HomeMy WebLinkAboutPermit Mechanical 2004-11-17
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.- CITY 01< ~rKlNGFIELD
Building/Combination Permit
PERMIT NO: COM2004-01419
ISSUED: 11117/2004
APPLIED: 11/17/2004
EXPIRES: 05/17/2005
VALUE:
Status
Issued
225 Fifth Slreet, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3553 GARDEN AVE
ASSESSOR'S PARCEL NO.: 1802064200500
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE:
Alteration
Residenlial
PROJECT DESCRIPTION: Gas pipe and install of LP insert.
Owner: PARMENTER CHERYL R
Address: 3553 GARDEN A VENUE SPRINGFIELD OR 97478
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I CONTRACTOR INFORMATION I
Contractor ':0<<:-*- ~ License
AMBASSADOR PIPINGI,~,cf ~':0 121469
" , ,- -
I . BUlbDlNG'fNFORMA TION I
9.~-~v.:-'~'V
# of Units: <J:9 ~pfSlories: . Lol Size:
Primary Occupancy Group: R.3>, 'X-"~ ~~eighl of Slruclure Sq Ft hi Floor:
Secondary Occupancy Group: "':>~~~<<:, ~ Type of Heat: ~....O '" ~q Ft 2nd Floor:
Primary Construction TYlle~' if:' VJII ~:~ ':0'\)' Water Type: c,,,,,0 ~# oSq ft Basement:
Secondary conslructiongy'p'e:8' ~'\) ~ \:5 f<-<:f' Range Type: J>f?, 0<:- i;-"I. ~ifF~Garage/Carport
# of Bedrooms: .;j;. ,;J::> '< ':0~ ':ii:-,$ 'If- ~ Energy Palh: ,q,($ O,q,C$ ~q, '0 <>><:>'t~gJ;t Other:
"" ',,::-,,X' ""off ~ '\) Sprinkled Building: ,'1>~ '&oil, ~!,/'l-fl:' ,OcSIi'li"tlt Load:
~~~ ^.~~n~~~
~~~ ' , DEVELOPMENTINEORM1TJON;I'c,~-'~~0~0J
'{' ,~ e ~
~' 0'< .~' /-<' ,'S' ,-~. REQUIRED PARKING
,0 '1>?j ~q," ,,'" 00 ~q,' .~.,., rJ"
Overl~Y-'j)i~!f' cl' ,,5:J'" ~i><:- ~O >;oS X'li
. # Str~q;te.e~(]{qd:' (f) q," 100 ~'O'O
Pa~":D-<;ive-Rg'(C.....q>\ q,~ O,f?, <0<:5
~....,v,,~ ," G e. ~'
% of ot'COverage:~q, ~ .,c,
~ 0" -" "'. ~' ~'
.{:- _,,<>>""_~<:-o, o.,.'~i::-q,.
Contractor Type
Mechanical
Expiration Date
03/27/2005
Phone
541-726-5723
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Selback:
Solar Selbacks:
Tolal:
Handicapped:
Compacl:
..... I" -
I PUBLIC IMPRdvE~ENTS I
Slreellmprovements:
Storm Sewer Available:
Speciallnslrudion:
Sidewalk Type:
DownsponlslDrains:
Notes:
I Valuation Descriotion I
Description
Type of Construclion
$ Per Sq Ft
or multiplier
Square Foolage
or Bid Amount
Value
Dale Calculaled
Total Value of Projecl
Paee 1 of2
,
.
.
. CITY OF ~rK11~ld<1]<'LU
Status
Issued
Building/Combination Permit
PERMIT NO: COM2004-01419
ISSUED: 11/17/2004
APPLIED: 11/17/2004
EXPIRES: 05/17/2005
VALUE:
225 Fifth Slreet, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspeclion Line
I Ff'f's tilW
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% Slate Surcharge
LP Gas Tank & Piping
Miscellaneous Mechanical
Amount Paid
Dale Paid
$10.00
$4.50
$3.15
$12.00
$33.00
11/17/04
11/17/04
11/17/04
11/17/04
11/17/04
Receipt Number
2200400000000001423
2200400000000001423
2200400000000001423
2200400000000001423
2200400000000001423
Total Amount Paid
$62.65
I Plan Reviews I
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.
~ Renuired Inso~
Rough Mechanical: Prior 10 Cover
Final Mechanical: Wben all mechanical work is complete.
Rough Gas: After line is installed and required lesting and capped if not allached to an appliance.
Final Gas: When all gas work is complete.
By signa lure, I slate and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon Is true and correcl, and I further certify that any and all work performed shall be done in accordance with
Ihe Ordinances of the City of Springfield and the Laws of Ihe Stale of Oregon pertaining 10 the work described herein, and
that NO OCCUPANCY will be made of any structure withoul permission of Ihe Community Services Division, Building Safety.
I further certify that only contraclors and employees who are in compliance wilh ORS 701.005 will be used on Ihis project.
I further agree 10 ensure that all required inspections are requesled al the proper lime, that each address is readable from the
street, Ihallhe permil card is located at the front of Ihe property, and Ihe approved sel of plans will remain on the sile al all
limes during conslruclion.
JV\OlJ \1ll~!
Date
'~CkA~~J.""'^ .
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Owner or Conlraclors Sig
Pal!e 2 of2
225-Fifth'Street
, Springfield, Oregon 97477
,I 541-726-3759 Phone
Job/Journal Number
COM2004-0l4l9
COM2004-0l4l9
COM2004-0l4l9
COM2004-0 1419
COM2004-01419
Payments:
Type of Payment
,. Check
.'
It
1111712004
.
RECEIPT #:
6
.ity of Springfield Official Receipt
~evelopment Services Department
Public Works Department
2200400000000001423
Date: 11/17/2004
Descrlpllon
LP Gas Tank & Piping
Miscellaneous Mechanical
-Mechanical Issuance F ee-
+ 7% State. Surcharge
+ 10% Administrative Fee
Paid By
AMBASSADOR PIPING, INC.
Received By
jmp
Page I of!
Item Tolal:
Check Number Authorization
Batch Number Number How Received
8166
In Person
Paymenl Total:
1:47:14PM
Amount Due
12.00
33.00
10.00
3.15
4.50
$62.65
Amount Paid
$62.65
$62.65