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Home My WebLink AboutPermit Building 2003-1-13 " 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: COM2002-01283 ISSUED: 01/02/2003 APPLIED: 11113/2002 EXPIRES: 07/02/2003 VALUE: $ 219,000.00 SITE ADDRESS: 1090 GATEWAY LP ASSESSOR'S PARCEL NO.: 1703222002300 Springfield TYPE OF Commercial Miscellaneous TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Interior remodel and elevator structure addition. Existing Structure is appro x 6,000 square feet. Adding 395 Sq Ft. Owner: FRED HAMPLE Address: 372 W 12TH AVE #4 EUGENE OR 97401 Phone Number: 541-683-0653 Phone Number: 541-683-0653 Contractor Type Architect General Electrical Mechanical Owner I CONTRACTOR .INFORMATION. . '.r M:...l.; ..;::.. .......,""~~ law reqUires you to Contractor follow ru/es~m~ bytllJt~li~ DAVID JONES ~otifjcation Center. Those rules are set fQrth MElLI CONSTRUCTION CO In OAR 952-D9.h9P10 through ~Rifil4001- CHRISTENSON ELECTRIC IN8090. You m~@btain copies *bSl00&S by COMFORT FLOW calling the igwter. (Note: thEll~~uDBle FRED HAMPLE number for the Oregon Utility Notification OPJ (."., ~... '-ouV-""~-c!"q.q) BUILDING INFORMATION I . Phone 541-342-6511 541-485-1417 541-688-6121 541-726-0100 541-683-0653 # of Buildings: Primary Occupancy Group: Secondary Occupancy Yrimary Construction Type Secondary Construction # of Bedrooms: B # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: NOTICE: I DEVELOPMEN~W.ft EXPIRE IF THJJ~{aa c COM MEN THIS PERM"NS~tf.ED PARKING Overlay AAfar 180 g~~ OR IS ABANDONED J@AI: . 21 # Street Trees PERIOD. Handicapped: 2 Paved Drive Rqd: Compact: 5 Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 395 SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 47.00 22.00 62.00 75.00 % of Lot Coverage: 20.00 IPUBLIC IMPROVEMENTS I Street Storm Sewer Available: Special Instruction: Sidewalk Type: Downs pouts/Drains Notes: 1 of 4 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: COM2002-01283 ISSUED: 01/02/2003 APPLIED: 11/13/2002 EXPIRES: 07/02/2003 VALUE: $ 219,000.00 I Valuation Description I Description Bid Amount Type of Construction Use Bid Amount $ Per Sq Ft $1.00 Square Footage 219,000.00 Value $219,000.00 $219,000.00 Date Calculated 11/2012002 Total Value of Project I Fees Paid I Fee Description Amount Paid Date Receipt Number Plan Review Comm/IndlPublic $619.06 11/18/02 2200200000000000195 + 7% State Surcharge $80.88 1/2103 1200200000000000486 + 8% Administrative Fee $92.43 1/2103 1200200000000000486 Boiler/Comp 3-15 HP $44.00 1/2/03 1200200000000000486 Building Permit $952.40 1/2/03 1200200000000000486 Fixture $84.00 1/2/03 1200200000000000486 Furnace - up to 100,000 btu $24.00 1/2103 1200200000000000486 Plan Review - Planning $55.00 1/2/03 1200200000000000486 Planning Final Occy Inspection $110.00 1/2/03 1200200000000000486 Sanitary Sewer - Improvement $100.74 112/03 1200200000000000486 Sanitary Sewer - Reimbursement $132.54 1/2103 1200200000000000486 SDC MWMC Administration $10.00 1/2/03 1200200000000000486 SDC MWMC Improvement $135.12 1/2/03 1200200000000000486 SDC MWMC Reimbursement $1,291.49 1/2103 1200200000000000486 SDC Sanitary/Storm Admin $15.02 1/2103 1200200000000000486 SDC Transpo Admin $693.25 1/2/03 1200200000000000486 SDC Transpo Improvement $10,156.82 1/2/03 1200200000000000486 SDC Transpo Reimbursement $2,301.96 1/2/03 1200200000000000486 Storm Drainage Impervious Area $36.66 112/03 1200200000000000486 Storm Sewer - 1st 50 Feet $45.00 1/2/03 1200200000000000486 Vent Fan $6.00 1/2/03 1200200000000000486 Total Amount $16,986.37 I Plan Reviews I Fire Department Review 11/20/2002 12/17/2002 OK GRG Plan Review-Remodel/addition to office building-Medical offices-rehabilitation Specify method for monitoring all smoke detection per International Mechanical Code 606 as noted on Sheet M-1. Post address numbers visible and legible from the street fronting the property. 2 of 4 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: COM2002-01283 ISSUED: 01102/2003 APPLIED: 11/13/2002 EXPIRES: 07/02/2003 VALUE: $ 219,000.00 Initial Review Planninl?: Review 11/20/2002 11/20/2002 11/2012002 11/20/2002 APP APP LLH AJD Land Use Compatibility Statement issued-see attached document Applicable Conditions that have to be satisfied prior to occupancy: 1. Install 3 bicycle parking spaces 2. Install enclosed trash receptacle area Public Works Review Structural Review SUB Review 11/20/2002 11/2012002 11/20/2002 12/0212002 12/06/2002 12/05/2002 APP APP APP PJO TR JF Approved as noted on plans Pass Building Envelope. HV AC and Light energy code review To Request an inspection call the 24 hour recording at 726-3769. AIl inspection 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. 1 Foundation: After forms are erected but prior to concrete placement. 2 Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 3 Shear Wall Nailing: Before covering sheathing with finish materials. 4 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 5 Wall Insulation: Prior to cover. 6 Ceiling Insulation: Prior to cover. 7 Roofing: Prior to installing any roof covering. S Drywall: Prior to taping. 9 Ceiling Grid: After drywall approval but prior to cover. 10 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 11 Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. 12 Final Building: After all required inspections have been requested and approved and the building is complete. 13 Rough Plumbing: Prior to cover and including required testing. 14 Final Plumbing: When all plumbing work is complete. 15 Rough Mechanical: Prior to Cover 16 Final Mechanical: When all mechanical work is complete. 17 Footing: After trenches are excavated. 18 Roof SheathinglN ailing: Before covering sheathing with finish material. 19 Final Fire Department. After all requirements of the Fire Department have been met. 20 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. 21 SUB Final: After all required energy inspections have been requested and approved. 22 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. 23 SUB Ceiling Grid: Interior Lighting 3 of 4 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: COM2002-01283 ISSUED: 01102/2003 APPLIED: 11113/2002 EXPIRES: 07/02/2003 VALUE: $ 219,000.00 By signature, I state and agree, that I have carefuUy 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 ofthe 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 wiD be used on this project. I further agree to ensure t t all required inspections are requested at the proper time, that each address is readable from the stre t, t t the permi ard. located at the front of the property, and the approved set of plans will remain on the site at all s cti . j)~ Owner or Contractors Signature 4 of 4 d~~J Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone _ine Items: Job/Journal Number COM2002-01283 COM2002-0I283 COM2002-01283 COM2002-0 1283 COM2002-01283 COM2002-0 1283 COM2002-01283 . COM2002-0I283 COM2002-0I283 COM2002-01283 COM2002-0I283 COM2002-0 1283 COM2002-0 1283 COM2002-01283 COM2002-0 1283 . . 112/2003 3:05:I9PM City of Springfield Development Services Department Public Works Department Official Receipt Receipt #: 1200200000000000486 Date: 01102/2003 Description Amount Paid Planning Final Occy Inspection 110.00 Plan Review - Planning 55.00 36.66 Storm Drainage Impervious Area SDC Transpo Reimbursement 2,301.96 10,156.82 1,291.49 135.12 SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration 10.00 Building Permit 952.40 Fixture 84.00 Storm Sewer - 1st 50 Feet 45.00 Furnace - up to 100,000 btu Boiler/Comp 3-15 HP 24.00 44.00 Vent Fan 6.00 80.88 + 7% State Surcharge .. Page I of2 cReceiptrpt 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ,.- COM2002-0 1283 COM2002-0 1283 COM2002-0 1283 COM2002-01283 COM2002-0I283 Payments: Type of Payment Check Paid By + 8% Administrative Fee Receipt #: 1200200000000000486 Date: 01102/2003 Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin THE HAMPLE F AMIL Y LTD Received By Ch eck N umber Conti rm No ddk Page 2 of2 1/2/2003 3:05:19PM City of Springfield Development Services Department Public Works Department Official Receipt 92.43 132.54 100.74 15.02 693.25 Line Item Total: $16,367.31 How Received Amount Paid In Person 16,367.31 $16,367.31 Payment Total: cReceipt.rpt Jf ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER COM2002-01283 NAME OR COMPANY: PROGRESSIVE REHABILITATION ASSOC. LOCA TlON: 1090 GA TEW A Y LOOP MAP & TAX LOT NUMBER: 17-03-22-20 02403 DEVELOPMENT TYPE: MEDICAL CLINIC NEW DEVELOPED BLDG (S.F.): EX. DEVELOPED BLDG (S.F.): EX. IMPERVIOUS SURFACE (S.F.): NEW IMPERVIOUS SURFACE (S.F.): 6,395 6,000 720 710 ITE: ITE: 130 LOT SIZE (SF): I. STORM DRAINAGE IMPERVIOUS SQ. FT. $ 0.282 PER SF 130 x TOTAL STORM DRAINAGE SDq $ 2. SANITARY SEWER-CITY A. REIMBURSEMENT COST: NUMBER OF DFU's 6 B. IMPROVEMENT COST: NUMBER OF DFU's 6 (SEE REVERSE SIDE) x $ 22.09 PER DFU , $ x $ 16.79 PER DFU P TOTAL LOCAL W ASTEW A TER SDC: I $ 233.28 1 3. TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 6.395 x 36.13 x $ 16.81 PER TRIP x 0.85 NTF 1$ 3,301.38 1 B. IMPROVEMENT COST: 6.395 x 36.13 x $ 74.17 PER TRIP x 0.85 NTF 1$ 14,566.52 1 EXISTING A. REIMBURSEMENT COST: -6.00 x 11.01 x $ 16.81 PER TRIP x 0.9 NTF 1$ (999.42)1 B. IMPROVEMENT COST: -6.00 x 11.01 x $ 74.17 PER TRIP x 0.9 NTF 1$ (4,409.70)1 " TOTAL TRANSPORTATION REIMBURSEMENT SDC: $ 2,301.96 TOTAL TRANSPORTATION IMPROVEMENT SDC: $ 10,156.82 TOTAL TRANSPORTATION SDC:I $ 12,458.781 4. SANITARY SEWER - MWMG NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 6.395 x $380.4 I PER FEU B. IMPROVEMENT COST: NUMBER OF FEU's 6.395 x $39.80 PER FEU EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's -6.00 x $190.20 PER FEU B. IMPROVEMENT COST: NUMBER OF FEU's -6.00 x $19.90 PER FEU MWMC CREDIT IF APPLICABLE (SEE REVERSE) 1 $ 2,432.71 I , $ 254.52 I 1 $ (1,141.22)1 1$ (119.40)1 $ TOTAL MWMC REIMBURSEMENT FEE: $ TOT AL MWMC IMPROVEMENT FEE: $ MWMC ADMINISTRATIVE FEE: $ TOTAL MWMC SDC:' $ 1,436.61 1 SUBTOTAL (ADD ITEMS 1,2,3, &4) '$ 14,165.331 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) $ 14,165.33 x 5% $ 708.27 TOTAL TRANSPORTATION ADMINISTRATION FEE: $ TOTAL SEWER ADMINISTRA TlON FEE: $ PIAV1i\.eLIAJ. Ow lAb etj SDC COORDINATOR 12/24/2002 DATE TOT AL SDC CHARGES COM2002-01283, PROGRESSIVE REHAB. 1090 GATEWAY LOOP.xls , $ 14,873.60 I JULY 2001 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQuiv ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULA TE ONLY THE NET ADDITIONAL FIXTURES) FIXTURES NEW OLD UNIT EQUIVALENT 3 1 3 3 6 2 3 6 12 1 3 2 2 3 2 2 1 5 6 3 FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASE/OlL/SOLIDS/ETe. INTERCEPTORS FOR SAND/AUTO WASH/ETe. LAUNDRY TUB CLOTHES WASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERA TOR/WATER STATION/ETC. RECEPTOR FOR COMMERCIAL SINK! DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLE LAVATORY/RESIDENTIAL BAR URINAL, STALL/WALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INST ALLA TION MISCELLANEOUS: 2 NUMBER OF EDU'S* TOTAL DRAINAGE FIXTURE UN1TS= .EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day DRAINAGE FIXTURE UNITS o o o o o o o o o o o o o o 4 o 1 -5 6 o o o o 6 CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE . IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y YEAR ANNEXED 1979 or before 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 .RA TE PER $1,000 ASSESSED VALUE $ 4.92 $ 4.83 $ 4.77 $ 4.64 $ 4.47 $ 4.30 $ 4.09 $ 3.78 $ 3.41 $ 2.98 $ 2.52 RATE PER $1,000 ASSESSED VALUE $ 2.06 $ 1.64 $ 1.45 $ 1.31 $ 1.13 $ 0.97 $ 0.82 $ 0.63 $ 0.41 $ 0.22 $ 0.04 YEAR ANNEXED 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) x x CREDIT TOTAL COM2002-01283, PROGRESSIVE REHAB. 1090 GATEWAY LOOP.xls I $0.00 $0.00 $0.00 ~. JULY 2001 mitted has the tollowing ire specific land use . an 225 FIFTH STREET. SPRlNGFIELD, OR 97477 . PH:(541)726-3753 ~r~a~541)726-3689 ELECTRICAL PERMIT APPL!CATION ,/. /...... Zoning- City Job Number COt'VI.Zt:Jot:-O/Z-?:J Date / / / )/O...?~ ~ 0'1'" . 3. . \\\e6 c\' I D q D (,0.. TO~ (1 ')0.. '1 1 n{') P . C\;";' ":J:~;e '!/ve LEGAL DESCRIPTION ,,~~O\e {\o\~.. (\~. ~\(\Y:i oe":J ~ I 7tJ 3 22 ZOO ~'Jo~~{\6 ~ , \\,,'!). \ " 0 JOB DESCRIPTION 15F'<o~o>J?i-' "'IO~\{\~ / 'i}'V" '" '" \ZQ\y\Dd.~ I 6 P d Slo(( ~ DEc~~",e~J~v~e Permits are non-transferable and expire if ~dt'j{ is not started within 180 days of issuance o/lr work is Suspended for 180 days. 1. $106.00 sq. ft. or less ach additional 500 sq. ft. or portion thereof $ 19 ;00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. 2. Electrical Contractor rHRISTENSDN F.T Fl.TRTr., INC.200 Amps or less cd.. 201 Amps to 400 Amps Address 1298 BF'TI--WT URDTF 401 Amps to 600 Amps . 601 Amps to 1000 Amps orr.'/:-. City EUGENE Phone 541-688-6121' Over 1000 ~h\s&€1\f ,\\t. \N "Q' ~\Ol\C~:. ~1c~~tt\..an~\S \>t.~~\1 \~~ . \\\\S ?t.~ Supervisor License Number 271 C)S . \}\\\o~ 1-\ \'J\t.~Cc.P..\o~. Expiration Date 10/01/03 CO\'J\ '\COdlUtQ.tl~fitln, Alteration or Relocation f\~'{ 200 Amps or less Constr. Contr. Number 26-34C 201 Amps to 400 Amps 401 Amps to 600 Amps $ 63.00 l@J,.,.l')O $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 10/01/03 Expiration Date Over 600 Amps or 1000 Volts see "B" above. D. Signature of Supervising Electrician New Alteration or Extension Per Panel One Circuit . U ~O- $ 43.00 Each Additional Circ~WteqtM{el:) 'JJ~i'J S~~~<t(9t'f.Qmg~p~ili...eO{egoo tn$ 3.00 All t::.\' ted1:)'1\U sa to' too) No\\t 2.001- . SO \O~~~~~~a\OCOP'~tnete\epnoo.e $ 50.00 00~~~~8 \WfdEi~!Note... Not\"ca\'u,\ 50.00 ~im~t( 1W~~~m!gn~3t~~i344). $ 25.00 numo . 1-8UU~ c.. . 'LlillitedeenW'~mmercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ( ")"" liATHAN PHILIPS Owners Name ?C lJO, r 1) <,c:, \ v-f Q-I' hC\. b Address .in Cj [) c:: a.. To Ll. )~ '-j t 0 (') P City S? ~I d Phone --9 n. Oh OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 4. ,:J Jl 0 . Do 7% State Surcharge , .;. I ',.:) ~~~ T100~ToAALdministrativeFee ~ A ^"o....~ P\.. 'J\) ~ ;JS~.l cl I():JV' ~ <:J).;. S1mred Dri"<(T' YB"""'" F<>n>>YEJoctri,~ Pmni< Appl","", 1-03."'" Inspection Request: 726-3769 3\)0 \ q aLP '-\ Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1090 GATEWAY LP ASSESSOR'S PARCEL NO.: 1703222002300 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2002-01283 ISSUED: 01113/2003 APPLIED: 11113/2002 EXPIRES: 07/13/2003 VALUE: $ 219,000.00 Springfield TYPE OF Commercial Miscellaneous TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Interior remodel and elevator structure addition. Existing Structure is appro x 6,000 square feet. Adding 395 Sq Ft. Owner: FRED HAMPLE Address: 372 W 12TH AVE #4 EUGENE OR 97401 Phone Number: 541-683-0653 Phone Number: 541-683-0653 I CONTRACTOR INFORMATION. Contractor DAVID JONES MElLI CONSTRUCTION CO ~ CHRISTENSON ELECTRIC INC <~ ~\)~\)"\ COMFORT FLOW "\~" ,S ~ FRED HAMPLE ...;'?--x' ~~*-~,<F\~ ,~ iiJ~'B~~ORMATION I €.,. S~~ ~~ ~~~ # of Buildings: ~\~". ~"\ ~~\j ,S W. of Stories: Primary Occupancy Grou*\) ~Y..,~ ~\:) \)~ ~~ight of Secondary Occupancy "\~S ~\)~ R,Y..,\:) ~Y..,~ Type of Heat: Yrimary Construction Type ~~~~~Y..,~f\i \:)~ Water Type: Secondary Construction \J\) ;:1. \ ~ Range Type: # of Bedrooms: ~~ Energy Path: Lot Size: Sq Ft 1st Floor: S~ Ft 2nd Floor: ~1~Basement: 0~ '\o~ 'arage/Carport d O~ ~ili r: ~~(l) O~flJ.8q}0 ~~cU>~ Surface Area: . {IX r Co.fJ. \~ ~. I DEVELOPMENT INFOY.~~~O ~~0 0~~~O\' ~. ~~ ",~\J ~O~~rl:JO ,~ ~\REQUlRED PARKING , 0 ~O ~. ~ ~~ ~0 ~O Overlay D~~ 0~'l; ~0 f::J'(;:).~vO ~0~.~~ ~Yotal: 21 # Stree~~ v~~ ~,~ ~O ~~ a;lf; Handicapped: 2 paved~~~~r "'~ 0 ^,0~' r/bo~~~fb Compact: 5 \0.;&0 Cb"? ~ cP' O~ o.~'V % of Lot~~9t>'I) ~0 ~0 ~1Y.OO ~ OV"..-~ -^~ ~~ ~'\~ .-$:'_C'\Cb'\:)' ~~ ~,O ~~ U if- ..r ,,J! !pUBLIC IMPROVEM.e Contractor Type Architect General Electrical Mechanical Owner SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 47.00 22.00 62.00 75.00 Street Storm Sewer Available: Special Instruction: Notes: 1 of 4 License Expiration Date Phone 541-342-6511 541-485-1417 541-688-6121 541-726-0100 541-683-0653 63771 458 460 02/12/2004 05/0112003 06/27/2003 395 Sidewalk Type: Downspouts/Drains Status: . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Desc ription Bid Amount Type of Construction Use Bid Amount Fee Description Plan Review Comm/IndlPublic + 7% State Surcharge + 8% Administrative Fee Boiler/Comp 3-15 HP Building Permit Fixture Furnace - up to 100,000 btu Plan Review - Planning Planning Final Occy Inspection Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Vent Fan + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2002-01283 ISSUED: 01113/2003 APPLIED: 11/13/2002 EXPIRES: 07/13/2003 VALUE: $ 219,000.00 I Valuation Description I $ Per Sq Ft $1.00 Square Footage 219,000.00 Total Value of Project Value $219,000.00 $219,000.00 Date Calculated 11/2012002 I Fees Paid I Amount Paid Date Receipt N um ber $619.06 $80.88 $92.43 $44.00 $952.40 $84.00 $24.00 $55.00 $110.00 $100.74 $132.54 $10.00 $135.12 $1,291.49 $15.02 $693.25 $10,156.82 $2,301.96 $36.66 $45.00 $6.00 $21.60 $15.12 $90.00 $126.00 11/18/02 1/2/03 1/2/03 1/2/03 1/2/03 1/2/03 1/2/03 112/03 112/03 112/03 1/2/03 1/2/03 1/2/03 1/2/03 1/2/03 1/2/03 1/2/03 112/03 1/2/03 112/03 1/2/03 1/13/03 1/13/03 1/13/03 1/13/03 2200200000000000195 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000486 1200200000000000530 1200200000000000530 1200200000000000530 1200200000000000530 $17,239.09 I Plan Reviews I 2 of 4 Status: Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2002-01283 ISSUED: 01/1312003 APPLIED: 11/13/2002 EXPIRES: 07/13/2003 VALUE: $ 219,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review 11/2012002 12/17/2002 OK GRG Plan Review-Remodel/addition to office building-Medical offices-rehabilita tio n Specify method for monitoring all smoke detection per International Mechanical Code 606 as noted on Sheet M-l. Post address numbers visible and legible from the street fronting the property. Initial Review Planninl!: Review 11/20/2002 11/20/2002 11/2012002 11/2012002 APP APP LLH AJD Land Use Compatibility Statement issued-see attached document Applicable Conditions that have to be satisfied prior to occupancy: 1. Install 3 bicycle parking spaces 2. Install enclosed trash receptacle area Public Works Review Structural Review SUB Review 11/20/2002 11/2012002 11/2012002 12/02/2002 12/06/2002 12/05/2002 APP APP APP PJO TR JF Approved as noted on plans Pass Building Envelope. HV AC and Light energy code review To Request an inspection call the 24 hour recording at 726-3769. AIl inspection 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 Reo,uired Insoections I 1 Foundation: After forms are erected but prior to concrete placement. 2 Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 3 Shear Wall Nailing: Before covering sheathing with finish materials. 4 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 5 Wall Insulation: Prior to cover. 6 Ceiling Insulation: Prior to cover. 7 Roofing: Prior to installing any roof covering. 8 Drywall: Prior to taping. 9 Ceiling Grid: After drywall approval but prior to cover. 10 Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 11 Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. 12 Final Building: After all required inspections have been requested and approved and the building is complete. 13 Rough Plumbing: Prior to cover and including required testing. 14 Final Plumbing: When all plumbing work is complete. 15 Rough Mechanical: Prior to Cover 16 Final Mechanical: When all mechanical work is complete. 3 of 4 Status: Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2002-01283 ISSUED: 01113/2003 APPLIED: 11/13/2002 EXPIRES: 07/13/2003 VALUE: $ 219,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 17 Footing: After trenches are excavated. 18 Roof Sheathing/Nailing: Before covering sheathing with finish material. 19 Final Fire Department. After all requirements of the Fire Department have been met. 20 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. 21 SUB Final: After all required energy inspections have been requested and approved. 22 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. 23 SUB Ceiling Grid: Interior Lighting 24 Rough Electric: Prior to Cover 25 Electric Service: Approval required prior to utility company energizing service. 26 Final Electric: When all electrical work is complete. 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 wiD be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the perm it card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date 4 of 4 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Line Items: Job/Journal Number COM2002-0 1283 COM2002-01283 COM2002-01283 COM2002-0 1283 Payments: Type of Payment Check Paid By Description Receipt #: 1200200000000000530 Date: 0111312003 Perm ServlFdr 200 amps or less + 7% State Surcharge Add, Alter, Extend Circ Ea Add + 10% Administrative Fee PHILIPS ELECTRIC 1/13/2003 9:16:21AM. . City of Springfield Development Services Department Public Works Department Official Receipt Amount Paid 126.00 90.00 15.12 21.60 Line Item Total: $252.72 Received By Check Number Confirm No How Received Amount Paid djb In Person 252.72 . Payment Total: $252.72 I Page 1 of 1 cReceiptrpt