wastewater SOC: Reimbursement Cost w Local Wastewater Water heater Electrical Plan Review (25% of electrical fee) Storm Sewer Storm Sewer - Each additional 100 feet or portion of Miscellaneous c,?pies Mechanical Permit fee (based on value of work) First copy Hose bibb Water closet Urinal Sink/basin/lavatory Floor drain/floor sink/hub Drinking fountain Branch circuits with service Of feeder each circuit Services 201 to 400 amps Services 200 amps or less Fixture Technolo~x fee (5% of permit total) State ofg!~9~^~,~~~c:;~~~~~~!~~~_~p"pricable 1ees) Deferred Submittal Admin fee (10% of applicable fees) Technology fee (5% of permit total) "I ,Check Check 877 HOWARD S WRIGHT CONSTRUCTORS LIMITED HSWC petty cash case-freeman $42,102.59 $262.20 $42,364.79 www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00257 2800 GATEWAY ST CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 permitcenter@ci,springfield,or.us RECEIPT NO: 2010000273 RECORD NO: 81 I-SPR2010-00257 !lATE: 09/09/2010 lQ.~SCRll'tf6~1'-'!~'-:':?i' C'."'f'"...."". '.'-\, . -j';;3i#{-?it~,._~:..." t=g<:::C_O\.lt.tr':'cOQIO.'i;'+~,SJ2;"~n1fQJJ~:U)J.!.g~;;:';~''''Yc0f-J Structural Plan Review Fee Commercial 100-00000-425602 $12,100.89 Fire. Life, Saf."ty Plan Review 100-00000-425602 $7,446.70 TOTAL DUE: $19,547.59 [:;-F1AYIVIENJ;TYPE#t"":~AYOR,,; -CASHIERKKAU~~f:~[QMMIONIs'i];;;-j;(:-"-1'i",i,::-", ;~_AIVI0UNtpAfD'-lYCf'""'t''I-C;;'iJ Check 40085 Bergmeyer Associ,ates, Inc ,;~(_", ,-'.,~ <11',';' ',_ $19,547.59 , ,.,'~" .,r. . ..,,~ . .' $19,547.59 . 1 ...i I .~. .;~!. '. " , ,,.,' ";:/ '\ "J '("j'." ;." ~?,), . -~. ' . ., ". - ,\ ; .... \ .. .,' .. ,'(. , . . \ " \ ~ .-~,~,;" .~,. .' i.. '-.'