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Home My WebLink AboutPermit Electrical 2005-12-21Status: Issued 225 Fifth Street, Springfield, OR 541.:7263753 Phone 541-726-3676Fax 541:1 26-37 69 I nspection Line OF SPRIN Buildin g/Combinatio n Permit PERMIT NO: COM2005-01761ISSUED: 1212112005APPLIED: 1212112005 E)GIRESz 0612112006 VALUE: SITE ADDRESS: 2135 8TH ST ASSESSOR'S PARCEL NO.: 1703261201212 PROJECT DESCRIPTION: Replace service panel Springfield TYPE OF TYPE OF USE: Electrical Work Only Repair Residential Owner: Address: Contractor Type Electrical SCOTT DERAGISCH 2135 8TH ST SPRINGFIELD OR 97477 # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: o/o of Lot Phone Number: 541-747-0665 Expiration Date Phone Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING \t {eq\}i{es'j 'Jtr\ tJ gr) ,nOS \a{'l e oteqon \orthseta(e t Contractor OWI\ER 11\a'j ob\a N ote1O $ Per Sq Ft or muhiplier td Square Footage orBftI Amount Type: Downspouts/Drains r .{Ot}eNet # of Unib: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontlard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacls: Street Storm Sewer Available: Special Instruction: Notes: R-3 VN nla $$ DEVELOPMENT INFORMATION Description Tvpe of Construction lof2 Value Date Calculated [.}- ^Nn -00 Valuation Description I Status: Issued 225 Fifth Street, Springfield, OR 541:126-3753 Phone 541-726-3676Fax 541:7 26-37 69 I nspe ction Line F PRINGFIELI} Buildin g/Co mbination Permit PERMITNO: COM2005-01761ISSUEDT 1212112005APPLED:. 1212112005E)?IRBSz 0612112006 VALUE: Fee Description + l0oh Administrative Fee + 7Yo State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Amount Paid $6.30 $4.41 $63.00 $73.71 Total Value of Project Date Paid t2t2u05 t2t2u05 t2t2u05 Receipt Number 1200500000000001847 1200500000000001847 1200500000000001847 Fees Pa Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Electric Service: Approval required prior to utility company energizing service. By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certiS that any and all work performed shall be done in accordance * with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCT PANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certi$ that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to all required inspections are requested at the proper time, that each address is readable from the that is tocated at ttre front of the property, and the approved set of plans will remain on the site ta 0s- at Owner or Contractors 2of2 Date L ml I Keoured Inspecnons I / Construction Contractors Board pennit g{?*arco\ - C) la 6 ( Address: Z t3 f 8{'^ Sl Issued by:\,?Da:rei lZ-Z(-o;- Statement: lnformation Notice to Property Owners About Gonstruction Responsibi Iities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not Itcensed with the Constraction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom ltcensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: fil. l. I own, reside in, or will reside in the completed structure. ,fif 2. I understand that I must become licensed as a constrrction contractor if the structure is sold or offered for sale before or on completion. (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR )E 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to about Construction Responsibilities on the reverse side of this form. 700 Summer St ItlE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:lgg.gfulgl4g p/zrhs- of permit applicant) _------r-16"A (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 tr 3A. My general contractor is Acting as Your Own General Cd-ntractor? INFORIIiATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES If you are acting as your own contractor to construct a new home or make a subshntial improvement to an existing str*cture, y$T.I can prevent many problems by being aware of the following responsibilities and concerns. Employer Responsibilities You wil.l, in most iastances, be ruIed to be an lnemployer" and the contractors you contract with wil[be "ernployees" if you qse contractors not licensed with the Constnrction ConFactors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. Ac the employer, you must comply with the fqllowiqf: Oregon's Withhotding Tax Law: As an employer, you must witlihold income taxes from employee 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 Deparhnent of Revenue at 503-3784988. Unemployment fnsurance Tax: As an employer, you are required to pay a tax fot unemployment insuraace purposes on the wages of all employees" For more information, call the Oregon Employment Department at 503-947-1488 The Oregon Business Identification Number (BII.I) is a combined numbar for both Orggon W-itt*p,lding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or lvww.dor.state.or.us/formspay.htrnll for the appropriate forms. lYorkers' Compensation Insurance: As an employer, you are subject lo the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on the job" For more information, call the Workers' Compensation Division at the Department of Consunrer and Business Services at 503-947-78 I 5. U.S. Internal Revenue Service: As an employer, you must withhold fedsral income'tax ftom employees' wages)- You will be liable for the tax payrnent even if you didn't actually withhold the tax. For a Federal EIN number, call the Other Responsibilities and Areas of Concerns Code Complinnce: As the permit holder for this project, you are responsible for resoMng any failwe to meet code requirements that may be brought to your attention through inspections. Liability and Property f)amage fnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and on"rissions such as iailing tootrs, paint over spray. water damage fiom pipe punctures, fire or Time; }i{ake *ure you have suificier:{ time to supcrvise your ernployees. [xpertise: Make sure ycu have the skills to act as your own g;iral contracior, to coordinat'e the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Cor:tractors Board (503-3784621) or write the agency at P0 Box 14140' salem' oR 97309-5052' i:i ' "' ') 'If,'r! l Property_owner.doc 06-0 I -M I c::truction,co*r:ctars aoara,:,ac:Ynce yitn.ons_!0t.oss(s), eas:eYtle rgas orej:rt.3Y.Yre, I 225 Fifth Street Springfhld, Oregon 97 477 541:726-3759 Phone -W of Springfield Official Receipt - evelopment Services Department Public Works Department RECEIPT#: 1200s00000000001847 Date: 1212112005 8:30:05AM Job/Journal Number coM2005-01761 coM2005-01761 coM2005-01761 Description + lYo State Surcharge + l0% Administrative Fee Perm Serv/Fdr 200 amps or less Amount Due 4.41 6.30 63.00 Item Total:$73.71 Payments: Tlpe of Palment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check DEAN BERGEN djb 8037 In Person Payment Total: s73.1r -$ffir,, I 't ,) 1212U2005 lofl {lnru& City of Springfield 225 Fifth Street, Springfield, OR97477 541-726-3759 Phone 541-726-3676Fax May 04,2006 DERAGISCH SCOTT 2135 STH ST SPRINGFIELD OR 97477 Job Number: Location: coM200s-0r76r 2135 STH ST Project:Replace service panel Dear Permit Holder: The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid, the work which has been authorized by the permit must begin within 180 days of the date of issuance, and an inspection must be requested at least every 180 days' According to our records, you obtained a permit for a project at2135 8TH ST which is set to expire on 6l2lD0A6. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notify you that your permit(s) will be expiring shortly. If you are ready to request an inspection for your project, please phone the inspection line at 541'726-3169. If you do not request an inspection prior to the expiration date, your permit(s) will expire and additional permit fees will be required in order to complete your project. If you have any questions, please feel free to phone me at 541-126-3190. Sincerely, Lisa Hopper ?I Building Safety Supervisor The follol&iQg Proiect as submitted require sPtBzuning does not I 5 WL LEGAL DESCRIPTION F INSTALI-4,7'ION 225 FIFTH STREET o SPRINGFIELD, OR 97477 o PH:(541)726-3753 ' FAli ELECT RI CAL P E KM IT APPLI CATI ON City Job Number COnt s- or 76 (o Autl r(.,rlzecl stgnature Date /7-z (-o r 3.CO IIIPLET'E F EE S CH E D U LIi BE LOW A. Nen' Residential - Single or Multi-Family' per dwelling unit. Service Included 601 Amps to 1000 Amps $ 163.00 la 03Z6(Z otz IZ City Over 1000 Amps/Volts Reconnect OnlY C. Tenrporar-v Services or Feeders Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit E. Nliscellaneous SigniOutli os Limited Limited $37s.00 $ s0.00 $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 Supervisor Lber // License/um Expiration Da('/ Expiration Date Constr. Contr. Number of Supervising Electrician Owners Name Address ,9 i € No,8 e e. ,u'SftDf /,"/L Phone 7(7 -obb{Pump or OWNER INSTALLATION The instaliation is being made on property I own which is not intended for sale, lease or rent.Minimum Electric it Inspection Fee is $45.00 * Surcharges $s $ s0.00 $ 25.00 $ 4s.00 4. SUBTATALOFABOW 7% State Surcharge 10% Administrative Fee TOTAL L3Signature vq( 670 Inspection Request: 726'37 69 Shared Drive(T:)/Building Fonns/Electrical Penuit Application l-03.doc ?t JOB DESCRIPTION Permits are non-transferable and not started within 180 days of Suspended for 180 daYs. 2.CONTRACTOR Electrical Contractor Address 1000 sq. ft. 61 ft. or or ss0.00 Alterations or Relocation : $106.00 s 19.00 L= v'Of\O \A). the \he \s Amps to 400 Amps -atl