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Home My WebLink AboutPermit Building 2007-8-16 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01081 ISSUED: 08/16/2007 APPLIED: 07/20/2007 EXPIRES: 02/16/2008 VALUE: $ 60,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1007 HARLOW RD ASSESSOR'S PARCEL NO.: 1703223300400 Springfield TYPE OF WORK: Medical Office TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: Third floor remodel. Owner: WILLAMETTE MEDICAL CENTER LLC Address: 541 WILLAMETTE ST #106 EUGENE OR 97401 Phone Number: 541-686-1807 I CONTRACTOR INFO~MA TION I Contractor Type Contractor License Expiration Date Phone Architect BERGSON & DELANEY 541-683-8661 General MElLI CONSTRUCTION CO 63771 02/12/2008 541-485-1417 Electrical ROBS ELECTRIC INC 156678 08/14/2008 541-686-5444 Mechanical COMFORT FLOW 460 06/27/2009 541-726-0100 Plumbing BARON PLUMBING INC 147744 05/1412009 541-935-1081 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: B # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: lIB n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: I PUBLIC IMPROVEMEN!MI:,mON: Oregon raw requfres you to .ow rU~~~t~~y the Oregon Utility Notification Center. Triose. rules are set forth In OAR 95~OO~~ OAR 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 1-800-332-2344). Storm Se~'~le: Special IDf~~tmMIT SHAll EXPIRE IF THE WORK Notes: AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Pae:e 1 of 3 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01081 ISS UED :08/16/2007 APPLIED: 07/20/2007 EXPIRES: 02/16/2008 VALUE: $ 60,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 60,000.00 Value Date Calculated Description Total Value of Project $60,000.00 $60,000.00 07/20/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Comm/Ind/Public $293.31 7/20/07 2200700000000001172 Plan Review Fire & Life Safety $180.50 7/20/07 2200700000000001172 Total Amount Paid $473.81 I Plan Reviews I Fire Department Review 07/25/2007 08/13/2007 OK GRG Plans Review: Third floor nurses station remodel. Job #COM2007-01081. Fire extinguishers shown on Plan Sheet 2/A1. Will verify on inspection. Initial Review 07/23/2007 07/23/2007 APP LLH Initial Review 07/23/2007 07/23/2007 WI LLH Computers not working. Unable to print information to process application. Planninl.!: Review 07/25/2007 07/30/2007 APP EMM Public Works Review 07/3012007 07/30/2007 APP JHJ Attached SDC Worksheet. No New SDC's. (JHJ) Structural Review 07/23/2007 07/30/2007 WI JMP Received 7/25/2007 with multiple projects and a backlog. Structural Review 08/14/2007 08/14/2007 APP JMP Received final internal approval. SUB Review 07/25/2007 08/03/2007 APP JF No energy code issues or inspections. To Requestan 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. UeouireCUnsoections . Framing Inspection: Prior to cover and after all rough in inspections have been approved. 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. Pal.!:e 2 of 3 CITY OF SPRIl'ltJ'f11ELD . Building/Combination Permit Status Issued PERMIT NO: COM2007-01081 ISSUED: 08/16/2007 APPLIED: 07/20/2007 EXPIRES: 02/16/2008 VALUE: $ 60,000.00 . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-367~ Fax 541-726-3769 Inspection Line Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work 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 ofany 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. ~ A. -r~' IJ~~ (-&; -07 / Owner or Contractors Signature Date Pal.!:e 3 of 3 ~ 0- <<I '0:/" (]) 0 0 0 0 e 10 I"- 0 Z '- ID /l,) .. ID ...... t- (/) '- CO /I) /I) ..... l"- e 0 (\I (") .... ::z: ::;) .""')' - Cl UJ 3: - City of Springfield Community Services Division 215 Fifth Street Springfield, OR 97417 Telephone: (541) 726-3759 Fa."'i: (541)726-3689 I ~? fV")' - O.lP:6 \ " - '(. r" ':. ,J)7/1,L)J 07-\' ~'" Building PenniL II !Date .. ~~ ~OOv\~L ~ . Projeel1'i\le lC01 ~\N f2-0f\"D Pmjed Addrt!ss c c;;> "- ~ ~.:l ....... N <;;> C> -1 ~ (...> r>> 0> Special Inspection llod TESting ~ >-: . . . To nppliGilnls ot'ptojcclS requiting spec~aJ Dup<<liofl or te~log 31$ pet Section HOot aflhe Oregoo Slmdu",1 Spednlty Code. Pl~se reVteW' (he illfornmlKlf1 below. WJti:Ir Jtl\l 11ll\"e ' ftMsbed, adoowicdge an l..i':~.~g orlbe iOfonnalion b,!" 3igning below, and retum dW I'umIlo the City. " BEFORE A PERMIT CANBI lSSUiD: llrc owner or G\mers rt:presenlDfivc. on the advice.oJl~ respons;ble Projro. Engin~~r or Adileo. shall carnplete, sign. ood submiK to tbe CilJ for. - :..v:and ""'f'"'' ..\1 thb fonn cO/JIpicl~ 00 both the fnlnland bL\dc.. . . CJ. .""" ....... C) Co (...> .~ ...... Co> '0:> The owner und GencTal COIllrm:fot, whm: i1pplicabh:, 3hallilbo ~koowlellge the fuUowJn~ cunditions app]K;ahIc to Special r~tjim <lIUJlorTesliog. 1. C{)nlril~1Or- i:s rcpD!!$iWc fm- "'0""- noliflQuon rg,.1he J~pecthm or TC5ting ontcm.lli~ted. 2. Tcstirlg Jabofoa!my shall lake Olppfopriale samples and IT.l/lspmllh~ to Ihcir labocatory ror prOllerevalLitt1i(J[\ OIlCsting.. ~ ;::; ;l> · Copies ohIl bbllI1llury reporls lmd i,..... ~wtjons are lo be $till Co lhe Ol)" by l11e TC5'l~AgCl'J>.)'-. 3. Spccillll~ijon AgC'KY is tQ submlll1:lm~ _ qUillilicaUons of on-sire Spti:ia1IRspetlon to I.he Oty tbr~rovilL 4. Specjollos:pa:lQT willI provide imJ'tcthm rcpod3 to ltie buildi~ cfficilll of allil1~lptcljon tlCti.'ities.. . S. COJlloolJr i3 n:s[JOflSible 10 re\lie\y the City i1pprolled plans. fur addiliollal wptttXm 01' kslil1g ~iJemcfll:5 tlt.a1ltlay b< noted.. BEFORE A CmTJFl CA 1"E OF OCCUPANCY WiLL BE lSS liED: The 5pednl raspectio 11 Age.nc:y shall submit 10 !ht: BuiJdirlg omdi1lIl~e.mro\ (bill all il.t:ms requirin: ilspeclfon have been Juili~cd nnd reported and \\'ere tLlllu: bc~ of the inspector's koowltdge, in COl:tfiJnnM\CC with Ih~<lIl~."".tI pIons. ~pecilkatiom iI1d appli1:abk wOO;man~ . provisions. Thme ~ no! tcsftd IlIlIffor impcdeihball be noted ill 1M 3tl!1emQll. The _ "'to ..~ is to fle rubmittcd to the City priorlo II request for frnal insp;dions. ACKNOWLEDGE~IENTS .~G~ Owner Name (Printed) ~D~~' Engineer or Architect Firm (prin~) ..~A" Testing lll'ol1ra\ory Name (Prlnled) 0.~ OWner Sig11~ . 9iM", ~1~AA ' Enginecu- ~'''~Sig~aturt ,. r r t - ~... Te.3Iing Labondory Rep. Signature ::l;; e cr; -u. C{:;:l L \..' .~.,\ (p. (t~ -IV~ \) Reinforced Concrete, Gunite, Grolll and Morlar: Concrele Gunite Gronl I . ~ar i/' /1 / "I,,)l{< ./' '/" ' I ./' /' I //1 I Precilsl/Pre-stressed Com:rete: 1 Pile.s Post-Tens I Pre-Tens f I Cladding . / / /' I I I I I I I I I ! - ./ 1iI- ../' ~,,/' " I /" / / / / , SMOKE CONTROL: rJfrAe<lkage lesling / Control Verification /' ROOFING: !dMnsuJation inst.a lIatiorvR-Valuefo / Test sfripslseams SPECIAL lJ.'iSPECTION Ai'iD TESTI1'iG SCHEDULE Al!,.grel!,ale Test of Mix Design ~inron::in,g Test l'vlix Desi~-Weighrnm;ler Cerl1< Reinforcing Placement Continuous Batch Plant Inspect. I Inspcct Placing Ca:st Slim pies - Sam pIes [Pic kULVDelivered) I Compression Tcst~ ~/ / GRADlNG. EXCA V A nON, AND FILL Acceplance'tesls ~ Establish 1i nal grade , Fill placement inspectiolllcon(inuou~ ' Soil Densit)' STRUCTURAL STEELI\VELDJNG: ample and test tlisl specific members belmv) Shop material identilication (mill cert) Weld inspection Shop Ultrasonic inspection Sbop High Strength Bolting Shop A325 _N _X 1\490 _N X Mctul deck welding inspection Reirllorcing Steel welding inspection Reinforcing steel mill certitlcnte Metal stud welding inspectioll Concrele insert welding inspection lvloment resisting sleellrames , 4.ggre,gnte T esls LReintorcing Tests rTendon Test , Mix Desip;ns" Reinlorcillg Placement I Insert PlacemenL Concrete Batching COrlcrete Placement Illstallation Inspection Cast SUnloles I Pick-ull Silmvles Compression Tests ~'~ / / / / / , FIREPROOFING: #l'lnCement inspection Density lests Thickness tests / Inspect batching . I #- / ADDITIONAL INSRUCTJONS, OTHER TEST, & rNSPECfJONS: 5O~P~Dep Gel,u Nh COe.tJ) Form Completed by: .PROVIDE STRENGTH REQUIRED BY ARCHlTECT OR ENGINEER OR CONTRACT DOCUi'rIENT LOC.-\TlON OFVALUES l'SF T/Cpsi Field Field Field F _F Date CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET JOURNAL OR JOB NUMBER COM2007-0IOS] NAME OR COMPANY: Willamette Medical Center LOCATION: ]007 Harlow Road MAP & TAX LOT NUMBER: 17 03 22 33 00400 DEVELOPMENT TYPE: Interior Remodel NEW DEVELOPED AREA (S.F.): EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURFACE (ST): ]. STORM DRAINAGE IMPERVIOUS SQ. FT, 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: ~OO x 0 B, IMPROVEMENT COST: 0,00 x ;2. SANITARY SEWER-CITY (see reverse side) A. REIMBURSEMENT COST: NUMBER OF DFU's 0 B. IMPROVEMENT COST: NUMBER OF DFU's 0 *No New SDC's ]TE: ITE: LOT SIZE (ST): x No New Impervious Area $ 0.346 PER SF TOTAL STORM DRAINAGE SDC:' No New Fixtures x $ 26,S33 PER DFU x $ 20.404 PER DFU $ 47.24 TOTALLOCALWASTEWATERSDC:' $ x o $0,00 I $0,00 I x $ 20.43 PER TRIP NTF o NTF $ 90.10 PER TRIP x x o x $ 20.43 PER TRIP x o $0,00 I $ 90.10 PER TRIP x 0 NTF $0,00 I $ 110.53 TOTAL TRANSPORTATION REIMBURSEMENT SDC: TOTAL TRANSPORTATION IMPROVEMENT SDC: TOTAL TRANSPORTATION SDC:I $ I No New Building Square Footage o x 4. SANITARY SEWER - MWMC NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's B. IMPROVEMENT COST: NUMBER OF FEU's 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) NTF 0.00 #N/A PER FEU #N/A x 0,00 #N/A #N/A PER FEU x x #N/A PER FEU #N/A x #N/A PER FEU #N/A TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: TOTAL MWMC SDC:I #N/A SUBTOTAL (ADD ITEMS ],2,3, & 4) I #N/A 5. ADMINISTRATIVE FEES; BASE CHARGE (SUBTOTAL ABOVE) Jesse Jones Civil Engineer, EIT $0.00 #N/A #N/A #N/A #N/A #N/A x 5% '#N/A TOTAL SEWER ADM]NISTRA T]ON FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: TOTAL SDC CHARGES 7/30/2007 DATE #N/A #N/A #N/A 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) Interior Remodel FIXTURE TYPE BA TIITUB DRlNKING FOUNT AlN FLOOR DRAIN, FLOOR SINK INTERCEPTORS FOR GREASE/OIUSOLIDSIETC, INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB CLOTHES W ASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRlGERATOR/WATER STATION/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 LAVATORY SINK: SINGLE LA V A TORY/RESIDENTIAL BAR URINAL, STALUWALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDU'S* FIXTURES UNIT NEW OLD EQUIVALENT 3 I 3 3 6 2 3 6 12 I 3 2 2 3 2 2 I 5 6 3 DRAINAGE FIXTURE UNITS o o o o o o o o o o o o o o o o o o '0 o o TOTAL DRAINAGE FIXTURE UNITS = I 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 SEPARATELY 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 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) YEAR ANNEXED 1992 1993 1994 1995 1996 1997 1998 1999 ,2000 2001 2002 2003 2004 RATE PER $1,000 ASSESSED VALUE $1.45 $1.25 $1.09 $0,92 $0.72 $0.48 $0.28 $0.09 $0.05 $0.00 $0.00 $0,00 x x CREDIT TOTAL $0.00 $0.00 $0.00 '225' F:ifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0 1 081 COM2007-01081 COM2007-01081 COM2007-01081 COM2007-01081 COM2007-01081 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description Building Permit Miscellaneous Mechanical ~Mechanicallssuance Fee~ + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By MElLI CONSTRUCTION City of Springfield Official Receipt Development Services Department Public Works Department 1200700000000001053 Date: 08/16/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received IIh 037657 In Person Payment Total: Page I of 1 1:04:32PM Amount Due 451.24 50.00 20.00 25.06 40.10 50.12 $636.52 Amount Paid $636.52 $636.52 8/16/2007