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Home My WebLink AboutPermit Electrical 2008-7-1 -~~ Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO. COM2008-00961 [- ISSUED. 07/0112008 APPLIED. 07/0112008 EXPIRES: 0110112009 VALUE: 225 F,fth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS ./ 56 KREMONT AVE ASSESSOR'S PARCEL NO 1803023304600 Sprlllgfield TYPE OF WORK Electrical Work Only TYPE OF USE New ReSIdential PROJECT DESCRIPTION Heat Pump Owner Address BOSTICK CURTIS A 56 KREMONT AVE SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OWNER LIcense EXPiratIOn Date Phone BUILDING INFORMATION' # of Umts Primary Occupancy Group Secondary OccupalllY Group Primary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms # of Stories HeIght of Structure Type of Heat Water Type Range Type Ellergy Path Sprmkled Bmldlllg Lot S,ze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basemellt Sq Ft Garage/Carport Sq Ft Other Occupant Load ilia I DEVELOPMENT INFORMATION I Front yard Setback SIde I Setback Side 2 Setbdlk Redryard Setback Solar Setbacks Overlay DlSt # Street Trees Rqd Paved Drive Rqd % of Lot Coverage REQUIRED PARKING Total Handlcdpped Compact t I\.V I .Jf_ THIS PERMIT SHALL EXPI~tP,UBIeK,~~VEMENTS' Street Improvel!Jent( RiZED UNDER THIS PERMIT IS NOT ATTENTION CSilli!WiIl~Npr.Ulres X~I~I~y nn" 11 fl~NCED 0 A follow rules adopted by t~e Orego StOI m Sewer Available' R IS BANDONED FOR N If t ' CenDownsl'QutslDTslDS>':' set forth Special Instru~tlo''; 180 DAY PERIOD Ino~~~a ~~~-001"001 0 thr-ou9n 0: R 952-001- 0090 You may obtam copies of the r~les by Notes calling the center (Note the telepnone n..",h"" Inr the Oreqon Utility Notlflcal1on ':.-enter IS l-bUU'.:)v"-""'''''J I ValuatIOn DescrmltonI Description Type 01 ConstructIOn $ Per Sq Ft or multiplier Square Footage or Bid Amoullt Value Date Calculated Pa2e I of2 Status Issued CITY OF SPKll"l\.JJ1IELD" Building/Combination Permit PERMIT NO: COM2008-00961 ISSUED. 07/0112008 APPLIED: 07/0112008 EXPIRES: 0110112009 VALUE: 225 F,fth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lllle Total V dlue of Project Fees Paul I Fee DescriptIOn + 10% AdmmlStrahve Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Orc Add, Alter, Extend Ore Ea Add Amount PaId Date PaId ReceIpt Number $520 $624 $260 $48 00 $400 7/1/08 7/1/08 7/1/08 7/1/08 7/1/08 2200800000000000998 2200800000000000998 2200800000000000998 2200800000000000998 2200800000000000998 Total Amount PaId $66,04 I Plan RevIews I To Request an rnspectlOn call the 24 hour recordmg at 726-3769. All inspections requested before 7:00 a.m will be made the same working day, mspectIons requested after 7 00 a.m. wIll be made the followmg work day I, RellUlred InsnectInns I Rough ElectrIc Prior to Cover fmal Electric When all electllcal work IS complete By SIgnature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certify tbat all mformatlOn hereon IS true and correct, and I further certify that any and all work performed shall be done m accordance WIth the Ordmances oftbe City ofSprlngfiefd and the Laws of the State of Oregon pertammg to the 1V0rk desCrIbed herem, and that NO OCCUPANCY will be made of any structure WIthout permISsIOn of the CommuDlty ServIces DIVIsIOn, BUlldmg Safety, I further certlty that only contractors alld employees who are m comphance WIth ORS 701 005 will be used on thIS project I further agree to ensure that all requIred mspectlOns are requested at the proper time, that each address IS readable from the street, thdt the permIt card IS located at the front of the property, dnd the approved set of plans Will rem am on the SIte at all times dllrmg constructIOn Owner or Contractors Slgllature Date Page 2 of2 ZON INITIALS DATE SOURCE 225 FIYI1I STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (S41)726-3689 ELECTRICAL J:ERMIT APPYCATION CIty Job Number C J" - ()O,/~/ New AlteratIOn or ExtenSIOn Per Panel One Crrclllt / $ 48 00 -</g---- ,::- Each AddIlIonal CrrclIlt or wIth /7/7 & ~/" #H,S PcRn1/T SSeWlce/?r'peedp PeTrOlt / $ 400 "7 Owners Name //.v !f( )cnL-~.~A\UTHnRIZED UNtlEit /, IH~IL:~E ~l( Address, <;" c.. k v- e YV\ b V\\ A v~OMMENCEDF.'R~ISl.:Ifi\ffil>ef/t.SellVl~/feerler not mcluded)-Eacb InstallatIOn - u TS--AD-AiI!DOTVED-----rf';u: - _. - - CIty ,-<;'rdlo\~{\e l~ Phone 7LfCf-9~)~ DAY P_r1TTlgatlOn FOR $5500 Slgn/Outlme LIghtmg $ 55 00 LUOIted Energy/Resldennal $ 28 00 LUOIted EnergylCommerclal $ 50 00 MlDlmum Electric PermIt InspectIOn Fee IS $50 00 + Surcharges 4 rSl7nT~TAf~~'~~~~ _ ,, _':. _~ S-;), uJ I ~6 WCATION OF INSTALLATION: Kreme,>,\1 A-v",' ---5"",,,,--.o,{I",'1 d" , LEGAL DESCRIPTION \l(03 02-':; -$ 0%00 JOB DESCRIPTION 'v1 ("'(} t Ou 10u (', C I Permits are non-transferable and expire If work IS not started wlthlD 180 days of ISsuance or If work IS Suspended for 180 days 2 CONTJ?:1CTOR INSTALLATION ONLY_ Elec~~ Contractor Address "'" ~ / CIty ExpIratIOn Date ~ ~ "'" SIgt] ,/ e of Supervlsmg ElectrIcIan .. ' OWNER INST ALLA TION The mSlallatlOn IS bemg made on property I own whIch IS not illtended for sale, lease or rent Owners Slgnatur/,-) ----:nt-, If //# V/<)~--k Inspechon Reqnest 726-3769 Date 3 r-COMPLETEFEiiscmiiJULEBEWW---"-r L ~ ~ ~__ _ ~ _ _~_ _ ~ R""" , ' ! A L~!~_ResI~~?_h~.::-_Sinj:~e~~ ~~I1tl-flamdr pe.':.,dwelhn_g "nit. ServIce Included 1000 sq It or less Each addItIOnal 500 sq It or portIon thereof Each Manllfact'd Home or Modular Dwellmg ServIce or Feeder $11700 $ 2100 $5500 c' - B . ,ServICes Or Feeder~ -'-InstallatIOn, Alterahons or Relocahon ._~ - -~ ~ - 200 Amps or less ~~~'~ to 400 Amps ATTE ole' w reqUIres you ll) follow I oe~~~ Oregon Utl:lty NolIflcf!jQI~oN 11l~Q,gWlllfes are set forth in OAR G\i&QOQlOtlIripSYiVoogh OAR 952-001- 0090 't'oo:6llJlllctltMllfl copies of the rules by calling the center (Note the telephone nu~er :\Ol,jblf~~~PvUillitl';.1'.wllli~~iOh -Qenttlfvl$ V~-t1?j~~44J . $ 70 00 $ 83 00 $13800 $18000 $41300 $ 55 00 Installahon, AlteratJon or RelocatIon 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above c - D I Branch CIrCUIts L_ __ _" __ _ _ __ _ _ $ 55 00 $ 76 00 $110 00 12% State Surcharge 10% AdmmlstratIve Fee 5% Technology Fee // OL( \# I.LJ < Shared Dnve(T )/BUlldmg FormslElectncal Peront ApphcatlOD 1-08 doc TOTAL (I) 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 ns Perrmt# ell"" - ()()9(p/ Address 60 r(!;PJ/J~;-- ISS~~/ fv\.....; Date 7 -/ -~ Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) requires residential constructzon permit applzcants who are not licensed with the Constructzon Contractors Board to sign the following statement before a bUilding permit can be Issued This statement IS required for residential buzldlng, electrical, mechamcal and plumbing permits Licensed architect and engineer applzcants, exempt from licenSing under ORS 701 010(7), need not submit this statement This statement will be filed with the permit FIll III the appropnate blanks and Illltlal boxes I and 2, and either box 3A or 3B ~I o 2 I own, resIde Ill, or WIll resIde III the completed structure I understand that I must become hcensed as a construction contractor If the structure IS sold or offered for sale before or oft completion o 3A My general contractor IS (Name) (CCB #) I wIll IllStruct my general contractor that all subcontractors who work on the structure must be hcensed wIth the ConstructIOn Contractors Board OR 0: 3B I WIll be my own general contractor I[J hire subcontractors, I WIll hIre only subcontractors hcensed wIth the ConstructIOn Contractors Board If I change my mllld and hIre a general contractor, I WIll contract wIth a contractor who IS hcensed wIth the CCB and wIllllnmedlately notify the office ISSUlllg this bUlldlllg permIt of the name of the contractor I hereby certIfy that the above mformatlOn IS correct and that I have read and do understand the Information NotIce to Property Owners about Construction Responslblbtles on the reverse side of this form. c ~ ,([jc~ /-/--{]8 (SIgnature ofpenmt apphcant) (Date) (WhIte copy to ISSUing agency permit file, pink copy to applicant) Property_owner doc 06-0 I -04 Acting as Y ouilr Own.General Contractor? __ ...\, \ _ (k , . INFORMATION NOTICE TO PROPERTY OWNERS ' -..AB~UT, CQN,~:rRUCTlON'RESPONSIBILlTlES . ... ' , NOTE ThIs InformatIOn Notice to Property Owners about Construction ResponsIbilitIes was developed by the ConstructIOn Contractors Board In accordance wIth ORS 701 055(5), passed by the 1989 Oregon LegIslature , If you are acting as your own contractor to construct a new home or make a substanl1allmprovement to an eXlshng structure, you can prevent many problems by bemg aware of the follOWing responslbl!tl1es and concerns Employer Responsibilities . You Will, In most Instances, be ruled to be an "employer" and the contractors you contract With Will be "employees" If you use contra~tors not !tcensed with the ConspUcl1on Contractors Boar~Jo do labor In construchng or to assist In the constructIOn or. unprovement qf a residential structure As the employer, you must comply \yith the followmg: . Oregon's WIthholding Tax Law: As an employer, you must Wlthhold m~ome taxes from employee wages at the hme employees are paId You Will be !table for the tax payments even If you don't actually Withhold the tax from your employees For more informatIOn, call the DLp';:, ~H>""t of Re~enue at 503c378-4988 ..: . ,'. 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 Infonnahon, call the Oregon Employment Department at 503-947-1488 . .. The Oregon Busme~s Idenl1ficatlOn Number (BIN) tS a combmed number for both- Oregon' Wlthholdmg and Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or WWVo. dor stale or us/formsoav htmll for the ap~J1 vpuate forms . r < ) . . Workers' CompensatIOn Insurance: As an employer: you are subject to the Oregon Workers' CompensatIOn Law, and must obtam workers' compensatIOn Insurance for your employees If you fall to obtain workers' compensahon ~ ; ( , I _ msurance, you could be subject to penalties and be !table for all clatm costs If one of your employees IS mJured on the Job For more informatIOn, call thc Workers' Compensal1on DlV1'slOn at the Department of Consumer and Busmess ServIces at 503-947-7815 .. US. Internal Revenue Service: As an employer, you must wlthhold,federaJ mcome tax from employees' wages' You Will be !table for the tax payment even If you didn't actually Withhold the tax For a Federal EIN number, call the IRS at 1-800-829-4933 or VISIt their wl.b sIte at ,,'vw l1S !!OV .' Other Responsibilities ami Areas of Concerns Code Comphanee' As the perrott holder for thIS proJed, you are responsIble for resolvmg any'faIlure to meet code reqUIrements that may be brought to your attentIOn through mspecl10ns " ~ Liabihty and Property Damage Insnranc'e: Contact your msurance agent to' see If you have adequate msurancc coverage for aCCIdents and omtSSlOns such as fallmg tools, pamt over spray, water damage from ptpe punctures, fire or work that mllst be redone "' '. }...........0- Time: Make sure you have suffiCIent hIDe to supemse your employees ExpertIse: Make sure you have the skIlls to act as your own general contractor, t~ coordmate the work of rough-m and fimsh trades, and to notIfy bUIldmg offiCIals as the appropnate tImes so they can perfonn the reqUIred mspecl10ns IfYOll have addll10nal questIOns call the ConstructIOn Contractors Board (503-378-4621) or wnte the agency at PO Box 14140, Salem, OR 97309-5052 Property_owner doc 06-01.04 225 FIfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone City of Spnngfield OffiCIal ReceIpt Development ServIces Department Pubhc Works Department Job/Journal Number COM2008-00961 COM2008-0096I COM2008-0096! COM2008-00961 COM2008-00961 Payments Type or Payment CredltCard cRecelOtl RECEIPT #: 2200800000000000998 Date' 07/0112008 Description Add, Alter, Extend Clrc Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdmlOlstratlve Fee PaId By CURTIS BOS1ICK Item Total L:heck Number Authorization Received By Batch Number Number How Received nJm 51108b In Person Payment Total Page 1 of 1 I 58 28PM Amount Due 4800 400 260 624 520 $66 04 Amount Paid $66 04 $66 04 7/1/2008