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Home My WebLink AboutPermit Electrical 2008-7-22 SPAINOPlSLD .", ,.,,, ZON \Q..-- v- III.: tfId INITU}LS - 'fl ,.....--., / DATE '1. ~ ...lJ.. --v K ., SOURCI{Y\ O:s('\U :/zz/oJ ' COMPLETE FEE SCHEDULE BELOW '.: ::"'>'C[Ty;.G)F'tST~iti:!'.JctRrEt'r:r!<DRE@d~ ';~ ';", "- _~;f. ' ~~ " - w 7 ~ " "$ 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689 ELECTRICAL PERMIT APPLICATION.. ?' CIty Job Number Co""'\zoO?- Of I 0 ~ Date 1 LOCATION OF INSTALLATION 7/2-.5 ;11"un - 5IY~";" LEGAL DES<;'R1PTION /70 l.3SJLj o6t (TOA _ ~e";-Resldent"l- SlOgle 0; l\fUltI-Fa';'I1). per d;el~g umt, Spy,'N<<he!J d f? q 7 l/ 7 ~ Semce Included ---, - ./ JOBDESCRlPT!QN 'I I) 1000sq ft orless $11700 R.e:pI4ce. f-<<se. /3oJ<<;;C:>/d r4,ue/ EachaddJtiOnal500sq ft or ~A).J/)';;' J'l1dve....Cir.c.ut-r"r portiOn thereof Permits are non-transferable and expire If work IS not started W1thlO 180 days of Issuance or If work IS Suspended for 180 days 2 CONTRACTOR INSTALLATION ONLY Electncal Contractor Address CIty Phone ~ :::~:t::: :~::nse Number \ ~ ~ \r Constr Contr Number D ExpIratIon Date SIgnature of SupervISIng Electnclan Owners Name RA/1)\/ L _ f7erSb..J Address 7/ ~ f2.1~iro S7: Clty.5PNIoJ4f,~/) Phone7y,f{-S87/ , 1/ OWNER INSTALLATION The mstallatiOn IS beIng made on property I own whIch IS not mtended for sale, lease or rent ~~re~~ ~ ,(~.Gh. ~ InspectIOn Request 726-3769 3 Each Manufact'd Home or Modular DwellIng ServIce or Feeder $ 2100 $55 00 B Services or Feeders - InstallatIon, AlteratlODs or Relocation 200 Amps or less ~ fo-.... ... ~ . 201 Amps to 400 AnlpseqUlres you tn 401 Amps to 600 An\p@ Oregon Utility 601 Amp;~o 100d%,l;~les are set forth '0 "'00~'Arii IY~\1 OAR 95~-U01. L ,ver:"J uU'", p',\:;1J!:i s of the ru' . CJ "I ,Reconnect OnIYN n'~ uJ " ~ "" '-<-lifer" \. ole the telephulI.. number for the OregQn Uhlity l'J.ol,ltcatlon C.ceTJtUlPlU'l"l36srS'J~2!4'4f.aers InstallatIon, AlteratIon or Relocation 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above D Br dDCh ClrcuJts I '-!().c>O $ 70 00 $ 83 00 $13800 $18000 $4 13 00 $ 55 00 $ 55 00 $ 76 00 $110 00 New AlteratIon or ExtenSIOn Per Panel One CIrCUIt $ 48 00 Each AddJilonal CIrCUIt or WIth '1 0 0 t) ServIce or Feeder Permit '^ 6R'\f0 o. <90 N(}T\CE~~ lJAITnPJ1\E IF'THE '!I',Il''I'f. ' - 1fH\~I'I~\IIWSIlS~~T~'I'['RWII"{ldl:leltlJ"-Each 1nstallatlOn .Of\IZ~~~~: ABANDONE.D FOR$ 55 00 - 11J~~IOD. $ 55 00 ~t~Jl nergylReSldenlIal $ 28 00 LImIted Energy/CommercIal $ 5000 MlOllDum ElectrIC Permit InspectIon Fee IS $50 00 + Surcharges 4 SUBTOTALOFABOVE - $226>.oc> 12% State Surcharge JlI:S 2b. Y' c> 10% Adnumstratlve Fee L.#. t!> 5% Technology Fee :;[__)./ .' 0;; TOTAL f 27&:f. L/ 0 Shared Dnve(f )/Butldmg FonnsIE\ectncal Permlt Apphcatlon 1-08 doc C'41{ 8tY~1\ 7 3~11f. g-J2 /-3 Status Iss u ed 225 FIlth Street, Spnngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme CITY OF SPRll'ltJI<IELD' Building/Combination Permit PERMIT NO: COM2008-01103 ISSUED: 07/22/2008 APPLIED, 07/22/2008 EXPIRES: 01122/2009 VALUE: SITE ADDRESS 7125 MAIN ST ASSESSOR'S PARCEL NO 1702353406100 Spnngfield TYPE OF WORK Electneal Work Only PROJECT DESCRIPTION Replace electncal panels and add CIrCUIts TYPE OF USE RepaIr Resldent..1 Owner RANDY PERSON Address 638 6TH ST SPRINGFIELD OR 97477 Contractor Type Electncal I CONTRACTOR INFORMATION I Contractor OWNER LIcense 1/ 01 VOlts Pnmary Occupancy Group Secondary Occupancy Group Pnmary Construchon Type Secondary ConstructIOn Type 1/ of Bedrooms Front yard Setback SIde I Setb.ck SIde 2 Setback Rearyard Setback Sola. Setbacks Street Improvements Storm Sewer A v .IIable Spec..1 Insh uctlOn Notes Descnptlon BUILDING INFORMATION I 1/ of Stones' R-3 Helgbt of Structure Type of Heat VB WaterT~Ite9VOll~ JjENTlON: OI~i~Il'Ote9~~~~ " tUles adOY"':: 8 !.~'" !\!',2.QO'. 101l0'l'l fl\efIp ~- nla \Irl,r~~o~ C~, Jt\4~t ~~!;"""IUI~S ':" InO ~~:ll~~t.~~ Q090" ~ir:'~ U\M~~.n call1n9 101 \\\8 Ote2~~'\2..2344l. t\umbet let ~'~D1n' C8t\ 1/ Street Trees Rqd Paved Dnve Rqd % of Lot Coverage Phone Number 541-746-5871 EXpIratIOn Date Phone Lot S,ze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft GaragelCarport Sq Ft Other Occupant Load REQUIRED PARKING Total HandIcapped Compact I PUBLIC IMPROVEMENTS I O~~ "O't\C~~ .Rll S~r>.tt~~~i~o't l\'\IS PER,.. Ul~OEtt 6l\'tNto"f'U1\ f>,U1t10RllEO OR IS r>.~f>,~OO COMtJ\E~CO~ PERIGO. f>,~'l180 I, Valuahon DescrmtIOn I $ Per Sq Ft or mulhpher Square Footage or Bid Amount Tvpe of ConstructIOn Page I of2 V.lue Date Calculated -~ji Status Iss u ed CITY OF SPRIl'Iitjt<u,LD Building/Combination Permit PERMIT NO: COM2008-01103 ISSUED' 07/22/2008 APPLIED, 07/22/2008 EXPIRES: 0112212009 VALUE: 225 FIfth Street, Sprmglield, OR 541-726-3753 Phone 541,726-3676 F dX 541-726-3769 InspectIOn Lme Total Valne of Project Fees Pa,,1 I II III Fee DescrIptIOn + 10% Admmlstratlve Fee + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Clrc Ea Add Perm Serv/Fdr 200 amps or less Amount PaId Date PaId ReceIpt Number $22 00 $26 40 $11 00 $80 00 $14000 7/22/08 7/22/08 7/22/08 7/22/08 7/22/08 2200800000000001121 2200800000000001121 2200800000000001121 2200800000000001121 2200800000000001121 Total Amount PaId $279 40 I Plan RevIews I To Request an mspectlOn call the 24 hour recording at 726-3769, All mspections requested before 7,00 a m, WIll be made the same workmg day, inspectIOns requested after 7:00 a m WIll be made the followmg work day I ReoUlrerl T nsoechons . 11111 " Rough ElectrIc PrIor to Cover ElectrIc ServIce Approval I eqUlred prIor to uhhty company energIZIng servIce Fmal Elech IC When all electrIcal work IS complete By sIgnature, I state and agree, that J have carefully exammed the completed applicatIOn dnd do hereby certIfy that all mformatIon hereon IS true and correct, and I further certify that any and dll work performed shall be done m accordance With the Ordmances of the CIty of Sprmglield and the Laws of the State of Oregon pertammg to the work descrIbed herem, dnd that NO OCCUPANCY WIll be made of any slructure WIthout permISSIOn of the Commumty ServIce; DIvISIOn, BUlldmg Safety I further certIfy thdt only contractors dnd employees who are m comphance WIth ORS 701 005 WIll be used on thIs project I further agree to ensure that all reqUired mspechons are requested at the proper hme, 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 remam on the sIte at all hme~/p~ 7/:22/0% I L ' Owner_or Contractors SIgnature Date Pa2e 2 of 2 - Construction Contractors Board 700 Summer St NE SUIte 300 PO Box 14140 Salem OR 97309-5052 Phone 503-378-4621 Web Address www ccb.state or us Pemut# COWl 200g- - C) / /01 Address IIZ5' /1.I!j}IN $T Issued by ~:S Date ~;l0P . Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) reqUires residential constructIOn permzt applzcants who are not licensed with the Constructzon Contractors Board to Sign the following statement before a buzldlng permit can be Issued 1111S statement IS required for reSidential bUilding, electrzcal, mechanzcal and plumbing permits Licensed archztect and engineer applzcants, exempt from lzcensmg under ORS 701 010(7), need not submzt this statement This statement will be filed with the permit Fill m the appropnate blanks and IrntIal boxes I and 2, and either box 3A or 3B ~ p2 I own, reside m, or will reside m the completed structure I understand that I must become hcensed as a constructIOn contractor If the structure IS sold or offered for sale before or on completIOn o 3A My general contractor IS (Name) (CCB #) I Will mstruct my general contractor that all subcontractors who work on the structure must be hcensed with the ConstructIOn Contractors Board /' OR J2f 3B I Will be my own general contractor If! lure subcontractors, I will lure only subcontractors hcensed with the ConstructIOn Contractors Board If I change my mmd and lure a general contractor, I Will contract With a contractor who IS licensed With the CCB and Will munedlately notIfy the office Issumg tlus bUlldmg permit of the name of the contractor I hereby certify tbat the above mformatlOn is correct and that I bave read and do understand tbe InformatIOn Notice to Property Owners about Construction ResponsibilIties on the reverse SIde of thIS form. ~/~A_~ ~ (Slghature of permit apphcant) (Whzte copy to Issumg agency permit file, pmk copy to applzcant) 7/2~~g Property_owner doc 06-01-04 Kcting -as -=-Your Own General Contractor? , ,-- , M" \ \ ~ , 'INFORMATlON'NOTICE TO PROPERTY OWNERS ABOUT<CONSTRUCTION RESPONSIBILITIES " ,- , \ .) \ \ , NOTE ThIs InformatIon NotIce to Property Owners about ConstructIon ResponSIbIlITIes was developed by the Construction Contractors Board In accordance with ORS 701 055(5), passed by the 1989 Oregon Legislature , . ' If you are actmg as your own contractor to construct a new home or make a substantlallmprovement to an eXlstlng structure, you can prevent many problems by bemg aware of the followmg responsIbilities and concerns Employer Responsibilities You wlll, m most mstanceq, be ruled to be an "employer" and the contractors you contract WIth wdl'be "employees" If you use contractors not Itcensed With the Constructlon Contractors Board to do labor m construCtlng or to assist m the constructlon or unpr~vement of a re~lde;nlial structure As the employer, yoo must comply With the following: " t .... ~. ~ Oregon's Withholding Tax Law' As an employer, you must Wlthhold Income taxes from employee wages at the lime employees are paId You WIll be)lable for the tax payments even If you don't actually WIthhold the tax from your employee;, For more mforrnatlOn, ~all the Department of Revenue at 503-378-4988" - Unemployment In;,urance Tax: As an employer, you are reqUlTed to pay'a tax for unemploymenl'msurance purpos~'" on the wages of all employees For more mformatlon, call the Oregon Employment Department at 503-947-1488 The Orego~ Busmess IdentlficatlOn Number (BIN) IS a combmed n\!mber for both 'Oregon Wlthholdmg 'a~ Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or WW\\ dOl state or us/formsoav html! for the appropnate forms Workers' Compensation Insurauce: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtam workers' compensalion msurance for your employees If you fad to obtam workers' compensatJon , ' , msurance, you could be subject to'penallies and be \table for all claim costs If one of your employees IS mJured on the Job For more mformatlOn, call the Workers' Cvwp,-"satlon Drv1Slon at the Department of Consumer and Busmess ServICes at 503,947-7815 .......... U,S, Internal Revenue Service' As an employer, you must Withhold federal mcome tax from employees' wage~ You WlIl be Itable for the tax payment even If you didn't actually Withhold the tax For a Federal EIN number, call the IRS at 1-800-829-4933 or VISit them web site at W\.If\Y.l!ii. gov ~ , I " Other. Responsibilities 2lllld Areas of Concems , Code Compliance: As the peront holder for thiS project you are responsible for resolvmg' any failure to meet code reqlllrements that may be brought to your attenlton through mspectlOns , - , Liability and Property Damage Insurance, - Contact 'yo~r In;,urance agent to see If you have kdequate msurance coverage for aCCidents and omiSSions such as fallmg tools, pamt over spray, water damage from pipe punctures, fire or work that must be redone '- -- '-~', ~~ , r "'\ . Time Make sure you have suffiCient lime to supemse your employees " ~ ,t-!i- . , , Expertlse' Make ,ure you have the skIlls to act as your own general contI-actor, to coordmate the work of rough-m and fimsh trades, and to nOlify bmldmg offiCials as the appropnate limes so they can perform the reqmred mspectJons If you have addItIOnal questIOns call the Construction Contractors Board (503-378-4621) or wnte the agency at PO Box 14140, Salem, OR 97309-5052 " Property_owner doc 06,01,04 225 FIfth Street Springfield, Oregon 97477 541-726-3759 Phone ~J:Q~J;~ Iii:", , CIty of Sprmgfield OffiCllll ReceIpt Development ServIces Depllrtment PublIc Works Department Job/Journal Number COM2008-0 11 03 COM2008,O II 03 COM2008-0 II 03 COM2008-0] 103 COM2008-0 I ] 03 Payments Type of Payment CredltCard cRecemt 1 RECEIPT #. 2200800000000001121 Date: 07/22/2008 DeSCription Penn Serv/Fdr 200 amps or less Add, Alter, Extend Clrc Ea Add + 5% Technology Fee + 12% State Surcharge + 10% AdmInIStratIve ree Paid By RANDY PERSON Item Total Check Number AuthorizatIOn Received By Batch Number Number How ReceIVed dJb 050248 In Person Payment Total Page I of I 101900AM Amount Due 14000 8000 1100 2640 2200 $279 40 Amount Paid $27940 $279 40 7/22/2008