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Home My WebLink AboutPermit Electrical 2019-10-28SPRINSTIELD OREGON Web Address: www.springfield-or, gov City of Springfield Development and Public Works 225 Fifth Street Springfield/ OR 97477 547-726-3753 Email Address: permitcenter@springfield-or.gov & Permit Issued: October 28,20L9 Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Service panel change Type of Work: Replacement Worksite Address 593 71ST ST Springfield, OR 97478 Parcel 1702352404300 Owner: Address CARLSTROM BRIAN & KRISTI 593 71ST ST SPRINGFIELD , OR 97478 Business Name SEE PROPERry OWNER INFORMATION - Primary Lacense Owner (Propefty) License Number OWNER Phone Inspection 4999 Final Electrical 4500 Rough Electrical Inspection Group Elec Res Elec Res Inspection Status 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 requrred inspections for this project, Schedule or track inspections at www. buildingpermits.oregon.gov Call or text the word "schedule" to 1-BBB-299-2821 use IVR number: 811020835245 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work is not started within 180 Days of issuance or if work is suspended for 18O Days or longer depending on the issuing agency's policy, All provisions of laws and ordinances governing this Wpe 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: Oregon law requires you to follow rules adopted by the Oregon Utiliw Notification Center, Those rules are set forth in OAR 952-001-0O1O through OAR 952-001-OO90, You may obtain copies of the rules by calling the Center at (5O3) 232-L947, All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.010 (Structural/Mechanical), ORS 479,54O (Electrical), and ORS 693.010-O2O (Plumbing). Printed on: 10/28/19 page 1 of 2 C:\myReports/reports//production/01 STANDARD Building Permit Residential Electrical Permit Number: 811-19-002438-ELEC IVR Number: 811020835245 TYPE OF WORK JOB SITE INFORMATION LICE NSED PROFESSIONAL IN FORMATION PENDING INSPECTIONS SCHEDULING INSPECTIONS Permit Number: 81 1-19-OO243E-ELEC Page 2 of 2 Fee Description Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (12olo of applicable fees) Printed on: 10/28/19 Quantaty Total Fees! Fee Amount $ 112.00 $s.60 $13.44 $ 13 1.04 1 Page 2 ol 2 C r \myReports/reports/,/productron/01 STANDARD PERMIT FEES STRiilGFIELO {& Transaction Receipt 811-19-002438-ELEC Receipt Number: 472826 Receipt Oate:10128119 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR97477 54t-726-3753 perm itcenter@spri ngfield -or. gov 0ntG0N www. sp ri n g f iel d-or. g ov Worksite address: 593 71ST ST, Springfield , OR 97478 Parel: 1702352404300 Fees Paid Transaction date 10t28119 10t28t19 10t28t19 Units 100 Ea 100 Ea 1.00 Automatic Technology Fee Description Services 200 amps or less State of Oregon Surcharge - Elec (12% of applicable fees) Account code 224-000A0-4261 02- 1 033 82'l -00000-21 5004-0000 204 -OOOOO -4256 05-0000 Fee amount $1 12 00 $'r3.44 $5 60 Paid amount $112.00 $13.44 $5.60 Payment Method Credit card authorization: 818270 Payer: CARLSTROM BRIAN & KRISTI Payment Amount:$131.04 Cashier: Katrina Anderson Receipt Total:$131 .04 Printed: '10/28119 4:08 pm Page 1 of 1 Fl N_Tra nsaction Receipt_pr CITY OF SPRINGFIELD, ORBGON Electrical Permit A lication 225 Fifth Street. Springfield, OR 97477oPH(54I )726-3753. FAX(541 )726-3689 This permit is issued under OAR 91E-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days ofissuance or ifwork is suspended for 180 days. C-, -7 LOCAL GOVERNMENT APPROVAL Zoningapproval verified? E Yes E No CATEGORY OF CONSTRUCTION EJ'esidential I Government I Commercial JOB SITE INFORMATION AND LOCATION Job site address: 59 3 J tSt S1-"- l City (\State: Qrf ap,7)4)L Taxlot.: DESCRIPTION OF WORK ice {r't c-( PROPERTY OWNER nr\r-\rta Address: 51 I,E+--.-t City:(1 A €t State: O lA zIP: 1? LtTL Phone*/ -52l- f l0O Fax: E-mail: B.,c-r^.'C--t.rn^o.i l.a"nr This installation is owned by me or a made on residential of my immediate property 479.s40( is not intended for sale, exchange, lease, or rent. OAR CONTRACTO INSTALLATION Business name: 5.r\ Address City State ZIP Phone:Fax: E-mail: CCB license no BCD license no. Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: FEE SCHEDULE Number of inspections per item ( )Qty.Cost ea. Total cost Residential, per unit, service included: 1,000 sq. ft. or less (4)$t86.00 $ Each additional 500 sq. ft. orportion thereof $36.00 $ Limited energy (2)$44.00 $ Each manufactured home or modular dwelling service or feeder (2)$89.00 $ Services or feeders : in s t a I I ati ou, a I t eration, rel o c ation 200 amps or less (2)\$l12.00 $ttz 201 to 400 amps (2)$131.00 $ 401 to 600 amps (2)$221.00 $ 601 to 1,000 amps (2)$285.00 $ Over 1,000 amps or volts (2)$654.00 s Reconnect only (2)$89.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2)$89.00 S 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 q Each additional branch circuit $8.00 $ Miscellaneous fees: service orfeeder nol included Each pump or irrigation circle (2)$ Each sign or outline lighting (2)$89.00 $ Signal circuit or a limited-encrgy panel, alteration, or extension (2)$89.00 $ Each additional inspection: (l)$r02.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00) $ (B) Enter l27o surcharge (. l2 x [A])$ (C) Technology Fee (5% of[A])$ TOTAL fees and surcharges (A through D):s13l .dl DEPARTMENT USE ONLY permitno.: 11@)'l3g I Date: @bbItl Last edited 7/l/2019 BJones Reference: Name: $89.00 h, P roperty Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2ll This statement is required for residential buitding, 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. N Please check the aPProPriate box: I own, reside in, or will reside in the completed structure and my general contractor ts 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 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 understand the lnformation Notice to Homeowners About Construction Res and I hereby certify that the information on this homeowner statement is true and accurate. CrCrrt O-\s\ r\ /1,l Print Name of lb-28- tq Signature of Permit APPlicant Date ponsibilities, -oPermit #: Address:5qz 1\s: >4 * lssued by KFr Date:,.p(?-€ \n This Copy for Permit Offices lnformation Notice to Owners About Construction ResPonsi bi I ities (oRS 701.325 (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salern, OR 97309-5052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www.oregon. gov/ccb Homeowners acting as their own general contractors to construct a or make a substantial improvement to in existing structure, can prevent by biing aware of the following responsibilities: new home many problems a a a Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, ano 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 thl time employeesire 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 -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 Withiolding 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 it tn" Department of Consumer and Business Services at 800-452-0288. Tax Withholding: Employers must withhold Social Security Tax and Federal lncome Tax from employee wageJ. 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. o a a a a Other Responsibilities of HomeowRers: Code Compliance: As the permit holderfor 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 contractors should coniact iheir 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. f /nrnnartrr nrrrncr arinnted g-?O15 This Copy for Permit