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Home My WebLink AboutPermit Electrical 1993-5-7 1 ~ . .-1. .. . I~~' ....- \- 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 r. .' '_ S' /.l./!i1 97/t},L"00 Slgnatura 726-3769 LO~\lHo. OF INSTALl-ATt~^ ,.l-. /( )-1 ~'h f\ \ ~ '_'J\WJ. J I (rB~~rION u~\c() 1. , ~pB D~SCRIP'f..ION +-:-~ ""\ ..q- \ \ k 1\ 1 'Jl t ,l...u().I P2rmits are non-transferable and expire if vork is not started vi thin 180 days of issuance or if vork is suspended for l80 days. CONTRACTOR INSTALLATION ONLY / Blec ical Contractor / City " Supervisor Expiration Date Constr Contr. .~ .Date of Supervising Elect~ Ovners Nanl~ ~LI r-laA.~f"t\ . Address {()q~ l 1J\ C 9\ ~ Ci ty M. p ft. Phone _iJ!J(9-1f;2 ] O~- ~~TALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. ~ DATE~--~P)~-F{-q~ RECEIPT II: ,;1- JC<,~ RECEIVED BY: (--.::\A.f)(;::(-", ~). . :J'I\'\- City Job Number 3. COMPLETE FEE SCHE~ULE BELOIl A. Nev Residential-Single or Multi-Family per'dvelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 85.00 $ l5.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less $ 50.00 20l amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over lOOO amps/volts $300.00 Reconnect Only $ 40.00 C. Temporary Services or'Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.0D $ 55.00 $ 80.00 see liB" above D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit ~ Each Additional . ~ Circuit or vith Servi~ or Feeder Permi t ~ $ 35.00dCS lv. $ 2.00,11 E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited .Energy/Comm not included) 5. $ 40.00 $ 40.00 $ 20.00 $ 36.00 4\CD jiJJS 4':.z . r'F::... SUBTOTAL OF ABOVE 5% State Surcharge TOTAL , .1.. ,'''k . . Permit No: q ?JO;::).~ Address: lL"A~<,.~ \..7JA oft Issued by: (:!fllf)\_~ Date: o111Q~ , / (- FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 101.055(4), requires residential construction permit ,applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued, This state. ment is required for residential building, electrical,mechanical, and plumbing permits. Licensed Architect-and Engineer applicants, exempt from registration . under ORS 701.010(7), need not submit this statement This statement will be filed with the permit . Fill i.n t?7 applicable blanks, and initial. boxes'1 and 2, and either box 3A or 3B: 1. ~. I own, 'reside in, or will reside in the completed structure. . I 2. I I understand that I must register as a construction contractor. if the structure is sold . or offered for"sale before or upon completion, 3, A.I I My .general contractor i~ Contractor registration number '. I will instruct my general contractor that all'subcontractors who work on the struc- ture must be registered with the Construction Contractors .Board, . OR I ~ ." '.. 3. B.~I will be my own-B....~,-c.~ contractor. . . I -If'l hire subcontractors, I will hire only subconiractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office i~suing this building permit of the name of. .the contractor. .1 hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the ""~'~;;m~,;t~ . Sh#3 . l~"""" olP",," A""'~l - . D", CONSTRUCTION 'CONTRACTORS BOARD 0244J 8/91 , . ~ "," , '.. WHITE COPY TO ISSUING AGENCY PERMIT FilE PINK COPY TO APPLICANT . ~"". . INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES ,/ . .. NOTE: This Information Notic~ to Property Own~rs About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If ybu are acting as your own'contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent ro,any problems by being aware of the following responsibilities and areas of concern. ,- EMPLOYER RESPONSIBILITIES:' If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you' wiH,in most instances, be ruled to be an "employer" and the peop'le you hire will be "employees". As tre employer, 'you must comply with the following: . , , . ' , , . Oregon's Withholding Tax Law: As an employer, you must. withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division DHR at 378-3224. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be'liable for all claim costs if one of your employees is injured on the job.. For more information, call the Workers' Compensation Division DIF at 373-7434. U.s. Internal Revenue Service: As a[l employer, you must withhold federal income lax from employees' wages. You will be liable for the.tax paYme'~teiien' if y'o.u~idn:t actually withhold the tax. For'more information, call the Internal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: . '~~-"" ;. Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought..to your attention through inspections. Liabiliiy and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done, Time to Supervise Employees: Make sure 'you have sufficient time to supervise your employees, Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough.in and finish trades, and to notify building officials at the appropriate times so' they can perform the required inspections. If you have additional questions, write to: Construction Contractors Board 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 " . Phone 503-378-4621 0244J 10/24/89 "1- i'4 ., ' " .1, '. ..I. ; 1 . ,:,~ ') "r~ "'1