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Home My WebLink AboutPermit Electrical 2019-11-05OREGON web Address: www.springfield-or. gov Building Permit Residentia! Electrical Permit Number: 81 1-19-O02483-ELEC IVR Number: 811052889465 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 547-726-3753 Email Add ress: permitcenter@springfield-or.9ov SPRINGTIELD tb Permit Issued: November 05, 2019 TYPE OF WORK Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Add 6 branch circuits Type of Work: New JOB SITE INFOR}'IATION Worksite Address 2555 GRAND VISTA DR Springfield, OR 97477 Parcel L703243tOt700 Owner: Address: NAKAMURA GERALD T & ROSELEE K 2555 GRAND VISTA DR SPRINGFIELD , OR 97477 LICENSED PROFESSIONAL PhoneBusiness Name OWNER - Primary License ccB License Number 000000 PENDING INSPECTIONS Inspection 4999 Final Electrical 4999 Final Electrical 4500 Rough Electrical 4250 Branch Circuits Inspection Group Elec Res Elec Res Elec Res Elec Res Inspection Status Pending Pending Pending 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' Scheduleortrackinspectionsatwww,buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811052889465 schedule using the oregon ePermitting Inspection App, search "epermitting" in the app store p€rmits expire if work is not started within 18o Days of issuance or if work is suspended for 18o Days or loncer 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 regutating construction or the performance of construction' ATTENTToN: oregon law requires you to follow rules adopted by the oregon utilitY ilotifiGation center' Those rules are set forthinoARg52.ool-oolothroughoARg52.ool.oogo.Youmayobtaincopiesoftherulesbycallingthecenterat(503) 232-L947. All persons or entities performing work under this permit are required to be licensed (st;uctural/Mechanical), ons czg'seo (Electrical), and oRS 693'o1O-o20 (Plumbing) Printed on: 11/5/19 Page 1 of 2 unless exempted bY oRS 701'O1o C :\myReports/reports//production/0 1 STANDARD Ir Permit Number: 81 1-19-OO2483-ELEC Page 2 of 2 Fee Descraption Branch circuits without service or feeder Technology Fee State of Oregon Surcharge - Elec (l2o/o of applicable fees) Printed on; 11/5/19 Quantity 6 Total Fees: Fee Amount $ 129.00 $6.4s $ 15.48 $ 1s0.93 Page 2 of 2 C: \myReports/reports//production/01 STAN DARD PERMIT FEES OREGON www. sp ri n g field -or. gov Worksite address: 2555 GRAND VISTA DR, Springfield, OR97477 Parcr'l:1703243101700 Transaction ReceiPt 81 1-19-002483-ELEC Receipt Number: 472888 Receipt Date: l115/19 Fees Paid Transaction date 11t5t19 1115t19 11tst19 Payment Method Cashier: Katrina Anderson Units 6.00 Qty 't.00 Ea 1.00 Automatic TechnologY Fee Credit card authorization 09221c Description Branch circuits without service or feeder State of Oregon Surcharge - Elec (12% ot applicable fees) Account code 224-00000-426 1 02- 1 033 82 1 -00000-2 1 5004-0000 204 -00000 -425605-0000 City of SPringfield Development and Public Works 225 Fifth Street SPringfield, OR97477 54L-726-3753 permitcenter@spri ngfield:or' gov Paid amount $'129.00 $1s.48 s6.45 Payment Amount:$150.93 Receipt Total:$150.93 SPRINGFIETD b Fee amount $129.00 $15.48 $6.45 Payer: NAKAMURA GERALD T & ROSELE Printed: 11l5/19 11:24 am Page 1 of t Fl N-Transaction ReceiPt-Pr \r CITY OF SPRINGFIELD, OREGON Electrical Permit A lication 225 Fifth Street. Springfield, OR 97477o PH(541)726-3753. FAX(541)726-36E9 DEPARTMENT USE ONLY Permir no.: l7-OO 21 6 3 Date rt/slr1 h, 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. FEE SCHEDULE Number of inspections per item ( )Qty Cost ea. Total cost Residential, per unit, service included: 1,000 sq. ft. or less (4)sl 86.00 $ Each additional 500 sq. ft. orportion thereof $36.00 $ Limited energy (2)s44.00 $ Each manufactured home or modular dwelling service or feeder (2)$89.00 $ Services or feeders: instaIlation, alteration, relocation 200 amps or less (2)$l12.00 $ 201 to 400 amps (2)$131.00 $ 401 to 600 amps (2)$221.00 $ 601 to 1,000 amps (2)$28s.00 $ Over 1,000 amps or volts (2)$6s4.00 $ Reconnect only (2)$89.00 s Temporary services or feeders: installation, alteration, relocation 200 amps or less (2)$89.00 $ 201 to 400 amps (2)$122.00 s 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 potrcl a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit $ b. Fee for branch circuits without purchase ofa service or feeder fee: First branch circuit (2)\$89.00 saq Each additional branch circui ('{)7<$8.00 $qo Miscellaneous fees: senice orfeede:r not included Each pump or irrigation circle (2)$89.00 $ Each sign or outline lighting (2)$89.00 $ Signal circuit or a limited-encrgy panel, alteration, or extension (2)s89.00 $ Each additional inspection: (l)$102.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00)'lz1 (B) Enter l2o/o sttrcharge (.12 x [A])$, (C) Technology Fee (5% of [A])s b.rl5 TOTAL fees and surcharges (A through D):$15D,13 LOCAL GOVERNMENT APPROVAL Zotingapproval verified? f] yes E No CATEGORY OF CONSTRUCTION I Residential ! Government E CommercialI JOB SITE INFORMATION AND LOCATION Job site address: LS.(C G tlAltf lJ I ti:f{ Dt?t Ut city: s?Q i^16 Ft LLA State: 6) (L zP:?7?V Reference Taxlot. DESCRIPTION OF WORK c tttcut PROPERTY OWNER 4eNA 'EAN.) VAddress ( citv: (;tU *Cfi ei-A State:1)|(zrP:7'7?77 vrronet\t]f 7<4 0r1Q Fax: CONTRACTOR INSTALLATION Business name Address City:t 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: Last edited 7/l/2019 BJones This installation is made on residential or farm properfy family. Thisofimmediate for lease. or rent. OAR Signature:n k.n $8.00 Prope rty Owner StatementRegarding construction Responsibiritiesoregon Law requires residential construction.permit appticants w no "r"r*'r""n."d with the:ff:li'Ji3!!?:'r1'r'6eo'iJ to 'ig; tn" roriowrng ,ii"i",t berore , il;i;s permitcan be tsTh ntstateme ts forrequired residential electricalbuilding and plumbing permits.Licensed architect and e I anginee pp icants,from nsliceexempt ndeu Jng ORS 01701 0 notneed(7t,uS thbmit ts statement.Th is ntstateme will be filed with the it.perm Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name ccB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that lwill reside in. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. lf I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the lnformation Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. L of Permit of Permit APP|icant k4 4cr\ol 2 Date Permit #:\q-1\ro3 Address:2s9{6c,"^A$\+.^ lssued by Date 1'.\s\11 This Copy for Permit Offices mechanical, lnformation Notic-e to Owners About Constru;iion Responsi bi I ities (oRs 701.325 (3)) new home many problems or a Homeowners who use rabor provided by workers not ricensed by the construction contractors Board, may be considered an employer, .nJ th" workers who piovide the labor may be considered employees. As an ",ploy"', you must comply with the following: oregon,s withholding Tax r-1ry, rmnloyers must withhold income taxes from employee wages atthetimeemployeesarepaid.Youwillbeliableforthetaxpaymentsevenifyoudon,tactually withhold the tax tro, voui imptoyees. For more information, call the Department of Revenue at 503-378-4988. Unemployment lnsurance Tax: Employers are requtred to pay a tax for unemployment insurance purposes on the *rg". of all employ"".. Fot more information, call the Oregon Employment Department at 503-947 -1488' Oregon's Business ldentification Number (BlN): is a combined number for both Oregon withhording and Unemproyment rnsurance Tax. To flre for a BrN, go onrine 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 *"g"J. 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 unnrw.irs.gov. a o a a a Other Responsibilities of HomeowRers: 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 contractors 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, orwork 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 CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 97309-5052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www. oregon. qov/ccb f /nrnnor-f-rr nrerncr :rlnnfed 9tO16 This Copy for Permit