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Home My WebLink AboutPermit Electrical 1994-07-13OREGOTVCITY OF 225 FIFTE STREET SPRINGPIEI,D, OREGON 97 INSPECTION REQTIBST: 7 0FFICE: 726-3759 Authorleod 1. LOCATION I,EGAL DESCRIPTION JOB DBSCRIPTION Permits are non-transferable and expire if vork is not started vithin L80 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY ELectrical Contractor City- Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name Address The zoning' and approval. not require epcclflc u50- L rt" !iP>...lGFlELD BTECTRICAL PERHIT APPTICATION City Job Nunber 7 FEE SCEEDTII,E BELOII A. Nev Residential-Single or MuIti-Family per dvelling unit. Service Included:ftems Cost $ 8s.00 Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Serviee or Feeder Services or Feeders Installation, Alterations or Relocation: s 1s.00 $ 40.00 B 200 20i 401 601 Over Reconnect 0n1Y One Circuit Each Additional Circuit or vith or Feeder Permi r less o 400 amps -o 600 amps _o l-000 amps_ amps/voIts _ $ s0.00 $ 60.00 $100.00 s130.00 $300.00 s 40.00 amps o amps t amps t amps t 1000 C D. Branch Circuits Nev, Alteration or Extension Per Panel u/' $ 3s.00 35 gervice 1(, /s 2.oo L E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation - Sign/Out1ine Lighting Limited Energy/Res _Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 Over 600 amps or 1000-7oTts see trB" above citv ?ztrzfz/l Yno". 72O -7L 3c. OIJNER INSTALLATION The installation is being made on property f ovn vhich is not intended for sale, Iease or rent.s $ $ $ 40 40 20 36 00 00 00rs Signature:00 5 DATE: RECE (* RECETVED 74 1,d0 Permit #: 1-t)4,Issued by: Address Date: l\/7? N ltv A/ 01t1 Statement: lnformation Notice to Property owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement 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 appropriate blanks and initial boxes I and2, and either box 34 or 38: 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3,A'. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 38. I will be my own general contractor If I hire subcontractors, I will hire only subcontractors registered with the Consffuction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notiff the office issuing this huilding permit of the name of the contractor. I hereby certify that the above information is correct and thatl have read and dounderstand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 1- /3- ?r OR (of permit applicant) (White copy to issuing agency pennitfile, pink copy to applicant) (Date) _\ F C[\Ocrr. (r r S;.(R(.\;v-\-,-- a' rnforrnation Notiee to Property Owners l itlot*:: Tlris ln/i;rnxzri*n Nrstice t<; Fraperty Owners aboul Crtnstruction Responsibilities t'''; - : w*.r rlev;:l*7:erl lsy the {rsnstrurtion Contrtu:tors Board in *tcordance w,itlz ORS 701.055(5). " t- l lf you ;ire a*ting as y{}r}r *wfl contrile t{}}' f{} csnstrud{ a *ew lt+m* llr ttake a subsmntial improvemettt tt an existing structurr, yoll ciiir-! prevent many problems by being aware of the fnllowing responsibilities and arqas of concern. EMPLOYER HESPONSIBILITIES: . 'I;;i If ycu hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the constniction or improvement cf a residential structure, you witrl, in most instances, be ruled to be an employer and the peopie you hire wiltr tre employees. As the employer, you rnuiit comply with the following: Oregcn's withhotding tax !aw: As an employer! you must withhold income taxes from employee wages at the time employees are paid. You will be liahle ior thc tax payments sven if you don't actually withhold the tax from your employees. For more information, cail the dlregon Dept. of Revenue at 945-8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wagesofallernployees" Formoreinformation,calltheOrcgonEmploymentDivisionattheDepartrnentofHtmanResources at378-3524. \{orkers' compensation insurance: As an ernployer, you are subject to the Oregon Workers'Compensation Law, and must obtain workers'eompensation insurance f,or your employees. If you fail to obtain workers' compensation insurance, youmay I besubjecttopenaltiesandwillbeliableforallclaimcostsifoneofyouremployeesisinjuredonthejob. Formoreinformation, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S.Internal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. You will be liableforthetaxpaymenteven ifyoudi<Jn'tactuallywithholdthetax. Formoreinformation,callthelntemalRevenueService ar t-800-829-1040. OTHEH 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. r . Liabiliff and property damage insurance: Contact your insurance agent to see if you have a&quate insurance coverage fbr accidents and omissions such as falling tools, paint overspray, water damage from prpe punctures, fire, or wort that must be re-done. firne tc supervise employees: Make sure yor"l h*ve sufficient time io supervise your employees. Expertise: Make scre you have the expertise to act as yourown general contractor, to coordinate the work of rough-in and finish trades, and to notify huilding officials at the appropriate times so they can perform the required inspections. If you have additionai questions, write or call the Construction Contractors Board pO Box 1414A, Salem, OR 97309-5052, 5431378-4621). The Board is located ar 70t] Summer St. NE Suite 300, in Salem. prop-own.pm4 ,t94 225 FTFTE STREET SPRTNGFIELD, OREGON 97477 INSPECTT0N REQUEST: 7 0FFTCE: 726-3759 1. LOCATION OT LEGAL DESCRTFIION JOB Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. CO}ITRACTOR INSTALLA:TTON ONLY Electrical Contractor Address ci.Phone Supervisor License Number zau0g-bJ-tq City Job Number Authorizad COHPLETE FEE SCEED{'LE BELOS SPGIINGFTELO as oubmitted hm tho epecific lend us6 ELECTRTCAL PERHTT APPLICATTON Nev Residential-Single or Multi-Family per dvelling unit. Service Included: Items Cost 1-000 sq.ft. or less Each additional 500sq. ft or portion thereof Each Manuf'd Home or -Modular Dvelling Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 roquire A Sum B Services or FeedersInstallation, Alterationsor Relocation: 200 amps or less -/ 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- over 1000 amps/voIts -Reconnect 0n1y $ s0.00 s 60.00 $100.00 $130.00 $300.00 $ 40.00 fu.* Exp iration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician r/1 0vners Name adlre!s Ci ty Phone - ?:a OVNER INSTALLATION The installation is being made on property f ovn vhich is not intended for saIe, lease or rent. Ovners Signature: DATE: Temporary Services or Feeders InstaLlation, Alteration or Relocation c 200 amps or less $ 40.00 20L amps to 400 amps - $ 55.00 0ver 401 to 600 amps - $ 80.00 0ver 600 amps or 1000 voT[s see I'Brr ami6- D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Serviceor Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Eaeh installation Pump or irrigation $Sign/0utline Lighting- $Limited Energy/Res - $Limited Energy/Comm $ SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL 40, 40, 20 36. 00 00 00 00 5 RECETVED B *e /7azzafi,Oz.?>a