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Home My WebLink AboutPermit Electrical 1994-07-25CITY OF SPR'NGF'ELD, OREGO'V siPlrINGFTELO sPRrNGrrBLD, OREG0N 97 INSPECTION REQIIEST: 7 225 FTFTH STREET APPTOVAI' as eubrnltlod har the lollowlngThe toltowlng Foioct zoning, and doos not require ePecific 477 6 land use ELECTRICAL PERUIT APPLICATION Ci ty Job Nunber ?y'l/=a FEE SCEEDUI,E BELOII Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost 3-000 sq. f t. or less Each addi.tional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 $ 1s.00 s 40.00 Services or Feeders InstalIation, Alterations or Relocation: OFFICE: 726-3759 Dato 1 ON OF -fl^ LEGAI DESCRIPTION JOB 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. COMRACTOR INSTALI,ATION ONLY Electrical Contractor Address Ci tv Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Name Address Ci OVNER INSTALI.,ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Orner gnature: 200 amps or less 201 amps to 400 amps -40L amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amps/volts - Reconnect 0n1Y 200 207 0ver 0ver Temporary Services or Feeders Installation, Alteration or Relocation 3 A Sum B c $ s0.00 s 60.00 s 100. 00 $130.00 s300.00 $ 40.00 amps or less $ 40-00 abt to 600 amps $ 80.00 OOO .rp" or tbOO vo-Es see "Bu aE6G- D Branch Circuits Nev, Alteration or Extension Per Panel One Circuit / s 3s.oo or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utline Lighting- Limited Energy/Res SUBTOTAL OF ABOVE 5% State Surcharge 32 Administrative Fee TOTAL zE €> one ?//'4* Each Additional Circuit or vith Service s 40.00 $ 40.00 $ 20.00 $ 36.00 a-aD 5 DATE:.O RECETVED I /:.a7ra-/37 / aFe Issued by: Address: Date: Statemert: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires resid.ential 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, exemptfrom 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 ts 1. I own, reside in, or will reside in the completed structure. 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. 38. I will be my own general conffactor 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 noti$ the office issuing this building permit of the name of the contractor. Ihereby certify thatthe above information is correctand that I have readand do understand the Information Owners about Responsibilities on the reverse side of this (Signature of permit applicant) (Whrte copy to issuing agency perrnit file, pink copy to applicant) OR Notice to 7 4 ?/ Permit *: ?!// l> E r Information Notice to Property Owners AboS Cons!ryction Responsi bi l ities Note: 'fhis lnfr;rmation Notice to Property Owners about Construttion Responsibilities '., . ' x'ai deve lrlp*l hy, th[ Co]iilrruction Contractors Bourrl in ut-cordance v.'ith ORS 701.055(5). If you are acting as your c)$'n contractor to e onstrucl a new home or make a substantial improvernent to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBTLITIES: If you hire persous not registe4ed with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding thx law: As an employer, you must withhold 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 iax from your employees. For more information, call the Oregon Dept. of Revenue at 945-8091 . Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wagesofallemployees. Formoreinformation,calltheOregonEmploymentDivisionattlrcDepartmentofHumanResourres at378-3524 Workers' compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and mti* obtain workerql,compeqsltion insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penaltie"s and will be liable for all claim costs if one of your employees is rnjured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. tnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. You will be liable forthe tax payment even if you didn'raciually withhold the tax. For more information, call the Internal Revenue Service at 1-800-829-1040. 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 requirernents .. I that may be brought to your attention through inspections' ,''* Lisbility Bnd prwrty damage insurance: contact your insurance agent to see if you have acequate insurance coverage for accidenis and omiisions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. 5A3878-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 lt94 and finish