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Home My WebLink AboutPermit Building 2011-3-11 www.ci.springfield.of.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00217 IVR Number: 811186739264 225 Fifth 5t 5pringfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.us PROJECT STA TUS: STATUS DATE: Issued 03/11/2011 ISSUED: APPLIED: 03/11/2011 02/10/2011 EXPIRES: VALUE: 09/07/2011 $517,700.00 SITE ADDRESS: 1460 G ST, Springfield, OR 97477-4112 ASSES OR'S PARCEL NO: 1703362204601 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Surgery 6 & 7 alterations OWNER: ADDRESS: MCKENZIE WILLAMETTE REGIONAL MEDICAL CTR PO BOX 190700 SAN FRANCISCO CA 94119 Phone Number: CONTRACTOR INFORMATION Contractor Type Medical Gas Electrical Contractor General Contractor Contractor Name EMK MECHANICAL INC JK GUCKENBERGER ELECTRIC INC DORMAN CONSTRUCTION INC Lie Type GGB ELECTRICAL GGB # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: ATTENTION: Oregon law WPcl'u'i\fe!"l,e~buto foilow rules adopted by tlV\lat~,,'!;ype' Utility Notification Center. Those Rahge[]fYl>~~t forth in OAR 952-001-001 0 throl~a1,Q/iR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-BOO-3:1i1eft'iicaVSpeeially Code Edition: Springfield Fire Code Edition: o lot Size: Sq Ft 1 5t Floor: Sq Ft 2nd Floor: Sq Ft Basement: 5q Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: # of Bedrooms: Sprinkled Building: Fire Ala rms: Energy Path: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: e: 1llE WORK . NOTIC ~"11 SI-II\LL EXPIRE ~~"\1 IS 1'101 1HIS PEf''''' R 11-1\5 PC-f"" I\U1HOR\7.ED \J\'1D~5 I\BI\NDONtD FOR COMMENCES ~~R\OD. I\NY \ 80 DI'\, . Springfield Building Permit 3/11/2011 10:55:49AM Page 1 of6 www.cLspringfield.OLuS PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00217 IVR Number: 811186739264 Issued 03/11/2011 03/11/2011 02/10/2011 225 Fifth 51 Springfield,OR 97477 Phone: 541.726.3753 !nspection Phone: 541.726.3769 Fax: 541.726.3676 permitcenter@ci.springfield.or.us EXPIRES: VALUE: 09/07/2011 $517,700.00 ISSUED: APPLIED: SITE ADDRESS: 1460 G ST, Springfield, OR 974774112 ASSESOR'S PARCEL NO: 1703362204601 PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial Surgery 6 & 7 alterations DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Descriotion Bid Springfield Building Permit PUBLIC IMPROVEMENTS I Valuation Description Tvee of Construction NA Unit Amount Unit'Tvoe 517,700.00 Bid 3/11/2011 10:55:49AM Sidewalk Type: Downspout/Drains: I Unit Cost 1.00 Value 517,700.00 517,700.00 Page 2 016 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00217 IVR Number: 811186739264 225 Fifth SI 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 03/11/2011 ISSUED: APPLIED: 03/11/2011 02/10/2011 EXPIRES: VALUE: 09/07/2011 $517,700.00 SITE ADDRESS: 1460 G ST, Springfield, OR 97477-4112 ASSESOR'S PARCEL NO: 1703362204601 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Surgery 6 & 7 alterations FEES PAID ~ Amount Paid Date Paid $989.79 02/10/2011 $234.00 03/11/2011 $189.00 03/11/2011 ._w._~_~____'.__.~_.'_ _ Medical .G-,,-s~ermitJ~,,-(ba_s.~...?n value of work) _~ ___ __!1.2~~5_____ 03/11/201 ~________._ 20~ 1.!l~0~~0 Structural Plan Review Fee Commercial $1,566.51 03/11/2011 2011000450 ___ ___"_.w,....~...__ *__-.,-.-........-_._____.._.____._ Technology fe~_l~'.._of permit totai) $221.35 0~/11/2011' __ ____}~1.1 000,:5~ State of Oregon Surcharge (12% of applicable fees) $531.23 03/11/2011 2011000450, Services 200 amps or less $162.00 03/11/2011 201_1000450 Building Permit.Fee, $2.410.01 03/11/2011 .___~~2~0_ Electrical Plan Review (25%.of electrical fee) $146.25 03/11/2011 2011000450 Mechanical Permit fee (based on value o/work) $1,286.69 03/11/2011 2011000450 Floor drain/floor sink/hub $19:00. 03/11/2011 2011000450 Total Amount Paid $7,882.08 DescriDtion Structural Plan Review Fee Commercial Branch circuits with service or feeder each circuit --..- Oth.:.~ Limi~~~~~__ ReciDt# 2011000264 2011000450 2011000450 Springfield Building Permit 3/11/2011 10:55:49AM Page 3 of 6 . .1 ",'J-- CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00217 IVR Number: 811186739264 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 03/11/2011 ISSUED: APPLIED: 03/11/2011 02/10/2011 '('~:"":'-' 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@cLspringfield,or.us EXPIRES: VALUE: 09/07/2011 $517,700.00 SITE ADDRESS: 1460 G ST, Springfield, OR 97477-4112 ASSESOR'S PARCEL NO: 1703362204601 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Surgery 6 & 7 alterations Plan Review ~ Department Application Acceptance Received Due Date 02/10/2011 02/10/2011 Completed 02/16/2011 Result Application Accepted Planning Review 02/16/2011 02/16/2011 02/16/2011 Approved Reviewer David Bowlsby Liz Miller PubHc Works Review 02/16/2011 02/16/2011 0211712011 Approved Structural Review 02/16/2011 02/16/2011 02/24/2011 Waiting internal Comments: Waiting fOf other dept reviews Review 02/16/2011 02/16/2011 02/28/2011 Not Required M Greene Chris Carpenter Steve Graham _Electr.jCC!IJ~~Y. i~YV..:'>:.1. ~-~~~~.'" ::i:E;" '.02../1. 6/:?01',1~':02j1'6/g01.'.:1. {;~ ;03/02!2(f1.'1r.7J0~.,';A. a~'(lnfo.ReqUlfed ,'~:;,:~<;":Brycin""--.RjCl:rard.S'on"J '.~:': :\:~"':,,';__ 5,,:,~,7:~~-~"fi..--::{C . ',' ' . ,,,,,,< ,--:0"" ," >. -: .,~"-'~ ,,,,",1>'" <..vy T7:""; <"iJ>:4i,~r+ "::7':-< ' " ,#,~'0"~1." >~;v" ....i,~,~ Ii' '.';.".,\\ ;.. ';'"i<"~ ',.,? ,"""\ .' ".:1"t"";;tt J(':;!1;-r-;,~'yrli>'7 ';': \t"., fj ;' "'''; -'Y',' , r--Fomments:,: '7po~-~Y>'jtQlE~lfff1,~Qr~p""er~~1\U~BYSJ~r'}~.~~~! t9; ~ii,2xe: ~\e~s- an,d ;mrs;j~':~9t~__~~t~:g,~t'ba,9k 1o'l!1e',~hort!Y:1&:.;<' .,1:: ~~A'1J:~,>:C;71 ,:J~, ,; ,... ' . '.., __"_,^_,,,-,,-,___. - ~__~,_"~:w.--c,-i.",_.",,,,-,,,,,,,--,",,-"!,,,,,,,,,,,","'_ _ Electrical Review 02/16/2011 02/16/2011 03/03/2011 Comments: See attached documents for three items to be addressed. Approved -Permit Issuance 03/03/2011 03/03/2011 03/11/2011 Issued Springfield Building Permit 3/11/2011 10:55:49AM Bryan Richardson Nancy Machado Page 4 016 S~4~H~~EL~ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00217 IVR Number: 811186739264 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 03/11/2011 ISSUED: APPLIED: 03/11/2011 02/10/2011 EXPIRES: VALUE: 09/07/2011 $517,700.00 SITE ADDRESS: 1460 G ST, Springfield, OR 97477-4112 ASSESOR'S PARCEL NO: 1703362204601 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Surgery 6 & 7 alterations INSPECTIONS REQUIRED ~ Inspections 9009 SUB Ceiling Grid 9012 SUB Final SUB Ceiling Grid: Interior Li9hting SUB Final: After all required energy inspections have been requested and approved. Rough Plumbing: Prior to cover and including required testing. 3500 Rough Plumbing 3800 Medical Gas Piping 3999 Final Plumbing 1260 Framing Final Plumbing: When all plumbing work is complete. 1540 Gypsum Board/Lath/Drywall Framing Inspection: Prior to cover and after all rough in inspections have been approved. . Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. Firewall: Located and constructed according to plans. . 1550 Firew~1I 1560 Fire~top Assemblies 1710 Fire Sprinklers 1734 Fire Alarm Rough 1740 Fire Alar~ Final 1800 Emergency Egress Lighting 1999 Final Building Final Building: After all required inspections have been requested and approved and the building is complete. 2180 Fire/Smoke Damper 2300 Rough Mechanical 2999 Final Mechanical Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. 4225 Service or Feeder 4500 Rough Electrical 4999 Final Electrical Roug~ Electric: Prior to Cover Final Electric: When all electrical work is complete. Springfielc,l BUilding Permit 3/11/2011 10:55:49AM Page 5 of6 sr. RI.N.G. FIE~.D . ~'ll_ :;;., ~ ~~""OREGON www.ci.sprlngfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00217 IVR Number: 811186739264 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541.726.3676 perm itcenter@ci.springfield,or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 03/11/2011 02/10/2011 EXPIRES: VALUE: 09/07/2011 $517,700.00 03/11/2011 'SITE ADDRESS: 1460 G ST, Springfield, OR 974774112 ASSESOR'S PARCEL NO: 1703362204601 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Surgery 6 & 7 alterations 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 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 contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 further agree to ensure that an required inspections are requested at the proper time, that each address is readable from the street, that the permit 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. ,fl!aJtLt, :0'f Owner or Contrac or Sign ture 3///-/ / Date Springfield Building Permit 3/11/2011 10:55:49AM Page 6 of 6 Electrical Permit Ap~lication \~~~m:Z, .'. ~'<!:4'D1Il~]1 ns Fifth Strftt.Sprioglkld. OR 97477. PH(541 )726-3753. F1L\:(541 )7~'.J689 .~~~ ~fi~ .- - . - - DEPARTMENT USE ONLY . ... . Permil no.: Date: Q.. \1 ~.~ \ This permit ill: iuued under OA.R 9J8-309-OO00. Pcrmit~ are nontransferable. Permits expire if work n not started ft'ithin 180 days ofissuantt or if work is suspendled for 180 days- ..... i.OCAL GOVERNMENT "APPROVAL" ',' " , Zoning approval veri lied? !'DIY cs 0 No .' "" CATEGORY OF CONSTRUCTION .. . ," .' . o Residential , 0 Government I )g:tommercial JOB SITE INFORMATION ,AND LbCATlON: Jobsileaddress:'WofJ r-,., ~ City:":~ ""'" ~ I Slaleti" ~ ZIP: L.\ t"r- Subd. .iViSiO~. ~t:)5'?1r-.0'2.. Lol no.:()il. \\0[';" I..... . ':. DE~FWORK .. ..... . !\\\ ",",On. l.. \ n .\- --'\ J...\ te( ~ (\ PRQ!:fERTY OWNER' .. : . .... Name:U~'(nh-=110, \. ")-\\\ \..w')~ Address:{'\n TN., '\0....... \. 7{)' City;<\N (\ -<n I\ I Slate f\- Z[PC\\" \ \q I Fax: Phone: E-mai[: This installation is being made on residential or faml property owned by me or a memher of mv immediate familv. This property ";s nol intended for sale: exchange, lease, or renL OAR 479.540([) and 479.560(1). Signature: , CONTRACTOR INSTALLATION Bosiness name: \ I<! L t- J ~ I ; ,-;T"' ~ , Address: .2..1"51 110/\ ' l Citv: C. -(,orA IState:OV Phone: ~I =1-<1,,-' I. -"', ! Fax:'StH E-mai[ ;-'"";:;>?, ~ ..jt< "'E\.H....c...oM CCI31icen":'no.: 40512..'1 I BCD licen,., no.: 2.0.2..1'C- SiWling supervisor's license no.: ~'i'0;:; S Print name of siWling supervisoro~n.LC.,. , , L..,v If , . ZIP cn4-11 -1%-3 ~S5 Sigrrntllre of signing supervisor: /' u 440-1584-) (9f08fCOM) ~\)~w" ?.:/ ./ ""~ \5:' '., .FEE SCHEDULE'," .' Nilnibe'r,orim~~~ons,~dtC~;,~J~ -_'::IQt!~l;- -~~ ResidPlltial, per unit, Sf'rVice included: .t< '. Tolal. cost -". 1,000 sq, fl. or less (4) r...ach additional 500 sq. ft. or portion thereof Limiled energy (2) Each manufactured home or modular dwelling service or feeder (2) $134.00 $ $ 25,00 $ $ 32.00 $ $ 63,00 $ Sen'ices or feeders: installation, alteration. relocation 200 amps or less (2) f), $ 81.00 $ I (Jl') fP 201 to 400 amps (2) $ 95,00 $ 40 I to 600 amps (2) $158.00 $ 60 I to \,000 amps (2) $205.00 $ Over 1.000 amps or volts (2) $469.00 $ Reconnect only (2) $ 63.00 $ I Temporary services or feeders: installation. uIteralion, relocation 200 amps or less (2) 201 10400 amps (2) 40110600 amps (2) $ 63.00 $ $ 87.00 $ $126,00 $ Over 600 amps or 1,000 volts, see services or feeders section abm'c Branch circuits: new. altem/ion, exJension per panel 8. Fee fOT brancb circuit..; with purcha<re ofa service or feeder fee: I'J.Q! $ 6,00 $~ p? Each branch circuit b. Fee for branch circuits without purchase of a service or feeder fee: first bmnch circuit (2) Each additional branch circuit $ 55.00 $ 6.00 $ $ A-tiscelIaneous fees: service or feeder not included Each pump Of irrigation cjr~Je (2) $ 63.00 Each sign or outline lighting (2) S 63.00 $ $ $ tBCl ,(1:> $ -='1" Signall,..;rcuit or a limited-energy panel, alteration. or extension (2) ~ S 63.00 Each additional insJWCtion: (I) $58.00 ,,' '" ',c,:c'.AI1PlICANT,USE". (A) Enter subtotal ofaboYc fees (Minimum Pennit Fee S58.00) (B) Enter 12% surcharge (.12 x [AD (C) Technology fee (5% of lAD TOTAL fees and surcharges (A through C): $~CO $ ~U.~ $ !')~q. 75 $ ~ ~~ \1\\9.'1..5 ~~ ~ ~ck~ Structural Permit Application DEPARTMENT USE ONLY SriL Z:O((-<.3C 21( Penmt no.: Date: - /6 - I This permit is issued under OAR 918~460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL This project has final land-use approval. Signature: [Jute: This project has DEQ approval. Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within ,nood plain: 0 Yes 0 No CATEGORY OF CONSTRUCTION o Residential JOB SITE INFORMATION J City: Subdivision: Reference: Name: Address: City: Phone: 747 ....... s Phone: E-mail: CCB liccnse no: Slatc~ ZI Fax: Print name: , Signalure: SUB-CONTRACTOR INFORMATION Nl-lmc cell License Numher Phone Number 'Electrical "- Plumbing r Mechanical , rr Co !J7 P "',- GJAVlwL..- \L.LUTC- Jf~(l( 4-e;> 1 ""'I -"I vck - c c1V'^ 54-I. 34-4-- "t15 7 ~- FEE SCHEDULE 1. Valuation information (n) Job description: Oe.c. ~ 7 AI.! ..rll~ Occupancy T-'Z. Construction type: "L-A SqliUre feet: (".,OO Cost per sqnare foot: Sn Other information: Type or Ileaf: I~nergy I'ath: Dnew os. alteration D addition (b) Foundation-only penllit? DYes J}-No Total valuation: I $ 300,000 2. Building fees (n) Perinit fee (llse valuation table): $ 2..'1/0. ?, ,(b) Investigative fee (equal to [2a]): $ (c) Rcinspection ($ per hour): $ (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [Za+2b+2c]): $ /Jl 7 :c:> (c) Sublotal offces above (28 tbrough2d): $ 3. Plan review'fees 0",,<:) ; (3) Plan review (65% x permit fee (2a]): $/' (b) fire and lite safety (40% x pennil fee [2a]): $ (c) Subtotal of fees aho\'c (3a and 3b): $ 4. Miscellaneous fees ~~ / .2D.se (a) Seismic fec, 1% (.01 x permit fee fla]): $ TOTAL fees and surcharges (2c+3l:+4n): ---- - , ~ ----- / I lA-F{ (fl~D (N ~(....- S.~RIN.. GF.IE.L~.D. ...... . _. ""'.oiU. '. '1;li!1 ". i'OREGON TRANSACTION RECEIPT crTY OF SPRINGFIELD 225 Fifth St Springfield, OR 974n 541-726-3753 www.ci.springfield.or.us 811-5PR2011-00217 1460 G 5T permitcenter@ci.springfield.or.us RECEIPT NO: 2011000450 RECORD NO: 811-SPR2011.00217 DATE: 03/1112011 !DeSCRIl:?,:tjbN::"::'H7~.:,';:.. .J'b~~;::.J;~;,["".J.J.J'i:'~"'''.J.Ji~.:.::~:i}'.'GCQUNJ~cj)fiE 'i:::",,:I#,.t.'i'+L"'AMOUNi~DiJE" ~ :,:,..,...::1 Branch circuits with service or feeder each circuit Building Permit Fee Eiectrical Plan Review Floor drainlfloor sink/hub Mechanical Permit fee (based on vaiue of work) Medical Gas Permit fee on value of Other Limited Energy Services 200 amps or less State of Oregon Surcharge (12% of applicable fees) Structural Plan Review Fee Commercial Technology fee (5% of permit total) 224-0000Q.426102 224-0000Q.425602 224-00000-426102 224-00000-425603 224-00000-425604 224-00000-425603 224-00000-426102 224-00000-426102 821-00000-215004 224-00000-425602 100-00000-425605 TOTAL DUE: 234.00 2,410.01 146.25 19.00 1,286.69 126.25 189.00 162.00 531.23 1 221.35 6,892.29 Check 228601 MCKENZIE W1lLAMETTE REGIONAL MEDICAL CTR 6,892.29 TOTAL PAID: 6,892.29 TRANSACTION RECEIPT 811-SPR2011-00217 1460 G ST www.ci.springfield.or.U5 CITY OF SPRINGFIELD 225 Fifth St Sprlngfleld,QR 97477 541-726~3753 perm itcenter@ci,springfield.or.us RECEIPT NO: 2011000264 RECORD NO: 811-SPR2011-00217 DATE: 02/10/2011 [[jESi::RI~tl()N,ci~t~'*"'''-, .~:-' Go. '4Yo1J:i'';4'" ",.',,' 0 . -.1 'Ac.(;:6IfNT~CODE':o,:;{'"~.''k,-,,, 'ii'^'AMOlJNJ!o.lfEf.. ,,~ Structural Plan Review Fee Commercial 224.00000-425602 989.79 TOTAL DUE: 989.79 t:i:~.&M~I'IT.Jip'E- . '-c'HAYOR. 'CASHiER:fDBowtSB'{","i'~';.';"'&9_MMEjrr1>~4~f!";4:4~ '_:;".7-;;'~MOU!lT PAIDl >~J .. .1 Credit Card GMA Architects 989.79 001560 TOTAL PAID: 989.79