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Home My WebLink AboutPermit Electrical 2004-04-22Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-00453ISSUED: 0412212004APPLIEDz 0412212004 EXPIRESz 1012212004 VALUE: SITE ADDRESS: 496 36TH ST ASSESSOR'S PARCELNO.: 1702311302500 PROJECT DESCRIPTION: 200 amp service Owner: RON WICHERT Address: 496 36TH ST SPRINGFIELD OR 97478 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: New Residential PhoneNumber: 54l-221-8002 License Expiration Date PhoneContractor Type Electrical Contractor OWNER CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 VN SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: COMMENC ED OR ANY 180 DAY pgglQlved Drive Rqd: Yo ofLot Coverage: ATTENT ION:Oregon law requ tres you to REQUIRED PARIflNG Total: Handicapped: Compact: NOTICE: THIS PER AUlHORI MIT SH ZED UND UtilitY Sidewalk Type: Downspouts/Drains: lotificatio tollow rul n Center' Thosees adoPted bY the Oregon rules are oAR 952-00 set fort in oAR 952-00 1-0010 thro'u calling the nurnber tor $ Per Sq Ft or multiplier of the rules t' Square Footage or Bid Amount Total Yalue of Project Paee I of2 PUBLIC IMPROVEMENTS Description Type of Construction Value Date Calculated ]Il,l |,UII-L'II\(J I1\T (JI(IVIA I I(J1\ I IS NOT CITY F Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2004-00453ISSUED: 0412212004APPLIED: 0412212004 EXPIRESz 1012212004 VALUE: Fees Pa Fee Description + l0o Administrative Fee + 7Yo State Surcharge Perm Serv/Fdr 200 amps or less Total Amount Paid Amount Paid $6.30 $4.41 $63.00 $73.7r Date Paid 4t22t04 4t22104 4t22t04 Receipt Number 1200400000000000s2s r200400000000000s2s 1200400000000000525 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 of2 Keourreo lnsDecuons Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress:ryfulg[4g permit *.COwtzp -OOt{ t3 L) a/ Address: t / lc Z6-t'q sl Issued by:o^t", V /Zzhv/7 E+ Statement: lnformation 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 701.010(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 3A or 38 l. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) -x I will instruct my general contractor that all subcontractors who work on the strrcture must be licensed with the Construction Contractors Board. OR 3B. I will be my own general contactor. 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 certify that the information is correct and that I have read and do understand the Information Property Construction Responsibilities on the reverse side -( of L (Signature o f permit applicant) (While copy to issuing agency perrnitfile, pink copy to applicant.) ) Property_owner.doc 03/ I I /03 tr Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CON$TRUCTION RESPON$IBI LITIES ,VOff: This lnfarmation Notrce ta Praperty Owners afiouf Construction Responsi*ilifres w#$ develaped by the Consfrucfibn Confraclors tsaard in accordance wf,? OR,S 701.A55$), passed by the 1989 Oregon tagistiture. lf you are acting as yonr own contractor to construct a nsw home or make a substantial improvement to an existing structure, you can pr€vent many problems by being aware of the following responsibitities and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "employer" and the contractors you contract with will'be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in conskucting or to assist in the construction,or improvement of a residential structure. As the employer, you mu$t comply with the following: Oregon's Withholding Tax 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 tax from your employees. Sor a State Business ID number, call the Business Information Center at 503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unernployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Departmeat at 5A3-947-1488. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Larry, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation 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 Revenuo Service: As an employer, you must withhold federal income tax frorn employees' wages. You will be ljabie fr:r the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this prdect, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage fnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and ornissions such as falling tools, paint ovsr spray, water damage from pipe punchnes, fiSe or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skilis to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notifu 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. Properfy*owner.doc 03ll I /03 zzirmrnsrREET e SpRINGFTELD, oR97477 o PH:(541)726-3753 oF ELE CT RICAL P ERM IT AP P LICATI O N CityJobNumber COtUV-o e7 f3 oate OLIZZ.)Zoning .ri ri 3 :.rj: ii i.d ";,s:: ti;1lil. 27- o $ 106.00 $ 19.00 $s0.00 Vqb Supervisor License Number Expiration Date 3bik r^l 6t- OZ 3TO JOB DESCRIPTION 7no a ht r(L Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1 Electrical Contractor J W l\L cV Address 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 Over 600 or 1000 Volts see "B" above. New Alteration or Extension Per Panel One Circuit C. D. s 63.00 $ 75.00 $125.00 $ 163.00 $37s.00 $ s0.00 6-3 (,,.- City r/c/ ptrn" 2Zt-ytnz NOT SHALL EXPIR ERM\T Installation. Alteration or Relocation F tF lHE2tldm[. o,'",, DOiitD hUfln*pt to 6oo Amps $ s0.00 $ 69.00 $100.00 $ 43.00 $ 3.00 $ 2s.00 $ 45.00 Fee is $45.00 * Surcharges Constr. Contr. Number Expiration Date Signature of Supervising ./ -ceo on is nsnt'lurHon D 65 \'t/ b3o a37 t Inspection Request: 726-3769 4. Shared Drive(T:)/Building Fonns/Electrical Pennit Application l-03-doc 1. / or Feeders DESCRIPTION A. ,,New Residential - Single or &Iulti-Farnily per drtelling unft., '' :,:: : l B. Sergices or Feetleis - Inslallation;Alterations or Relocation:. . Owners Name /", r8,n,h)o law Address City .\0r')^r a € c I OWNER INSTALLATION 0090- OAR 952-001 may obtain The installation is being made on is not intended for sale, lease or $ s0.00 $ 50.00 Permit Inspection ST]BTOTAL OF ABAW 7Yo State Surcharge l0% Administrative Fee TOTAL Those -4 Q '#:"ffi 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone ^ity of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT #: 1200400000000000525 Date: 0412212004 10:53:11AM Job/Journal Number coM2004-00453 coM2004-00453 coM2004-004s3 Description Perm Serv/Fdr 200 amps or less + 7o/o State Surcharge + l0% Administrative Fee Amount Due 63.00 4.41 6.30 Item Total:$73.71 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check ROYALE CONSTR djb In Person Payment Total: $73.71 -sE?r 561 l 4/22/2004 Page I of I suano