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Home My WebLink AboutPermit Electrical 2018-10-10SPRiNGFIELD City of Springfield Developfient and Public Works 225 Fifth Street Spnngfield, OR 97477 541-726-3753O REGON Building Permit Residential Electrical Permit Number: 81 1-18-002404-ELEC IVR Number: 81 10031 95533 Web Adoress www.sOinofr€ld-or'.oo!Email Aooress: permitcenter@spnngnelo-or.go! Permit lssuedi OctoDe' 10 2018 ...]Y.PE OF WORK . , ' Category of Constructioni Single Family Dwelling Submitted Job Value: S0.00 Description of Work: Replace eleclncaL box Type of Work: Replacement JOB.STTE INFORMATIOI{ Worksite address '1163 QUINALT ST Springfield OR 97477 Parcel 1703264106900 Owner: Address MCGILVERY JAMES D i 163 QUINALT ST SPRINGFIELD OR 97477 LICENSEO PROFESSIOTTAL INFORi'ATION Business name OWNER - Primary License License number 000000 Phone lnapection 4999 Final Elect(cal 4999 Final Electrical 4500 Rough Electncal 4225 Service or Feeder lnspection group Elec Res Elec Res Elec Res Elec Res lnspecuon status Pending Pending Pendrng Pending SCHEDULING INSPECTIO}IS Various rnspections are minimally required on each prqect and often dependent on the scope of work. Contact the issuing JUrisdiction indicated on the permit to determine required inspections for this project Scnedule or track inspectons at www.buildingpermits oregon.gov Schedule by phone cal ''-888-299-2821 use IVR number 811003195533 Schedule usrng the Oregon ePermitting lnspection App. search 'epermitting" in the app store Permits must be postod an clear view on the worksite. Permits expire if work is not staned within 180 Oays of issuance or it work is 6uspended for 180 Deys or longer depending on the issuing agency's policy. All provisions of lews and ordinances gove.ning this type of work will be comphed with whether speclfied herein or nol Grenting of a permh aloes not prcsume to give authority to violate or cancelthe provisions ot any other state or local law regulating construction or lhe performance of construction, ATTENTION - CALL BEFORE YOU DIG: Oregon law reguires you to foliow rules adopted by the Oregon Utility Notific.tion Center. Those rules are set ,orth in OAR 952-001{010 through OAR 952{01-0090. You may obtain copies of the rules by calling the Center a! (877) 668.1001 or dial 811. All perBons or entities perlorming work under this permit are reguired to be licensed unless exempted by ORS 701.010 (Structu.au echanical). ORS 47S.5,a0 (Electrical). and ORS 593.010{20 {Plumbing). Pnnred on 10/10/18 PaoE i ol2 std_BuildrngPerma._p' {s PENDllrlG INSPECTIONS Permrt Number 811- 18-002404-ELEC Page 2 ol 2 Fee Description Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec ( 12olc of applicable fees) Quantity Total Fees: Fee Amount $ 109.00 $ 13.08 s1,27 .53 Pnnteo on 10/10'18 oage 2 a: 2 sto_BuilcjrngPermr._p' PERMIT FEES 5PfllricflEt0 & OREGO N 'r rvw springfield'or gov Transaction Receipt 811-18-002404-ELEC Roceipt Number: 468294 Receipt Date: 10/ 10/18 Cily of Spnngfi€ld Dewlopment a.d Pob c Works 225 Fifth St.eet spnngneE, oR 97477 54t-126-3753 permke.ter@sp.inqrield-or.cov lvortsiie address: 1163 OTJTNALT ST. Spring ield, OR 97477 Parcel: 1703264106900 Fees Paid 10/10/18 Uniit 100 Ea Servrces 200 amps or less Srale of Orego. Surcharge - Elec (12'A ol 22+O00m-426102-1033 $109 @ s109 00 10/10/r8 100 Ea 1 0O Aulomatac Tecinology Fee 821 -0000+21 500+0000 1o(}moo{1r2560t0000 s13 0a $5.45 $13 08 $5 45 Payment Method: Credn card authonzation 072214 Payer:james mcgilvery $127 53 Pnnr6d: 1o/10/r8 r1 23am t127.s3 FrN Ir..3.donR@Dtj. 10t10t14 Cashier Katr na Alrdelson Electrical Permit Application 225 Fifth Street.Springfi€ld. OR 974774PH(5,41)726-3753.FAX(541)726-3689 This permit is issued uDder OAR 918-309-0000. Permits are trotrtransferable, Permits expire if work is trot started withiD 180 days of issuance or if work is suspeoded for 180 days. Job site address 1 FEE SCHEDULE NuEber of iospections per item ( )Coster-Totalcost Residetrtial. per unit, senic€ included: 1,000 sq. ft. or less (4)s181.00 s S 00 S Limired energl (2) Each manufactwed home or modular dwelling service or feeder (2)s 86.00 sReferenceTalilot Services or feeders: insrallat ion. altera,ion. relocation PROPERTY OWNER s127.00 s E-mail:j;)1._tnc; This installation is being made on residential or farm propert-v owned by me or a member of my immediate famill. This propes is not intended for sale. exchange. lease, or rent. OAR 479.s40(1 ) and 419.560(l). 200 amps or less (:) Brstrch circuitsi neia. alteration. etension per panel Business name a. Fee for bBnch circuits with purchase ofa service or feeder fee Each branch circuit s 7.42 s b. Fee for branch circuits without puchase ofa service or feede, fee: i sFelxcF't!ol-- l-L..€&,4SYiiB.,tr,\ i tNql+ t S 5 ureallgnS s S Each additional bmnch circuit Each pump or irrigation circ)e (2)s 86.00 Signal circuil or a limted-energ-v panel. I s 99.00I alEration. or exension (2) i Esch additiodal iDspection: (1) E-mail CCB license no Signing supen,isor's Iicense no I Print name ofsipning supervisor: BCD license no Siglature of signing supervisor: (A) Enter subtotal of above fees (Mirimun Permit Fee 599.00) (B) Enter t 29i, surcharge (.12 x [A]) s s s DEPARTMENT USE ONLY Permitno.: 16-ooXott o"t", )O lo IB LOCAL GOVERNMENT APPROVAL Zoning approval verified? ! Yes n No CATEGORY OF CONSTRUCTION I Residential E Govemment JOB SITE INFORMATION AND LOCATION Cin 1 Stzte: Qfl ZP 77 DESCRIPTION OF WORK R"t-c"l fut 5 *l-'Name : t'66 Address: 77 Oqu/t lf ztP,97t/ 7 7Cir;*: f,p o $;-;Ll Stl,te: OR Yr,"""'jq,f4- 3pl CONTRACTOR INSTALLATION Address Srater)wCitr i Fax: I s 109.00 S oo200 amps or less (:) 201 lo 400 amps (:) s215.00401 to 600 amps (:) 601 Io 1.000 amps (2)s277.00 Over 1.000 arnps or volrs (2)$635.00 S Reconnect only (2)i s 86.00 s 86.00 5 201 to 400 amps (2)s 118.00 s s172.00401 ro 600 amps (21 Over 600 arnps or 1.000 voits. see services or feeders section above s E6.00 s 7.42 First branch circuil (ll 5 Miscellineous fees: rervice or feeder not included S 00 5sEach sien or outline lighting (2) | Ss99.00 DEPARTMENT USE $121"6TOTAL fees and surcharges (A through D) Last edit€d 7/1/2018 BJones (C) Technolos Fee (5% oflAl) (a7 E Commercial Phone: Fa)(: I Each addinonal 500 sq. ft. or poftion I thereof ls*.oo ls I $ Temporar-v services o a leede'|s'. installation. aheratioh, relocation ZIP CITY OF SPRTNGFIELD, OR-EGON loo. F r-e p=rti; e',.rns r Statem s nt Regai'd i n g eonsti'ucrion Respons ibi lities -|r=,.ri-\nl,\rj:=.l,!r=.-=<id:--::j^lr'<:;:,r-r,:nnar,r;:rrlir::;< Con-st;-rciron Ccnii:cicrs Soaic ic sign the iolloiving steiemeni befora a buiicing par-.-irii can D€ :rcr,:; ,aE<:na tri , t1l Name E:piratioft Date I will inform my general contractor that all subconi-3ctors who work on the structure [']ust be Iicensed wiih the Construction Contractors Board. ot =+I will be performing work on property I own, a residence that I reside in, or a residence that lwill reside in. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. lf I change my mind and hire a general contractor, lwiil select a contmctor who is licensed will the CCB and wiil immedlately give the name of the contractor to the ofice issuing this Building Permit. I have read and undersiand the lnformation Notice to Homeowners About Consiruction Responsibililies, afld I heraby certiry that the information on this homeowner shtement is true and accurate, Jorrr 2 n:.1. Pnnt Name of PermitApplicani ',ru7,U''rtrt.,lolilr* FE*t.*;iP;itApph;t Dara Permit #: Address 0 otbl, w_ lssued by:)D Bat-. This Copy for Pemit Oifi.'J I r N informaiion lJotiee to Owners Abotiflnnef i"E rnf inn Reennnqih !iir !;necwnais:c:jj-_! zsi:€it'ovin gEiei:l ccni:=c:ors ic corsi:!c: = :'lsy!'i:i: :i --ilii ::!:::::i.=i --r:::'.'-:--'::::: :;'l :--"-rS::--.: =i:'i:--:.i;n. :i_'l :r_i.:: :l=-' l::- : :: :1. :a::.; :w:-: ei:-i iailcwin-c '=srcnsrLiiiii==: Oragon's ij,iiihholding Tax L:w: -mployers musi wiihholi income iexes iiom employe= wages at the tim€ employees are paid. You will be liable for the tax payments even if you don't actually wiihhold the tax from your employees. For more inJormatjon, call the Department of Revenue at 503-378+988. Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purposes on the wages of a,i employees. For more infonnation, call the Oregon Employment Department at 503-947-1488. Oregon's Business ldentification Number (BlN): is a combined number- for both Oregon VVithhoiding and Unemployment lnsurance Tax. To file for a BlN, cail 503-945-8091 or go to n 11-055 for the appropriate forms Workers Compensation lnsurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation Insurance for their employees. lf you faji to obtarn Workers Compensatjon lnsurance, you could be subject to penaities and be liable for ail claim costs if one of your workers is injured on the job. For more informatjon, call the Worl<ers Compensation Division at the Department of Consumer and Busjness Services al503-947-7815. Tax Withholding: Employers must withhold Socral Security Tax and Federal Income Tax from employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federai EIN number, call the IRS at 1-800-829-4933 or visit their website at www irs oov. CONSTRUCTION CONTRACTORS BOARD 700 Summer St NE; Suiie 300, PO Box 14140, Salem, OR 9730*5052 Telephone: 503-378-462'1 - Faxr 509373.2007 Website Address: www oreoon oov/ccb Other Responsibilities of Homeowners : Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifyjng building officials at the appropriate times, so that the required inspections can be performed. HomeowneTs are also responsible for resolving any iailure to meet code requir-ements that may be found through inspections. Property Damage and Liability lnsurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. L)abiiity Insurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensatlon lnsurance. Expertise: HomeowneTs should maka sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough-in and inish trades. i/DroDe.W owner adopted 9-2-3-08 This Copy for Per,nit Applicant I I I I