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Home My WebLink AboutPermit Mechanical 2004-7-1 . (?Iq .' 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 & -, -~.....~~- ~.; -.-.....-..-,--. ,,-~ . . 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 . a~~~!!!~F]~.." '.._ .0 .... ~. ..~ ; ~. ~--.----. ' 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 r,.,.. , -r;:.- ~ . 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