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Home My WebLink AboutPermit Electrical 1992-05-22a ,a acml sl.ruN(;FIELL) - % 225 FIFTB STREET SPRINGFTEI,D, OREGON 97477 INSPECTION REQUESTT 726-3769 IAGAL DESCRIPTION JOB DESCN,IPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COI.ITRACTOR INSTALI.ATION ONLY Electrical Contractor Address ci ty-Phone Supervisor License Number Expiration Date constr contr. Number Expiration Date Signature of Supervising Electrician 0vners Name Dw+l nt C LA,r AddressZ b€rt N' z-lJr Ci Phone 741 - 1L3g OVNER INSTALI,ATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Signature: DATE: RECEIPT ELBCTRICAL PERHIT APPLICATION City Job Number SCEEDULE BBLOS ial-Single or ltl-Family per dvelling unit. Service fncluded: Items Cost I sq.ft. or less $ 8s.00 Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular Dvelling Service or Feeder $ rs.00 $ 40.00 Services or Feeders Installation, Alterations or Relocat ion: 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect 0n1y ,L Temporary Services or Feeders Insta1lation, Alteration or Relocation Sum B STETOTAL OT ABOVE 5Z State Surcharge TOTAL $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 w C 200 amps or less $ 40.00 201 amps to 400 amps _ $ 55.00 Over 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see I'8" above D. Branch Circuits Nev, Alteratlon or Extension Per Panel One Circuit S 35.00 Each Additional Circuit or with Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation sign/outline Lighting- Limited Energy/Res Limited Energy/Comm $ $ $ $ 00 00 00 00 40 40 20 36 5 RECEIVED BY: qa.o" L ' 2-a? OFPICE: 1 L--, Permit No:7=o Address: lssued b Date: R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicantJwho are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. A My general contractor is Contractor registration numbe I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board' 3.B I will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. certify that the above inlormation is correct and that I have read and understand a 1 2 3 OR I hereby the lnfo reverse rmati Notice to Property Owners about Construction Responsibilities on the this 9-zz-qL na re pp Datett CONSTRUCTION CONTRACTORS BOARD o244J 8191 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ERTY O'., ''*'ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: f,h[s,lnforp-ation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with OFIS 701.055(5), : passed by the 19&9 Qre,gon Legislature" - lf you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an"employer" and the people you hire will be "employees". As the employer, you must comply with the following: s Withholdin Tax Law As an employer, you must withhold income taxes from employee wages at the me employees are pai will be liable for the tax payments even if you don't actually withhold the tax from your employees For more information, call the oregon Department of Revenue at 37g-33g0. Unemploymelt lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurancepurposes@mployees.Formoreinforrnation,cattineoregonEmploymentpivisionDHFl a|378-3224. Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' CompensationLaw,andmuffipensationinsuranceforyouiemployees'ityoufailtoobtainworkerS, compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 37g-74g4. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. ymentevenifyoudidn'tactuallywithholdthetax'Formoreinformation,call the lnternal Revenue Service at 221-3g60. OTHER RESPONSIBILITIES AND AREAS OF CONCERN Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liabi and lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents an omrssrons s uch as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-don e. Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. t, Elpertise: Make sure you have the expertise to act as your own general contractor, to.coordinate the work of rough-in and finish trades, and to notify building officials at the appropriate times Fo tfey can perform the required inspections. , ,., lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10t24t89