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Home My WebLink AboutPermit Electrical 2019-11-19OREGON web Address: www.springfield-or.gov Building Permit Residential E lectrical Permit Number: 81 1-19-O02600-ELEC IVR Number: 8tl0977 47 229 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 Email Address: permitcenter@springfield-or.9ov SPRINGFIELD $ Permit Issued: November 19,2Ol9 TYPE OF WORK Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Panel change Type of Work: Replacement JOB SITE INFORMATION Worksite Address 375 S 51ST PL Springfield, OR 97478 Parcel 1702333403600 Owner: Address: STEPHENS JOHN & ]AN 375 S 51ST PL SPRINGFIELD, OR 97478 LICENSED PROFESSIONAL INFORMATION Business Name OWNER - Primary License ccB License Number 000000 Phone PENDING INSPECTIONS Inspection 4999 Final Electrical Inspectaon 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. Sched ule or track inspections at www. building permits'oregon' gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 8LL097747229 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store PERMIT FEES Fee Description Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (12olo of applicable fees) Quantity Tota! Fees: 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 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 regulating construction or the performance 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-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain copies of the 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 (StructuraUtlechanical), ORS 479.54O (Electrical), and ORS 693.O1O-O2O (Plumbing)' printed on: 11/19/19 page 1 of z C:\myReports/reports//production/01 STANDARD 1 Fee Amount $112.00 $s.60 $13.44 $ 131.04 \r Permit Number: 811-19-OO2600-ELEC Printed on: 771!91f9 Page 2 of 2 Page 2 of 2 C ;\myRepo.ts/reports//production/01 STANDARD SPRINGfIETD {b Transaction Receipt 81 I -1 9-002600-ELEC lVR Number: E1 1 0977 47 229 Receipt Number: 473044 Receipt Date: 1ll19/19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54r-726-3753 permitcenter@spri n gfi eld -or. govOREGON www.springfield-or.gov Worksite address: 375 S 51ST PL, Springfield, OR 97478 Parcr-l 1702333403600 Fees Paid Account codeTransaction Units date 11l',t9t't9 1.00 Ea 11119119 1.00 Ea Description Services 200 amps or less State of Oregon Surcharge - Elec ('t 2olo of applicable fees) 224-00000- 4261 02- 1 033 821 -00000-21 5004-0000 204-00000-425605-000011119t191.00 Automatic Technology Fee Fee amount $1 12.00 $13.44 $5.60 Paid amount $112.00 $13.44 $5.60 Payment Method: Check number: 'l I 17 Payer: STEPHENS JOHN & JAN Payment Amount:$131.04 Cashier: Katrina Anderson Receipt Total:st 31 .04 Printed: 11/19/19 l:07 pm Page I of I Fl N_TransactionReceipt_pr lr "L CITY OF SPRINGFIELD, OREGON Electrical Permit lication 225 Fifth Streeto Springfield, OR 97477r PH(541)726-3753. FAX(541 )726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days ofissuance or ifwork is suspended for 180 days. h, .LEL + LOCAL GOVERNMENT APPROVAL Zoningapproval verified? E Yes n No CATEGORY OF CONSTRUCTION ffiesidential E Government fl Commercial JOB SITE INFORMATION AND LOCATION Job site address: 3-75 S 5 i* ? lore- ,city$prinq{ie-td State:f)(zrP:q"1Ltl I Reference:Taxlot. DESCRIPTION OF WORK PROPERW OWNER Name 5aF,,.,, Slpnl-,er6., - Address:ffi ; $cl q't't"' 3 1 City: \/a 6p{2 State:6) fQ ZIP914<{,1 [rhone:5qg3i] Ll3gs-Fax: E-mail:6i,Ud',5 This IS made on or farm, property Thisownedbymeoramy immediate family property is 479.540(t) Signature: not intended sale, exchange, lease, or rent. OAR 4',79 .s60( Business naf,(e: Address City:ZIP ^pPhone: 'l Fax: E-mail ( CCB license no.:BCD license no Signing supervisor's license no. Print name of signing supervlsor: Signature of signing supemsor: FEE SCHEDULE Number of inspections per item ( )Qty Cost ea. Total cost Residential, per unit, service included: 1,000 sq. ft. or less (4)$186.00 s Each additional 500 sq. ft. or portion thereof $36.00 $ Limited energy (2)$44.00 $ Each manufactured home or modular dwelling service or feeder (2)s89.00 $ Services or feeders: installatiotr, alteration, relocation 200 amps or less (2)it $l12.00 $ l\z_ 201 to 400 amps (2)$r31.00 $ 401 to 600 amps (2)$221.00 $ 601 to 1,000 amps (2)$285.00 $ Over 1.000 amps or volts (2)$654.00 $ Reconnect only (2)$E9.00 $ Temporary services or feeders: installation, alteratiort, relocation 200 amps or less (2)(r $E9.00 $ 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 b. Fee for branch circuits without purchase ofa service or feeder fee First branch circuit (2)$89.00 s Each additional branch circuit $8.00 $ Miscellaneous fees: seruice orfeeder not included Each pump or irrigation circle (2)$89.00 $ Each sign or outline liehting (2)$8e.00 $ Signal circuit or a limited-encrgy pancl, alteration, or extension (2)$89.00 $ Each additional inspection: (l )$102.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00) $IL (B) Enter l2%o surcharge (.12 x [A])$ (C) Technology Fee (5% of [A])$ TOTAL fees and surcharges (A through D):s171, cl DEPARTMENT USE ONLY Permirno.: \q-@)b@'1 Date:\\q \t Last edited 7/l/2019 BJones CDNTRT ,.T.1E' A ie.\.)- Property 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 appllcants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be fited 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 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 Notice to Homeowners About Construction Responsibilities, this homeowner statement is true and accurate. Print Name of Permit of Date lo@ -Permit #: Address. I- Datelssued by (. 1 q 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, Salem, OR 97309-5052 Telephone: 503-378-4621 - Fax: 50$373-2007 Website Address : www. oregon. gov/ccb Homeowners acting as their own or make a substantial improvement to by being aware of general contractors to construct a new home an existing structure, can prevent many problems the following resPonsibilities: a a o a 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 empioyees. As an employer, you must comply with the following: Oregon,s Withholding Tax Law: Employers must withhold income taxes from employee wages at th-e time employees are paid. You will be liable for the tax payments even if you don't actually *itnnotO the tax fiom your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment tnsurance 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 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 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 800452-0288. Tax Withholding: Employers must withhold Social Security Tax and Federal lncome Tax from employee *ageJ. 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. a e 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 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 injunes 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. o Jr^>^^^+, ^..,nar :innl'ad A-7()l 6 This Copy for Permit