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Home My WebLink AboutPermit Electrical 2004-04-14Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00423ISSUED: 0411412004APPLIED: 0411412004 EXPIRESz 1011412004 VALUE: SITE ADDRESS: 475 35TH ST ASSESSOR'S PARCEL NO.: 1702312411800 PROJECT DESCRIPTION: Reconnect meter base OWNCT: SALINAS JUAN IGNACIO & MARY FRANCES Address: 475 35TH ST SPRINGFIELD OR 97478 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential License Expiration Date PhoneContractor Tvpe Electrical Contractor OWNER CONTRACTOR INFORMATION IFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Typer # of Bedrooms: R-3 YN # of Stories: Height of Structure Type of Heat: Water Type: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: ATT ENTION sa o/o oILot Coverage: NOTICE: THIS PERMTT SHALL EXPIRE IF THE W AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. REQUIRED PARIflNG Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount Sidewalk Type: Downspouts/Drains: Total Value of Project Pase I of2 Description Tvpe of Construction Value Date Calculated \m Range you to the Oregon UtilitY {otilication SETBACKS in OAR 0090 . You may obtain calling the center. nuinber {or the Valuation Description I Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line PERMIT NO: COM2004-00423ISSUED: 0411412004APPLIED:. 0411412004 EXPIRESz 1011412004 VALUE: Fee Description + l0o/o Administrative Fee + 1Yo State Surcharge Service Reconnect Total Amount Paid Amount Paid $s.00 $3.s0 $s0.00 $s8.s0 Date Paid 4n4t04 4n4t04 4n4t04 Receipt Number r200400000000000481 r200400000000000481 1200400000000000481 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. I 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 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. Owner or Contractors Signature Date Pase2 of? LLl rees raro I Keourred lnsDecttons l Construction Contractors Board Permit #: 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:ryslg!4 Address: @rvZe;.- y' -6 OqZ3 q7{ 35+^ >f Issued by:\a Date: Ll_/q _Ot-( Statement: Information Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction 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 licensing under ORS 701 .01 0(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 eitherbox 3A or 38: -k-l. I own, reside in, or will reside in the completed structure. )[f 2. I understand that I must become licensed as a constnrction contactor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) I will instruct my general confractor ttrat all subcontractors who work on the sfirrcture must be licensed with the Constnrction Contractors Board. OR 38. I will be my own general conhactor. 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 Property Owners about Construction Responsibilities on the reverse side of this form. L/ (Signature of permit applicant) (llhite copy to issuing agency perrnit file, pink copy to applicant.) ) Property_owner.doc 03i I l/03 Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERT ABOUT CONSTRUGTION RESPONSIBILffIES \J IVOff'i Tltis lnfarmatian Notice to Prapefty Owners about Construction Responsrbilltr'es Lyas deve/oped by the Constructian Contractors fuard in accordance with ARS 7A1.A55(5J, passed by the 198g Oregon tegistiture. If you are acting as your own contractor to construct a new home or make a subskntial improvement to an existing skucture, you can prevent many problems by being arvare of the follorving responsibilities and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "employey''and the conkactors you contract with will be "ernployees" if you use conhactors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construclion or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wagss at the time employees are paid. You will be liable for the tax payments even if you don't actually withhald the tax from your employees. For a State Business ID number, call the Business lnformation Center at 503-986-2200. Unemployment Insurance Tnx: As an employer, you are required to pay a tax for unernployment insurance purposes on the wages of all employees. Formore information, call the Oregon Enrployment Departmentat503447-1488. Workers' Compensation Insurancel As an employer, you are sulrject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compansation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on thejob. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Reyenue Service: As an employer, you You will be liable for the tax payment even if you didn't, IR$ at 866-816-2065 or fax them at 801-620-71 15. must withhold federal income tax from employees' wages. actually withhold the tax. For a Federal EIN number, call the Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this pmject, you are responsible for resolving any failure to meet code requirements that may be brought to your attenfion through inspecfions. Liabitity and Property Damage fnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidonts and omissions such as falling tools, paint oyer spray, water damage from pipe punctures, fre or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the shlls to act as yolr own general conffactor, to coordinate the work of rough-in and finish kades, and to nctifu 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\ ar write the agency at PO Box 14140, Salem, OR 97309-5052. Properfy_owner.doc 03i I lr'03 225 Fifth Street Springfieldo Oregon 97 477 541-726-3759 Phone ^ity of Springlield Official Receipt --evelopment Services Department Public Works Department RECEIPT #: 1200400000000000481 Date: 0411412004 1:42:05PM Job/Journal Number coM2004-00423 coM2004-00423 coM2004-00423 Description + 7Yo State Surcharge + l0o/o Administrative Fee Service Reconnect Amount Due 3.50 5.00 50.00 Item Total:$s8.s0 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check ruAN SALINAS djb s83 In Person $58.50 Payment Totat: -S5&-5d' 411412004 Page I of I t&.ll*sa3.o 225 FIFTII STREET . SPRINGFIELD, OR97477 o E LE CTRI CAL P ERMIT AP P LI CATI O N City Job Number -c;,o\73 Date 1/t,t /orJ PHz(541)726-3753 r FAX: -o $ 106.00 $ 19.00 $50.00 , approval Zoning Date 1. LEGAL DESCRIPTION 8CD JOB DESCRIPTION ?e-<o a*e<-F fulerert-Gr&Sr- Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. LOCAT'ION OF INS'TALI-A'I-ION 3. 4lg 3S+t-. Sl- - Single or Multi-Faruily per drvelling unit. 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 B., Electrical Contractor Address Constr. Contr. Number Expiration Date Signahrre of Supervising Electrician / C. Temporar.v Services or Feeders Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps S 69.00 401 Amps to 600 Amps $100.00 D. 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 $ 63.00 $ 75.00 $125.00 $ 163.00 $37s.00 $ s0.00 3CiryPhone Supervisor License Number Expiration Date or/ Owners Name ora * YlAa o Address Ll25 35u^ 4,. 5 eO Pump or Jr1*o""t tot aoc-ffi6 City OWNER INSTALLATION A-Phone / 5 -g (,aOO Sign/Outline Lighting Limited Energy/Residential TOTALInspection Request: 726-3769 Shared Drive(T:)iBuilding Fonns/Electrical Pennit Application I -03.doc e $ s0.00 $ 25.00 $ 45.00 Fee is $45.00 t Surcharges raqulrenot a.s use Limited OR IS P ER\00 z"z, State Surcharge ED 3so >oc F-'e=