HomeMy WebLinkAboutPermit Mechanical 2004-7-1
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.' CITY OJ< ~rRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00805
ISSUED: 07/0112004
APPLIED: 07/0112004
EXPIRES: 0110112005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726.3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3463 Hutton
ASSESSOR'S PARCEL NO,: 1703222000805
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: Repair Commercial
PROJECT DESCRIPTION: Replacing existing water heater/identical replacement/connections are the same
Owner: OUTBACK RESTAURANT
Address: 22500 SE 64TH PL STE 120 ISSAQUAH WA 98027
I CONTRACTOR INFORMATION'
Contractor Type
Mechanical
Contractor
AUTOMATIC HEAT
License
149452
Expiration Date
10/2212005
Phone
541-726-7654
BUILDING INFORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# 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 GaragelCarport
Sq Ft Other:
Occupant Load:
nla
, DEVELOPMENTINFORMATION ,
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks: '(\7\78;::';::88'009' ~ S! JelUe~
..""?.......:F....r: tl!!!i~ ":-:::_:,:: :~: ~:. _::~:-....
euoljd9191 9ljl :910N) 'J9.1U9~~iJilMQ~~PROVEMENTS I
Street Imprt~Iit7,\mpljIIO s9!do:> U!lllqo ^llW nOA '0600 Sidewalk Type: .
. WO'?S6 l:I\iO lj5noJljl 0 WOo WO';::S6 l:I\lO U! !:l16i QO/!:l3d A
Storm Sew'1!jjj\Jj'\i!'!P!~\? SEllnJ 8S0lj1 'J81U98 UOllll:>rlIION ION S/I ~6I!'Wt>1iV~i 1:10 a \fa 08! AN\f
Special Instr~M?f1:u059JO 9ljl '\q p8,dope :;8In~ MOl'lOj )l1:10M 3 IWI:13d SIHl 1:130Nn 3:JN3WWO:J
N' 01 no^ s8J!nb8J Mel UC58JO :NOI1N311\i HI :if 31:1fdX3 11\fH a3Zfl:10HlnV
otes, S I/WI:13d S/Hl
...---
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I Valuation DescriDtion I
~V'.LUIV
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Page 1 on
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.
. CITY VI' ~rKll"\ju1'1J!,LJJ
Building/Combination Permit
PERMIT NO: COM2004-00805
ISSUED: 07/0112005
APPLIED: 07/0112004
EXPIRES: 0110112006
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fee~ P.'ilid I
Fee Description
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$0.00
I Plan Reviews I
To Request an inspection caU the 24 hour recording at 726-3769, AU 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 foUowing work
day.
I Reouired In~nection~ I
Rough Gas: After line is installed and required testing and capped if not attacbed to an appliance,
Final Gas: When all gas work is complete,
By signature, I state and agree, tbat 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 berein, 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 wbo 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 tbe proper time, that eacb 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
:Jla:7/~~, ;-1- OV
90wner or Contractors Signature C/ Jate
Palle 2 of2
{. ~ /"
?i5-Fi~h Sireet
_Springfield, Oregon 97477
541-726-3759 Phone
.
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Jiiiily of Springfield Official Receipt
Wvelopment Services Department
Public Works Department
RECEIPT #:
3200400000000000137
Date: 07/01/2004
1:55:53PM
Job/Journal Number
COM2004-00805
COM2004-00805
COM2004-00805
COM2004-00805
COM2004-00805
Description
Fixture
Miscellaneous Plumbing
+ 7% State Surcharge
+ 10% Administrative Fee
-Mechanical Issuance Fee-
Payments:
Type of Payment Paid By
Cash AUTOMIC HEAT
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
lkw In Person
Payment Total:
Amount Due
14.00
31.00
3.15
4.50
10,00
$62,65
Amount Paid
$62.65
$62,65
7/112004
Page 1 of 1
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tJw:J
. CITY VI' ~rIuNGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00805
ISSUED: 07/0112004
APPLIED: 07/0112004
EXPIRES: 0110112005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3463 Hutton
ASSESSOR'S PARCEL NO.: 1703222000805
Springfield TYPE OF WORK: Mechanical Only
TYPE OF USE: Repair Commercial
PROJECT DESCRIPTION: Replacing existing water heaterlidentical replacement/connections are the same
Owner: OUTBACK RESTAURANT
Address: 22500 SE 64TH PL STE 120 ISSAQUAH W A 98027
, CONTRACTOR INFORMATION I
Contractor Type
Mechanical
Contractor
AUTOMATIC HEAT
License
149452
Expiration Date
10/2212005
Phone
541-726-7654
I BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# 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:
nla
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED. PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Dralns:
Notes:
I Valuation Descriotion I
Description
Type of Construction
$ PerSq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Page I of2
'!
r,..:.>
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00805
ISSUED: 07/01/2004
APPLIED: 07/01/2004
EXPIRES: 01/01/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Fp.p.~ PIW.I
$10.00
$4.50
$3.15
$14.00
$45.00
$31.00
$-31.00
$-14.00
Date Paid
7/1/04
7/1104
7/1104
7/1104
7/1104
7/1104
7/1104
7/1104
Receipt Number
Fee Description
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Fixture
Miscellaneous Mechanical
Miscellaneous Plnmbing
Refund - Plumbing
Refund - Plumbing
Amonnt Paid
3200400000000000137
3200400000000000137
3200400000000000137
3200400000000000137
32004000000000000137
3200400000000000137
32004000000000000137
32004000000000000137
Total Amount Paid
$62.65
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769, AIl 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.
I Rp.ouirp.d TnSDP.ctions I
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Final Gas: When all gas 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 of any structure without permission of the Community Services Division, Building Safety.
1 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 reqnested at the proper time, tbat 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
Pa~e 2 on