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Home My WebLink AboutPermit Electrical 2018-09-25OREGON Web Address: www.springfield-or.qov Building Permit Residential Electrical Permit N um ber: 811 -18-002282-ELEC IVR Number: 81 1047351008 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 Email Address: permitcenter@springfield-or.qov SPRINGTIELD s Permit lssued: September 25,2018 Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Change out 60 amp panel to 200 amp panel Type of Work: Replacement Worksite address 2180 OTTO ST Springfield, OR97477 Parcel 1 703244306800 Owner: Address: KYCEK SIERRA 2180 OTTO ST SPRINGFIELD, OR 97477 Business name OWNER - Primary License CCB License number 000000 Phone lnspection 4999 Final Electrical 4999 Final Electrical 4500 Rough Electrical 4225 Service or Feeder lnspection group Elec Res Elec Res Elec Res Elec Res lnspection status Pending Pending Pending Pending Various inspections are minimally required on each project and often dependent on the scope of work. Contact the issuing jurisdiction indicated on the permit to determine required inspections for this pro.iect. Schedule or track inspections at www.buildingpermits.oregon. gov Schedule by phone call 1 -888-299-2821 use IVR number: 81 1 047351 008 Schedule using the Oregon ePermitting lnspection App, search "epermitting" in the app store Permits must be posted in clear view on the worksite. Permits expire if work is not started within 180 Days of issuance or if work is suspended for 180 Days or longer depending on the issuing agency's policy. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. ATTENTION - CALL BEFORE YOU DIG: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at (877) 668{001 or dial 81 1. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010 (Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing). Printed on: 9/25118 Page 1 of 2 std -BuildingPermat-pr Permit Number: 81 1 -18-O02282-ELEC Page 2 of 2 Fee Description Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (L2o/o of applicable fees) Printed on: 9/25118 Quantaty Total Fees: Fee Amount $109.00 $s.45 $ 13.08 $r27.53 std_BuildingPermit_pr 1 Page 2 ol 2 Transaction Receipt 81 1 -1 8-002282-ELEC Receipt Number:458136 Receipt Date: 9/25118 City of Springfield Development and Publrc Works 225 Fifth Street Springfield, OR 91477 541-726-3753 permitcenter@springfield-or.9ovwww. sprin gf ield-or. gov Worksite address: 2180 OTTO ST, Springfield, OR97477 Parcel: I703244306800 Fees Paid Transaction date 9t25t18 Units 1.00 Ea 'r.00 Ea 1.00 Automatic Technology Fee Description Services 200 amps or less State of Oregon Surcharge - Elec (12yo ot applicable fees) Account code 224-0000G.4261 02-1 033 821 -00000-2 1 5004-0000 1 00-00000-425605-0000 Fee amount $109.00 $13 08 $5.45 Paid amount $109.00 $13 08 $5.45 9t25t18 9t25t18 Paymenl Method: Credit card authorization: 56031 1 Payer: donald mannila Payment Amount;$1 27.53 Cashier: Katrina Anderson Printod: 9/25/18 3:59 pm Page 1 of 1 Receipt Total:sl 27.53 FIN_TransaclionRecerpl_pr CITY OF SPRINGFIELD, OREGON Electrical Permit A lication 225 Fifth Streeti Springfield, OR 97477tPH(541)726-3753r fAX(541)726-3689 DEPARTMENT USE ONLY permirno.: t%lQt>@x Date:q,(>s I tg SPiIiGFIELD This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started rvithin 180 days ofissuance or ifwork is suspended for 180 days. Signature of signing supervisor FEE SCHEDULE Number of inspections per item ( )Qry.Cost ea. Total cost Residential, per unit, service included: 1.000 sq. ft. or less (4)s181.00 $ Each additional 500 sq. ft. or portion thereof $ 3s.00 $ Limited energy (2)$ 43.00 $ Each manufactured home or modular dwelling service or feeder (2)$ 86.00 $ Services or feeders: installation. alteration, relocation 200 amps or less (2)$ 109.00 $y' 201 to 400 amps (2)s127.00 $ 401 to 600 amps (2)$2'r 5.00 $ 601 to 1,000 amps (2)s277.00 $ Over 1,000 zrmps or volts (2)$63s.00 $ Reconnect onll'(2)$ 86.00 $ Temporary services or feeders: installation. aheration. relocation 200 amps or less (2)$ 86.00 $ 201 to 400 amps (2)$ 118.00 s 401 to 600 amps (2)$172.00 S Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: nen'. aheration, extension per panel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ b. Fee for branch circuits without purchase ofa service or feeder fee: $ 86.00 S Each additional branch circuit s 7.42 $ Miscellaneous fees: service orfeeder not included Each pump or irrigation circle (1)s 86.00 $ Each sign or outline lighting (2)$ 99.00 s Signal circuit or a limited-energv panel. alteration. or ex'tension (2)s 99.00 s Each additional inspection: ( I )s99.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (lVlinimum Permit Fee $99.00)$ffi (B)Enter 12%o surcharge (.12 x [A])$ (C) Technolog Fee (5% of [.4])$ TOTAL fees and surcharges (A through D): I Stn.9 First branch circuit (2) ) LOCAL GOVERNMENT APPROVAL Zoningapproval verified? [ Ves E No \. i CATEGORY OF CONSTRUCTION tResidential E Government n Commercial JOB SITE INFORMATION AND LOCATION Job site address: ZIXO OtLo S't. ZrP: /7412Citl':State: 0R Taxlot. DESCRIPTION OF I t PRoPERW owNER Name: ciq' Address: Z For: E-maii " /t/a nni/) /O jOA n/<1, Cotrr being made on residential or farm properly member of my'immediate family. This for Signature This installation is owned by me or a propert)'ls 479.s40(1) c6NTRAcTOR INSTALLAfON Business name: Address: <_/City:State:ZIP Fax:Phone E-maii: CCB iicense no. Signing supervisor's license no. Print name of signing supervisor: Last edited 7/1/2018 BJones $ 7.42 7 Referer{ce: />r.) / starc: OP ztPt c1747-Z BCD license no.: Prope!'ty Owner Statement Regard i n g Construction Respons ibi lities Cregon Law iequires residential consti-,..rciion permit applicants who are nci licensed wjth ihe Consri-r.rcrjon Contractors Board to sign the fcllowrng statement before a buiiding permii can be issued (ORS 701.325 (2)) This statement is required for residential building, electrical. mechanical, and plumbing pei'miis. LicenseC architect and engineer applicants, exemptfrom licensing under ORS 70'1 .01 C {7), need not submit this statement. This statement will be filed with the permit. =ie=se c:::k t:e =cc':c::a:; lc:. , I I own, reside in, or will reside in the compleied structure and mi/ general contractor is: Name UUD?t Expiration Date I wiil inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or i will be performing work on properly I own, a residence that I reside in, or a residence that I will r-eside in lf I hire subcontractors, I Contractors Board. lf I change my who is iicensed with the CCB and rssuing this BuiJding Permit. rarill hire only subcontractors licensed with the Construction mind and hire a generai contractor, I will seleci a contractor wiil immediateiy give the narne I have read and understand the lnformation Notice to Homeowners About Construction Responsibilities, and I hereby certiry that the inforrnation on this homeowner statement is true and accurate. 7)*,il s {ln lolf)I of PermitApplicant ature of Pennit Applicant 7- rz-/g DdLC at gD c4f. SF Permii #; lssued by:Ddt-. q Address tb q1Y This Copy for Permit Offices d IB- Information Notice to Owners About Gonstruction Res PPns ibi I ities (oRS 701.32s (3)) Homeownei-s acting as their own general contractors to consi:-uct a ne'ru home or rnak: a subst=ntial :.nprorernentic in existing stiucture. can pr=rrent 5ia;;1 prohieins by being aware of the following responsibiliiies: Homeovilneis who use iacoi ci-oriided by work;is nct llcensec b-v ine Construciion Ccntractors Board, may be ccnsrdered an emoloyer, and the workers who prcvjde tne iab,cf rna'r' 5e consider;C en-ipiolrees. As an ernployei, you must cor-nply with tne foliowing: Oragon,s \r{iithholding Tax Law: Employers must withhold Income taxes fi-om employee wages at thl time employees are paid. You will be liable for the tax payments even if you don't actuaily withhold the tax from your employees. For more rnformation, call the Department of Revenue ai 503-378-4988. Unemployment lnsurance Tax: Employers are required to pay a tax for unempioyment insurance purposes on the wages of ali employees. For more information, cail the Oregon Employment Department at 503-947- 1 48B. Oregon's Business ldentificatlon Nurnber (BlN): Withholding and Unemployment lnsurance Tax. To fi is a combined number for boih Oregon rie for a BlN, call 503-945-809'1 or go to for the appropriate forms.ore d Workers Compensation lnsuran6s; Fmpioyers are sublect tc the Oregon ,Ar'orkers Compensation Law, anC r r ust o btain Workers Compensation lnsurance for their employees. tf you fail to obtain Workers Ccmpensation Insurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division atthe Department of Consumer and Business Services at 503-947-7815. Tax Withhoiding: Employers must withhold Social Security Tax and Federal lncome Tax from employee wages. You may be liable for the tax payrnent, even if you didn't actually withhold the tax. For a Federai EIN number, cailthe lRS at 1-800-829-4933 orvisittheirwebsite atwww,irs.oov CONSTRUCTION CONTRACTORS BOARD 700 Summer St NE, Suite 300 PO Box 14140, Salem, OR 97309-5052 Telephone: 503-378-4621 - Fax 503-373-2007' Website Address: www oregon.goviccb e Othen Responsl blllties of F{ormeowners : Code Corirpliance: As the permit holder for a construction project, the homeowner is responsible for notifying building ofilcials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requii-ements that may be found through inspectlons. property Damage and Liability lnsurance: Homeowners acting as their own contractors should contact their insurance ageni to ensure adequate insurance coverage for accidents and omissions, such as failing tools, paint overspray, water damage from pipe punctures, flre, or work that must be redone. Liabiiity lnsurance must be sufficient to cover injuries to persons on the iob site who are not otherwise covered as employees by Workers Compensation lnsurance. Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expeftise required to coordlnate the work of b-oth rough-in and finish trades. o fTproperty_owner adopted 9-23-08 This Copy for Permit APPlicant