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Home My WebLink AboutPermit Electrical 1995-06-13CITY OF SPR OBEGO'VL kt-B The foilowing projoct Jcntng, and doos not as submfied hf,6 ttxl requiro oprcilic lqnd uec S' YGFTELO ELECTRTCAL PERHTT APPLICATION Nunber 9scq $ 8s.00 .s ls.00 $ 40.00 aporoval.taW Mu Zoni 225 FtmE slnEBT SPRINGFIEI^D, oREGoN 974 INSPECf,TON REQUEST: tzOFFICE: 726-3759 77 6'-3769.r 1 OP ,ALLATTON o A IJGAL DESCRTPTTON Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Blectrician Ci ty Job 3. COHPIATE FEE SCEEDI'LE BELOII A. 1-000 sq.ft. or less Each additional 500sq. ft or portion thereof Each Manufrd Home. or Modular Dvelling Sertice or Feeder Nev Residential-Single orMulti-Family per dvelling unit.Service fncluded: Items Cost Sum JOB DESCRIPTION Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended ior180 days. 2. COT.ITRACTOR INSTALI.ATTON ONLY Electrical Contractor owners t'tame SC TT o Address / aS'Z SeG Upt fr s7- cit "6&C -5s37 OgNER Services or FeedersInstallation, Alterationsor Relocation: SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Admini.strative Fee TOTAL Temporary Services or FeedersInstallation, Alteration or Relocation 200 amps"or less $ 4O.OO201 amps to 400 amps - S 55.00Over 401 to 600 amps - S BO.OO0ver 60O amps or 1000ro-ITs see trBn affi Branch Circui ts ; .. Nev, Alteration or Extension per panel One Circuit $ 35.00Each AdditionalCircuit or vfth Serviceor Feeder Permit _ S 2.00 Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utIine Lighting- Limi ted Energy/Res -Limited Energy/Comm B c D E 200 amps or less 20L amps to 400 amps - 401 amps to 600 amps - 601 amps to 1000 amps-over 1000 amps/volts - Reconnect OnIy ,- s s s s $ s 00 00 00 00 00 00 @oo 60. 100. 130. 300. 40. 50 n The installation is being made onproperty I ovn vhich is not intendedfor sale, Iease or rent. Osners ignature: )- DATE: s 40.00 s 40.00 $ 20.00 s 36.00 5 ep RBCEIVED /3- Permit #: Address: lt552 S€Ocr-o 1 P S-r- Issued by:-/>--,S z7 Statemeht: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrtcal, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3A or 38: 1. I own, reside in, or will reside in the completed structure. E 2. 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 (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this huilding permit of the name of the contractor. I hereby certify thatthe above informationis correct and thatl have read and dounderstand the Information about Construction Responsibilities on the reverse side of this form. Ag* e/rt /?s (Signature of permit applicant) (White copy to issuing agency permitfile, pink copy to applicant) ",Ut Notice to Property (Date) A' Information Notice to'Property Owners About Construction Responsibilities Notc: This InfornrutionNbiil'c to l'rottert v- Ov'rrcrs uhottt t'rrnstntr'!irtn R(,t1trm5ibi!iyiss :. '' w*s det,tlopul hr- 71r.-i Can.itrursion Co,r$rut'tors Board irt at't'orrJan<.:e wirh ORS 70t.055{5),' If you hire persons not registered with the Construction Contractors Board to do labor in constructing cr assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be ;ur employer and the people you hire will be employees. As the ernployer, you must comply with the following: If you arre acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, )'oll ciin prevent many problems by being aware of the followrrg responsibilities and areas of concern. EM PLOYER RESPONSIBILITIES: Oregon's withholdiig tax law: As an employer, you must withhold income taxes frori: employeb wages atthe time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from yorir employees. For more information, call the Oregorr Dept. of Revenue at 945-809f i ' Unemployment insurance 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 Employment Division at thc Department of Htmannesources at378-3524. Workers'compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain worksrs' compensatien insurance, you may besubjecttopenaltiesandwillbeliableforallclaimcostsifoneofyouremployeesisinjuredonthejob. Formoreinform4ti6h, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Internal Rcvenue Service: As an employer, you must withhold federal income tax from employees'wages. You will be liable forthe tax paymeriteven if you didn't actually withhold the tax. For more information, call the.Intemal Revenue Service ar r-800-829-1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN; Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requireqrcng that may be brought to your attention through inspections. / \-. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must tre re-done. fime to supervise employees: 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. If you have additional questions, write or call the Construction Contractors Board (PO Box lat+0, Salerrr OR 97309-5052, 5031378-4621). The Board is located at 700 Summer St. NE Suire 300, in Salem. prop-own.pm4 1194