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Home My WebLink AboutPermit Electrical 2019-12-23SPRINGFIE[D OREGON Web Address: www.springfield-or. gov Building Permit Residential Electrical Permit Number: 81 1-f 9-OO2852-ELEC IVR Number: 8110927 39499 City of Springfield Development and Public Works 225 Flfth Street Springfield, OR 97477 541-726-3753 Email Address : permitcenter@springfield-or.gov Permit Issued: December 23,20L9 Category of Construction: Single Family Dwelling Type of Work: New Submitted Job Value: $0.00 Description of Work: Electrical work for garage addition with bedroom ]OB SITE IT{FORMATION Worksite Address 410 36TH ST Springfield, OR 97478 Parcel 17023 1 1302900 Owner: Address: 410 36TH LLC 2450 BIRCH LN EUGENE, OR 97403 LICENSED PROFESSIONAL Business Name OWNER - Primary License CCB License Number 000000 Phone PENDING INSPECTIONS Inspection Group Elec Res Elec Res Elec Res Elec Res Elec Res Inspection Status Pending Pending Pending Pending Pending SCHEDULING INSPECTIOI{S 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. bui ld i ngperm its.oregon. gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 8LLO92739499 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expare 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 hereln 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. ATTENTIOTI: Oregon law requires you to follow rules adopted by the Oregon Utiliw Notification Center, Those rules are set forth in OAR 952-OO1-OO10 through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (5O3) 232-t947. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O (StructuraU Mechanical ), ORS 479.540 (Electrical), and ORS 593.O10-O20 (Plumbing). Printed on: l2l23lt9 Page 1 of 2 C :\myReports/reports//production/01 STAN DARD [, {fi TYPE OF WORK Inspection 4999 Final Electrical 4999 Final Electrical 4500 Rough Electrical 4220 Electrical Service 4250 Branch Circuits Permit Number: 81 1-19-OO2852-ELEC Page 2 of 2 Fee Description Branch circuits with service or feeder each circuit Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (12olo of applicable fees) Printed onr 12/23/19 Quantity Total Fees: Fee Amount $24.00 $112.00 $6.80 $ 16.32 $159.12 3 1 Page 2 of 2 C :\myReports/reports//production/0 1 STAN DA RD PERMIT FEES SPRINGTIELD ,b OREGON www.springfield-or.gov Worksite address:410 36TH ST, Springfield, OR 97478 Parcel 170231 1302900 Transaction Receipt 81 1 -1 9-002852-ELEC IVR Number: 8l 1092739499 Receipt Number:473366 Receipt Dale:12123119 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 permitcenter@springfield-or. gov Transaction Units date 12123119 1.00 Ea 12t23t19 1.00 Ea Description Services 200 amps or less Branch circuits with service or feeder each circuit State of Oregon Surcharge - Elec (12o/o of applicable fees) Fees Paid Account code 224-00000-4261 02-1 033 224-00000 - 4261 02- 1 033 82 1 -00000-2 1 5004-0000 204-00000-425605-0000 Fee amount $1 12.00 $24.00 $16.32 $6.80 Paid amount $112.00 $24.00 $16.32 $6.8012t23t191.00 Automatic Technology Fee Payment Method: Check number:535 Payer:410 36TH LLC Payment Amount:$159.12 Cashier: Katrina Anderson Receipt Total:$1 s9.12 Ptinted. 121231 19 1 0:55 am Page 1 of 'l F I N_Tra nsaction Receipt_pr -l rb-It 12123t19 3.00 Qty CITY OF SPRINGFIELD, OREGON Electrical Permit A lication 225 Fifth Streeto Springfi eld, OR 97477 r PH641)726:37 53. 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. SPRINGFTTLO h,C- LOCAL GOVERNMENT PPROVAL Zonitg approval verifi ed?CS ENo GATEGORY OF CONSTRUCTION dResidential ! Goverrrment E Commercial JOB SITE INFORMATION AND LOCATION Job site address State: OE ZIP:? 7?B Reference:Taxlot. DESCRIPTION OF WORK {v4^ PROPERW OWNER/?/a"Z; Address: 4/d ? 6 fq fft State: D<zry 774 6 flo-? Zoa Fax: E-mail: Auue/d-ztze C^ /t q cc* This installation is being made on residential or farm properry owned by me or a member of my immediate family. This property rs 479.s40(t) Signature: not intended for sale,exchange,lease,or rent.OAR and 4 79 ) R INSTALLATION Business name: Address 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: 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 $ Each additional 500 sq. ft. orportion thereof $36.00 $ Limited energy (2)$44.00 $ Each manufactured home or modular dwelling service or feeder (2)$89.00 $ Services or feeders: installation, olteration, relocation 200 amps or less (2)($l12.00 s llz 201 to 400 amps (2)$13r.00 $ 401 to 600 amps (2)$221.00 $ 601 to 1,000 amps (2)$28s.00 $ Over 1.000 amps or volts (2)$654.00 $ Reconnect only (2)$89.00 $ Temporary services or feeders: installation, alteratiort, relocation 200 amps or less (2)$89.00 $ 201 to 400 amps (2)$r22.00 $ 401 to 600 amps (2)$177.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: neu,, alteration, extension per panel a. Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit ?$8.00 s ;7/ b. Fee for branch circuits without purchase ofa service or feeder f6e: First branch circuit (2)$89.00 $ Each additional branch circuit $8.00 $ Miscellaneous fees: service orfeeder nol included Each purnp or irrigation circle (2)$89.00 $ Each sign or outline lighting (2)$89.00 $ Signal circuit or a limited-energy panel, alteration, or extension (2)$89.00 $ Each additional inspection: (1)$102.00 $ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00)' i36 (B) Enter 12%i strcharge (. l2 x [A])s /a'72 (C) Technology Fee (5% of [A])$ bqo TOTAL fees and surcharges (A through D):$ /9!z DEPARTMENT USE ONLY permit no.: \7 -ooZ%9 2-2 c Date: lr\ al I rq Last edited ?/l/2019 BJones Name: State: Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Conltruction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2ll This statement is requlred for residential building, 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 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 struc{ure must be licensed with the Construction Contractors Board. 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 and I hereby certify that the information on Notice to Homeowners About Construction Responsibilities' this homeowner statement is true and accurate.m Print Name of Permit APPlicantB /z-73 -/7 Signature of Permit APPlicant Date Permit #:\^-OO>e3> -rLcL Address: Jr^ }1 al rrlssued by Date w\z This Copy for Permit Offices 'l 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. oov/ccb o o a o a a Homeowners acting as their own general contractorc to construct a new home or make a substantial imlprovement to in existing structure, can Prevent many problems by biing aware of the following responsibilities: Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, rnay be considered an employer, and the workers who provide the labor may be considered employees. 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 ire 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 Department of Revenue at 503-378-4988. Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purposes -on 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 With-holding and Unemployment lnsurance Tax. To flle 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 it tne 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. o a Other Responsibilities of Homeowners: 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 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 tr--^^^*, ^..,nar :innta.i A-?n16 This Copy for Permit