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Home My WebLink AboutPermit Electrical 2020-03-09OREGON Web Address: www.springfield-or.gov Building Permit Residential Electrica! Permit Number: 811-2O-OOO454-ELEC IVR Number: 811027483051 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 Email Address : permitcenter@springfield-or. gov SPKINGf IELD ,b Permit Issued: March 09, 2020 TYPE OF WORK Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: House re-wire Type of Work: Alteration JOB SITE INFORMATION Worksite Address 650 54TH ST Springfield, OR 97478 Parcel 170233 1302300 Owner: Address: VALVIDARES CASIMIRO ROMEO LOPEZ 558 NICHOLAS DR SPRINGFIELD , OR 97477 LICENSED PROFESSIONAL INFORMATION Business Name SEE PROPERTY OWNER INFORMATION - Primary License Owner (Property) License Number OWNER Phone PENDING INSPECTIONS Inspection 4999 Final Electrical 4999 Final Electrical 4500 Rough Electrical 4220 Electrical Service Inspection Group Elec Res Elec Res Elec Res Elec Res Inspection Status Pending Pending Pending Pending SCHEDULING INSPECTIONS Various inspections are minimally required on each project and often dependent on the scope of work. Contact the issuing jurisdiction indicated on the permit to determine required inspections for this project. Schedule or track inspections at www.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811027483051 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work is not started within 18O Days of issuance or if work is suspended for 18O Days or longer depending on the issuing agency's policy. All Provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not, Grantlng of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. ATTENTIoN! Oregon law requires you to follow rules adopt€d by the Oregon utility Notification Center. Those rules are set forth in OAR952-0O1-OO1O through OAR 952-OO1-OO9O, You may obtain copies of the rules by catting the Center at (503) 232-t9a7. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1,o1O (Structural/Mechanical), ORS 479.54O (Electricat), and ORS 693.O10-O20 (plumbing). Printed on: 3/9/20 Page 1 of 2 c:\myReports/reports//production/01 STANDARD *,,./ Permit Number: 81 1-20-OO0454-ELEC Page 2 of 2 Fee Description Branch circuits with service or feeder each circuit Services 200 amps or less Technology Fee State of Oregon Surcharge - Elec (12olo of applicable fees) Printed on: 3/9/20 Quantity Total Fees: Fee Amount $64.00 $ 112.00 $8.80 $2t.12 $20s.92 8 1 Page 2 of 2 C: \myReports/reports//production/01 STAN DARD PERMIT FEES SPRINGFIELD Trt Transaction Receipt 81 1 -20-000454-ELEC IVR Number: 81 1027483051 Receipt Number: 474044 Receipt Date: 3/9/20 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54L-726-3753 permitcenter@spri ngfi eld -or. govOREGON wwllr.sprin gf ield-or. gov Worksite address: 650 54TH ST, Springfield, OR 97478 Parcr-l 170233I302300 Transaction Units date 319120 1.00 Ea 3t9t20 8.00 Qty 3t9t20 3t9t20 Description Services 200 amps or less Branch circuits with service or feeder each circuit State of Oregon Surcharge - Elec (12o/o ol applicable fees) Fees Paid Account code 1.00 Ea 1.00 Automatic Technology Fee 224-00000 -4261 02- 1 033 224-00000 - 426'1 02- 1 033 821 -00000-21 s004-0000 204-00000-425605-0000 Fee amount $1 12.00 $64.00 $21.'t2 $8.80 Paid amount $1 12.00 $64.00 $21.12 $8.80 Payment Method Credit card authorization: 700271 Payer: VALVIDARES CASIMIRO ROMEO LOPEZ Payment Amount:$205.92 Cashier: Chris Carpenter Receipt Total:$205.92 Printed: 3/9/20 9:29 am Page 1 of 1 F I N_Tra nsaction Receipt_pr CITY OF SPRINGFIELD, OREGON Electrical Permit lication 225 Fifth StreetrSpringfield, OR 974770PH(541)726-3753.FAX(54I)726-3689 This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days ofissuance or ifwork is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zoningapproval verified? E Yes f] No CATEGORY OF CONSTRUCTION ! Residential I Government ! Commercial JOB SITE INFORMATION AND LOCATION Job site address: 6<0 Sr{ Fk Af City4)r,no[-./State:fQ zrP:77"t7 B x"tu{n"",/Taxlot. DESCRIPTION OF WORK PROPERTY OWNER Name: Address:l City:State: O(\zrp:1(LIFB Phone 2-Fax: E-mail This installation is being made on residential or farm property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.s40(t) and 479.560(1 ). Signature: CONTRACTOR INSTALLATION Business name: Address City:State;ZIP Phone:Fax E-mail CCB license no.BCD license no. Signing supervisor's license no. Print name of signing supervisor: Signature of signing supervisor: €fr DEPARTMENT USE ONLY p"r rrno.,3o 'LlSq-C oate:ilQ {l ) FEE SCHEDULE Number of inspections per item ( )Qty.Cost ea. TotaI cost Residential, per unit, service included: 1,000 sq. ft. or less (4)$186.00 $ Each additional 500 sq. ft. or portion thereof $36.00 $ Limited energy (2)$44.00 $ Each manufactured home or modular dwelling service or feeder (2)$89.00 $ Services or feeders: insta I I ation, alteration, relocation 200 amps or less (2)$l12.00 silL 201 to 400 amps (2)$131.00 $ 401 to 600 amps (2)$221.00 $ 601 ro 1,000 amps (2)s285.00 $ Over 1,000 amps or volts (2)$654.00 $ Reconnect only (2)$89.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2)$89.00 $/ 201 to 400 amps (2)$122.00 $ 401 to 600 amps (2)$177.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a. Fee for branch circuits with purchase ofa service or feeder fee Each branch circuit $8.00 si*/ b. Fee for branch circuits without purchase ofa service or feedEi fe6 $89.00 $First branch circuit (2) Each additional branch circuit $8.00 s Miscellaneous fees: service or feeder not included Each purnp or irrigation circle (2)$89.00 $ Each sign or outline lighting (2)$89.00 $ $Signal circuit or a limitcd-cncrgy pancl, alteration, or extension (2)$89.00 Each additional inspection: (1)$102.00 s DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00) S (B) Enter l27o surcharge (.12 x [A])s 7L L2 (C) Technology Fee (5% of [A])$ TOTAL fees and surcharges (A through D):s Last edited 7/1/2019 BJones 4C Oregon ProPertY Owner Statement Rega rding Gons truction ResPons ibilities not licensed with the Law requires residential constru ction permit apPlicants who are building Perm it can be on Contractors to sign the following statement before a BoardConstructi issued. (ORS ?o{.325 (2)) I have read and understand the lnformation Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. '(Lu"/^'"''y6 Print Name of Permit 03 - oq- ?o zo Date permitsandplumbingmechanical,electrical,building,notneedresidentialfor0.01 (7),701tsoRsrequiredunderstatementThisfromicensingexemPtndapPlicants,a engineerarchitectLicensed thewith permit.filedbewillntstatemetsThstatement.itbmsu Please check the aPProPriate box: I own, reside in, or will reside in the completed structure and my general contractor is: CCB#Expiration Date Name @ lwillinformmygeneralcontractorthatallsubcontractorswhoworkonthestructuremustbe ficenseO witn ine Construction Contractors Board' or r wi, be performing work on property r own, a residence that r reside in, or a residence that I will reside in. rf r hire subcontractors, r wiil hire onry subcontractors ricensed with the construction contractors Board. rf r change my mind and hire a generar contractor, r wifl serect a contractor who is ricensed with the cc6 ano wiil immediate[ live the name of the contractor to the office issuing this Building Permit -{Permit #: Address:0ro /ssued oy,&-ort ,?LC) This Copy for permit Offices this {qft \r tt lnformation Notice to owners Aboutconstruction Responii bi riiies (oRs 701.325 (3)) Homeowners acting as their ownor make a substantial improvement to by being aware of general contractors to construct aan e-xisting structure, can prevent the following responsibilities : new home many problems a o Homeowners who use labor provided by workers not licensed by the construction contractorsBoard, may be considered an employer, and the workers who provide the labor may be consideredemployees. As an emproyer, you must compry with the foilowing: oregon's Withholding Tax Law: Employers must withhold income taxes from employee wagesa!lhe time employees are paid. You will be liable for the tax payments even if you don,t actuallywithhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947 -1 488. o Oregon's Business ldentification Number (BlN): is a combined number for both Oregon Withholding and Unemployment lnsurance Tax. To file for a BlN, go online to the Oregon Business Registry. For questions, call 503-945-8091. o Workers Compensation lnsurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation lnsurance for their employees. lf you fail to obtain Workers Compensation lnsurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division at the Department of Consumer and Business Services at 800-452-0288. o Tax Withholding: Employers must withhold Social Security Thx and Federal lncome Tax from employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, go online to www.irs.gov. o Code Gompliance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. t o qccidents and omissions, fire; o'r work that must be to pe.rsons rhSUtOOCe ' Homeowners should make s ..i in. tiPertise required to ouldshactitheirAScontractorsowncelnsuranHomeownersLiabilandngityDamageProperty coveranceinsuure rage fqruateenstoadeqncelnsuratheiragentcontactfrompipepunctuieswaterdamageoverspray,nottools,arewhopaintASfallingsuchonjob-sitethecoveriniuriestosufficientbemustlnsuranceonLiabilitYredone.ComPensatiWorkerseesbyASemploycovered generalowntheirASactothenrutsetoskillsthehavetrades.ishfinuretheYandrough-inbothofworkthecoordinateExPertise contractor Other Responsibilities of Homeowners: f / PropertY-Pwner adoPted 9-20 16 This CoPY for PermitPO Box 14140,Salem, OR O TelePhone:503-378-4621 - Fax: