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Home My WebLink AboutPermit Electrical 2019-09-24OREGON web Address: www.springfi eld-or.gov Building Permit Residential Electrical Permit Number: 81 1-19-OO2206-ELEC IVR Number: 811034235921 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 547-726-3753 Email Address : permitcenter@springfield-or. gov SPRINGFIELD tfi Permit Issued: September 24,2Ot9 TYPE OF WORK Type of Work: New JOB SITE INFORMATION Worksite Address 712 S 37TH ST Springfield, OR 97478 Parcel 17023 14304003 Owner: Address: ROTHROCK LEE R 712 S 37TH ST SPRINGFIELD , OR 97478 LICENSED PROFESSIONAL IN FORMATION Business Name OWNER - Primary License ccB License Number 000000 Phone PENDING INSPECTIONS Inspection 4999 Final Electrical Inspection Group Elec Res Inspection Status Pending SCHEDULING INSPECTIONS 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.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 8LL03423592L Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store PERMIT FEES Fee Description Balance of minimum permit fees - electrical Signal circuits or limited energy panel, alteration, or extension Technology Fee State of Oregon Surcharge - Elec (L2o/o of applicable fees) Quantity Total Fees: 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 goveming this type of work will be complied with whether speclfied 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' ATTENTIONT Oregon taw requires you tO follow rules adopted by the oregon utility Notification center. Those rules are set forth in oAR 952-OO1-OO1O through oAR 952-OO1-OO9O. you may obtain coples of the rules by calling the center at (503) 232-1947, All persons or entities performing work under this permit are required to be licensed unless exemPted by oRs 7o1'o1o (structural/Mechanical), oRs 479.54o (Electrical), and oRs 693.o1o-o2o (Plumbing). 1 Fee Amount $13.00 $89.00 $5.10 $12.24 $ 1 19.34 Printed oil 9124179 Page 1 of 1 C : \myReports/reports//prcduction/0 1 STAN DARD Ir Category of Construction: Single Family Dwelling Submitted lob Value: $0.00 Description of Work: Install grounding rods for electrical SPRINGFIELD 'lrOREGON www. sp ri n g fi eld-or. gov Worksite address: 712537TH ST, Springfield, OR 97478 Parcel 170231 4304003 Transaction Receipt 81 1,19-002206-ELEC Receipt Number: 472501 Receipt Dale= 9124119 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR97477 541-726-3753 permitcenter@springf ield-or. gov Fees Paid Transaction date 9t24t19 9t24t19 9124119 9t24t19 Units 1.00 Ea 1.00 Automatic 1.00 Ea 1.00 Automatic Technology Fee Description Signal circuits or limited energy panel, alteration, or extension Balance of minimum permit fees - electrical State of Oregon Surcharge - Elec (12o/o ot applicable fees) Account code 224 -00000 -426 1 02- 1 033 224-000004261 02-1 033 821 -00000-2 1 5004-0000 20 4 -0 000 0 -4256 05 -00 0 0 Fee amount $89.00 $13.00 $12.24 $5.1 0 Paid amount $89.00 $13.00 $12.24 $5.1 0 Payment Method: Credit card authorization: 233205 Payer: ROTHROCK LEE R Payment Amount:$119.34 Cashier: Katrina Anderson Receipt Total:$1r 9.34 Printed: 9/24119 2:36 pm Page 1 of 1 Fl N_TransactionReceipt_pr [-t.-r. Electrical Permit Iication 225 Fifth Srreeto Springfietd, OR 97 4j7. pH(S4l)726.3 753 o FAx( 5 4l)7 26_3 689 APEIi.GT.GLD This days ffl#i:l.T:l'$;iXi13,ti3ll;1li"1itt ff;ft. are nontransrerabre. permirs expire irwork is not started within r80 CITY OF SPRINGFIELD , OREGON DEPARTMENT USE ONLY Permit no- Date:q APPROVALLOCALGOVERNMENT Zoning approval verifi ed?flYes E No TEGOCA OFRY CONSTRUCTION ! Government ! Commercial LOCATIONJOBSITERMATIINFOANOND Job site address: '-? ( L s. v1w f, P L State: 6!ZIP: Reference Taxlot. DESCRIPTION OF WORK tLAJST PoupD nr(oDS o fuwrqBrJr"IfrC€ kso^tb BEPL PROPERTY OWNER o\?(ecName: L, Address: I I L City:State: Q ZrP: I1 1 5Phone$ftt-)Fax: E-mail: INSTALLATION Business name Address: State ZIP: Phone:Fax: E-mail: CCB license no BCD license no. Print name of signing supervisor: FEE SCHEDULE Number of inspections per item ( )Cost ea. Total cost Residential, per unit, service inctuded 1,000 sq. ft. or less (4)$r86.00 $ Each additional 500 sq. ft. orportion thereof $36.00 $ Limited energy (2)$44.00 $ Each manufactured home or modular dwelling seryice or feeder (2)s89.00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2)$l r2.00 $ 201 to 400 amps (2)$131.00 $ 401 to 600 amps (2)$22r.00 $ 601 ro 1 ,000 amps (2)$285.00 $ Over 1.000 amps or volts (2)$654.00 $ Reconnect only (2)$89.00 $ Temporary services or feeders: installation, alter"ation, relocation 200 amps or less (2)$89.00 $ 201 to 400 amps (2)$122.00 $ 401 to 600 amps (2)$177.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit $8.00 $ b. Fee for branch circuits without purchase ofa service or feeder fee: First branch circuit (2)$89.00 $ Each additional branch circuit $8.00 $ Miscellaneous feesz service orfeeder not included Each pump or irrigation circle (2)$89.00 $ Each sign or outline lighting (2)$89.00 $ Signal circuit or a limited-energy pancl, alteration, or extension (2)$89.00 $ Each additional inspection: (1)$r02.00 $t) DEPARTMENT (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00) $[ (B) Enter 1270 surcharge (.12 x [A])$ (C) Technology Fee (5% of [A])$ TOTAL fees and surcharges (A through D):$( Last ediled 7/l/2019 BJones Qty. I .p Residential -=a# S r. fA, Signature: ^on Signing supervisor's license no.: Signature of signing supervisor: Property Owner Statement Regarding Construction Responsibilities Oregon Law requires r,esidential construction permit applicants who are not licensed with the Conitruction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2ll 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. Please check the aPProPriate box: I own, reside in, or will reside in the completed structure and my general contractor is Name CCB#Expiration Date I will inform my general contractor that all subcontractors who work on the struciure must be licensed with the Construction Contractors Board. or 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, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and underctand the lnformation and I hereby certify that the information on Notlce to Homeowners About Construction Responsibilities, this homeowner statement is true and accurate. L R, Ircr H tzo s\L Print of of q ->4-\9 Date Permit #: Address: Zilo lssued by /t'"P'Date This Copy for Permit Offices E ) lnformation Notice to Owners About t Construction ResPonsi bi I ities (oRS 701.325 (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 973095052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www. oregon. oov/ccb ath/ a a a a o Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered empioyees. As an employer, you must comply with the following: Oregon,s Withholding Tax Law: Employers must withhold income taxes from employee wages at thL time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax fiom 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 purposes bn the wages of all employees. For more information, call the Oregon Employment Department at 503-947 -1 488. Oregon's Business ldentification Number (BlN): is a combined number for both Oregon Withholding and Unemployment lnsurance Tax. To flle for a BlN, go online to the Oregon Business Registry. For questions, call 503-945-8091. Workers Compensation lnsurance: Employers are subjecl to the Oregon Workers Compensation LaW and must obtain Workers Compensation lnsurance for their employees. lf you fail to obtain Workers Compensation lnsurance, 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 at the Department of Consumer and Business Services at 800-452-0288. Tax Withholding: Employers must withhold Social Security Tax and Federal lncome Tax from employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, go online to www.irs.oov. a Other Responsibilities of Homeowners: Code Comptiance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. property Damage and Liability lnsurance: Homeowners acting as their own contraclors 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. Liability lnsurance must be sufficient to cover injuries to persons on the job 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 expertise required to coordinate the work of both rough-in and finish trades. a a a .t^-^^^a' a..rnar :/nnfari a-?Ol6 This Copy for Permit