The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2005-08-09Buildin g/Co mbination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:126-3753 Phone 541-7263676Fax 541:7 2637 69 I nspection Line PERMIT NO: ISSUED-:'* APPLIED: E)PIRES: VALUE: coM2005-01079 08/09/200s 08/09/200s 04t04t2006 $ s00.00 SITE ADDRESS: 378 S 43RD ST Springfield TYPE OF Single Family Residence ASSESSOR'S PARCEL NO.: 1702323403200 TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace wiring for 14 circuits in existing panel. Interior repairs of mechanical, plumbing and structural for subfloor replacement. Phone Number: 54l-736-9213Owner: Address: Contractor Type General Electrical Mechanical ROBERT MXON 378 S 43RD ST SPRINGFIELD OR 97478 Contractor OWNER License Expiration Date Phone rrill fi&f 10t04t200s s41-e1s-e828INC CONTRACTOR INFORMA'II ON # of Units: Primary Occupancy Group: Secondary Occupancy " Primary Construction Type Secondary Construction # of Bedrooms: Frontlard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: - Special Instruction: NIT tt0 0ril R-3 ERMIl IS NOT nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: to OWNER VN Ileight of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: oh of Lot Coverage: REQUIRED PARIflNG Total: Handicapped: Compact: DEVELOPMENT INFORMATION Notes: 1of 3 m EASTSIDE OWNER Oregon CITY OF SPRIN Building/Co mbination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Rax 541:7 26-37 69 I nspection Line PERMIT NO: COM2005-01079ISSUED: 08/09/2005APPLIED: 08/091200sE)PIRESz 0410412006VALUE: $ 500.00 Description Estimate Fee Description + l0%o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add -Mechanical Issuance Fee- + l0o/o Administrative Fee + 7o/o State Surcharge Building Permit Dryer Vent Exhaust Hoods Fixture Minimum/Adj ustment Mechanical Vent Fan Total Amount Type of Construction Estimate $ Per Sq Ft Square Footage or muhiplier or Bftl Amount $1.00 s00.00 Total Value of Project Amount Paid Date Paid Value $s00.00 $s00.00 Receipt Number 120050000000000r168 r200500000000001 168 1200500000000001 168 1200500000000001168 1200500000000001450 1200500000000001450 1200500000000001450 1200s000000000014s0 1200s000000000014s0 1200500000000001450 1200500000000001450 1200500000000001450 12005000000000014s0 Date Calculated t0t04t200s $8.20 $5.74 $43.00 $39.00 $10.00 $18.80 $13.r6 $45.00 $6.00 $9.00 $98.00 $24.00 $6.00 8t9t05 8/9/0s 8/9/05 8/9/0s tot4t05 t0t4t0s t0t4t0s t0t4t05 t0t4t05 t0t4t05 tot4t05 tol4t05 tot4t0s $325.90 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. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to coYer. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. 2of3 Reouired Insnections rL Valuation Description I Ieelralq l Status: Issued 225 Ftfth Street, Springfiel{ OR 541:72G3753 Phone 541-72G3676F2x 541:1 2G37 69 hs pe ction Line CITY OF SPRINGFIELD Buitdin g/Co mbin ation Permit PERMIT NO: COM2005-01079ISSUED: 08/09/2005 APPLIED: 08/0912005E)PIRESz 0410412006VALUE: $ 500.00 Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. 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 certiS 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 OCCT PANCY win be made of any structwe without permission of the Community Services Division, Building Safety. I further certiff 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 card is located at the front of the property, and the approved set of plans will remain on the site at all times /o -c/-o f Owner or Contractors Signature Date 3 of 3 Construction Contractors Board Permit *: LOI+tLc;.o to?, Address: 37 Y S L/38 S+- Issued by:C Date: lo l- 3 f 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 1 and 2, and either box 3A or 38: k, ftz tr 3A. My ge,neral contractor is (Nane)(ccB #) I 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:Erys1!q]4 Y 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. I will instruct my general contractor that all subcontactors 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 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 fnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. applicant) (White copy to issuing agency pennitfile, pink copy to applicant.) Property_owner. doc 06-0 I -04 ra /ot/or' '(oate; Actimg as "r-our Own Generafl Contractor? INFORMATION ttOTlCE TO PROPERTY OWNERS ABQUJ CONSTRUCTTON RESpONStBtLtTtES NOTE: This lnformation Notice lo Propeiy Awners abou! Construction Responsibdrliis Lvas devetoped by the Construction Contractors Board in accordance with ORS 701.055(5J, passed by the 1g8g Oregon L,egislature. If you are acting as your cwn contractor to construet a new home or make a substantial improvement tp an existing structure, you can prevent nrany problems by being aware of the following responsibilities aRd concerns. Employer Responsibilities You will,.in.most instanees, be ruled ta be an "errryloyer" and &e contractor-s you conkact with will be "employees" if you us€ contactors not licensed with the Conskuction Contractors Board to do iabor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with ti-e foltowing: Oregon's \trithholding Tax Law: As an employer, you must withhold income taxes from employee rvages at the trme employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from yqur employees. For more information, call the Department of Revenue at 503-3784988. ::r r: j i Unemployment Insuranee Tax: As an employer, you are requked t<rpay a t*x for uneinployment insurance purposes-- on the wages of all employees. For rnore informatlon, call the Oregon Employrnent Department at 503-947-1488. -\- The Oregon Business Identification Number (BIhI) is a combined nurnber fsr tro&:Oregon \{itbholding and Unemploymant lnsurance Tax. To file for a BlN, call 503-945-8091 or r.v.yu,.dor,Qlate.or.qslfqrmspay.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for yow empioyees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and bd'Iiable for all claim costs if onr of your employees is injuied on the job. For more information, call the '$lorkers' Compensation Division at the Departmant of Consumer and Business Services at 503-947 -7 81 5. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' *ag"i)- You will be liable for the tax payment €ven if you didn't actually withhold the tax. For a Federal EIN number, cali the IRS at 1-800-8294933 or visit their web site at lvlt'w-irs.gov. Other Responsibilities and Areas of Concerns Code Compli*nce: As the permit hoider for this project, you are responsibie for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property llamage Insurance: Contact your insurance agent to see i'f you have adequate insrnafcg coverage for accidents and omissions such as falling tools, paint or/er spray, water damage &om pipe punctures, fire or work that must be redone. Time:Makesureyouhavesufficienttimetosuperviseyouremployees.!;l Expertise: Make sure you have ihe skilis to act'as your own general contractor, 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 inspechons. (t If you have additional questions call the Construction Contractors Board (503-3784621) ar write the agency at PO Box 14140, Salem, OR 97309-5052. Property*owner.doc 06-01-0 4 ;'u : ) 225 Fifth Street Springfii:id, Oregon 97 47 7 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT#: 1200500000000001450 Date: 1010412005 11:15:2eAM Job/Journal Number coM2005-01079 coM2005-01079 coM2005-01079 coM200s-01079 coM2005-01079 coM2005-01079 coM2005-01079 coM2005-01079 coM2005-01079 Description Building Permit Fixture Vent Fan Exhaust Hoods Dryer Vent Minimum/Adjustment Mechanical -Mechanical Issuance Fee- + 7o/o State Surcharge + l0o/o Administrative Fee Amount Due 45.00 98.00 6.00 9.00 6.00 24.00 10.00 13.16 18.80 Item Total:s229.96 Payments: Type of Paynent Paid By Received By ChEkNumber Bdch Number Authorization Number How Received Amount Paid ROBERTNIXON djb 01741A In Person $229.96 PaymentTotal: m tl 'i { ( I 10/4/200s 1of1 aetsalli'! CreditCard 225FIFTHSTREET . SPRINGtr'IELD, OR97477 o PH:(541)726-3753 oF E IE,CTP.I CAL P ERMIT AP P LI CATT ON JobNumber CS,t Dbf - O t O-? 1 Date 1.3. 32 g > Ll3I LEGAL DESCRIPTION)7oZ3Z31 oizeo -o A. JOB DESCRIPTION W.yAE l( c(rc$.i Permits are non-transferable and expire if work is "- not started within 180 days of issuance or if work is Suspended for 180 days. ,, Service Included 1000 sq. ft. or less Each additional500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder o $106.00 $ 19.00 $s0.00 B. Electrical Contractor Address I S 05C G€ City SPFcD i7Y78 Phone law €L€C,ENTI Wl$e ow Iu\ tort! R952 -001- ." b:[-tol\on onngs nu You lpoo D. E. N ,z-?34 4) $ 63.00 s 75.00 sl2s.00 $163.00 $375.00 $ s0.00 s 43.00 s 3.00 tu'000 ru\ ,2 Supervisor License Number \ 7) 7s Expiration Date ,0-0 l- h7 Constr. Contr. Number lt177O Expiration Date 10.'01- os Signature of Supervising Electrician Owners Name I"d t Address s78 OWNER INSTALLATION The insallation is being made on proPerty I owu which is not intended for sale, lease or rent. Owners Signature: Installation, Alteration or Relocation 200 Amps or less $ 50'00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps 5100.00 Over 600 or 1000 Volts see "B" above. New Alteration or Extension Per Panel . One Circuit / Each Additional Circuit or with , ? Service or Feeder Permit ' J cl3 37 City SP phone 736 - 1Zt 3 pumporirrigation Sign/Outline Lighting $ s0.00 s 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45'00 Minimum Electric Permit Inspection Fee is $45'00 * Surcharges gZ ,7r'|Yo State Surcharge l0% Administrative Fee TOTAL gLo ?t ?a Inspection Request: 726'3769 4. Shared Driv(T: /Building Forms/Electrical Permit Appl ication 1 -03'doc City g- Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 2637 69 Ins pe ction Line CITY O Buitding/Co mbination Permit PERMIT NO: COM2005-01079ISSUED: 08/09/2005APPLIED: 08/0912005E)PIRES: 0210912006 VALUE: SITE ADDRESS: 378 S 43RD ST Springfield TYPE OF ASSESSOR'S PARCEL NO.: 1702323403200 TYPE OF USE: PROJECT DESCRIPTION: Replace wiring for 14 circuits in existing panel Electrical Work Only Repair Residential Owner: Address: ROBERT NIXON 378 S 43RD ST SPRINGFIELD OR 97478 Phone Number: 541-736-9213 Contractor Type Electrical Contractor EASTSIDE ELECTRIC INC License 117770 Expiration Date r0t04t200s Phone 541-915-9828 ,. # of Units: Primary Occupancy Secondary Plimary Secondary # of Bedrooms: Frontlard Setback Side l Sefrack: Side 2 Seback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: esb{ Overlay Dist: # Street Trees Paved Drive Rqd: Yo ofLot Coverage: 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 PARIilNG Total: Handicapped: Compact: $ Per Sq Ft or multipfier Square Footage or Bkl Amount DEVELOPMENT INFORMATI( PUBLIC IMPROVEMENTS Description Tvpe of Construction lof2 Value Date Calculated r\lL theb.j 0 Valuation Description I Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541 :7 26-37 69 Inspection Line Buildin g/Co mbination Permit PERMITNO: COM2005-01079ISSUED: 08/09/2005APPLIED: 08/0912005E)3IRESz 0210912006 VALUE: ' Fee Description + l0%o Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Amount Paid $8.20 $s.74 $43.00 $39.00 $95.94 Total Value of Project Date Paid 8t9t05 8/9/05 8t9t05 8t9t05 Receipt Number 1200500000000001168 r200s00000000001168 1200500000000001168 1200500000000001168 Fees Paid Plan Reviews To Request an inspection call the24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Reouired fnsnecfions By signature,I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certiff that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community ServicesDivision, Building Safety. I further certi$ 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 2of2 Date L LL Job/Journal Number coM2005-01079 coM200s-01079 coM2005-01079 coM2005-01079 225Fitth Street Springfieldn Oregon 97 477 541-726-3759 Phone .'ity gf Springfield Official Receipt -_ evelopment Services Department Public Works Department RECEIPT #:1200s00000000001168 Date:08/09/2005 t:54:47pM Descripfion Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + l0% Administrative Fee Amount Due 43.00 39.00 5.74 8.20 Item Total: Payments: Tlpe of Payment $95.94 Paid By Received By Batch Number Number How Received Amount PaidCreditCardEASTSIDE ELECTRIC djb 035493 In Person Payment Total:$9s.94 t, 81912005 lofl l-r