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Home My WebLink AboutPermit Electrical 1999-5-7 ~ ~r NGFIELD T', . oe, allowmg project as s b . ,wnmg, and does not reqU .mltted has the fOllowing apProval. Ulre specific lan'd Use Zoning 1-.f) fI-- 97477 Oete ?- 7 - <t q 726-37Ji,~nzed Signature cIo....J 225 FIFTH STREET SPRINGFIELD, OREGON INSPECTION REQUEST: OFFICE: 726-3759 1. LOCATION .OF INSTALLATION si5'lo chu'O/<ef'. Dr' 1Iftf) 'fft?!r () I.~m JOB DESC~TION ' ~J ~ #~W ct'~c",./J City Supervisor Expiration Number Date ure of Supervising.Electrician Owners Name 5J-~u.e lie.. t"f110^- Address 3~/o Clrel'cYce'l. 01' Ci ty <rJl'! Ylc, (,of (rJ Phone 7f 6 -373 '6 P V' OYNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent: O:;l~ --~------------T.-t--------------------- DATE: r: 17/11 . RECEIPT #: II // <7 HW 3 RECEIVED BY: .w tJ.I./ \ ELECTRICAL PERMIT APPLICATION \,~ L) -Job Number q g'1 3 C; 9 3. COMPLETE FEE SCHEDULE BELO\l A. New Residential-Single or Multi-Family per dwelling unit. Service Included: Items Cos t Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion Permits are non-transferable and expire thereof if work is not started within 180 days Each Manuf'd Home. or of issuance or if work is suspended for 5~ou~dular Dwelling 180 days. ,.." (0Q\),(e 0 llti\\~vice or Feeder . , '\'.',(j''''.lu(' .C< t\'le Ole90 s~t\ort\'l 2. CONTRACTOR INSTA;Ll:AHON ~edb~ elu\eSB~e9"~ijQi:ces or Feeders \o\\01NIU\eS;'~\\'IOS U9\'10P-R ~ lM"!'a~lation, Alterations Elec t rical Con traCh'DI:HicatiOO ~o~ot\'lIOr'eso\ t\'le \ \'O~eloca t ion: '. OP-R9':l ObtaIO""''' .t\'lete\e~,""'tiOO Address '3 I~ "n uma~~n''''I.~l'lot?'i\iWl'lot'~oo amps or less I ;JJ- a\liOg\fl"'~;eOlegO\,J~'2..'2.34A)201 amps to 400 amps fWlP.1\OI\ ,_ ,.800-'3 401 amps to 600 amps OU ceol"" ,- 601 amps to 1000 amps Number Ov~r 1000 amps/volts Reconnec t' Only $ 85.00 $ 15.00 . $ 40.00 $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 s-o C. Temporary Services or Feeders Installation, Alteration or Relocation D. 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts Branch Circui ts $ 40.00 $ 55.00 $ 80.00 see nBII above New, Alteration or Extension Per Panel One~c;ircuit $ 35.00 Each Additional Circuit or with Service 2- Co! or Feeder Permit ~ $ 2.00 not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm E. 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ 7'1- (7) ~, 7(} 2. 2-Z- "/'j.'12.- 40.00 40.00 20.00 36.00 Permit #: '1f/31 3 J-/ 1) d If-dkc...t. J IA/J Date: S/7/~1" " Address: Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with /he Construction Contractors Board 10 sign the following statement before a building permit can be issued. This statement 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 in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: KJ D I. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. o 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR D . 38. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information NotiCP. ~~uetion Responsibilities on the reverse ;e_o~t~; ;m. (Signature of penn it applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) ----..,..-" ....- ~~ .........-.--..~..--~------- '. " .- . ..Information Notice to Property Owners About Construction Responsibilities . Note: This Information Notice to Properry Owners about Constrllction Responsibi/ities was developed by the Construction Contractors Board in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantiaf improvement to an existing structnre, yon can prevent many problems by being aware of the following responsibilities and areas of concem. 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 will. in most instances, be ruled to be an employer and the peopie you hire will be employees, As the 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 thc tax payments even if you don't actually withhold the tax from your employees. For more infonnation, call the Oregon Depl. of Revenue at 945-8091. 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 Department at 378-3524. Worker's compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and mnst obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensatiou insurance, yon 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 infom1ation, eall the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. u.s. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax, For more information, call the Internal Revenue Service at 1-800-829-1040. 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. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insunUlce coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must bc re-done. Time to supervise employees: Make sure you have sufficient time to supervise our employees, Expertise: Make sure you bave 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 "i'I',vl',;ate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (pO Box 14140, Salem. OR 97309-5052, 503/378-4621). The Board is located at 700 Summer SI. NE Suite 300, in Salem prop.own.pm4 1/94 SP-001