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Home My WebLink AboutPermit Electrical 1997-6-30 ~/,,~. . . S.ttGFIELD The following project as submitted ros th f II zoning, and does not require specific 18~ 0 0 aporoyal. use . Zoning (~.n. 225 FIITH STREET D,;~ie~':1)'-C\'l SPRINGFIELD, OREGON:t 7 4 77 AuthQjod Sign t (\ I'Y\ INSPECTION REQUEST: \ 726-376~ au~ . OFFICE: 726-3759 ' 1. LOCATION OF IN~TAL~TION & 3 7 Xd Ltr /6/ /I d LEGAL DESCRIPTION J7 f)3 .15 2;.3 0/500 JOB DESCRIPTION U/lCni.ck. SO /TJ 200 Atk45- . 'v ., Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. CONTRACTOR INSTALLATION ONLY ~ ectrical Contractor ~ / .[ City Numbe~ ~ Expi- tion Date gnature of Supervising Electri~ Owners Name G/, dell, ,t'~() f/lmb'1I? Address ;'37 Kd(, If/vd Ci ty 51?' t'J~ ;7Y1"ihone 1'// -() 31 3 OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. ~~2d~ ~~-~M-------------------------------- DATE: I) --.~()-q7 RECEr P 11 : _ U do. (,. -<:"y I, RECEIVED BY: ~) O)YJ (h ;;U:,L,) 3. ELECTRICAL PERMIT APPLICATION ,., .~' 'ob Number ~I 00 L/ COMPLETE FEE SCHEDULE BELOV >f New Residential-Single or Multi-Family per dwelling un.it. Service Included: A. Items Sum Cost 1000 sq.ft. or less Each additional 500 sq. ft or ponion 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 amps to' 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 .t::)O Qu $ 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 1000 $ 40.00 S 55.00 $ 80.00 volts see lTBl1 above ).P~. ftranch Circuits 61fff~ . New, Alteration or Extension Per Panel .' One Circui t Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ 2.00 E. M~llS~eous (Service/feeder not included) -Each lnstallation p~~ ~/i1Hi:S\tAltlili"'PIRE IF THE W~. 00 :34~~Pl~(;l~fJilW"~T Ir.SN;"q.. 00 L..l,III1.t ~..j:.D~ ~nes 'S 'id. 00 L'i'nl'r'~~t.ID'~aIltNuVNl:U FOSt 36.00 ANY 180 DAY PERIOD. SUBTOTAL OF ABOVE . So ,(5V 5% State Surcharge ,:;z .50 3% Administrative Fee J ,SO TOTAL C,LI . m; 5. -../ " . . Permit #: qi! () cI-I- Address: G37 ~ rglvct Issued bY:~ Date: G -j() ~97 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 70 1.0 10(7). need not submit this statement. This statement will be filed with the permit. Fill in the appropriate.blanks and initial boxes 1 and 2, and either box 3A or 3B: " ~ D 1. I own, reside in, or will reside in the completed structure. 2. 1 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 D 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If! 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 han read and do understand the Information Notice to P;:~t a;z;sponsibilities on the reverse Si; :~~s _f;; - -f (Sigmilirre of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) . .. . , ,. ... Information Notice to Property Owners About Construction Responsibilities Note: This Informatio/l Notice to Property Owners abollt Constructio/l Responsibilities was developed by the Construction Contractors Board in accordance with ORS 70J.()55(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many 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 ofa residential structure, you will. in most instances, be ruled to be an employer and the pcople you hire will be employees. As ihe employer, you must comply with the following: Oregon's withholding tax law: Asan employer, you11lustwithhold 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 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. Workers' compensation insurance: As an employer, you are subject tothe Oregon Workers' Compensation Law, and must, obtain workers' compensation insurance for your employees. I I' you fall to obtain \vorkers' compensation insurance, you may be subjectto penalties and will be liable for all claim costs if one of your employees is injured on the job. Formore information, call 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 forthe 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 perm it holder for this project, you are responsible for resolving any fai lure to meet code requirements that may be brought to your attention through inspections. Liability and proper1)' damage insurance: Contacl your iusurance agentto see if you have adequate insurance coverage for accidents and omissions such as falling tools, pa,int 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 sure you have the expertise to act as your own general contractor, to coord inate 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 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.Saleni.. prop-own.pm4 1/94