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Home My WebLink AboutPermit Electrical 2005-07-06Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-7263676Frx 541:7 2647 69 I nspection Line CITY OF SPRIN Buitdin g/Combination Permit PERMIT NO: COM2005-00853ISSUED: 0710612005APPLEDt 0710612005E)?IRES: 0l/0612006 VALUE: SITE ADDRESS: 2534 37TH ST ASSESSOR'S PARCEL NO.: 1702194206000 PROJECT DESCRIPTION: Service upgrade and add 4 circuits Springfield TYPE OF TYPE OF USE: Electrical Work Only Alteration Residential Owner: Address: DONALD BAHRET 2534 37TH ST SPRINGFIELD OR 97477 Phone Number: 541-747-7032 Contractor TVpe Electrical Contractor FARMERS ELECTRIC Expiration Date 03t24t2007 License 89886 CONTRACTOR INFORMI # of Unib: Primary Occupancy Group: Secondaly Occupancy himary Construction Type Secondary Construction # of Bedrooms: Frontyrrd Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: R-3 VN # of Stories: Height of Type of Heat: Water Type: Range Type: Enerry Path: Sprinkled Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load:nlz Square Footage orBitl Amount 1 Overlay Dist: # Street Trees Paved Drive Rqd: oh of Lot Coverage: Afi to follow Notification Center. Those rules are set Type: in OAH 952-001-0010 through OAR 952-00bownspouts/Drains 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification REQUIRED PARI(NG Total: Handicapped: Compact: $ Per Sq Ft or multiplierDescription Tvpe of Construction lof2 Value Date Calculated Phone 541-998-6772 l, U lL t rli\ b 11\ r (rt(]vlA r r(rr\ | -\ U Valuation Descriotion I Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-36768ax 541:7 26-37 69 I nspection Line Buildin g/Co mbination Permit PERMIT NO: COM2005-00853ISSUED: 0710612005 APPLIED z 0710612005EIGIRES: 01/0612006 VALUE: Fee Description + l0Yo Administrative Fee + loh Sttte Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Amount Paid $7.s0 $s.25 $12.00 $63.00 $87.75 Total Value of Project Date Paid 7t6105 7t6t0s 7t6t05 7t6t05 Receipt Number r200500000000000948 1200500000000000948 1200500000000000948 1200s00000000000948 Fees Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Rpnrrirpd Insnecf By signaturer l state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certiff that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certi$ 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 2oI 2 Date LL- 225 FIFTH STREET . SPRINGFIELD, OP.97477 O PH:(541)726-3753 O FAX: (54 E L E CTRI CAL P ERMIT AP P LICATI ON City Job Number COrArcof-oc2 8-S-3 Date .i.-t .,',zeo Si0 Ao os rrrowrng project itne! do6s not has the following land use N..r4 t7 1 LOCATI ON O F INSTALIAT'ION +r. LEGAL DESCRIPTION 70 Zt9tl L o6000 JOB DESCRIPTION .*J Permits are non-transferable and if work is " not started within 180 days of issuance or if work is Suspended for 180 daYs. ., Electrical Contractor Address Expiration Date -,,'/ Constr. Conff of Supervising Electrician 3. COMPLEI|E P-EE SCHEDL,LE BELOW A. New Residentiat = Single or lVlulti-Family per drvelling unit' Service Included 1000 sq. ft. or less Each additional500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder ThomrnlcFamotdar$b $ 106.00 lst $ 19.00 ss0.00 $ 63.00 $ 75.00 $12s.00 $163.00 $375.00 $ 50.00 B. {010 s q 3={c" one D. tion Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. New Alteration or Extension Per Panel One Circuit $ 43.00 Each Additional Circuit or with , , Service or Feeder Permit t( $ 3'00 Owners Name Address Z City >Pr -1,\ Phone /a OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Pump or irrigation $ s0.00 $ 50.00 $ 25.00 Limited Energy/Commercial $ 45'00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges "fszt -703 t\ I S i grrlOutline Li ghting Limited Energy/Residential 7 t*' g7 7, Inspection Request: 726-3769 Shared Driv{T:)/Building Forms/Electrical Permit Application I 43.doc Phone Supervisor License Number I 200 mayobtain rurnberforthe C. "TEmPorary Services or Feeders to 63 City -Each Installation 4. .. SW,TOTAL OiABOW '|Yo State Surcharge l0% Administrative Fee TOTAL aP,P76Y21 aPProvat 225 FIFTH STREET . SPRINGFIELD, OR97477 o PH:(541)726-3753 o FAX: (541)72 PERMIT APPLICA City Job S-Date ning ! (> .z^' BELOI,I/ ry 1 LOCAT'ION OF City J 3. LEGAL JOB DESCRIPTION " not Suspended for 180 daYs. Address L and expire if work is 180 days of issuance or if work is 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 or $ 106.00 s 19.00 $50.00 oo A. B. C. E. e ruc Phone J.ovl,lq" 2oo Amps or less 6')$ 63.00 $ 75.00 sl2s.00 $ 163.00 .00 $ 43.00 $ 3.00 $ 50.00 $ 50.00 $ 2s.00 $ 4s.00 Or Supervisor License Number Expiration Date lD- M"ffi; 3q /bs Amps/Volts Reconnect Only egon \atN r New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit Pump or irrigation Sigrr/Outline Lighting Limited Energy/Residential Limited Energy/Commercial 201 Amps to 400 Amps 401 Amps to 600 Amps to 1000 Amps 7o/, Stzte Surcharge l0% Administrative Fee TOTAL ol o Consr. Contr. Number 6q 6AL 4D7 Signature of Supervising Electrician n_ Owners eddressJ 3 8f cdsrta Phone 7?z-v--/l OWNEX INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 7t tz tion o ,lLo 7fo 52f d5 Dz'LInspection Request: 726-3769 4. Shared Driv{T:)iBuilding Forms/Electrical Permit Application l43.doc Expiration Date Alterations or 69.00 $100.00 200 20t 401 Volts see "B" above. D. Branch \0u- Jn' Status: Issued 225 Fifth Street, Springfield, OR 541J263753 Phone 541-726-3676Fax 541:7 2637 69 Inspe ction Line GFIELD Buildin g/Co mbinatio n Permit PERMIT NO: COM2005-00853ISSUED: 0710612005APPLED: 0710612005E)GIRES: 01/0612006 VALUE: SITE ADDRESS: 2534 37TII ST ASSESSOR'S PARCEL NO.: 1702194206000 PROJECT DESCRIPTION: Service upgrade and add 4 circuits Springfield TYPE OF TYPE OF USE: Electrical Work Only Alteration Residential Owner: Address: Contractor TVpe Electrical Contractor OWI\ER DONALD BAHRET 2534 37TH ST SPRINGFIELD OR 97477 Phone Number: 541-7 47 -7032 License Expiration Date Phone CONTRACTOR INFOR] # of Unib: Primary Occupancy Group: Secondary Occupancy Piimary Construction Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Secondary Construction # of Bedrooms: ro n number nla Center Front;nrd Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm SewerAvailable: Special Instruction: Notes: Overlay Dist: # Street Trees Paved Drive Rqd: oh of Lot Coverage: Sidewalk Type: DownspoutMDrains REQUIRED PARKING Total: Handicapped: Compact: PIRE II tIS PEi ANDOI L. Vvuntr MIT IS NU I ED FOR ,tU un to n DAY PERIOD $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROYEMENTS Description Type of Construction lof2 Value Date Calculated J lIuff.UUrtr rtrr trXivrar rtrt\l to torth by Valuation Descrintion I Status: Issued 225 Flfth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Ftx 541:7 2637 69 I ns pection Line Buildin g/Co mbination Permit PERMIT NO: COM2005-00853ISSUED: 0710612005APPLIEDz 0710612005E)PIRES: 01/0612006 VALUE: Fee Description + l0o/o Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Amount Paid $7.s0 $s.2s $r2.00 $63.00 $87.75 Total Value of Project Date Paid 7t6t0s 7t6t05 7t6t0s 7t6t0s Receipt Number 1200500000000000948 1200s00000000000948 1200s00000000000948 1200500000000000948 Plan Reviews To Request an inspection call the24 hour recording at 72G3769. AII 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 Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Reorrired fnsnecf By signature,I state and agree, that I have carefully examined thg ssmplet€d 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 SpringfieH 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 Seruices 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 during construction J^1.^ b - ?ooS Owner or Contractors Signature 2oI 2 Date J .,!-rl _./ r ees raro I Construction Contractors Board Permit *: COrrlZo*S-C9CJ q<.f3 Address:tL- >l Issued by:Date: Statement: Information Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensedwith 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 befiled with the permtt. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38: 700 Summer St ltE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:www.cc$tg!94g Sr El-2. -Nf, I own, reside in, or will reside in the completed structure. 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 instruct my general contractor that all subcontractors who work on the strrcture must be licensed with the Construction Confractors Board. OR B. 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 immediately notiff the office issuing this building permit of the nzrme 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. fi,^rl lZ B,-\ff J.^[^ q , rgs5 (Signature of permit applicant) (White copy to issuing agency permitfile, pink copy to applicant.)---! (o'6 Property_owner. doc 06-0 I -04 .Acting as 1our Own General Contractor? rNFoRMATpni mortcE To pRopERTy owNERS ABOUT CONSTRUCTION RESPONSIBILITIES \ NATE: This lnformatian Natico to Property awners about Construction Respansibilities was devetoped by the Construction Contractors Eoard in accordance with ORS 7A1.055(5), passed by the 1989 Oregan Legistature. If you are acting as your own contractor to construct a new home or make a subs,tantial improvement to an exisling structure, you can prevent many probiems by being aware of the following responsibilities and concerns. Employer Responsibilities You will, in most instances, be ruied to be an o'employer" and the contractors you contract with will be "employees" if you q$e gonkastors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the conskuction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's lilithholding Tax Law: As an employer, you must withhold income taxes from employee wages at the tirne employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax fiom your employees. For more information, call the Deparbnent of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemploymertt insurance purposet> on the wages of all employees. For more information, call the Oregon Employmant Department at 503-947-1488. The Oregon Business Identification Number (BhI) is a combined number fur both Oregon Withhoiding # Unernployment Insurance Tax. To file for a BIN, cali 503-945-8091 or www.dor.stale.or.us/formspay.htmll for the appropriate forms. : ; Workers' Compensation I*surance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must ebtain 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 yor.r employees is injured on the job. For more informafion, call the Workers' Compensation Division at the Department of Consumer and Business Services at 543-947 -7 815. U.S. fnternal Revenue Service: As an employer, you must withhold federal income taX from employeesl wagoql' You will be liable for the tax payment even if you didn't actuaily withhold &e tax. For a Federal EIN number, call t6- Code Compliance: As the permit holder for this project, you are re sponsible for resolving'ilny failure to meet code requirementsthatmaybebroughttoyourattentionthrcughinspections Liability and Property Damage fnsurance: Contact your insurance agint to see if you have adequate insuranie coverage for accidents and omissions such as failing tools, paint over spray, water damage from pipe punclures, fire or work that must be redone. Time:lvIakesureyouhavesufficienttimetosuperviseyouremp1oyees. Expertise: Make sure you havb tlt,i skilis to act as your ow.h generil confractor, to coordinate the work of rough-in and finish trades, and to notify buiiding officiais as the appropriate times so they can perform the req*i:"ed irspections. If you have additional questions call the Constniction Conkactors Board (503-3784621) or write the agency at P0 Box 14140, salem, oR 97309-5052- . -r,, ,){i .,c,,.,:,r..,:, v : Properfy_owner.doc 06-0 1 -04 225 Fifth Street Springfield, Oregon 97 477 541:72G3759 Phone City of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT#: 1200500000000000948 Date: 0710612005 9:03:05AM Job/Journal Number coM2005-00853 coM2005-00853 coM200s-00853 coM2005-00853 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + l0% Administrative Fee Amount Due 63.00 12.00 5.25 7.50 Item Total:$87.75 Payments: Tlpe of Payment Received By Check Number Batch Number Auttorization Number How Received Amount PaidPaid By Check DONALD BAHRET djb 8210 In Person $87.75 Payment Totat: -55ffi 7t6t2005 I of I ryr3l : FROIl :SUB ELECTRIC FRX NO. 154L1262399 @8 2@@5 @3t2?Pl1 P2 Springfield Uttlitr Boatd Eteciric Service Cenbr 1001 Main fireel $Pringfietd, OR 97477 541-726'2395 511-7202399 Fax Letter of Request For Service Connection EMERGENCY RECONNECT ONLY This letter to be used only if local inspector is unavailable' Other use may result in tampering charges' Date:7'6 4g- n,,1tg-r" J am requ esting this service be energized in compliance with oRS47e.570 My reason for requesting such hookuP: Ir Ow [,1 s </a.f )c t,Jo*. (4 Permit#:o0 Bfs PTEASE IN FULL Address of Service Location:L 3 Supervisor License #:*-, FULL c--Contractor's #: Iq:f ot Expiration Date: ' lD-t 'DL Name of ComPanY EmPloYed Address of ComPanY: Telephone Number of ComPanY: 0 Ol.' r I q ftilA konJ uut &t Date lnspection Called F $ignature of Supervisor Electrici S:forms/Enginoeing/Letter of Request for Sevlce Connacllon s f L q, aL 1)u ,A{e k,l- riom SUB ELECIRIC DATE: TO:L-ts*ilo,PEr+ FROIII: FAX:'/ 26-3b PHONET @a 2005 @3i27P11 P1FRX NO. :54L1262399 FAX CO VER SHEET ELECTRIG DEPARTMENT 1001 Maln Strest $prlngfleld, OR 07477' (641) 726-2s96 o5- Number of pages lndudlng oovgr eheet: llllearager --f-l*, &rt/^ 253/ ."i Arlr*)HA* % 37# 5"r ,IO(!'I MAIN STREET ePR[.loFtELD, oR 07477 FAXr (51{} 720't8Q0 -"-/'lroOrtn :" -7t4:a7L? I [.) t) AZA*xt-dAf f/"*Z'*L /--