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Home My WebLink AboutPermit Electrical 2019-10-04ORE6ON Web Address: www.sprlngfi eld-or.9ov Building Permit Residential Electrical Permit Number: 81 1-19-OO2281-ELEC IVR Number: 817070493642 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 Email Address: permitcenter@springfield-or.9ov SPRII{GFIELD ,s Permit Issued: October 04,2Ol9 Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Replace breaker box Type of work: Replacement Worksite Address B5O CENTENNIAL BLVD Springfield. OR 97477 Parcel 1703264301 100 Owner: Address: TREZONA ]AMES H & SUSAN PO BOX 8407 coBURG, OR 97408 Business Name OWNER - Primary License CCB Lacense Number 000000 Phone PENDING INSPECTIONS Inspection 4999 Final Electrical 4999 Final Electrical 4220 Electrical Service Inspection Group Elec Res Elec Res Elec Res Inspectaon 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.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 8tL07O493642 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work is not started within 18O Days of issuance or ifwork is suspended for 18O 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 canc€l the provisaons of any other state or local law regulating construction or the performanc€ of construction. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-O01-OO1O through OAR 952-OO1-OO9O. You may obtain copies ofthc rules by calling the Center at (5O3) 232-L987. 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). Printed onr 10/4/19 pdqe 1 of 2 C:\myReports/reporLs//production/01 STANDARD TYPE OF WORK JOB SITE INFORMATION LICENSED PROFESSIONAL INFORMATION SCHEDULING INSPECTIONS Permit Number: 81 1-19-OO2281-ELEC Page 2 of 2 Fee Description Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (LZo/o of applicable fees) Printed on: 10/4/19 Quantity Total Fees: Fee Amount $112.00 $s'60 $r3.44 $ 131.04 1 Pase 2 of 2 C r\myReporLs/reports//production/01 STANDARD PERMIT FEES W Transaction Receipt 811-19-002281-ELEC Receipt Number: 472601 Receipt Date: 10/4/19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54L-726-3753 perm itcenter@ springf ield-or. govwww springfield-or.gov Worksite address: 850 CENTENNIAL BLVD, Springfield, OR97477 Parcel 1703264301100 Fees Paid Transaction date 1014119 10t4t19 10t4t19 Units 1.00 Ea 1.00 Ea 1.00 Automatic Technology Fee Description Services 200 amps or less State of Oregon Surcharge - Elec (12ok of applicable fees) Account code 224-000004261 02-1 033 82 1 -00000-2 1 s004-0000 204-OOOOO- 425605-0000 Fee amount $112.00 $13.44 $5.60 Paid amount $1 12.00 $13.44 $5.60 Payment Method Credit card authorization: 039691 Payer: TREZONA JAMES H & SUSAN Payment Amount:$131.04 Cashier: Katrina Anderson Receipt Total:$131.04 Printed: 10/4/19 3:57 Pm Page 1 of 1 Fl N_Transaction Receipt_p r CITY OF SPRINGFIELD, OREGON Electrical Permit ation 22S Fifth Streeto Springfield, OR 97477o PH(541)726-3753.FAX(541)726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days ofissuance or ifwork is suspended for 180 days. {fr, 6DEPARTMENT USE ONLY p",-it no,\1'OO2 70 1''- to(q\rqDate: LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoningapproval verified? E Yes E No Number of inspections per item ( )Qty Cost Total costea. GATEGORY OF CONSTRUCTION Residential, per unit, service included: E Residential I Government E Commercial 1,000 sq. ft. or less (4)$186.00 $JOB SITE INFORMATION AND LOCATION Job site address So L €4Tr"Pp t/tt L Each additional 500 sq. ft. orportion thereof $36.00 $ City: S I State: D lL-zIP:Q'?yn l Limited energy (2)$44.00 $ Reference Each manufactured home or modular dwelling service or feeder (2)$89.00 S DESCRIPTION OF WORK L {ca cA- b (z-t+rlit-Dr Services or feeders: installation, alteration, relocation wL+ok /+.tLT1+ BftSI- r 200 amps or less (2)$l12.00 s PROPERTY OWNER 201 to 400 amps (2)$13I.00 $ Name:lLa 401 to 600 amps (2)$221.00 s Address:5D C|pTLDP tn L bc-O 601 to I ,000 amps (2)$285.00 $ City State: O ZIP:'7 '11 Over 1,000 amps or volts (2)$654.00 $ Phone:f Fax:Reconnect only (2)$89.00 $ E-mail: Jt 7 gz-o PL @- uo €b({Temporary services or feeders: installation, alteration, relocation This installation is being made on residential or farm property member of my immediate family. This 200 amps or less (2)$E9.00 $ a 201 to 400 amps (2)$122.00 $ sale, exchange, lease, or rent. OAR 401 to 600 amps (2)$177.00 $ Signature:Over 600 amps or 1,000 volts, see services or feeders section above ,/ cotrna INSTALLATION Branch circuits: new, alteration, extension per panel BusinAs*nerrrt'a. Fee for branch circuits with purchase ofa service or feeder fee: Address:Each branch circuit $8.00 $ City:&Y ZIP b. Fee for branch circuits without purchase ofa service or feeder fee Phone __^.lv Fax First branch circuit (2)$89.00 s E-mail Each additional branch circuit $8.00 $ CCB license no.BCD license no.Miscellaneous fees: service orfeeder not included Signing supervisor's license no.Each pump or irrigation circle (2)$89.00 $ Print name of Each sign or outline lighting (2)$89.00 $ Signature of signing supervisor:Signal circuit or a limitcd-encrgy pancl, alteration, or extension (2)$89.00 s Each additional inspection: ( I )$102.00 $ DEP USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00)$ ltz (B) Enter l27o surcharge (.12 x [A])$ (C) Technology Fee (5% of [A])$ TOTAL fees and surcharges (A through D)$o Last edited 7il12019 BJones Taxlot.: t 1 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential 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 structure must be licensed with the Construction Contractors Board' or i--7"1yJ- 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' ! have read and understand the lnformation and t hereby certify that the information on Notice to Homeowners About Construction Responsibilities' this homeowner statement is true and accurate. N . T'ftLryt *- Print Name of Permit APPlicanl of Permit APP|icant oci-LDr Date Permit #: Address: tr ^Co \ Date:lssued by: e9 This Copy for Permit Offices .J *.- r, lnformation Notice to Owners About Construction ResPonsi bi I ities (oRS 701.325 (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 97309-5052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www. oreoon. oov/ccb or Homeowners acting as their own general contractorc to construct a new home make a substantial iniprovement to in existing structure, can preYent many problems by being aware of the following responsibilities: a 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 employees. 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 from your employees. For more information, call the Department of Revenue at 503-3784988. Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purposes -on 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 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 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.gov. o a t a a a Other Responsibilities of Homeowners: Code Compliance: 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 coniact {heir 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 €r--^^^*, ^..,nar :7lnnfad A-?n1 6 This Copy for Permit