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Home My WebLink AboutPermit Electrical 1998-01-26SP}. .GFTELI) 225 FTFTB zoni0g, eod does not roqulr€ epecfilc hnd ueo approval. Date F r.r PERHIT APPLICATION Job Nunber qs) D 7S FEE SCEEDT'LE BELOV A. Nev Residential-Single or Multi-FamiIy per d'^relling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home. or Hodular.'DvelIing' Service or Feeder $ 1s.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less I201 amps to 400 amps 401 amps to.600 amps -601 amfs to 1000 amps- Over 1000 amps/volts Reconnect OnIy c Temporary Services or Feeders Insta1lation, Alteration or Relocation D. Branch Circuits I INSPECf,ION REQTIEST: OFFICE: 726-3759 726-3769 1 OF INSTALI.^ATION.Lr*rs (-ffit,rrry ?o o JOB DESCRT ON Permits are non-transferable and expirelf vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days 2. CONTRACf,OR INSTALI,ATION ONLT U Supervi sor License Number SbTS Expiration Date Constr Contr. Number l$Bclt? Exp iration Dare tZJAq Signature of Supervising Electrician Owners Address Hca R*t Ci ty se{Phone {- q) -)=----T- OgNER INSTALIJ\TION The installation is being made on property I ovn vhiih is not intended for sale, lease or rent. OvnerS-LSignature: DATE: 200 amps"or less $ 40.00 over 4b1 to 600 amps - $ 80.00 Over 600 amps or fbOO-frLts see (8" a5ffi IOCATTONt?{R\ Sum .B EIec t ri cal Con t rac to.K( J-, tGr"r E{.cr4esi Address W CgfrxW- pb Ci ty A,zre-re E,nt@vr-*:- - s s0.00 s 60.00 s100.00 s130.00 s300.00s 40.00 Nev, Alteration or Extension Per PaneL One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utline Lighting_ Limited Energy/Res Limited Energy/Comm $ 40.00 $ 40.00 $ 20.00 s 36.00 5 SUBTOTAL OF ABOVE 52 State Surcharge 32 Administrative Fee TOTALRECETVED B $ 8s.00 pnone 6ffi/78(- $ 40.00 2 Permit No: lssued Date: OR OFFICE USE ON STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: 14loWn,residein,orwillresideinthecompletedstructure' I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3.A My general contractor is Contractor registration number-. I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above inlormation is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. OR 3 (J--/C, 2 Signature of Permit Applican CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT Address:/ 1aa r(-+zrr' ,'' 7 ? NOTET This lnformation Notice to Property Owners About Construction was developed by the Construction Contractors Board in accordance with ORS'. Oa'sseOi5ry1,,th6',1 98O Oregon Legislat u re. INFORi,ilTION NOTICE TO PROPERTY Oil-NCNS ABOUT CONSTRUCTION RESPONSIBILITIES lf you are acting a's yo0r bwn contractor to coiistruct a new home or make a substantial ; existing structure, you can prevent many problems by being aware of the following of concern to an and areas EMPLOYER RESPONSIBILITIES : lf you hire pefsons not registered with the Construction Contractors Board Lo do labor in constructing or assisting in the construction or'iiiprorement of a iesidential stiuctui€, you wili,.in.most instances,:b5 ruled to be an "employer" and the peopie you hire will be "employlees''. As the. employei you must comply with the following: Oregon's Withholding,larx Law: As an employer, you must withhold income taxes irom emp-loyee wages at the 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 Oregon Department of,Revenue at 378-3390. .. : ? ., i:, i . , ii,- .,1.,. .:': I Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees,-,For more information, call the Oregon i at 378-3224. Employ-qnent Division DHR Workers' Compensation lnsurance: As an employer, yqu are subiect to the Oreg6n Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obthin workers' compensation insurance, you may be subject to penalties and,wilt be liablef0i'all Ciaim costs if one of your employees is iniured on the job. For more information, callthe Workers' Compensajion,.Pivision DIF at 973-7434. U.S. lnternal Bevenuq Service: As an employer, yqg must withhold federal income tax from employees'wages. mentevenit'y.iil.dion't.actu6llyyvithh6ldthetax.F9rmoreinfoimation,call the lnternal Revenue SeiVice ai 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERNi Code Gomplidhcd; As the permit holder,for this proj.ect, you are responsible for resolving any failure to meet code'requirements that may be brought to your attention through inspections' ,. Liability ahd Properfy Damage lnsurance:''Contact yti&rinsurance agent-to see,if you have adequate insurance Coverage for accidents and omissions such as falling tools, paint overspr*ylwater'tliimage from pipe punc- tures, fire, or work that must be re-done. Time,to Supervi se Employ€BSi', Make sure you have sufficient time to Supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. ,. . ..- . ! lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OFI 97310-0151 Phone 503-978-4621 0244J 10t24t89