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Home My WebLink AboutPermit Electrical 1996-10-30/\ SPF}A{GFIELD One Circuit Each Additional SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee TOTAL 3 0 ,.1o1" -{? 225 FI'PTE STRXET : .'!i1..;1;' SPRINGFTELD, oREGoN 97477 INSPECTION REQUESTz 726-3769 OFPICE: 726-3759 l2T'r'o*ro,tr'S'*r'ArroN !,re U M' -------JLEerRrcAL PERHTT APPLTCATToN City Job Nunber 161 3. COHPI,ETE FEE SCEEDT'LE BELOV A- Nev Residential-Single or Multi-Family per dvel-Iing unit. Service fncluded:Items , Cost 1000 sq.ft. or l-ess Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling SerVice or Feeder $ 8s.00 s 1s.00 s 40.00 B Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps _401 amps to 600 amPs _ 601 amps to 1000 amps- 0ver l-000 amps/volts Reconnect Only 1 IJGAI DESCRIPTIONoLl c) Od Sum JOB Crtcqt5 DESCRITTION d"lQJ Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2-CONTRACTOR INSTALLATION OT{LY EIec ical Contractor Address Ci ty Supe Expi Cons Expi Signa one ber Et ctrician s s0.00 s 60.00 s100.00 $130.00 $300.00s 40.00rvisor Li ration Date tr Contr. ration s Name ress 16 7o d (7 D C Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or less $ 40.00 over 4b1 to 60o amps - $ Bo.oo Over 600 amps or 1000-toTTs see "B" above Branch Circuits Nev, Alteration or Extension Per Panelf"re)aw4) 1T,1 'ci ty ',- rJ Phone 7 t lt-l - P7 Lt> OIJNER INSTALLATION The installation is being made on property I ovn vhich is not intended for sa1e, lease or rent. rs Si ture: DATE: E. Miscellaneous (Service/feeder not included) Circuit or vith Service or Feeder Permi t t / -Each installation Pump or irrigation $ Sign/Outline Lightine S t imited Energy/Res - $ Limited Energy/Comm S $ 3s.00 $ 2.00 g.do (-@ 40.00 40.00 20.00 36.00 of Supervising mbe te RECETVED 5 7 o? 7 l-/ I 225 FIFTH STREET SPRTNGFTELD, oREGoN 97477 INSPECf,I0N REQUESTz 726-3 oFFICE: 726-3759 The lollowing proiect as submitted ln9 thq il,"ii'ri, rii'll ?5es' not require epecif ic land approval.LDEzonl a,^y I 'n'lq ELESTRTcAL 169 ' SPr,..{(iFtELO 1000 sq.ft. or less Each add i. t ional 500 sq. ft or portion t hereo f Each Manuf'd Home- or Modular Dvelling Service or Feeder Services or Feeders InstaIlation, Alterations or Relocation: 200 amps or less -Z-201 amps to 400 amPs - 401 amps to 600 amPS - 601 amps to 1000 amPS- Over 1000 amps/vo1ts Reconnect 0n1y SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL M 3. COHPLETE FEE SCffiDTILE BELOS Nev Residential-Sing1e or MuIt j.-Fami.Iy per dwelling uni t. Service Included:Items Cost ONf 1 TI I,EGAI DE 110'44 SCRTPTION5zl oq A B C Sum $ 8s.00 s ls.00 $ 40.00 fl-04 ee ttBtt a5ove JOB ON Permits are non-trans ferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY ectrical Contractor Add s Ci ty Phon Supervisor cense er Expiration Date Constr Contr. Expi ra t i S lCLan 0vners Name Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or fess 201 amps to 400 amPs - Over 401- to 600 amps over 600 amps or 1000-7ofTs s s0.00 s 60.00 $100.00 s130. 00 $300.00 $ 40.00 40.00 55.00 80.00 $ s $ s Address t Ci Phone OVNER ALTATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. rs Signat D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.0O E. MisceLlaneous (Service/feeder not included) -Each installation Pump or irrigation S sign/outline Lighting- $ L:.mi ted Energy/Res - $ Limited Energy/Comm S 40.00 40.00 20.00 36.00 DATE: ure o f Supervising Da te RECEIVED 5 50 rcL--- Permit #: Address:tbTo /fu 5l- Issued by:L Date:/0--q Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Inw, 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, 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 filedwith the permit. Fill in the appropriate blanks and initial boxes r and2, and either box 34 or 38: 1. I own, reside in, or will reside in the completed structure. 2.r understand that I must register as a construction contractor if the structure is sold or offered for salebefore or upon completion. 3,{. My general contractor is _ (Name) Contractor regis. #I will instruct my general contractor that all subcontractors who work on the structure must beregistered with the Construction Contractors Board. If I hire subcontractors, I will hire only subcontractors registered with the construction contractorsBoard' If I change 11-mind and hire a general contractoi, I wil contract with a contractor who isregistered with the ccB and will immediately noti& the oifice issuing this building permit of thename of the contractor. I hereby certify thatthe above information is correct and thatl have read and do understand the Informationabout Construction Responsibilities on the reyerse side of this form. (Signature of permit applicant) (White copy to issutng agency permitfile, pink copy to applicant) OR Notice to (Date) f 38. I will be my own general contractor. \-.1 - - .-.: Informatis U,SL-InternaI Revenue Service: As an employer' y habb fotfie ta*'"payrnerit everi rf you dicin't actuaily at 1-800-829-1040 \_-./ ,l. ,'t _ n Notice to Property Owners . About eonstrugtion Hespon$ibilities you caI pre vent lair),,problcrru ily l:eurg aware of tbe following responsibilities and areas of concom. , , EM PLOYER HESPONSI BI LITIES: If you hire persgnl.pOt fesisteqtg{ f ift the_Corstruction Contractors Board to.do labor in.cor,rstructing -or assisting in the constru;oon *.r*pro;*a;?t "r are.ioentialrstructure,]y'9u will, in nlr1t instances, be rulid tt b* on employer and the people ;;;;;i, #;#pi.r";;. A; ft;;brJr*, v"u *ust co,optv y'3$:.'r:,towing:' ' ." ' Oregon,s rvithiitildingtax law:' As afl employer, you rriustwithhold income -t -* f:T "mployee ll'ages at the time employees ;;;;;. \;;, Jili$."fi"ele for.the tix p"ym.nt erren if you do#trrcttraily withh'oldthetd( fiom your ernployees. For more information, call the Oref,on flept; of'Revenue at 945-8091' r: unemployment insurance tax: As an employer, yoil {re required to pay a tax for unemployment insurance purposes on the wages cf all ernployees. For more informutiqnr."ali the,oregoq Emplqymerx.Dilision ar thoQEparjrnent of,Human eeyrrw at378-3524. \- I workers, compensation insurance: As an .*proy*r, v'o,i uri...iilj*it to fiie oregln wo,t ."lcompensati"" l1:j T:.# Hfirifl 1,*iff ftl**xilrnu:*:;n:li':#i$iT:,::{",:iii#J:F$:.r[F.Til[i#iT'I'iil1T,hffi call the workers, compensariorr Divisiorr at the Department of consum"r'uro n,-rsin"is Servicds at 945-?888' ---/ \-' ou r rust.withhold federal income'tax from'employees'wa6!es' ;iou willb9 .*ithho.Mthetax.Formoreinformation,callthelnternalRevenueSefvfee ,-: -1 ,, OTHEH RE$PONSIBILITIES AND AREAS OF CONCERN: code compliance: As the pcrr,,rit hol,Jer for this project, yoll afe responsible for resolving any failure to rneet code requiremepts that may be brought to your ame ntion through inspictic,ns. ' I i. . Llr.ility.pg properly damage insurance: contact your igsurance agent,to see if yog have adequate insurargp coverage for acci.dents ancl omission.i ,rr.t, * falting tools, paint overspr+y, ** a-""*ge rrom pipe punctures, fire, or work that must be re-done. Time to supervise emplo.yecs: Make sure you have sufficient time to supervise yorr employees Eraeitise: Make sure Yon have the exPertise to act as Yourown general contractor, to coordinate the work of rough-in and finish trades, anrJ to ritxifY truilding officials at the appropdat€ times so theY can perform the required If you have wrire or call the construcrion contractors Bciarcl (Po Box 14140; Salem, 5AY37B-4621). The Board i prop-own.Pm4 1194 -i at ?00 Summer St. NE S$ite 300, in Salem' 5052, ons