The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 1997-4-22 , , ... . ...... ...,..,... ,...., """. ,. zoning, and does not roquire specific land use approval. Zoning L D p..., Data 1/2.7 /fitr- ,/ A v1/l 225 FIFTH STREET Authorlzod Slgna;ur. ]V JA' l SPRINGFIELD, OREGON 97477 . INSPECTION REQUEST: 726-3769 OFFICE: 726-3759 1. ~f)G'F I~~~X\ \lll~tj[9'~ tJ"\\oC1i ~~ -7' :\~ ,..,." 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. ': CONTRACTOR INSTALLATION ONLY E1~ci~ical Contractor Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name R ObFg---J"::r ~ILIJR. Address '2-'37 Ct D n Q,rJ Dc. h )1 , ~ City.~INqF,rf)rJ. Phone '1Jf/--/73o OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: ;:/ /?~; / ~.w4v DA~E~~--~--~~)T~~~~------------- RECEIPT #:_ - i ?_r~~-O RECEIVED BY: f~ ELECTRICAL PERMIT JirPLICATION City Job Number lJ\~l[)~\~ 3. COMPLETE FEE SCHEDULE BELOII A. New Residential-Single or Multi-Family per dwelling unit. Service Included: ' It ems Cos t Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'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 amps to 600 amps 601 am~s to' 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'OT less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 100u $ 40.00 $ 55.00 $ 80.00 volts see liB" above D. Branch Circuits .' New, Alteration or Extension Per Panel One Circuit / $ 35.00 ~s. (Q Each Additional Circuit or with Service ~.ee or Feeder Permit ,/, $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE "3.1. s;.!!C. 5% State Surcharge \.,"l:!. ... 3% Administrative Fee \\~ TOTAL ~..,. (" .- ,. _.oF \, .. - Permit #: . Clr\o aY::) rim CA \'iJyf\f)QY\ Address: Issued by: Date: 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 the Construction Contractors Board to 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: ~ [WI 1. 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. D 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 ~ 3B. I will be my own general contractor. If I 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 pem1it 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 Notice to Property Owners about Construction Responsibilities on the reverse side of this form. (~ M ~gnature olQ'ermit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) . e ./ :'1. Hnfo~maltion Notice to Property Owners , About Construction Responsibilities Note: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors BOll/YI in accordance with ORS 701.055(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structurc, you can prevent many problems by being aware oftbe following responsibilities anll 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 will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply witb tbe following: Oregon'switbbolding tax law: Asan employer. you must withhold income taxes from employee wagesatthetime 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 Dept. 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 infonnation, call the Oregon Employment Department at 378-3524. 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 subje.ctto.pen'lltiesand will be liable for all claim costs ifoneofyouremployees is injured on the job. For more information. call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S.loternal Revenue Sen'ice: As an employer, you must withhold federal income tax from employees' wages. You will be liable fort he tax payment even if you didn't actually withhold the tax. For more information, call the Intemal Revenue Service at 1-800-829-1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project. YOll are responsible for resolving any fa i lure 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 insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures. fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sllre 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 ihey can perform the required inspections. If you have additional questions, write or call tbe Construction Contractors Board (PO Box 14140, Salem. OR 97309-5052, 503/378-4621). The Board is located at 700 Summer SI. NE Suite 30Q"i!!.Salem. prop.own,pm4 1/94