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Home My WebLink AboutPermit Electrical 2006-04-25Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line LD Buitding/Combination Permit PERMIT NO: COM2006-00486ISSUED: 0412512006 APPLIEDz 0412512006 EXPIRESz 1012512006 VALUE: SITE ADDRESS: 2723 33RD ST ASSESSOR'S PARCEL NO.: 1702193100304 PROJECT DESCRIPTION: Additional meter. Springfield TYPE OF WORK: ElectricalWork Only TYPE OF USE: Alteration Residential Phone Number: 541-747-8341 License Expiration Date Phone Owner: Address: FERGUSON CHERYL ROXANA 2723 33RD ST SPRINGFIELD OR 97477 Contractor Type Electrical Contractor OWNER TION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nla Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INF( PUBLIC IMPROVEMENTS Description Type of Construction Page I of2 Value Date Calculated *:tr \N)k" rb:q( Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Valuation Descriptiqu l Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00486ISSUED: 0412512006APPLIED: 0412512006EXPIRES: 1012512006 VALUE: Fee Description + lOoh Administrative Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid Total Value of Project Date Paid 4t25t06 4t2st06 4t25t06 4t25t06 Receipt Number 2200600000000000508 2200600000000000s08 2200600000000000s08 2200600000000000508 $7.80 $6.24 $15.00 $63.00 $92.04 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. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Reouired Insoect 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 certify 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 OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. O$4e&^fa..n "a -z-S-ti(a C)wner or Contractors Signature Pase 2 of 2 Date Construction Contractors Board 700 Summer St llE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 \ileb Address: www.ccb.state.or.us permitx; CQs(-^n! - sa\B Q2 Address: Z:lZ9 9 9x. Issued by:JbAf Date: Q-z5.oco Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensedwith the Constructton Contractors Board to sign thefollowing statement before a buildtng permit can be issued. This statement is requtredfor residential building, electrical, mechantcal and plumbing permits. Licensed architect and engineer applicants, exempt from licensing 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, md either box 3A or 38: 1. I own, reside in, or will reside in the completed structure. Z. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. tr 3A. My general contractor is (Name)(ccB #) I will instnrct my general contractor that all subcontractors who work on the structure must be licensed with the Constnrction Contractors Board. OR 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 immediatelynotiff 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 Property Owners about Construction Responsibilities on the reverse side of this form. X'X F 4-:!{-ot ) (Signature of permit applicant) (Date) (White copy to issuing agenq) pennitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPON$IBILITIES If you are acting as your own conffactor to coni'truct a new home or make a substantial improvemeiit to an existing structure, you can prevent nuury problans bybeir4 aware ofthe following'rerponsibilities asd concsms. Employer Responsibilities you will, in most instances, be ruled to be an "employer" and the contractorsyou contract with will bg l'employees" if you use contraotors not licensed with the Consffuction Contractors Board to do labor in co:rstruclr,"-g ol l9 assist in &e conshuction ol improvemart of a residential structure. As the employerryou must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes ftom employee wages atthe time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from yo91 . "*ploy""r. For more information, call the Departrnent of Revenue at 503-378-4988. t' : i Unemployment Insurance Tax: As an ernployer; you tre required to pay a tax for unemploymer$.insurance purposesl( on the wages of all ernployees. For more information, call the Oregon Employment Departmentat503-947-1488. ..'' ' ,/ The Oregon Business Identification Number (Bf.$ is a combined number for both Oreggn Wi*rtotaing # : Unemployrnent Inswanee Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formspay.htmll for the Iappropriate forms. Workers' Compensation Insnrance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workgrs' compensation insurance, you could be subject to penalties and be liable for ali claim costs if one of yotr employees is injured on the job. For more information, call the Workers' Compensation Dvision at the Department of Consumer and Business Services at 5A3-947 -7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' *ug.*'., You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800,829-4933 or visit their web site at www.irs,sov Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements lhat may b* brought to your attention through inspections. Liability and Property Damage fnsarance: Cohtact your insurance ag'ent to see if you have adeQuate insmance;/ coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone . i .- lz.- - t ' ,_ i- ..9-Time:Makesureyouhavesufficienttimetosuperviseyouremployees.. Expertise: Make sure you have the skills to act as your own general conkactor, to coordinate 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 Contractors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. ,, ,.i ,D!. i, ,4i1, . Property_owner.doc 06-0 1 -04 theabautOuinersCanstructianlnformationIftisfoNaticedevelopedbyTE:NO Property b ffte IoRswit?t I7ABaardContractorsaccardance ty Oregon Legislature.tnConstruction 5),a55(passed 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 phone C'\ of Springfield Official Receipt\_ /elopment Services Department Public Works Department RECEIPT #:2200600000000000s08 Job/Journal Number coM2006_00486 coM2006_00486 coM2006_00486 coM2006-00486 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 8% State Surcharge + l0%o Administrative Fee Date: 04/25t2006 l;16:08PM Amount Due 63.00 t5.00 6.24 7,80 ts; Type of Payment CreditCard Paid By CHERYL R FERG USON Received By Batch Number jmp Item Total: Number How Received l3ll80 In Person Payment Total: s92.04 Amount Paid $92.04 $e2.04 cReceintl Page 1 of I 412512006 SPFI'- "iFIELD Date ,t:) zoN INITIALS DATE SOURCE225 FIFTH STREET o SPRINGFIELD,OF.19T4TT o PH:(541)726-3753 o FAX: (541)726-3689 E LECTEICAL P ERM IT AP P LI CATI ON City Job Number Ce)G(Z-oob ooQ%co 1. LACATION LEGALDESCRTPTTON (1 OZ- \1 !1 adb JOB DESCzuPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. Contractor City Supen,isor Lioense Expiration Date Constr. Contr. Number Expiration Date -'lSignature of Supervising Electrician Owners Name Address C. Tenrporarv Sen'ices or liccdcrs Installation, Alteration or Relocation 200 Amps or less S -50'00 201 Amps to 400 AmPs S 69'00 401 Amps to 600 AmPs $100'00 Over 600 Amps or 1000 Volts see "B" above' D. Branch Circuits New Alteration or Extension Per Panel One Circuit Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less 201 Amps to 400 AmPS 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 Amps/Volts Reconnect OnlY Each Additional Circuit or with Service or Feeder Permit @ 4. SUBTOTAL OF ABO\,ts 8% State Surcharge 10% Administrative Fee TOTAL $50.00 ,V $ 63.00 $ 75.00 $ 125.00 $ 163.00 s375.00 $ 50.00 $ 43.00 $ 3.00 b9,oo (5.oa E. N{iscellirneous (Service/feeder uot included) -Each Installation Ciry OWNER INSTALLATION The installation is being made on properry I own which is not intended for sale, lease or rent. Owners Signature: Phone I tt-lK3q\Pump or irrigation $ 50.00 SigniOutline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45'00 * Surcharges . -r8.cD b.z &-t.go qz.oa Inspection Request: 726-3769 Shared Drive(T:)/Building Forrns/Electrical Permit Application I -06.doc $ 106.00 $ 19.00 3.CO\ITPLETE FEE SCHEDWE BELO'+I A. Nerv Residential - Single or Nlulti-Family per dwelling unit' ) CONTRACTOR B. services or Feeders - Installation. Alterations or Relocation: ^>(? 7LU Dit<3-,1- 3OO 3 A-:f.Z,,Zo-tL ['fr="p 4$,,.r\ j)"$', To Whom it may Concern: ln reference to my request for an addition Meter on my Second garage, my reasons for this request is to have light and power to this garage for the only purpose of having a place for our hobbie and standard house hold garage use. When we purchased the home last month we were not told or allowed to go into this garage because they had a old car parked in the garage... I did not know that the garage did not have power. ... The garage will only be used aia garage and never intended for any other use Thank You Cheryl Ferguson the owner of the home.... 412512006