HomeMy WebLinkAboutPermit Building 2007-7-27
Status
Issued
225 fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 110 INTERNATIONAL WAY
ASSESSOR'S PARCEL NO.: 1703154000100
Springfield
PROJECT DESCRIPTION: Emergency generator installation.
Owner: PACIFIC HOSPITAL ASSOCIATION
Address: PO BOX 7068
EUGENE OR 97401
CITY OF SPRINGFIELD'
Building/Combination Permit
. PERMIT NO: cOM2007-00843
ISSUED: 07/27/2007
APPLIED: 06/08/2007
EXPIRES: 01/27/2008
VALUE: $ 212,000.00
TYPE OF WORK: Office
TYPE OF USE: Addition
Commercial
Phone Number: 541-684-5233
I CONTRACTOR INFORMATION I
Contractor License
ROBERTSON/SHERWOOD/ARCHITECTS
1996 LLC 114258
BUILDERS ELECTRIC INC 4296
BUILDING INFORMATION I
Contractor Type
Architect
General
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
U
VB
Expiration Date Phone
541-342-8077
05/30/2011 541-687 -9445
12/10/2007 541-485-0922
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
476
I DEVELOPMENT INFORMATION I
I PUBLIC IMPROVEMENTS I AITENTION 0 I . to
: regon aw reqUIres you
folloWirNlulla~pted by the Oregon Utility
Notifi~tion Cen}.$.{.. Tbose rules are set forth
In OAK~'al~tJBf.;o01roaUWbugh OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephDne
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Froutyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
NOT~CE:
Notes: THIS PERMIT SHALL EXPIRE IF THE WORK
JUJTHORIZED UNDER THIS PERMIT IS NOT
cr)I\.~MENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Pal!:e 1 of 4
REQUIRED PARKING
Total:
Handicapped:
Compact:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Estimate
Use Bid Amount
Estimate
Pavinl!:
Fee Description
Plan Review CommlInd/Public
Plan Review Fire & Life Safety
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Building Permit
Fire SF Fee - Non-Residential
Paving
Total Amount Paid
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2007-00843
ISSUED: 07/27/2007
APPLIED: 06/08/2007
EXPIRES: 01127/2008
VALUE: $ 212,000.00
I Valuation Description I
$ Per Sq Ft
or multiplier
$1.00
$1.00
Square Footage
or Bid Amount
200,000.00
12,000.00
07/03/2007
07/03/2007
Value
Date Calculated
Total Value of Project
$200,000.00
$12,000.00
$212,000.00
~
Amount Paid Date Paid Receipt Number
$604.27 6/8/07 2200700000000000940
$371.86 6/8/07 2200700000000000940
$106.13 7/27/07 2200700000000001201
$50.68 7/27/07 2200700000000001201
$71.25 7/27/07 2200700000000001201
$890.65 7/27/07 2200700000000001201
$47.60 7127/07 2200700000000001201
$123.00 7/27/07 2200700000000001201
$2,265.44
I Plan Reviews I
Pal!:e 2 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status Issued PERMIT NO: cOM2007-00843
225 Fifth Street, Springfield, OR ISSUED: 07/27/2007
APPLIED: 06/08/2007
541-726-3753 Phone EXPIRES: 01127/2008
541-726-3676 Fax
541-726-3769 Inspection Line VALUE: $ 212,000.00
Fire Department Review 06/19/2007 07/14/2007 OK GRG (Plans review completed on 7/14/07)
Plans Review: Storage structure for
non-required emergency generator.
Job #COM2007-00843.
1. Provide fire extinguishers with a
minimum rating of 4-A:40-B:C
inside the generator storage
building. The top of the
extinguisher(s) shall be between 3
and 5 feet above finished floor (2007
Springfield Fire Code 906).
2. A construction permit fee shall be
submitted. Fees shall be paid prior
to plans pick up.
3. Pacific Source shall apply for a
2007 Operational Permit for
flammable and combustible liquids.
The permit shall be in place prior to
final fire inspection.
MSDS submittal for the diesel fuel
and the cut sheets for the diesel
generator and 850 gallon tank shall
substitute for an HMMPIHMIS
submittal.
Initial Review 06/08/2007 06/11/2007 APP LLH
Plan Review Comments 07/03/2007 10 JMP WE. Received partial responses
from John Bramwell. Still waiting
for the completed special inspection
forms.
Plan Review Comments 07/16/2007 10 JMP WI. Received the completed
signature page of the special
inspection forms from John
Bramwell.
Planninl!: Review 07/2612007 07/26/2007 APP EMM Development Agreement signed
7/26/07
Planninl!: Review 06/19/2007 WE Waiting on Final Site Plan Submitta
and Development Agreement.
DRC2007-00027 Major SP and
DRC2007-00028 DWP.
Public Works Review 06/19/2007 06/25/2007 APP JHJ Attached SDC Worksheet. No New
SDC's. (JHJ)
Structural Review 06/11/2007 06/25/2007 WE JMP Received 6/19/2007 with four more
jobs with a heavy backlog. See
attached documents for 3 structural
comments faxed to James M.
Robertson.
Pal!:e 3 of 4
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: cOM2007-00843
ISSUED: 07/27/2007
APPLIED: 06/08/2007
EXPIRES: 01127/2008
VALUE: $ 212,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Structural Review
SUB Review
07/26/2007
06/19/2007
07/26/2007
07/02/2007
APP
APP
JMP
JF
Received final internal approvals.
No energy code issues or inspections.
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Reouired InsDections .
Foundation: After forms are erected but prior to concrete placement.
Slab: To be made after all ins lab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector.
Provide results to City Buiding Inspector
Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.
Final Fire Department. After all requirements of the Fire Department have been met.
Final Building: . After all required inspections have been requested and approved and the building is complete.
Rough Electric: Prior to Cover
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 will 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 re 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 durin' con ion. .
~-I~ ~ ~ 7-Z7~;;77
Owner o~ractols Signatu;e Date
Pal!:e 4 of 4
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER C0M2007-00843
NAME OR COMPANY: Pacific Source (Generator)
LOCATION: 110 International Way
MAP & TAX LOT NUMBER: 17 03 15 40 00100
DEVELOPMENT TYPE: Pacific Source (Generator)
NEW DEVELOPED AREA (S.F.):
EXISTING DEVELOPED AREA (S.F.):
TOTAL IMPERVIOUS SURFACE (S.F.):
J. STORM DRAINAGE
IMPERVIOUS SQ. FT.
x $ 19.79 PER DFU
TOTAL LOCAL WASTEWATER SDC:' $
3. TRANSPORTATION No New Building Square Footage
BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR
NEW:
A. REIMBURSEMENT COST:
0.00 x 0
B. IMPROVEMENT COST:
0.00 x
EXISTING:
A. REIMBURSEMENT COST:
0.00 x 0
B. IMPROVEMENT COST:
0.00 x
;1. SANITARY SEWER-CITY (see reverse side)
A. REIMBURSEMENT COST:
NUMBER OF DFU's
B. IMPROVEMENT COST:
NUMBER OF DFU's
o
o
4, SANITARY SEWER - MWMC
NEW:
A. REIMBURSEMENT COST:
NUMBER OF FEU's
B. IMPROVEMENT COST:
NUMBER OF FEU's
ITE:
ITE:
LOT SIZE (S.F.):
x
No New Impervious Area
$ 0.336 PER SF
TOTAL STORM DRAINAGE SDC:I
No New Fixtures
o
$
26.03 PER DFU
x
o
x
$ 19.81 PER TRIP
$0.00 I
$0.00 I
o
NTF
x
x
$ 87.39 PER TRIP
x
o
NTF
x
$ 19.81 PER TRIP
$0.00 I
o
NTF
x
x
$ 87.39 PER TRIP x 0 NTF $0.00 I
TOTAL TRANSPORTATION REIMBURSEMENT SDC:
TOTAL TRANSPORTATION IMPROVEMENT SDC:
TOTAL TRANSPORTATION SDC:J $
No New Building Square Footage
0.00
#N/A
$0.00 I
$0.00 I
x
PER FEU
0.00
#N/A
PER FEU
x
EXISTING:
A. REIMBURSEMENT COST:
NUMBER OF FEU's 0.00
B. IMPROVEMENT COST:
NUMBER OF FEU's 0.00
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES;
BASE CHARGE (SUBTOTAL ABOVE)
$0.00 I
$0.00 I
x
#N/A PER FEU
x
#N/A PER FEU
TOTAL MWMC REIMBURSEMENT FEE:
TOTAL MWMC IMPROVEMENT FEE:
MWMC ADMINISTRATIVE FEE:
TOTAL MWMC SDC:! $
SUBTOTAL (ADD ITEMS 1,2,3, & 4) I $0,00 I
$
x 5% I $0.00
TOTAL SEWER ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE: $
TOTAL SDC CHARGES
Jesse Jones
Civil Engineer, EIT
6/25/2007
DATE
$0.00
Pacific Source (Generator)
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FWOR DRAIN, FLOOR SINK
INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC.
INTERCEPTORS FOR SANDI AUTO W ASH/ETC.
LAUNDRY TUB
CLOTHES WASHER/MOP SINK
CLOTHES WASHER - 3 OR MORE (EA)
MOBILE HOME PARK TRAP (1 PER TRAILER)
RECEPTOR FOR REFRlGERA TOR/W A TER ST A TION/ETC.
RECEPTOR FOR COMMERCIAL SINKJ DISHW ASHER/ETC.
SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)
SINK: COMMERCIAL, RESIDENTIAL KITCHEN
SINK: COMMERCIAL BAR
SINK: WASH BASIN/DOUBLE LA VA TORY
SINK: SINGLE LAVATORY/RESIDENTIAL BAR
URINAL, STALUWALL
TOILET, PUBLIC INSTALLATION
TOILET, PRIVATE INST ALLA TION
MISCELLANEOUS:
FIXTURES UNIT
NEW OLD EQUIVALENT
3
I
3
3
6
2
3
6
12
I
3
2
2
3
2
2
1
5
6
3
NUMBER OF EDU'S*
DRAINAGE
FIXTURE
UNITS
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
TOTAL DRAINAGE FIXTURE UNITS = , 0
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFU) set at 167 gallons per day
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
1990
1991
RATE PER $1,000
ASSESSED VALUE
$5.29
$5.19
$5.12
$4,98
$4.80
$4.63
$4.40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
RATE PER $1,000
ASSESSED VALUE
YEAR
ANNEXED
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0,09
$0.05
$0.00
$0,00
$0.00
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFfER ANNEXATION DATE)
x
x
CREDIT TOTAL
$0.00
$0.00
$0.00
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::il P RI N GF I ELD ~i!'TItf;~Wl\f~~~
l~
City ofSpriJJgfir ).
COHJIllllnit.y Services LmiISJ()(j
225 Fifth Street..
Springfield., OR 97_47}
Tck~phonc:(54l) 726-3759
Fa.-x: (541) 726~3689
~~_~l-eoet\r~__._~l:~b -01
Building Pcmlit it
OGle
PncificSource Gen€rator _____.__.________
ProjectTillc
110 International Way
rroject Address
Special Inspection a.nd Testing
T" 'pph~m'! of pwj,," "",,;0.," 'p";" impeel''';", '",wg " "'" S",U"" 1704 of th, 0",,," S bu'!maI S",d"l~ Cod,. PI,,,,, ,,"is. th, 'nIOM'UUH boj ow. WI"" y"" /,;,,,
fill!shcd, acknowledge an under~ianding of !be infonna!.ion by signingbcIow, and retum this form to the. City.
BEFORE A PERMll CAN BE ISSUED, Ths "Wn" "' "'~cr', "'I""","U", "" tho ,d,i", of tho """"",'bl, Pmj<ct Engffi", os Ambit,,\ 'b," ,.mpl,", ,igo, OM submif " U"
City for review and approvallhis form complclw on buill [lIe front and back.
The owner and Genct:al Contractor, w]lerc applit<1b1c, sball also acknowledge the following c~nditions applicable to Spe1;ial Inspection and/or Testing.
1. Contr.1ctor is responsible for proper notification for Ibe Inspection or Testing of items listed.
2. Tc-sting laboratory shall (-a~c approprialc sumples and transport llll~n 10 their lahoratory for proper evaluation or (esting.
· Capie..;; oLtlllahordlory reports and inspections are 10 be seal to Ule City by the Testing Agency.
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3. S/X-"t,iaI lnspectioll Al~(,."llCY .is to subm.it names aod qualifications of on-site Special tuspectQrs fo the City !orapproval.
4. Spccwl Iuspector shall provide inspection reports to the building official of aU inspection activities.
5. Contractor is responsible to review Ibe Cily :lpprovcd plans Jor additional inspection or {(:~liIlg requirements tllat IDay be noted.
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BEFORE A CElrrrFtCA TE OF OCcur ANCY WILL BE ISSUEl>: Th, S,,""oI ID.",,,tion A,,,,'Y ,1mI1 ,w,mit to "" BWldiog Officiol , ,to''''''''' lb., ,U if"", "goi""_
i05pe<"on I"" boon fulfill'" "'" ''PO'"'' on" w,,, "' UlS best 01 "" ""poot.,', Iomwkdg" ;. ,onf"""",,, w;th "" 'PPro,'" pIon" """i/i",tion, ond "PPli<obl, w.danombip
provisions_ 11105(:. ikms !lot tested and/or m.c;pectcd shal.I be: noted in tbe'stateWClll Tbe report is tu be .mbmitt.ed to the City prior w a request for final inspectiOlls.
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ACKNO'WLEDGEMENTS
~. c-t:;~-)/i
~./~ -,A . ~ -e.. "-"-
- ~~pr.?(f/ ~y Po? ,Chambers Construction Co. _ _~ .~ .... /~__._,.~.,_
Own): '); e ' Gon. .:::n.",,,, Film Nom, (prin,oci) . G'n;pl,l'wast., Signatlne
<y~P H:l- T~: -t-r"S ~fp., ~~___~
:z:,.7;;z:gn,ture .,- ~ A~'Y,:m' . ^ ~c;,; ""1' ~\.ep S,gu.-/
i-;~sting Laboratory Rep. Signature Building OfK;;TaIN;;:;;~-(r~~i~l~d)- '-..-- '-- I3Ul (. '" ._
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Pacific Source Uealth Plans
Owner Name (printed)
~'obertsoil Sl.1enmod Arch
Engineer or Architect Firm (hinted)
E~J: ~d.~ of b~~~
Testing Laboratory Nume (1 rinted)
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Reinforced --::oncrete, Gunite, Grout and Mortar:
Concrete Gunite Grout Mortar
~
x
')<.
Precast/Pre-stressed Concrete:
Piles Post-Tens Pre'-Tens
Cladding
SMOKE CONTROL:
. Leakage testing
Control Verification
ROOFING:
Insulation installation/R- V alue*
Test strips/seams
SPECIAL INSPECTION AND TESTING SCHEDULE
Aggregate Test of Mix Design
Reinforcing Test
Mix Design- Weighmaster Cert. * .
Reinforcing Placement
Continuous Batch Plant Inspect.
Inspect Placing
Cast Samples
Samples (Pickup/Delivered)
Compression Test*
Aggregate Tests
Reinforcing Tests
Tendon Test
Mix Designs*
Reinforcing Placement
Insert Placement
Concrete Batching
Concrete Placement
Installation Inspection
Cast Samples
Pick-up Samples
Compression Tests
FIREPROOFING:
Placement inspection
Density tests
Thickness tests
Inspect batching
ADDITIONAL INSRUCTIONS, OTHER TEST, & INSPECTIONS:
I
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GRADING, EXCAVATION, ANn FILL
Acceptance tests * PSF
Establish final grade
Fill placement inspection/continuous
Soil Density
STRUCTURAL STEEL/WELDING:
Sample and test (list specific members below)
Shop material identification (mill cert)
')(. Weld inspection .,c... Shop .x. Field
Ultrasonic inspection Shop Field
High Strength Bolting Shop Field
A325 N X
A490 N X
Metal deck welding inspection
Reinforcing Steel welding inspection
Reinforcing steel mill certificate
Metal stud welding inspection
. .)(. Concrete insert welding inspection
Moment resisting steel frames
F
F
STRUCTURAL WOOD:
Shear wall nailing inspection
Shear wall anchors
Inspection of Glu-Iam fab. * T/C psi
Inspection of truss joist fab.
Sample and test components
Fabrication welding of steel accessories
MASONRY
Special inspection stresses used* fm fg
Preliminary acceptance tests (masonry units, wall prisms)
Subsequent tests (mortar, grout, field wall prisms)
Placement inspection of units, and reinforcement
Masonry, mortar, grout, and reinforcing steel certificates
Form Completed bY:.Jab..", ~D\.m.we.ll Date h~'Z"il.I:"
*PROVIDE STRENGTH REQUIRED BY ARCHITECT OR ENGINEER OR CONTRACT DOCUMENT LOCATION OF VALUES
225 Fiftli Street
.. '
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-00843
COM2007 -00843
COM2007-00843
COM2007-00843
COM2007-00843
COM2007-00843
Payments:
Type of Payment
Check
cReceint 1
RECEIPT #:
2200700000000001201
Description
Fire SF Fee - Non-Residential
Building Permit
Paving
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 07/27/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
nJm 010993 In Person
Payment Total:
Paid By
P ACIFICSOURCE
Page 1 of 1
2:10:57PM
Amount Due
47.60
890.65
123.00
50.68
71.25
106.13
$1,289.31
Amount Paid
$1,289.31
$1,289.31
7/27/2007