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Home My WebLink AboutPermit Electrical 2000-04-10SPRINGFIELD Job# 00-00543-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 1 Job Number: 00-00543-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot #: 03700 Subdivision: 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 1810 00012th St Spr AssessorsMap#: 17032441 Lot: Block: Addition ctTY oF SPRfiNGFfiEL4 ORECON Owner: Gary Branson Address: 2427 DebraDr Scope Of Work: Electrical Only extend service mast Phone Number: City/State/Zip: Alteration Springfield, OR97477 Value: $0 Quad Area: # Of Units: Constr. Type: Water Heater: Office Use - Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: To request an inspection callthe 24hour recording at726-3769. All inspections 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 working day. Required lnspections Electrical Electrical Service -Must be approved to obtain permanent power. # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Area (Sq Main:Accessory:Total: Fee Paid On Receipt# Value/Quantity Fee Amount Electrical Reconnect Only State Surcharge For Electrical Permit Electric Administrative Fee Total Electrical 04t10t2000 04t1012000 04t1012000 1182 1182 1182 1 $40.00 $2.80 $1.20 $44.00 Grand Total $44.00 Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? [ Construction Contractr,. s Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us I own, reside in, or will reside in the completed stnrcture Permit #: Address ru Issued by:Date Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who ore not registered with the Construction Contractors Board to sign the following statement before a building pearmit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3,{ or 38 Yr X2 I understand that I must register as a construction contractor if the structure is sold or offered for sale before or on completion. 3,\. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certi$that the above information is correct and that I have read and do understand the Information Notice Property about Construction Responsibilities on the reverse side of this form. permit applicant) prop-own/f/ 3-99 (Tlthite copy to issuing agency permit file, pink copy to applicant.) ) X \-, \--,/ Informatio'n Notice to Property Owners About Construction Responsi bilities troic.. 7'his lnJbrnutitttt ,\olit'e ltt Properlt Ov'nc,rs ahout (.'onstruL'f i()n Resp()nsil:ilities ;.rts tlett'ftryetl hr tht Constt'uctiose (.)ontractors lSr.taril ln at"corclant.e u,ith O{lS 7{}1.$55( j) lf vott are acting as )'our o1vt1 colltractor to construct a ne\l honre or lnake a substantial improlenrent to an existing structute. yotl can prevent many problems-by"' being a*are of ihe fbtlowing responsibilities and concerns. E m ployer Responsibilities If you hire persotrs not registered ivith the Corrstruction Contractors Board to clo labor in constructing or assisting in the construction or impro\ielnettl of a resicjerrtial structure. you rvill. in most instances. be ruled to be an entploy'er ancl tlre people 1'ou hire wiil he emplo."--ees. As the emplo,v-er, )'ou ntust comply.rvith tlre fullou,irrg: Oregon's rvithholiling tax'liivi'As an employer. vou must'rvithhold income taxes from employ.ee lvages at the time employees are paid. You lvill be liable for the tax payments even if you dontt actuall.v l'ithhold the tax from your ernployees. For more iufonnation. cail the Oregon Department ol'Revenue at 503-945-8091. Unemployment insurance tax: As an employer, )'ou are required to pay a tax for unemployment insurance purposes on tlte w'ages of all entployees. For more information, call the"Oregon Ilnrploymenl Department at 503-. .,379-3524. i ; 'r' ' Worktrs'compensation insuranec; As an ernployer, you,arf: subjectro tlre Oregon Workers'Compensation l-arv, and ntust obtain rvorkers^ compensation insurance for vtrur emploYees. Lf y,ru, fail tg obtain rvoLkers' colnpensation insurance, )'ou may be subject to penalties and rvill be liable for'all clairn cosrs if one of 1,.ouremployees is injured on the joLr. For niore infonnation" call the Workers' Conrpensaliern Divisiog at the Department of Consulner and [Jusiness Sen,ices a[ 503-947-78 i0. U.S. Internal Revenue Sen'ice: As an emplo)'er. )'ou nrust rvithhold federal income tax f,rgni enrployees' wages. You will ba liable for the !ai\, paytnent even if ,vou {idr't actually rvithhplcl l&e tax. For nore infbrmation, call the Internal Revenue Sen,ice at l-800-829-1040. .i ,, Other Responsibilities and Areas of Concern Code cam;rliance: As the perrnit hokler lbr this pro.iect. yorr are resporrsible li''r icsolvinc anr, lailrrre tp meei code requirements that mav he brorrglrt to l,orrr attention thrcugh inspectiorrs. Liabilifl and property damage insurance: Contact vour irisrrance agent to see if yiru hare l6erlrrate insuralrce coverage firr accidents and ontissi<lns sttch as fallins tools, paint overspra-v. waler clamage liorn pipe punctrrres. llre. or u'ork that must be re-donc. 'Iime to supen'ise ernplovees: Make sure you hale sutficienr tinre to supervise your ernplove,es. fxpertise: l\'lake surc v$u ltavc tlie expertise to act AS \'our olvn uenerAl contractor" to ci,)rrldisate t6c rrork',olrouglt*irt and f inisli trailes. artd to.qiotili huikling ol''flcials as the appropriate tinres so thEy,.can ;:e rfbrnr the rcquircclinspections. If you have additional questions. rvrite or calI the construction contractors Boarcl {po ISox l4 t10" salem, oR97309-5052' 503-178-462i)' The Board is located at 7a'0 s;;;.r St'NE. Suite 300. in Salem. prop-orvn,rfi 3-99 CITY OF SPR,,VGFIELD, OFEGO'V 225 FIPTE STREEf, SPRINGFIEIJ, OREGON 97 477 INSPECTION REQT,EST:. 726_3 OFPICE: 726-3759 Signature 1 OF I..EGAL JOB PTION Permits are non*transferable and expire if vork is not started vithin 1B0 days of issuance or if vork is suspended for 180 days. 2. COI{TRACTOR INSTALI,ATION ONIY Electrical Contractor Ci tv Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Address OVNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. 0vne S DATE: use ELECTRICAL PERI{IT APPLICATION Ci ty Job Number COHPI.,ETE PBE SCffiDT'I,E BELOV Nev Residential-Single or MuIti-Family per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular Dvelling Sertice or Feeder s 8s.00 $ 1s.00 $ 40.00 Services or Feeders Ins tallation, Alterations or Relocation: 3 A SPFIINGFIELl, SUBTOTAL OF ABOVE 7% state Surcharge 3Z Administrative Fee TOTAL AHT RECD:? $ 44.00 CHANEE: CASHIER:003 Sum citv%Phone ?{?-b6*c/ 200 amps or less 201 amps to 400 amps -40L amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amps/vo1ts Reconnect Oniy Z Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or less S 40'00 over 4b1 to 600 amps - $ 80.00 or"i ooO.amps ot-iboo uoTts see 'Bu aETil 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 insta]lation Pump or irrigation - Sign/Out1ine Light ing- Limited Energy/Res Limited Energy/Comm 66 B D $ s0.00 s 60.00 s100.00 s130. 00 $300.00s 40.00 #6o c s 40.00 s 40.00 s 20.00 s 36.00 RBCEIVED BI: re 1- 5 o