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HomeMy WebLinkAboutPermit Electrical 1993-10-22 "'1- .:;.. ;;. The followIng proJ ct ,.' 2oning, and does ~ot ~: s~~:sltted. ~as the followl 225' FIITH STREET' approvlifl.-", q . peclflc land ulltLECTRICAL SPRINGFIELD, OREGON 974}7 ',Zonin ~ 0 () INSPECTION REQUEST: ' 726-3769 g, , ~ OFFICE: 72i>-3759,' 'Date Ib b.))~ 1. L~tI,9t\ OF ANST~Tr8~ize~ S','gF\ure , h~ -4y-J\ \. 'J Qr\\ 0 f\ f'\ \ 0.\1 PERMIT APPLICATION , CityJob Number c;(J> 1620 rd.-~erq3 3. COMPLETE FEE SCHEDULE BELOV " V j) New Reside\1tial-Sirigle or Hul ti-Fall!ily perdwelling uni t. Service Included: LE~ DES~ION \f')O:J~{(7q~) \'~<6ro ~OB DESCRIPTION(\ Ot.. n) ~ JQ. Q ]) L0 Sl) \.~~\f1.~Y Perm~ts are non-transferable a~ ~xpire if work is not started within 180 days of issuance or if work is suspended f r 180 days. CONTRACTOR INSTALLATION ONL Contractor Address / City Supervisor Expiration ~ ure of Supervisiug Elect' · ::::::sN~~~~ ~-r$tnIK. D. City F'l ~ Phone-rtto,..CT[tllp OVNER I~ALLATION The ins tallaJion 'is beirigJianF' o~ pro~~I-G-T,(f: 'A'l-i~ot in tended' 0i sale, lea~e or re~t.~~ " ' , Owners Signa ture: 'V~~ "'. ' ~ '11~' >I- ~E~-~---~----~:-{()-~~-~ RECEIPT .: 1\ iJ ,,\( )\ D'\! RECEIVED BY: (7) lL){t).... ..J ' , I terns Cost Sum 1000 sq.ft~ or less Each additional 500 ~q. ft or portion thereof Each Hanuf'd Home or Modular Dwelling' Service ,or Feeder $ 85.00 $ 15.00 $ 40.00 B. - Services or Feeders Installation, Alterations or, Relocation: 200 amps or less 201 amps to 400 amps 401 ~mps to 600 amps 601 amps to, 1000 ~mps Over 1000 amps/volts Reconnec t Only' L $ 50. OO.eJ.)' $ 60.00 $100.00 $130.00 $300.00 $ 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 , $ 40.00 $ 55.00 $ 80.00 volts see "B" abo've Branch Circuits New, Alteration or Extension Per Panel One Circuit ,Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 5. Misc~llaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res' $ 20.00 Limited Energy/Camm $ 36.00 SUBTQTAL OF ABOVE c:::"~,\ ro "-"I . I 5%' State Surcharge '-, ~O TOTAL (~lJ .00 l::'" Permit No: , CBl Co 20_ Address: 83q ~~Q 0 . Issued bt:J((['J6-) Date: (O:JQft~ --.., FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(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,~ t1jra~pliCable blanks, and initial boxes 1 and 2, and either box 3A or 3B: 1. I )( I I own, reside in, or will reside in the completed structure. ./ 2. I I understand that I must register as a construction contractor'if the structure is sold or offered tor sale before or upon completion. 3. A.I I My general contractor is -, 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 ..-A-::c I _ _ n - ,,/ '\ oO\OVJ~ 3. B..I \/ I I will be my own 9"=11--n-! contractor. /""-. It I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. It 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 issuing this building permit ot the name ot the contractor. I 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 reverse side of this form. ~'ill ~ -P,~~~, (!-nafU\e of Pem\J{APPllcant J CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 )0- Z- '2-' ~,3 Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT .. -"l.-. ...,. INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE~, This fnformati.on Notice toP.roperty Owners About Construction Respon~ibilities was developed by the CO,nstruction Contractors Board in accordance with ORS 701;055(5), . , ' passed by the 1989 Oregon Legislature. , I , \ . If you -are acting" as your own COhfractor to construct a new home' or make a substantial improve~ent to an existing structure, you can preve!1t many problems by being aware of the following responsibilities' and areas of concern.---' <.'. . . ' EMPLOYER RESPONSIBILITIES: ".;,'; If you hire pe~sons not registered with the Construction Contractors Board to do labor in <:;onstructing or assisting in the constructio'n or improveme.nt of a residential structure, you will, i.n most instances, be ruled to be an , . '" . . . .. . 'il"" . ,', ' "employer" an.d (he p.eople yo~ hir~ wi,lI b~ "emproyees'.':.As tti.e empioyer:youml,.ll;lt c~mply with the following: Oregon's With'h61ding Tax !l.,~\(V: As. an, eniploy~r, ypu must withhold inco~e taxes from' ~mployee wages at the time employees. are paid,. 'You will be 1i~,ple.Jor- the tax payments even it ypu don't actually withhold the tax from your employees. For more information, call the Oregon DepartmenJ of, R,evenue at 378-3390. . -, ,:1; - .~-' . ~', , ~ ~ ... '" .' . Unemployment Insurance Tax: As an' employer, you are required to pay" a tax for unemployment insurance purposes on the wages of all,emplo,yees. For mor.e informa!ioni~all the Oregon Employment Division DHR at 378-3224. . ',' 'I Workers' Compensation Insurance: As an employer, you are subject tothe Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fall 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, cal~ th~Workers' C~mp~nsatiOf) Qivision DIF at 373-7434. U.S. Interna! Revenue Service: ,As an ,employer, you must I/I(ithhold federal income tax from employees' wages. You will be liable for the tax paYl'J1ent even Wyou didn't actually withhold the. ta'x. 'FOr more information, call . . '. . , r the Internal Revenue Service at 221~3960. ' " OTHllER RESPONSIBllITDES AND AREAS OF CONCERN: -I' _ ,_- _ ~ ~ _" . ...'...'... Code Compliance: As the permit holder for this project; you'are respoosible for 'res0lving any failure to meet code ,requirements that may be brought to your' attention through inspections. Liability 'and Property Damage Irisurance:Contact yourinsurahce 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 tir:neto 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 S1. Nf, Suite ;300 Salem,' OR 97310-0151 Phone 503-378-4621 , 02'44j 10/24;89 ' ~ '!-" -, :." ...'. , ' , I ....--t