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Home My WebLink AboutPermit Electrical 2004-12-6 I " I I' I SPRI~ ;~6~~~~=;;;~d:':;;~~PH:(541)726-3753 . F~,(~~::~~ .~ CityJobNumber~zooc(-OIL(Z.b Date rz Qc=.O.+.{ &~O"'i,g 1'69~6",;it., . ~r.' '- '.. "0'< I..>.... "' 8, 'J~_ e 'j 3. ~PMP.f,f:rEFEES~1W!~~~i;ii,;~~~7'-1 A~;::':Y,jjl''';;:~'~~* 1000 sq. ft. or less ~, Each additional 500 sq. ft. or portion thereof Pump or irrigation Sign/Outline Lighting OWNER INSTALLATION MOYle.:' Limited EnergylResidential uE W"nv 1\1 I !;;. . " "r"::JIO~ IF.ln ~"" The installation is being made on property I own whiehJIS PERI~1,r1l1%~\liilergy/GommCl'C1al\1 IS ~:'::T . . d d' I I Iii ,..,''cO TI-II' eERM IS not mten e .or sa e. ease or rent. AU1'Mlnliilum Electric Pet'iitlt..I. n..spection'Fee Is $45.00 + Surcharges i IV"'-:--,_, r\<"\.\('. .~~I\"H H I.\'<ICY IV" COMf04l:I'i.s;}h,.l~' ' ~OFABOvE . ,". ' I l{ h ANY lM~J....,t<L~'h,' . " 7% State Surcharge '3 'Z Z 10% Administrative Fee IIbO 'S"?Bt ~ - 1. F LO~t.!6N OF iNsTALiAnoN, b o,'SS- /VlA 111/ .~T LEGAL DESCRIPTION /70'Z.. 353"3 DboOO JOB DESCRIPTION . AbD 2. c.... 4. c.- -, -t ~ Permits are non-transferable and expire If work Is not started within 180 days of issuance or if work Is Suspended for 180 days. 2. l'q)~crOR_ijvstA,LLA"~()N PNAi''] Electrical Contractor II; -tatl E I e. c\;-,'c.... I C'LO J\ A Address .:> \D HC," c.,'C>..... \Ie... City bu q.lj\.L v Phone '-/9 L{-1't3/Jo Expiration Date So Sln.5 /D/,/'2o",'7 \~S'tlIS- 0/ n 1"5 Supervisor License Number Consb'. Conb'. Number Expiration Date Signature of Supervising Electrician C\~"' -i.!. ~C? Owners Nam;))/r\ld\ "".,vlUL. p/o~ . / Address 40b{t( ~ClIt"""'l' ~'''f:'tt... ~, City #1rt1..c..OLA Phone Owners Signature: Inspection Request: 726-3769 $19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. r~slrir!.~~,:o!;"F~~~~_s~&t~~4(i~firi~'~'.AJter~ti~nrOrl.~el~~~;'~~'81 200 Amps or less $ 63.00 201 Amps to 400 Amps I ._<".,.(..~ j~ 401 A~ISIi'iJ~ppregodnba.U~ ~-~:on~~gllty "J",~ :irlopte y.- -. -.. 601 AtJltl~llIhJwj\mps ThoEll rill,,!; ariJ169illDrth Overtioollil\I\lilSIYQt~~~~~1 0 thr^' ''Jh O;15:rea>6l01. Recoitn0iW6My52-00 I bt' C' _ .:~ ^f 1h\J~OOS bit Y va 81n ~l"" 99,90. au ma, ". -.t~+ol"1."Il'Jl'nll C. r;t~blJ::~:tm;~J:~gl~\i~:13~~r~ Installation, A1t6iillWa,sRell,~a~n 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. ~ij~c~':Circilits'~ -::~,.'~~'~~~;),::;I;~i ,'.... -"1 New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit 1 $ 43.00 I $ 3.00 f.l1 '3 E'!"'!\l.cellane9us'(Servicelfee.de;nO\ iu~lud~d) ':'~~ci. In"!;dl2iio~ I $ 50.00 $ 50.00 $ 25.00 $ 45.00 TOTAL Shared Drive(T:YBuilding FonnsIElectrical Permit Application 1.(l3.doc -~~ . . l..u t' OF SPRII'it.t<u<..LD Building/Combination Permit PERMIT NO: COM2004-01426 ISSUED: 11118/2004 APPLIED: 11/18/2004 EXPIRES: 06/06/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6955 MAIN ST ASSESSOR'S PARCEL NO.: 1702353306000 Springfield TYPE OF WORK: Heating System TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Gas furnace Owner: DAVID VANDERPLOEG Address: 40014 MOHAWK RIVER RD MARCOLA OR 97454 Phone Number: 541-933-2717 I CONTRAC,v",m"ORMATlON I Contractor Type Electrical Mechanical Contractor TRITON ELECTRIC MARSHALLS INC License 155875 25790 Expiration Date 06/1312005 1212312005 Phone 541-484-9800 541-747-7445 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: R:. S~ ~t 2,,!:d.,lf\oor10R\\ Water Type: ~Ol\C&. \-II\LL E~q\FEBas~nl~hl: NOl Range Type: 1\-11S PERMll ~NOER \~\I~(6li';~1&C)rport Energy Path: ~Ul\-10RIIEO" ~~r.t,Q~l)w FO\{ Sprinkled Buildine:\MENCE['ntaR IS I\Occupant Load: vu'1" _ ... nC.Q\(\[). . ..., . -'\ "... . I DEVELOPMENT INFORMA.'nON I REQUIRED PARKING R-3 Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: ATTENTION: O~~tll\\t~l'llf\lJ6'you to 1'01101.'1 rubs sdoptOO by iOO Or0Qon Utility ;u~;::~~~~~;;Q~~O~ 0090. You may obtain copies ciI the rules bV Sidewalk Type: calling the oonte~ (Nota: tile telephono DownspoutslDrains: U1umber for the Oregon Utility Notificatioo Center Is 1-800-332-2344). Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Speciallustruction: Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pagelof2 ~Wi~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Appliance Vent Furnace - up to 100,000 btu Minimum/Adjustment Mechanical + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01426 ISSUED: 11/18/2004 APPLIED: 11/18/2004 EXPIRES: 06/06/2005 VALUE: Total Value of Project Fees PllidJ Amount Paid Date Paid 11/18/04 11118/04 11118/04 11/18/04 11118/04 11118/04 1216/04 1216/04 12/6/04 12/6/04 Receipt Number 1200400000000001628 1200400000000001628 1200400000000001628 1200400000000001628 1200400000000001628 1200400000000001628 1200400000000001695 1200400000000001695 1200400000000001695 1200400000000001695 $10.00 $4.50 $3.15 $6.00 $12.00 $27.00 $4.60 $3.22 $43.00 $3.00 $116.47 I Plan Reviews I To Request au 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 followiug work day. Uelluired Tnsnections I 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 bave carefully examined the completed application and do hereby certify that all iuformation hereon is true and correct, aud 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, aud 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 compliauce 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. Owner or Coutractors Signature Date Page 2 of2 225 Fifth Street Springfiejd, Oregon 97477 541;726-3759 Phone . .P~R'NQ.~.~U'I, WiL . , i I ~... -" ".._~"~-' ... Jiiily of Springfield Official Receipt _elopment Services Department Public Works Department RECEIPT #: 1200400000000001695 Date: 12/06/2004 1:34:08PM Job/Journal Number COM2004-01426 COM2004-0 1426 COM2004-0 1426 COM2004-01426 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 3.22 4.60 43.00 3.00 $53.82 Amount Paid CreditCard TRITON ELECTRIC djb 364919 In Person Payment Total: $53.82 $53.82 12/6/2004 Page I of1