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Home My WebLink AboutPermit Electrical 2019-11-13OREGON Web Address: www.springfield-or.9ov Building Permit Residential Electrical Permit Number: 81 1-19-OO2553-ELEC IVR Number: 811055041115 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR97477 541-726-3753 Email Address : permitcenter@springfield-or.9ov SPRINGf IELD $ Permit Issued: November 13, 2019 TYPE OF WORK Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: New AC unit Type of Work: Replacement ,OB SITE INFORMATION Worksate Address 6011 ORCHID LN Springfield, OR 97478 Parcel 1802033400166 Owner: Address MCKENZIE VALLEY HOMES LLC 3501 GARDEN AVE STE 2 SPRINGFIELD, OR 97478 LICENSED PROFESSIONAL IN Business Name OWNER - Primary License ccB License Number 000000 Phone PENDING INSPECTIONS Inspection 4999 Final Electrical 4250 Branch Circuits Inspection Group Elec Res Elec Res Inspection Status Pending Pending SCH EDULING 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: 811055041115 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 180 Days or longer dePending on the issuing agency's policy. Atl provisions of laws and ordinances governing this Wpe of work will be complied witfi whether specified herein or not. Granting of a permat does not presume to give authority to violate or cancel the provisions of any other state or local law regulatlng construction or the performance of construction' ATTENTION: Oregon law requlres you to follow rutes adopted by the oregon utility Notlfication center' Those rules are set forth in OAR 952-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (503) 232-L987. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O (Structural/uechanical), oRS 479.540 (Electrical), and oRs 693'O1O-O2O (Plumbing) Printed on: llll3/Lg Page 1 of 2 C :\myReports/reports//production/0 1 STAN DARD Permit Number: 8l 1-19-002553-ELEC Page 2 of Z Fee Description Balance of minimum permit fees - electrical Branch circuits without service or feeder Technology Fee State of Oregon Surcharge - Elec (l2o/o of applicable fees) Printed on: lrlr3l!9 Quantity Fee Amount $13.00 $89.00 $5.10 $12,24 $ 119.34Total Fees: C :\myReports/reports//production/01 STAN DARD 1 Page 2 of 2 PERMIT FEES SPRINGFI # ORTGON www.springfi eld-or. gov Worksite address: 601 1 ORCHID LN, Springfield, OR 97478 Parcel:1802033400166 Transaction Receipt 81 1-19-002553-ELEC Receipt Number: 472981 Receipt Date: 11/13/19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 permitcenter@springfield-or. gov Fees Paid Transaction date 11t13119 11t13t19 11t13119 't1t13119 Units 1.00 Qty 1.00 Automatic 1.00 Ea 1.00 Automatic Description Branch circuits without service or feeder Balance of minimum permit fees - electrical State of Oregon Surcharge - Elec (12ok of applicable fees) Technology Fee Account code 224-00000-426 1 02- 1 033 224-000004261 02-1 033 82 't -00000-21 5004-0000 204 -00000-425605-0000 Fee amount $89.00 $13.00 $12.24 $5.10 Paid amount $89.00 $13.00 $12.24 $5.1 0 Payment Method: Credit card authorization 1 08687 Transaction Comment: via Phone Payer: laura olds Payment Amount:$119.34 Cashier: Katrina Anderson Receipt Total $r 19.34 Printed: 11/13/'19 2:41 pm Page 1 of 'l Fl N_TransactionReceipt_pr [t "c- CITY OF SPRINGFIELD, OREGON Electrical Permit A lication 225 Fifth Street. Springfi eld, OR 97477 o PH(541 )726-3753. FAX(541 )726-36E9 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. LOCAL GOVERNMENT APPROVAL Zoningapproval verified? [ Yes E No CATEGORY OF CONSTRUCTION E Residential fl Govemment E Commercial JOB SITE INFORMATION AND LOCATION Job site address: 601I Orchid lnne City: Springfield State:OR ZrP:97478 Reference:Taxlot. DESCRIPTION OF WORK reconnect new AC unit, change j0 amp breaker to 20 amp PROPERTY OWNER Name: Scott and Laura Olds Address: 3501 Garden Ave CitySpringfield State:OR ZtP:97401 Phone: 541-345-8497 Fax: F.-mail/ a ur a old s @ gma i I .c o m This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 47 9.540(t ) and 479.560-( I ). Signature Zhr<rfltAr,E{rnhdidh nsrruLAloN Business name Address:L City: ^\ tUV-State:ZIP: Phone Fax E-rnail CCB license no.BCD license no. Signing supervisor's license no. Print name of signing supervisor: Signature of signing supervisor: DEPARTMENT USE ONLY permit no. : i{ -f-{^EI SS3 nate: \\a t FEE SCHEDULE Qty Cost ea. Total costNumber of inspections per item ( ) Residential, per unit, service included: 1,000 sq. ft. or less (4)$186.00 $ $36.00 $ Each additional 500 sq. ft. or portion thereof $44.00 $Limited energy (2) Each manufactured home or modular dwelling service or feeder (2)$89.00 $ Services or feeders: ins t a I I ation, a lt erati on, re lo cation $r r2.00 $200 amps or less (2) $13r.00 $201 to 400 amps (2) 401 to 600 amps (2)$221.00 $ 601 to 1,000 amps (2)$285.00 $ $654.00 $Over 1,000 amps or volts (2)r $89.00 )-8r'Reconnect only (2) Temporary services or feeders: installation, alteratiott, relocalion $89.00 $200 amps or less (2) $122.00 $201 to 400 amps (2) $177.00 $401 to 600 amps (2) 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: $8.00 $Each branch circuit b. Fee for branch circuits without purchase ofa service or feeder fee: First branch circuit (2)$89.00 so- $Each additional branch circuit $8.00 Miscellaneous fees: sertice orfeeder not included $89.00 sEach pump or irrigation circle (2) $Each sign or outline lighting (2)$89.00 $89.00 $Signal circuit or a limited-energy panel, alteration, or extension (2) Each additional inspection: (1)$102.00 $ DEPARTMENT USE 'X"z(A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00)g*r(B) Enter l2olo surcharge (.12 x [A]) st6g--(C) Technology Fee (5% of [A]) {W7rTOTAL fees and surcharges (A through D): Lnst edited 7/l/2019 BJones r\^ {fi, Property Owner Statement Regarding Gonstruction Responsibilities Oregon Law requires residential construction permit appiicants who are not licensed with the Construc.tion Contractors Board to sign the following statement before a building permit can be issued. (OR$ 701.325 (2)) This sgtement is requirod for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer appllcants, exempt from licenslng urider 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 Construclion Contractors Board. or lwill be performing work on property I own, a residence that I reside in, or a residence that lwill reside in. tf I hire subcontractors, I will hire only subcontractors licensed with the Construction Contrac,tors 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' 60lt orchid l-ane, spfld oR g747g x I have read and undenstand the lnformation and I hereby certify that the information on Notce to Homeownert About Co nstruction Responsibi liti es, this homeowner statement is true and accurate. Laura ,t Print Name of Permit APPlicant Pennit #: Address: lssued by:Date:+'i-Aa- t1/13/19 Date This Copy for Permit Offices lnformation Notice to Owners About Gonstruction Responsi bi I ities (oRs 701.325 (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 973095052 Telephone: 503-378-4621 - Fax: 50&373-2007 \Alebsite Address: www.oreoon. oov/ccb general contractors to construct a new home In exlsting structure, can prevent many problerns the followin g resPonsibilities : r 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 lqbor may be considered employees. As an employer, you must comply with the following: r oregon,s withholdlng Tax Law: Employers musl withhold income taxes from employee wages at th! rime employees-are paid. you will be liable for the tax payments even if you don't actually *tnnota the tax from your employees. For more information, call the Department of Revenue at 503-3784988. o Unemployment lnsurance Tax: Employers are required to pay a tax for unernployrnent insurance prrpoi.r tn the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1 488. r oregon's Business ldentification Number (BlN): is a combined number for both oregon vlfithiolding and Unemployment lnsurance Tax. To lile for a BlN, go online to the oregon Business Registry, For questions, call 503-945-8091' o 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 tne Departmeni of Consumer and Business Services at 800-4524288- r Tax yUithholding: Employers must withhold Social Security Tax and Federal lncome Tax from emptoyee \ /ages. you'miy be liable for the tax payment, even if you didn't ac"tually withhold the tax- For a Federal EIN number, go online to www.its.oov' Homeowners acting as their own or make a substantial improvement to bY being aware of a a a Other Responsibilities of HomeowRers: Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifying building ofricials at the appropriate times, so thal 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 punclures, fire, orwork that must be redone. Liabiiity 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 /nmnor'hr nurner arlnntFd q- 7O1 5 This Copy for Permit