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Home My WebLink AboutPermit Electrical 2003-5-21 . Status Issued ~ . CJTY OF .sr1Ul'1iul'IELD Building/Combination Permit PERMIT NO: COM2003-00390 ISSUED: 05/21/2003 APPLIED: 05/21/2003 EXPIRES: 11121/2003 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 65 LORIE CT ASSESSOR'S PARCEL NO.: 1703224102900 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: PROJECT DESCRIPTION: Add 3 circuits, 2 hose bibs and storm line to dryweII Addition Residential Owner: VOGENEY KENNETH J & CHARI L . Address: 65 LORIE CRT SPRINGFIELD OR 97477 I CONTRACTvI<.m"ORMATION I VN L. E -"!\Oti D t Ph Icense e' xp t;a on a e one \x J' \j\\\''' ~ xeo.\J. ,,0(1 \ \O~ ,\~\j'l Qxe", e ",e 00\' . oJ\ e9J~~ '0'1 \X\~, \\e"'_~Q, g?~c>", '0'1 I BUlLDING'INFORMATioN.~;o.,y.~X\ "~\ \X\e ~~o(l~ ~ 1'" ..,'v' 0e'" "\" " o<\\e'" \e\0:..c~\\o "0"'0(1 :\ 0" '(le I\" \X\e , .", # of.S~o,~~~s: c.?_OO . ~\~' ~o\e", .:<."I:.otl~lze: H~IgIi~~!\S.truct~[.~'! 0 :<.ex. ~ ~ u\V:.\ ~qIFt"lst Floor: TYP,~.of",l!~at:).,y. X--e ce(l Q,e~O C).~~~'Sq Ft 2nd Floor: Watei,l:Yp.":$I<;'l ~\O,\X\e. ",?p; Sq Ft Basement: 'Oi ,..?L\':( -'S Range TYP~k,'Oe r;>;f:l\e\ Sq Ft Garage/Carport Energy Piith: 0 Sq Ft Other: Impervious Surface Area: Contractor Type Electrical Owner Plumbing Contractor OWNER VOGENEY KENNETH J & CHARI L OWNER # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS , DEVELOPMENTlNFORMATION I REQUIRED PARKING , Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Com~\\W " e.~\.lt. 'l'l ~ '}o of Lot Coverage: f;;.'I..?\~t. ~f \ ~\ \':1 "0 \ .,n1:\C~:. ..... c.\\~\.\. ...\.l\c, ?t.~~~ cf\\\ I PUBLIC IMPROY.EMiNf~~ \}~$~~ ~~~\)UI~t.. r>-1.l1.(:;t.t.~Ct.\) ~~~k Type: , Caw' " \)(l.'i rt: . (l.~'i \~\1 Downspouts/Drams: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Paee 1 00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description Square Footaee Tvpe of Construction $ Per Sq Ft Total Value of Project ~ Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Clrc Add, Alter, Extend Circ Ea Add Fixture Storm Sewer - 1st 50 Feet Amount Paid Date Paid , $12.20 $8.54 $43.00 $6.00 $28.00 545.00 5/21/03 5/21/03 5/21/03 5/21/03 5/21/03 5/21/03 Total Amount Paid $142.74 I Plan Reviews , . CITY OF :srKll~ul'lJ:!.LJJ- Building/Combination Permit PERMIT NO: COM2003-00390 ISSUED: 05/21/2003 APPLIED: 05/21/2003 EXPIRES: 11121/2003 VALUE: Value Date Calculated Receipt Number 1200200000000001275 l20020000000000l27~ 1200200000000001275 1200200000000001275 1200200000000001275 1200200000000001275 To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. 1 Storm Sewer Line: Prior to filling trench. 2 Rough Plumbing: Prior to cover and including required testing. 3 Final Plumbing: When all plumbing work is complete. 4 Rough Electric: Prior to Cover 5 Final Electric: When all electrical work is complete. Paee 2 00 . . \...11}' OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00390 ISSUED: 05/21/2003 APPLIED: 05/21/2003 EXPIRES: 11/21/2003 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby eertify that all information hereon is true and correct, and 1 further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address Is readable from the street, that the permit card Is located at the front oflhe property, and the approved set of plans will remain on the site at all times during construction. 1~_~Hfl~ Owne~r Contra~s Sig~ure () "ij,,~ ? r; - Date Paee 3 00 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00390 COM2003-00390 COM2003-00390 COM2003-00390 COM2003-00390 COM2003-00390 Payments: Type of Payment Check 5/21/2003 City of Springfield Development Services Department Public Works Department Official Receipt .' Receipt #: 1200200000000001275 Description Fixture Storm Sewer - 1st 50 Feet Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By KEN VOGENEY Received By djb 9:49:34AM Date: 05/21/2003 Amount Paid Item Total: 28.00 45.00 43.00 6.00 8.54 12.20 S142.74 Check Number How Received In Person Payment Total: Amount Paid 142.74 S142.74 Lonl1rm No Page I of 1 . . cReceipl.rpt " . ~ CITY OF S\hdNGFIELD, OREGON 0 \~ eft ~$ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number CO.1I\ ZOO') - 0<:::' 3 'lo Date 200 Amps of'less $ 63.00 201 Amp~~~,~6illAmps $ 75.00 ;..\).\\'" (\ \J . '1)<\\ ",,401 Amps to!jOO :-\mps S125.00 -o.~' 0''''"'' ~ ':> - rI\l' nO'" \ ~601 Amp~ tOJIOOO Amps S163.00 . "e", -' '0'1 ,,\w~.~ ~- ,"'':>- _,~:-' ~ev ~@ver lQOO AmpsNohs $375.00 \V -'o\l -<,,0'" ,,'(\ . ."'''' O"~ _ ~ \ -o.v ,\ " Reconnect OnlyP '!..\O'(\ $ 50.00 11 \>-' \~,\>\0"'Ge",\e\l~\~~~~;e~~~'i.i\C.-O: ------- ---- Superviso~ License Number /K\'-\0'v;::::;.'i.\0"'...\l\l\' o'O\~e~iIe:s{tg~~~J.e[v~c~s o!~~~der~_____ _ _ ___ ___.J I~~~O\\\'-~~":r ",,-0.'1 '(\\e" 0.0'(\ n,'/;'/:. nil" \ .(\01" -{O\> ~pC.e 0,ljnsta1l1tion, Alteration or Relocation _ \.... U'-V 'X;\e ~'-r / \l\:J"'~"y,.\\"'VJ ,\0'" e'\':J 200 Amps or less Constr. Contr. Number .,~:Oe (',p,0,\ 201 Amps to 400 Amps " 40 I Amps to 600 Amps Over 600 Amps or 1000 V ohs see "B" above. D. r-Branch-Clr-;:uits '-----1 ----- -- ---nl/...- -- ----- --- - - ----- , New Alteration &.l\,lilXten~on Per Panel One Circ!(j\'{ \'(( \S ~() I $ 43.00 If J Ea~*,'d3)~~'l'l11~q::~r with 'I b J / ~~.w:.'{iJ 'F~\~\Jle\iTI11 ~ S 3.00 Owners Name t'i"iI f)~.h/ ~,\\~~' ~ S" 1V~\l-\~~~\l\) ~ _ ___________, Address t,"'} &,'e CQ. / ~"'\S '?~~i~\) ~~':Ii'~~ellaneous ~_ervice/feeder ~ot included) -~...ch lns~I~~io~ ,. ~~~, x.~'(S \,>\\.Iv' City ~'?Jj:;:';41 Phone -7.2 t, ~~~\~ \P1;mp or irrigation $ 50.00 \J ~'{ \ 'O~ Sign/Outline Lighting $ 50.00 OWNER INSTALLATION \>i Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges ,-----,..--- .----- -_._-----~I 4. : SUJ_J.:.~T~OF AB~~________J I. ~_LOq,A:TION.. OF IN~TALLATIC!.JI! ___ ___ /.,~ ~YJ~ CJ. t;;.?r,~,J:.,..,jd. LEGAL DESCRIPTION1 (f i- '/70"~2.z'-{ ( O"l-'760 JOB DESCRJPTlON / y AdA. 1- 50,4... v I z ~ zO AwW' J I 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 I . ____..,_.,___,________, _,,____ ___,I Electrical Contractor Address City Phone Expiration Date Expiration Date Signature of Supervising Electrician The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: , .~ /~rAJf r( U () Inspection Request; 726-3769 S-/2.01 ~ .- T . 3. COMPLETE FEE SCHEDULE BELOW A. New Residential- Single or Multi-Family per dwelling unit. -- - ~..'- -- ~.- Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 S 19.00 $50.00 B. I Services or Feeders - Installation, Alterations or Relocation: ~---.._-,--~,-~--"..~--- --- -.."--- ..^---. ._.,._._---,.~--.-._,_._----' S 50.00 $ 69.00 SIOO.OO 7% State Surcharge 10% Administrative Fee Ifl 3tr3 L( ~c) 1 S'7n TOTAL Shan.'d Drive(T)/Building Fonns/Electrical Pcnnit Applicalion I.03.doc ~ . . . . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: COM UX). 0 3" 0 Address: 6 ~ Loa.\~ c... +- ~g Issued by; Date; ~!z,'!o3 -. . . \, .I ", " " " . .' , Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed 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 licensing 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: ~l. %2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~ 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. IfI change my mind and hire a general contractor, I will contract with a contractor who is licensed 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 Notice to Property Owners about Construction Responsibilities on the reverse side of this form. A.-~.zz a. ~,. _erjv A':? " 0igna# oOermit applicant) / (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 03/11/03 Acting as_ t~r O~n General C~tractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . . . .~ . - . NOTE: This Information Notice to Properly Owners about Construction Responsibilities was developed by the Construction ContractDrs Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as YDur own cDntractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the fDllowing respDnsibilities and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "empIDyees" if you use contractors not licensed with the CDnstruction Contractors Board to dD labor in constructing or tD assist in the construction or improvement Df a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes frDm emplDyee wages at the time employees are paid. You will be liable for the tax payments even if you dDn't actually withhold ihe tax from YDur employees. FDr a State Business ill nurnber, call the Business Information Center at 503-986-2200. Unemployment Insurance Tax: As an employer, YDU are required to pay a tax for unemployment insurance purposes on the wages of all emplDyees. For more infDrmation, call the Oregon Employment Department at 503-947-1488. '- Workers' Compensation Insuranee: As an employer, YDU are subject to the Oregon Workers' CompensatiDn Law, and must obtain wDrkers' compensation insurance for your employees. If you fail to obtain workers' cDmpensatiDn insurance, YDU cDuld be subject to penalties and be liable fDr all claim costs if one of your employees is injured on the job. For more .informatiDn, call the Workers' CompensatiDn Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you rnust withhold' federal income tax from emplDyees' wages, You will be liable fDr the tax payment even if you didn't actually withhDld the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. '. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, YDU are respDnsible for resDlving any failure to meet cDde requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent tD see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. . " . Time: Make sure yo~. hav.e suffipient time to supervise your ernployees. 'I'.', ,.';- . , . . Expertise: Make sure you have the skills to act as YDur own general contractor, to coordinate the work of rough-in and finish trades, and. to notify building officials as the appropriate'times so they can perform the required inspections. If you have additiDnal questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. PropertLowner.doc 03/11/03 . ,