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Home My WebLink AboutPermit Plumbing 2011-6-17 Plumbing Permit Application 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 ,....". 'iJ;', "';""">"'."',,;"'", "'.", .... ,,~,"_-i ,..:;- " '.,,,.....>:_;H;':.;i:,:;.~,~.,':<',." ""DEPARTMENTUSE"ONL Y'"\t(f~ . . ,. . '. Date: This permit is issued under OAR 918-780-0060. Permits are issued only to the person or' contractor doing the work. Permits expire if work is not st~rted within 180 days of issuance or if work is suspended for 180 days. . ';'i~"Ti"';~;' '~\iEoCAL~OVERNI\IIEN:r"A.F'pR0VA.li!li!f~'~jh'lgl"ki: Zoning approval verified" 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION Job site address: City~ PFL.. Reference: '~j<.r,~;.:;:~:l;';?:'~~~i~',,:::. ' PlO . Name: Address: City:B{ Phone: Fax: E-mai]: This installation is being made on residential Or farm property owned by me or a member of my immediate family, and is exempt from licensingrequirements under OAR 9]8-695-0020. Signature: . CONTRACTOR INSTALLATION. Business name: :.("\ () City: Phone:S41- E-mai]: CCB license no.: Plumbing license no.: Print name: Signature: \ / C;''7<fot./ BCD license no.: -c/" 440.2500-J (11/08/COM) ;rt,:;,~.._; ;'):~:;~':;0~~.:;;1?~r~;r~:~{1':~E-EE{{S_CH EbtJ l:'Em~~\::t,:i:':~?:SJ~;;{f':i{'\Y:!:~;~~;~Y?:~ ~:'......, ". .. 8%~:';,~~~r~:/{I/j~~}~tt~: New residential I bathrooin/I kitchen (includes: first IOOfeet a/water/sewer lines, hose $23B.00 $ bibs, ice maker, under floor low~point drains and rain-drain packages) 2 bathrooms/l kitchen $374.00 $ 3 bathrooms/1 kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over I) $95.00 $ Residential fire sprinklers (includes plan review) o to 2,000 square feet $5B.00 $ 2,001 to 3,600 square feet $116.00 $ 3,601 to 7,200 square feet $174.00 $ 7,201 square feet and greater $232.00 $ Manufactured dwelling or pre-fab (circle one) Connections to building sewer and $5B.00 $ water supply Commercial, industrial, and dwellings other than one- or two-family Minimum fee $5B.00 $ Each fixture I $19.00 $ Miscellaneous fees 100' storm, sewer, water line $76.00 $ Each fix~re, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19.00 $ systems exceedina the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. ofhrs. x fee per hr.) $5B.00 $ Special requested inspections (no, of $5B.00 $ hrs. x fee per hr.) Each additional inspection: (1) $5B.00 $ ~i~iii)g,;r~ Mjnimum fee $ enter value of installation and equipment $ .'7). 2-<; Enter fee based on installation and equipment value. $ ~1i::g"~~if~'U~~j;p'p'(gi€ANm~US'E~ ,.~~y..';L, <m'oii."".. ',_ hi', "_,,E., ~.l'!.."__, C,"~, '" '", _"Ii _0::'.;' ," ~ *~j:"" (A) Enter subtotal of above fees $ ~'7 ~ (Minimum Permit Fee $58.00) (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [MB]) $ lo'"C!- (D) Technology Fee (5% of[A]) $ Lf'J'~ TOTAL fees and surcharges (A through D): $ (/)2 oT - SP.i.~....I.t.~=L~ ~ ~OREGOtol CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00226 IVR Number: 811133500251 www.ci.springfield.or.us 225 Fifth SI Springfield,OR 97477 Phone. 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 Issued pe rm itcenler@ci,springfield.or.us PROJECT STATUS: STATUS DATE: OS/27/2011 02/11/2011 OS/27/2011 ISSUED: APPLIED: EXPIRES: VALUE: 12/09/2011 $25,000.00 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477-8800 ASSESOR'S PARCEL NO: 1703220004102 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Occupancy Change from 'B' to '1-2'; 2-hour Fire-Rated Occupancy Separation Added Phone Number: OWNER: ADDRESS: PEACEHEAL TH PO BOX 1479 EUGENE OR 97440 CONTRACTOR INFORMATION I Contractor Type Medical Gas Contractor Name TWIN RIVERS PLUMBING lNC BERRY ARCHITECTS, P.C. JOHN HYLAND CONSTRUCTION INC Lie Type CCB ARCHITECT CCB General Contractor Lic No 17695 2822 46071 Phone 541-688.1444 Lie Exp 03/11/2013 06/30/2012 07111/2012 541-726-8081 # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type; Hazmat: o Construction Type Occupancy Type Occupancy Comments Type 1 B 1-2 3rd Floor Change to Occupancy Separation # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: t,TrENTION: Ore fallow rul gon law reolJirp.. , Not'f' ,es adopteLElectrical.s~ec"ll}PliJdl, Edition: I Icatlon C ' -, "'" (J, ego~ ~,'Iit~ in OAR 952 ooenter, T Sprjo91i~IJ!;F~re 0 'ElIition: o - 1-0010Ib." v earth 090, You may obt ' l\IIeCl\llIIidiM;.il'll'~6"'de Edition: C II" am.QOoie t f- a mg the center (IrJl'mtljjaP &~d1l1lml_Code: nUmber f "Ule; Ihe~p.1 b" -Ul Yes or the Oregclllumbing jie~P.r\tyl0Qde Edition: Cente ' v""'j 'iotlfiCalin Yes r IS 1-80~eSrn..e.:!t~~f."clany'1!ode Edition: Structural Specialty Code Edition: Lot Size: Sq Ft 1st Floor: Sq Fl2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: 49 2008 2010 2010 2008 2010 Site Information I Engineered .FiII: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: NOTICE: , . , Soils Report Requiredfj/S PER"JIT I IV SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD, Springfield Building Permit 6/17/2011 2:20:50PM Page 1 of4 SP~~N~.FIE~~ ~<!11 ~OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00226 IVR Number: 811133500251 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 OS/27/2011 ISSUED: APPLIED: OS/27/2011 02/11/2011 EXPIRES: VALUE: 12/09/2011 $25,000.00 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477-8800 ASSESOR'S PARCEL NO: 1703220004102 PROJECT DESCRIPTION: SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial Occupancy Change from 'B' to '1-2'; 2-hour Fire-Rated Occupancy Separation Added Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 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: Downspout/Drains: Valuation Description ~ Descriotion Bid Tvee of Construction NA Unit Amount Unit Tvoe 25,000.00 Bid Unit Cost 1.00 Value 25,000.00 25,000.00 FEES PAID ~ DescriDtion Structural Plan Review Fee Commercial Fire, Life, Safety Plan Review State of Oregon Surcharge (12% of applicable fees) Building Permit Fee Technology fee (5% of permit fatal) State of Oregon Surcharge (12% of applicable fees) Medical Gas Permit fee (based on value of work) Technolo~!, fee (5% of permit total) Total Amount Paid Amount Paid $183.46 $112.90 ----- $33.87 $282.25 $14.11 $10.47 $87.25 54.36 $728.67 Date Paid ReciDt # 02/11/2011 2011000272 OS/27/2011 2011001338 05127/201'''-- .-- -2011001338 OS/27/2011 2011001338 OS/27/2011 2011001338 06/1712011 2011001671 06/17/2011 2011001671 06/17/2011 2011001671 Springfield Building Permit 6f17f2011 2:20:50PM Page 2 of 4 SPr;~~ ~;,\:.~ ' ,.i~;',,,,:,' OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00226 IVR Number: 811133500251 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued OS/27/2011 ISSUED: APPLIED: OS/27/2011 02/11/2011 EXPIRES: VALUE: 12/09/2011 $25,000.00 SITE ADDRESS: 3333 RIVERBEND DR, Springfield, OR 97477-8800 ASSES OR'S PARCEL NO: 1703220004102 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Plan Review Occupancy Change from 'B' to '1-2'; 2-hour Fire.Rated Occupancy Separation Added I Department Application Acceptance Completed 02/11/2011 Result Application Accepted Received Due Date 02/11/2011 02/11/2011 Reviewer Kip Kaufman l~~}~evie",,' .: ..'? ~" 0211'1l2~11F' ,02/!;1(2Q1}, ',0?/lpI2D,1 r App[oV~~ ';;t - ; Gilbert Gordo~ .,:.. kt~o~merts,:;.,.',PI~ns,H~vfe,:,,::occupa~Cy.c1~S~i~~,~t19Q:'chang,e"fromcE3,t9., ,and change w~U~to 2, h~~ur ra!l~g,m.:x[strng ca~dla~ .\ :, ~ ';'. diagnostlc:centeron'thlrd .f!oor Qex\to:8IjVJ~' Job,#SPR2011 ~002?6. Ne~,9ccugancy'CJasslfi<;atlon:'1-2:\Cof1strqctldn, 1 . Type: 'H3-sprinkle'red, Occupant'Jo"ad;for'this' area;~,52., Plans reviewed: under)he'261 O'Springfield Fire,Code, and 20'1 o<~; ., ' ,. "." -,', "',' ,,' ""',' '~'; "',' ~.""" 0/"" ,"" '," " ' 0'. .' ,~,,{'. Oregd~, ~tiuctuffl Specl~ltyCode; , . ./: >d'-: 1~ . ,w ' ~~~, ""; W" " " " '_~ , , ,,' ., 'f' -""_'",,~ ,'", : " " ,,_ '.~" ;"'< 1.^"" ',~:",; ," " Wall "s'epa~~tionra~ing;cwill use th~'UL263'raied2 hour!non-bearlng'~aJ.I.:C!ss,€t,mbJy'y:lith90'rTIinute rated'doo~s'. c ~1~n~'~p.p~5rm::t',code r~~U[;~;';~htS.~l- ";,>:+ t,';Y2-'- f ";Y~:~r~~~:~:~ ' "~.. ' . Public Works Review 02/11/2011 02/11/2011 02/16/2011 Approved M Greene Comments: No SDC changes. Str~ctural Revi."",', 0211112011 '02/1112011,,:0211612011 ..-:'~,.,'."~ '0" ", --'" .' " .r" '; Planning Review 02/11/2011 02111/2011 0211412011 Approved Liz Miller /'" ~ .,' -',h '" " ;" i","J,-' "'_,d ~ Approved Structural Review 02/11/2011 02/11/2011 02/22/2011 Kip Kaufman ~~ Inspection OS/27/2011 OS/27/2011 06/10/2011 Comments: Inspection in process In Process Robert Castile INSPECTIONS REQUIRED I Inspections 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. Ceiling Grid: After drywall approval but prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. 1600 Ceiling Grid 1999 Final Building 8999 Final Fire 3800 Medical Gas Piping Springfield Building Permit 6/17/2011 2:20:50PM Page 30f4 S:~:~..~G:E~. .~\AI>"" . <'0':, ~ ::+>"' OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD . Building I Commercial Permit PERMIT NO: 811-SPR2011-00226 IVR Number: 811133500251 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitce nter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: OS/27/2011 02/11/2011 EXPIRES: VALUE: 12/0912011 $25,000.00 OS/27/2011 SITE ADDRESS: 3333 RIVER BEND DR, Springfield, OR 97477-8800 ASSESOR'S PARCEL NO: 1703220004102 SCOPE: Hospital WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial Occupancy Change from 'B' to '1-2'; 2-hour Fire-Rated Occupancy Separation Added PROJECT DESCRIPTION: 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. 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 loca d at t r nt of the property, and the approved set of plans will remain on the site at all times during cons tion. 0-/7~(L Owner or Contractor Signature Date Springfield Building Permit 6/17/2011 2:20:50PM Page 4 of 4 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 www.ci.springfield.or.U5 811-SPR2011-00226 3333 RIVERBEND DR perm itcenter@ci.springfield.or.us RECEIPT NO: 2011001671 RECORD NO: 811-SPR2011-00226 DATE: 06/17/2011 [DES'CRII~.TION oJ- "if'~t-. C~" ".; .\Y:;~ ">.. 7:1~:~'..j:'h:C.C.bl.iNT~C:6DE . .;;rvtl: t. ';'t AivlbuNT~b(JE- . .oJ I Medical Gas Permit fee (based on value 01 work) 224-00000-425603 87.25 Slate of Oregon Surcharge (12% of applicable fees) 821-00000-215004 10.47 _..2echn~I~~y fee.(5% of permit!otal) 100-00000-425605 4.36 TOTAL DUE: 102.08 L;;EP,il'!1~~LiYPE; ;;,CPAY..OR0'CASHIER:1.tARPEill-ER' '.: 'cOMM~riJ'stl'J?T;'<,,: -''!!iil:~:;..,AMbuNt)'~ID': ' .J Check TWIN RIVERS PLUMBING INC 102.08 31296 TOTAL PAID: 102.08