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Home My WebLink AboutPermit Electrical 2019-09-23OREGON web Address: www.springfi€ld-or.9ov Building Permit Residential Electrical Permit Number: 811-19-O02195-ELEC IVR Number: 811087002632 City of Springfield Developftent and Public works 225 Fifth Street Sp.ingfield, OR 97477 5!L-726-37 53 Email Address: Dermitcenter@sgrinqfi€ld-or.qov SPRINGFIELD tb Permit lssued: September 23, 2019 Category of Constructioni Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Generator Circuit Type of Work: New workslte Address 1221 S 41ST ST Sprinqfield, OR 97478 Owner: Address: ]OHNF&EUZABETHD MCCUNE LIVING TRUST 1221 S 41ST ST SPRINGFIELD, OR 97478 Parcel 1802064111400 Business Name OWNER - Primary License CCB License Number 000000 Phone Inspection 4999 Final Electrical 4999 Final Electrical 4500 Rough Electrical Inspectlon Group Elec Res Elec Res Elec Res Inspection Status 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 project. Schedule or track inspections at www. building permits.oregon.gov Call or text the word "schedule' to 1-888-299-2821 use IVR number: 811087002632 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store TYPE OF WORK JOB SITE INFORT,IATION LICENSED PROFESSIONAL INFORMATION PE'{DING INSPECTIONS SCHEDULING INSPECTIONS Pcrmlts expire lf work ls not started wlthin l8O Oays ol lssuanc€ or i, work ls susp€nded lor 180 Days or longer dependlng on the lssuln0 aeency's policy. All provlslons ot laws and ordlnanc€s gov.mln9 thls type of work wlll be compli€d wlth whcther.rEclfied hereln or not. Grantho ot a p€rmit does not presume to glve authority to violate or cancel th€ provlslons ot any oth€r strte or local law rcgulatlng construction or thc perlormance of consEuctlon. ATTE TIOI{: Oregon law requlres you to follow .ules adopted by th€ Oregon Utlllty tlotiflc.tion C€ntcr. Those rules are set forth ln OAR 952'OO1-O010 through OAR 952-OO1-OO9O. You may obtaln copl.s of th€ rulls by calllng the CentGr at (503) 232-L9A7. All persons or cntiues pertorming work under thls permlt are rcqulred to b€ llcens€d unl6s €xempted by ORS 7O1.O10 (Structuraul{€chanical), ORS 479.540 (Elcclrlcal), and ORS 693.Ol0-020 (Plumbing), Prlnted onr 9/23lr9 pag€ r ol2 C:\myRepo^s/.€@rtsl/prcduction/01 STANOARO Permit Numberl 811-19-O02195-ELEc Page 2 of 2 Fee Dcscription Balance of minimum permit fees - electrical Eranch circuits without service or feeder Technology Fee State of Oreqon Surcharge - Elec (12% of applicable fees) Quantity Fee Amount $13.00 $89.00 $5.10 $12.24 $119.34Total Fees: C:\mvReDorts/regort /production/01 STANDARD 1 PERTIIT FEES SPRINGFIETD ,h OREGON www. sp rin g fie ld -o r gov Woftsite address: 1221 S 41ST ST, Springfield, OR 97478 Parcel: 1802064111400 Development and Public works 225 Fifth Street Springfleld, OR 97477 54t-7 26-37 53 permitcenter@springfield-or.9ov Transaction Receipt 8r 1-19-{t02195-ELEC Receipt Numbert 472485 Receipt Date: 9/23119 City of Springfield Fees Paid Transaction date 9t23t19 9t23t19 9t23t19 Description Branch circuits without service or feeder Paid amount $89.00 $13.00 $12.24 204-00000-425605-0000 Fee amount $89.00 $13.00 $1224 $5.109/23t19 $5.10 Payment Method Credit card authorization 42742d Payer: JOHN F & ELIZABETH D MCCUNE Payment Amounti $119.34 Cashier: Katrina Anderson Receipt Tolal:$1'r9.34 Prinred: 9/23/'19 12:03 pm Fl N_TransactionReceipl_pr b -r- Units 1.00 Qty 1.00 Automatic 1.00 Ea 1.00 Automatic Balance of minimum permit fees - electrical State of Oregon Surch atge - Elec (12o/o ol applicable fees) Technology Fee Account code 224-00000426102-1033 224-00000426102-1033 821-00000-2 15004-0000 CITY OF SPRINGFIELD, OREGON Electrical Permit Application 225 Fifth StreetaSpringfield, OR 97477. PH(541)?2G375.1a FAX(S4l )72G16E9 DEPARTMENT USE ONLY p".*,no,\1-0O ilq{ Dale q\as\trh This permit is issued utrder OAR 9l&309-0000. Permits are nonlransferable. Permits expire if work is not started n ithin lt0 days of issuance or if work is suspended for 180 days. FEE SCHEDULE Number ofinspe.tions per item ( )Qty Cost ea. Total cost Residentirl, per unit, service included 1,000 sq. ft. or less (4)s Each additional 500 sq. ft. or ponion thcreof s36.00 S Limited energy (2)s.14.00 s Each manufactured home or modular dwelling service or feeder (2)s89.00 S 200 amps or less (2)$l t2.00 s 201 to 400 amps (2):i l.t l -00 S 401 to 600 amps (2)s221.00 S 601 to 1,000 amps (2)s2E5.00 s Over 1,000 arnps or volts (2)s65.1.00 s Reconnect only (2)s89.00 s Temporalv services ot leedelsi installation, aLetation, relocdtion 200 amps or less (2)s89.00 s 201 to 400 amps (2)s 401 to 600 amps (2)s Over 600 amps or 1.000 vohs. see services or feede$ section above BraDch circuits: nelri a etation. extension per pafiel a. Fee for branch circuits with purchase of a servicc or feeder fee Each branch circuit s1r.00 s b. Fee for branch circuits without purchase ofa scrvice or l'€eder fee First braoch circuit (2)I slt9.00 $6q Each additional branch circuit $ti.00 Miscelfaneous fees: .renice orleedet not itlcluded Each pump or irrigation circle (2)s89.00 S Each sign or outline lighting (2)$rl1).00 s Signal circuit or a limitcd{ncrgy pancl, alteration. or extension (2)s89.00 s Each additionrl inspection: ( l)$102.00 S DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00)5 d7-.- (B) Enter l2%o surcharge (.12 x [A])s [C) Techolog]i Fee (5% of [A])S TOTAL fees and surcharges (A through D)$\\1^?t LOCAL GOVERNMENT APPROVAL Zoning approval verified? ! Yes E No CATEGORY OF CONSTRUCTION fi-Residential E Govemment E Commercial JOB SITE INFORMATION AND LOCATION Job site address: t ZZ I s + is + City: $r Slate: C, r-zIY: | | 11/l Reference: J Taxlot. OESCRIPTION OF WORK Geie,qt'o r L; r PROPERTY OWNER Name:-f fr, +L:> _/tt < (,u,2 Address: (9-, / bo V e City z , E-rnail This installation is being made on residential or farm property owned by me or a membq of my immediatc family. This property is not intended for sale, exchange, lease, or rent. OAR 47 9.54O( l \ ^td M 9.56Ot l t. signu**,.ffi7.tnc C--, CONTRACTOR INSTALLATION Address City S ZIP Phone -a>n )./Fax: E-mail Y/ CCB license no BCD license no Signing supervisor's license no Print name ofsigning supervisor: - Signature of signing .up.wi.or{ Last editcd 7/U2019 BJones State: Phone:Fax: Business name: '=h4s-- sltr6.00 Serr.ices or feeders: ir stol|atio , alterutioh, relocotion s122.00 sl7?.00 S E ti Propefi Owner Statement Regarding Gonstruction Responsibilities Oregon Law requires residential construction permit appiicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 l2ll This statement is required for residential building, electrical, mechanical, and plumbing Frmits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this stalement. This statement will be filed with the Permit. Please check the aPProPriate box: t l I own, reside in, or will reside in the completed structure and my general contraclor is Name Expiration Dale I will inform my general contractor that all subcontractors who work on the struclure must be licensed with the Construction Contractors Board. or lwill 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, lwill select a contractor who is licensed with lhe CCB and will immediately give the name of the contraclor to the office issuing this Building Permit. I have read and under:stand the lnformation Notice to Homeowne.s About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. doL^ /qc C.e Prinl Name oi Permit Applicant c-23-1?c of Permit Applicant Date Permit #K.^co:r q< Address \all s, ql54 s+ Date llzeltl This Copy For Permit Offices tr rssued bd(k lnformation Notice to Owners About Construction ResPonsi bi I ities (oRs 701.32s (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 973095052 Telephone: 503-378-4621 - Fax 503-373-2co7 Website Address: www.oreoon.oov/ccb HomeowneE acting as their own general contracto6 to construct a or make a substantial improvement to an existing structure, can prevent by biling aware of the following responsibilities: new home many problems a Homeowners who use labor provided by workers not licensed by ihe construction contractors ao"ro, r"y be considered an employer, and the workers who provide the labor may be considered employeei. As an employer, you must comply with the following: oregon,s withholding Tax Law: Employers must withhold income taxes from employee wages at th-e time employeesire paid. You will be liable for the tax payments even if you don't actually *tnhoto the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purpo"". on the wages of all employees. For more information, call the oregon Employment Department at 503-947-1 488. oregon,sBusinessldentificationNumber(BlN):isacombinednumberforbothoregon WtrriolOing and Unemployment lnsurance Tax. To file for a BlN, go online to the Oregon Business Registry. For questions, call 503-945-8091 ' workers compensation lnsurance: Employers are subject to the oregon workers compensation L"*, a.o must oblain workers compensation lnsurance for their employees. lf you fail lo obiain Woit." Corp"nsation lnsurance, you could be subject to penalties and be liable for all claim.costs ii on"1iv*r *orkers is iniured on tlhe 1ob. For more information, call the Workers compensation biu,"ion itti," Departmeni of Consumer and Business Services at 800-452{288. Taxwithholding:EmployersmustwithholdSocialsecurityTaxandFederallncomeTaxfrom "rpf.V"" *"g"i You rjy be liable for the tax payment, even if you didn't actually withhold the tax' Foi a Federal EIN number, go online to www irs oov' a a a a a Other Responsibilities of Homeowners: codecompliance:Asthepermitholderforaconstructionproject,thehomeownerisresponsible tli not,tving uulraing ofiicials at the appropriate times, so that the required inspections can be oerformed. Homeowners "r" .l"o 1..iponsible for resolving any failure to meet code requirements ih"t ..y be found through inspections' PropertyDamageandLiabilitylnsurance:Homeownersactingastheirowncontractorsshould contacttheirinsuranceagenttoensureadequateinsurancecoverageforaccidentsandomissions, .ulfl a. t"ffing tools, painl ou"i"p'"y, water jamage from pipe punctures' fire' or work that must be redone.LiabilitylnsurancemustbeSuflicienttocoverinjuriestopersonsonthejobSitewhoarenot oin"*i." covered as employees by Workers Compensation lnsurance' Expertise:Homeownersshouldmakesuretheyhavetheskillstoactastheirowngenera|;;;r;t*, and the expertise required to coordinate the work of both rough-in and linish trades. a a This Copy for Permat