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Home My WebLink AboutPermit Building 2006-5-18 (7) . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-0I488 ISSUED: 05/18/2006 APPLIED: 1210612004 , EXPIRES: 02/09/2007 VALUE: $ 212,434,907.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3333 RiverBend Dr ASSESSOR'S PARCEL NO.: 1703220000902 Springfield TYPE OF WORK: Hospital PROJECT DESCRIPTION: Riverbend Hospital TYPE OF USE: New Commercial Owner: PEACEHEAL TH Address: PO BOX 1479 EUGENE OR 97440 I CONTRACTOR INFORMATION I Contractor Type Contractor License Expiration Date Phone Architect ANSHEN & ALLEN 415-882-9500 General TURNER CONSTRUCTION COMPANY 69988 11/09/2007 503 229-6000 Electrical E C COMPANY 49737 01/15/2008 503-224-3511 Low V oltage Electrical SECURECOM INC 117195 09/29/2006 541-988-3585 Plumbing TWIN RIVERS PLUMBING lNC 17695 03/11/2007 541-688-1444 I BUILDING INFORMATION I OU \0 # of Units: # of St%i~;S 'l U\I\I\'l Primary Occupancy Group: 1-1.1 Heigh'i'-ofStructur,l'o~'{\ $).' ("IJ-:.l e\"' Secondary Occupancy Group: B. OleQO'1~f6r~;a!;,e S ~_aa\- Primary Construction Type I~~)~' 09\ecw~~'tJ'l')1}J5"'~ 9~ les b'l Secondary Construction Type:,,"i"i\':.~ ,,\'!/;' a.O "el. "R"llngecl:ype:\\'{\e IU ^e r >J'J Iv Ce{\' - \'(\,~ - n ~O" # of Bedrooms: \0\\0 \IO{\ .aa'Ene~~r,JRat,~~ \e\e~. \IO{\ ~'O\I\ICa. "'6~.aa\ 0$'~p1ihkJ~!I.Buil~!~g:,ICa. n/a \~ _..O";:J ~.....,I \~ ,.'.\\\" _, \{\a~9a.'{0\:I,~i)EVELOEMEN:p,lNF6RMATlON I a.\\I{\Y- \01'" . '\ .UV C \1I'Oel \el IS (\U eel' Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: . I PUBLIC IMPROVEMENTS I r i\-\r. 'l'.JORSidewalk Type: ~01\C~:'l--J\\I S\-\1\\.\. r.'j,?~~~Rl--J\li IS ~ObownspoutslDrains: i\-\IS ?r.~lr.\) \l~\)r.R iB\-\~~\)O~r.\) rOil. 1\\li \-\0 " \) OR IS 1\ COl--J\l--J\r.~~r.1\'/ ?r.RIO(\' ' 1\~'/ ~ 80 Street Improvements: Storm Sewer Available: Special Instruction: Notes: to. ....J Paee I of8 . -iiii~ . . CITY OF SPRINul'lI'.LD Building/Combination Permit PERMIT NO: COM2004-01488 ISSUED: 05/18/2006 APPLIED: 12106/2004 EXPIRES: 02/09/2007 VALUE: $ 212,434,907.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Estimate Estimate $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 212,186,907.00 248,000.00 Value Date Calculated Description Estimate Estimate Tvpe of Construction Total Value of Project $212,186,907.00 $248,000.00 $212,434,907.00 07/01/2005 06/08/2005 l;..Fpp< P'Ii'\J Fee Description Amount Paid Date Paid Receipt Number Plan Review Commllnd/Public $443,476.63 12/6/04 2200400000000001481 Plan Review Fire & Life Safety $272,908.69 12/6/04 2200400000000001481 + I % Seismic Fee $5,518.79 7/1/05 2200500000000000873 + 100/0 Administrative Fee $55,187.86 7/1/05 2200500000000000873 + 70/0 State Surcharge $38,631.51 7/1/05 2200500000000000873 Building Permit $551,878.72 7/1/05 2200500000000000873 + 10% Administrative Fee $21.60 7/6/05 1200500000000000955 + 7% State Surcharge $15.12 7/6/05 1200500000000000955 Fixture $14.00 7/6/05 1200500000000000955 Sanitary Sewer - 1st 50 Feet $90.00 7/6/05 1200500000000000955 Special Waste Connection $112.00 7/6/05 1200500000000000955 Deposit $10,000.00 7/8/05 2200500000000000902 + 10% Administrative Fee $293.20 8/22105 2200500000000001132 + 7% State Surcharge $205.24 8122105 2200500000000001132 Plan Review Plumbing (30%) $1,029.13 8122105 2200500000000001132 Sanitary Sewer - 1st 50 Feet $45.00 8/22105 2200500000000001132 Sanitary Sewer Each AddtllOO' $560.00 8122105 2200500000000001132 Special Waste Connection $1,162.00 8122105 2200500000000001132 Storm Sewer - 1st 50 Feet $45.00 8/22105 2200500000000001132 Storm Sewer Each AddtllOO' $1,120,00 8/22105 2200500000000001132 + 10% Administrative Fee $14,201.30 9/2105 2200500000000001211 + 7% State Surcharge $9,940.91 9/2105 2200500000000001211 Add, Alter, Extend Circ Ea Add $22,602.00 9/2105 2200500000000001211 Low Voltage - Commercial Indus $63,585.00 9/2105 2200500000000001211 Perm Serv/Fdr 1000 amps/volts $19,125.00 9/2105 2200500000000001211 Perm Serv/Fdr 200 amps or less $15,057.00 9/2105 2200500000000001211 Perm Serv/Fdr 201 to 400 amps $18,150.00 9/2105 2200500000000001211 Perm Serv/Fdr 401 to 600 amps $1,375.00 9/2105 2200500000000001211 Perm Serv/Fdr 601 to 999 amps $2,119.00 9/2105 2200500000000001211 Plan Review Electrical (25%) $41,538.81 9/2105 2200500000000001211 + I % Seismic Fee $1,379.70 10/21/05 2200500000000001477 + 10% Administrative Fee $13,796.97 10/21/05 2200500000000001477 + 7% State Surcharge $9,657.88 10/21/05 2200500000000001477 Building Permit $137,969.68 10/21/05 2200500000000001477 + 10% Administrative Fee $5.90 2/7/06 3200600000000000057 Paee 2 of 8 Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line + 8% State Surcharge Plan Review Plumbing (30%) Storm Sewer - 1st 50 Feet Storm Sewer Each AddtllOO' + 10% Administrative Fee + 7% State Surcharge Fixture Special Waste Connection Storm Sewer - 1st 50 Feet Storm Sewer Each AddtllOO' Plan Review Comm/lnd/Public Plan Review Fire & Life Safety -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Air Handling Unit 10,000 & Ovr Air Handling Unit Up to 10,000 Appliance Not Listed Appliance Vent BackfIow Device Evaporative Coolers Exhaust Hoods Fixture Furnace - more than 100,000 Furnace - Unit Heater Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Heat Pump Inspection - Preliminary Medical Gas Base Fee Medical Gas Each Inlet/Outlet Medical Gas Plan Review Not Covered Mechanical Plan Review Electrical (25%) Plan Review Mechanical (25%) Plan Review Plumbing (30%) Plan Review Plumbing (30%) Sanitary Sewer - 1st 50 Feet Sewage Ejector Pump Special Waste Connection Trap or Waste not Conn to Fixt Vent Fan Water Line - 1st 50 Feet Water Line - Each AddtllOO' + 100/0 Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Temp Power 201 - 400 amps . $4.72 $159.30 $45.00 $14,00 $14.30 $10,01 $56.00 $14.00 $45.00 $28.00 $125.58 $77.28 $10.00 $10,748.00 $7,523.60 $435.00 $112,00 $28,260.00 $288.00 $210.00 $72.00 $90.00 $37,450.00 $90.00 $300.00 $18,804.00 $4.00 $6.00 $264.00 $45.00 $219.00 $14,625,00 $4,453.20 $540.00 $-6,035.53 $12,334.50 $-149.53 $12,992.40 $45.00 $112.00 $4,172.00 $1,260.00 $18.00 $45,00 $14,00 $9.00 $7.20 $21.00 $69.00 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-0I488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 02/09/2007 VALUE: $ 212,434,907.00 2/7/06 2/7/06 2/7/06 2/7/06 3/9/06 3/9/06 3/9/06 3/9/06 3/9/06 3/9/06 3/1 0/06 3/10/06 3122106 3/22106 3/22/06 3/22106 3/22106 3/22/06 3/22/06 3/22/06 3/22/06 3/22/06 3/22106 3/22106 3/22106 3/22106 3/22/06 3/22/06 3/22106 3/22/06 3/22106 3/22/06 3/22106 3/22106 3/22/06 3/22/06 3/22106 3/22/06 3/22/06 3/22/06 3/22/06 3/22106 3/22106 3/22/06 3/22/06 5/15/06 5/15/06 5/15/06 5/15/06 3200600000000000057 3200600000000000057 3200600000000000057 3200600000000000057 2200600000000000287 2200600000000000287 2200600000000000287 2200600000000000287 2200600000000000287 2200600000000000287 1200600000000000285 1200600000000000285 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000366 2200600000000000602 2200600000000000602 2200600000000000602 2200600000000000602 Paee 3 of8 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line + 10% Administrative Fee + 8% State Surcharge Low Voltage - Commercial Indus Plan Review Electrical (25%) Refu nd - Admin Fee Refund - Electrical Refund - Surcharge + 10% Administrative Fee + 10% Administrative Fee + 10% Administrative Fee + 7% State Surcharge + 8% State Surcharge + 8% State Surcharge Fixture Not Covered Plumhing Plan Review Plumbing (30%) Plan Review Plumbing (30%) Plan Review Plumbing (30%) Refund - Admin Fee Refund - Plumbing Refund - Surcharge Sanitary or Storm Sewer Cap Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each AddtllOO' Special Waste Connection Storm Sewer - 1st 50 Feet Storm Sewer Each AddtllOO' + 10% Administrative Fee ' + 5% Technology Fee + 8% State Surcharge Low Voltage - Commercial Indus Total Amount Paid . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-0I488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 02/0912007 VALUE: $ 212,434,907.00 $900.00 $720.00 $9,000.00 $2,250.00 $-2.10 $-21.00 $-1.68 $11.50 $11.80 $137.20 $96.04 $9.20 $9.44 $1,344.00 $28,00 $34.50 $35.40 $481.57 $-137.20 $-1,853.57 $-96.04 $45.00 $45.00 $28.00 $42.00 $45.00 $28.00 $13.50 $6.75 $10.80 $135.00 5/18/06 5/18/06 5/18/06 5/18106 5/19/06 5/19106 5/19/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8106 6/8106 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 6/8/06 618/06 6/8/06 618/06 819/06 8/9/06 8/9/06 8/9/06 1200600000000000678 1200600000000000678 1200600000000000678 1200600000000000678 VOUCHER #104418 VOUCHER #104418 VOUCHER #104418 ' 1200600000000000829 1200600000000000829 1200600000000000827 1200600000000000827 1200600000000000829 1200600000000000829 1200600000000000827 1200600000000000827 1200600000000000829 1200600000000000829 1200600000000000827 VOUCHER # 105568 VOUCHER # 105568 VOUCHER # 105568 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000000829 1200600000000001228 1200600000000001228 1200600000000001228 1200600000000001228 $1,916,230.78 I Plan Reviews I Initial Review 03/3012006 03/30/2006 10 LLH Received permission from Philip Farrington to recycle old plans. Structural Review 0610212005 06/03/2005 10 LLH Forwarded revised structural fill drawings to Clair Structural Review 06/19/2006 06/19/2006 APP AC ASI 106R.I - Approved with Conditions Structural Review 06119/2006 06/19/2006 APP AC Proposal Request #35R.3 and #35R.4 - Approved with Conditions Structural Review 06/19/2006 06/19/2006 APP AC Proposal Request #52 - Approved Structural Review 06/19/2006 06/19/2006 APP AC Proposal Request #63 - Approved Structural Review 06/19/2006 06/19/2006 APP AC Proposal Request #80 - Approved with Note to Inspector Paee 4 of8 . . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2004-0I488 225 Fifth Street, Springfield, OR ISSUED: 05/18/2006 541-726-3753 Phone APPLIED: 12/06/2004 541- 726-3676 Fax EXPIRES: 02/09/2007 541-726-3769 Inspection Line VALUE: $ 212,434,907.00 Structural Review 07/01/2006 07/03/2006 APP AC Deferred Submittal No. 0485-05510-DFO - Stair No.7, 9,10, and II - 1st Back Check - Approved with Notes to Inspector Structural Review 07/01/2006 07/03/2006 APP AC Deferred Submittal No, 0625-03450-DFO - 3rd Floor Precast Bracket Panel Reinforcing Drawings w/ Calculations (APS) - Approved with conditions Structural Review 07/01/2006 07/1712006 APP AC Deferred Submittal Package No. 0707-03450-DFO - 3rd Floor West Elevation Sills (between bracket panels) reivsion (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No, 0624-03450-DFO - Connection RDE-I and RDE-3 for panels SPI and SP3 (west elevation) (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No. 0557-03450-DFO-I - Parapet and Bay Windows - Hospital (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No. 0675-03450-DFO - Corner Window sills reinforcing, Level 4 Hospital - including shop drawings (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No. 0676-03450-DFO - Precast Window Sills Reinforcing - OHVI - shop drawings (APS) - Approved with Notes to Inspector Structural Review 07/01/2006 07/17/2006 APP AC Deferred Submittal Package No. 0632-15000-DFl - Seismic Bracing- Level 2. (Previously submitted plans for this submittal were taken and stamped by KPFF and returned to CLAIR 7/11/06 for the back check t( our first review of this submittal) - Approved with Notes to Inspector Structural Review 07/01/2006 07117/2006 APP AC Proposal Request #37 - Approved Structural Review 07/01/2006 07/17/2006 APP AC Proposal Request #97 - Approved Structural Review 07/0112006 07117/2006 APP AC Construction Change Directive #52 - Approved with Conditions Structural Review 07/01/2006 07/17/2006 APP AC Construction Change Directive #10- Approved Structural Review 07/01/2006 07/17/2006 APP AC Construction Change Directive #53 - Approved with Notes to Inspector Paee 5 of8 -~~ . . CITY OF SPRINGFIELD. Building/Combination Permit .. Status Issued PERMIT NO: COM2004-01488 225 Fifth Street, Springfield, OR ISSUED: 05/18/2006 541-726-3753 Phone APPLIED: 12/06/2004 541-726-3676 Fax EXPIRES: 02/09/2007 541-726-3769 Inspection Line VALUE: $ 212,434,907.00 Structural Review 07/01/2006 07/1712006 APP AC Construction Change Directive #70- Approved with Conditions Structural Review 07/01/2006 07/17/2006 APP AC Construction Change Directive #55R2 - Approved Structural Review 07/01/2006 07/1712006 APP AC AS1 #111 - Approved Structural Review 07/01/2006 07/17/2006 APP AC ASI #61 - Approved Structural Review 07/31/2006 08/01/2006 APP AC ASI #62 approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC ASI #115RI, 115R3, adn 115R4- Approved on 7/31/06 Structural Review 07131/2006 08/01/2006 APP AC ASI 120 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC ASI 130 - Approved 7/31/06 Structural Review 07/3112006 08101/2006 APP AC ASI 134 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC ASI 133 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 12 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 13 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 71 - Approved with notes to inspector 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 48 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC CCD 28 - Approved 7/31/06 Structural Review 07/31/2006 08/0112006 APP AC PR 65 - Approved 7/31/06 Structural Review 07/31/2006 08/01/2006 APP AC PR 34 - Approved 7131/06 Structural Review 07131/2006 08/01/2006 APP AC Deferred Submittal #0704-03450-DFO - 1st Floor Precasl Sills (plan and reinforcing) - OHVI . Approved 7/31/06 Structural Review 08/01/2006 08/03/2006 APP AC Deferred Submittal #0777-08810-DFO - West Elevation Window Systems Floors 1-3 - Approved with conditions Structural Review 06/03/2005 06108/2005 APP AC Approved for Structural fill Only Structural Review 06/30/2005 06130/2005 APP AC Approved for foundation, shell and core only, See attached documents for plan review comments and or conditions Structural Review 06/1212006 0611212006 APP AC ASI 87 plan review - approved 6/12/06 Structural Review 06/1212006 0611212006 APP AC ASI 100 plan review - approved 6/12106 Structural Review 06/1212006 06/1212006 APP AC ASI 60R.4 plan review - approved. Structural Review 06/1212006 06/1212006 APP AC ASI 97 plan review - approved 6112106 Structural Review 06/12/2006 0611212006 APP AC ASI 109 plan review - approved 6/12/06 Structural Review 06/12/2006 0611212006 APP AC ASI 099R.I plan review - approved 6112106 Structural Review 06/12/2006 06/1212006 APP AC ASI 104 plan review - approved 6/12/06 Structural Review 06/1212006 06/1212006 APP AC Proposal Request #24 plan review- approved 6/12106 Paee 6 of8 -u:: ~ . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01488 ISSUED: 05/18/2006 APPLIED: 1210612004 EXPIRES: 02109/2007 VALUE: $ 212,434,907.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 06/1212006 06/1212006 APP AC Proposal Request #22 plan review - approved 6/12/06 Structural Review 06/1212006 06/1212006 APP AC Proposal Request #32 plan review - approved 6/12106 Structural Review 06/1212006 06112/2006 APP AC Proposal Req uest #67 plan review approved 6/12106 Structural Review 06/1212006 06/1212006 APP AC Proposal Request #90 plan review approved 6/12106 Structural Review 06/1212006 06/1212006 APP AC Proposal Request #36 plan review approved 6/12/06 Structural Review 06/1212006 06/1212006 APP AC Proposal Request #77 plan review approved 6/12106 Structural Review 06/1212006 06/1212006 APP AC Deferred Submittal #0623-15900-DFO - Levell and 2 Reheat Control Valves - plan review - approved 6/12/06 Structural Review 06/1212006 06/1212006 APP AC Deferred Submittal 0536-15000-DFO - Tremco Firestopping (Lane-Douglas) - plan review - approved 6/12106 Structural Review 06/1212006 06/1212006 APP AC Deferred Submittal 0645-03450-DFO - Connection Detail DE-ll - plan review - approved with notes to inspector 6/12106 Structural Review 06/19/2006 06/19/2006 WE AC Deferred Submittal 0581-15000-DFO - Seismic Bracing - Parking Level (JH Kelly) - 1st plan review- Conditions of Approval Structural Review 06/19/2006 06/19/2006 APP AC Deferred Submittal 0598-15000-DFO - Seismic Bracing Parking Level Rev. #2 (JH Kelly) - 1st plan review - conditions of approval Structural Review 06119/2006 06/19/2006 DEN AC Deferred Submittal 0632-15000-DFO - Seismic Bracing Level 2 (JH Kelly) - 1st plan review - NOT APPROVED Structural Review 06/19/2006 06/19/2006 APP AC AS1108 - Approved Structural Review 0611912006 06/19/2006 APP AC ASI 95 - Approved with note to inspector To Request an inspection call the 24 hour recording at 726-3769. All 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. , Rr,n'\irpri In~nections I Water Line: Prior to filling trencb and including required testing. Storm Sewer Line: Prior to filling trench. Paee 7 of8 ~iii~~ . .CITY OF ~rKU\il:Jl'lJ'..LD Building/Combination Permit Status Issued PERMIT NO: COM2004-01488 ISSUED: 05/18/2006 APPLIED: 12/06/2004 EXPIRES: 0210912007 VALUE: $ 212,434,907.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Backl10w Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Special: See Plan Review and/or Inspector Notes. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement, Slab: To he made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Bolts Installed in Concrete: To be done by a State Certified Special Inspector. Provide inspection test reports to City Building Inspector. Structural Concrete: In excess of 2500 psi. To be done during construction by a State Certified Inspector. Provide results to City Buiding Inspector High Strength Bolting: To be done during construction by a State Certified Special Inspector. Provide inspection results to City Building Inspector, Special Inspection: Weld Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield. Special Inspection: Reinforcing Steel Mill Certificate Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall he provided to the City of Springfield. Special Inspection: Masonry, Mortar, Grout, and Reinforcing Steel Certificates Inspection: To be done during construction by a State Certified Special Inspector with approval from the City of Springfield. Copies of inspection results shall be provided to the City of Springfield. Structural Welds: To be done during construction by State Certified Special Inspector. Provide insp'ection test results to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. Low V oltage: Prior to cover. Low Voltage: Prior to cover. 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 he 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 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. Owner or Contractors Signature Date Page 8 of8 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 8P.J:Q~; . .Wi>~i.J <;a of Springfield Official Receipt .Iopment Services Department Public Works Department Job/Journal Number COM2004-01488 COM2004-01488 COM2004-0 I 488 COM2004-0I488 Payments: Type of Payment Check cReceintl RECEIPT #: 1200600000000001228 Date: 08/09/2006 Description Low Voltage - Commercial Indus + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By SECURECOM Item Total: Check Number Authorization Received By Batch Number Number How Received djb 39017 In Person Payment Total: Page I of I 12:11:46PM Amount Due 135.00 6.75 10.80 13.50 $166.05 Amount Paid $166.05 $166.05 8/912006