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Home My WebLink AboutPermit Electrical 2005-3-8 j . . "" . j 225 n~ U1 STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 ;, FAX: ~1)72~89;".9.o^" ~ ELECTRlCALP~APPUCA110N. . ... .~-i ql&j.A "O&~',,/q~ .~jJ' City Job Number COwl ZOO S- - 0 0 z.. s- 't . . . Date 51 "si2>\[ . "'.9. "& ~"6 '.. '. / f '~~ .... .... . 9",.0,i.' . . . _ v ~ "" .;1'; 7..., 3. &:eONu-a:~:;"~r;:;~;". ,..~.... . - _wa.~ '":::1 ._~~,,~.. - '& 1. qjTfI&rt(jNOE1m.sL4:T!f';:{TIijM~:>;lF.~ ~"..=---~~.._'1"",,",-~~,___~ I..{Oc..( M!J-I<ISF{"=.7-A SoT LEGAL DESCRIPTION A. ~~jf.<~i!~~.i!dWaill 170 323'3 L{. 06000 Service Included JOB DESCRIPTION 10QOsq. ft. or less A j, f Each additiona1500 sq. ft. .or b~ ]4t..TEvz.... Lt (I (l.C,.v\.1 S portion thereof . .~ . Permits ale non-transferable and expire If work Is ~M . . ome or .' . ,. not started within ~80 days of issuance or If work is(~-Z . g~q,[ $50 00 .. - Suspended for 180 days. UO\ltr.l\\\\ON ^"\\ 'lJl I '19\lJ8O 9\4\ IM~ "<i . 1@l~"'A'crOIl'fiN.W'fTf..r.u.Q:N!~~e\~~~ ~ "'. < ii.. ~~~~~'E'~ 2. _C:_I_l ,.b'tJ _ . ~ ~ .~~ ol;.. . OO-Z98 0 ~ ............. .....u~.uC)\\tr.lOOO~ , -- .. I"" ~ E!cctricalContractor *. ':{ iiJ'BS8\I\I-PS'Orl~~1103 . ~ I . $6:;.00 17?...,... 1.IlI~~U06eJoe~~~APtR~'i1 $ 75.00 Address /f\\n~~~_\~~M~~ $125.00. / "",...1 601 Amps to 1000 Amps $163.00 / City Phone.' Over 1000 AmpsIV01ts $375.00 . // . '_". .--RcconIicCl'biJy '". . $ 50.00 =~7 c~ / . 200 Amps 0~1_?-~ W i\\~ ~ ~i\'Y $ 50.00 Consn-o c;znn-. umber ~Qi\Ct.. 201<'Aln'!\s~,Ltoo~~~\\ ~S 69.00 \'rI1';:) I"ER\'J;;e1 ~"i.?o l0'0Amp.~~\) ~()\\ $100.00' 11:10Rl1\:.v P IS ~bl'\"~ : . Expiratio . ate t>.I \ E t-IOV& 6& Aim)s or 1000 Volts see "B" above. .' . CO\'JI\\~ ,-.-:-,..:. .;;;.r.:;'._""~"".,,,,,_.~. ;;,;~'_._,.~. -., ...~...,,,," . St' ~.h'~ of SUpCl'VlS. m' g E1cctn' 'Cllll1' < c1~. BfilnClECm:uilSi . . . .", ..,. -" " .t!" ,- 6. " . - ~....... .~~'{ ,at: ~'~;la"'-u'>:;'''"''''~-''''''''' '. .~~-' -. .. . . .'"' .- .~~''''. New Alteration or ExtensIon Per Panel . I lj'L.~' One Circuit. $ 43.00 I? Each Additional Circuit or with -, Service or Feeder Permit ..., $106.()().. .' ',,- $19.00 Owners Name a tIJ..c../c:rs ~. Address 4oC{ /J1IhvSrfCcz.l\ So, City S'?r~ Phone '55'1 ~brzO S 3.00 9~ OWNER INST ALLA nON The insrallalion is being made on property I own which is not.futended for sale, lease or rent . 4~ ~ Pump or irrigation Sign/Outline Lighting Limited EnergylR.eSidentia1 Limited En~fCommercial $ 50.00 $ 50.00 $25.00 $ 45.00 Inspection Request: 726-3769 MInimum Electric Permit Inspection Fee is $45.00 + Surcharges 4.~A&~.~~~."~."..'~ :...."... ,.' <2 ".' ~~~~:i~_~ ,::>j ""'6'1 7% State Surcharge -' oCZ-O 10% Administrative Fee ..> hO$.- TOTAL Shared Drive(T:YBuilding FonnslElectrical Permit Applicati~ 1.Q3.doc . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00258 ISSUED: 03/07/2005 APPLIED: 03/04/2005 EXPIRES: 09/07/2005 VALUE: $ 2,000.00 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 404 MANSFIELD ST ASSESSOR'S PARCEL NO.: 1703233406000 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration PROJECT DESCRIPTION: Remodel framing, plumbing and electrical Residential Owner: CHARLES COY Address: 404 MANSFIELD ST SPRINGFIELD OR 97477 Phone Number: 541-554-6120 Contractor Type General Electrical Plumbing Contractor OWNER OWNER OWNER I CONTRACTOR INFORMATION I ATTENTION: Oregon IlmI ~~~~ Expiration Date follow rules adopted by ttts ~~ .... . Notification Center. ~ Nlas as - fortiil . In OAR 952~1~10~ OMS52-4Dio .", .';,.t.;-......- __;_"..oOh~I:'ltd!ltn.bt'? \AlQ'''- ,.~-- ---- :: ;.-: - O-,,,,I.~ .....'n,IQIllI..,,_.alNI.pItanO _- ,n;;;: .. 1t!.~I~H"".!"-"_..."",,, oomb8r fer lh3 Oregon uUII&Y Ill"""""""""'. ~...qfIS\<lFj~~ "ireigbt 'Of Structure Type of Heat: Water Type: _ Range Type: Energy Path: Sprinkled Building: Phone # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: N011CEf/ Stre~t !rees ~~\:RE IF 1\1E WORK THIS PEipY.ifdJ)rN~~ll~lf;, PERMIT IS N01 ~~~~~;~~D~~~;e~BANDONED FOR Ai'pus'i.~CJi-1\'i~if{Wit\iENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Pa2e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Description Tvpe of Construction Bid Amount Use Bid Amount Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Miscellaneous Plumbing Penalty Fee - BWOP Building Penalty Fee - BWOP Electrical Penalty Fee - BWOP Plumbing Total Amount Paid . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00258 ISSUED: 03/07/2005 APPLIED: 03/04/2005 EXPIRES: 09/07/2005 VALUE: $ 2,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 2,000.00 Value Date Calculated Total Value of Project $2,000.00 $2,000.00 03/04/2005 Fpp<. PiillJ Amount Paid Date Paid Receipt Number $28.40 $9.94 $43.00 $9.00 $45.00 $45.00 $45.00 $52.00 $45.00 3/7/05 3/7/05 3/7/05 3/7/05 3/7/05 3/7/05 3/7/05 3/7/05 3/7/05 1200500000000000296 1200500000000000296 1200500000000000296 1200500000000000296 1200500000000000296 1200500000000000296 1200500000000000296 1200500000000000296 1200500000000000296 $322.34 I Plan Reviews I To Request an inspection call the 24 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. ~enuiredJnsnections I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 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 cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building Is complete. Paee 2 of3 . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line . \..,11 l' OF ~t'K11'\iGFIELD Building/Combination Permit PERMIT NO: COM2005-00258 ISSUED: 03/07/2005 APPLIED: 03/04/2005 EXPIRES: 09/07/2005 VALUE: $ 2,000.00 By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all Information hereon is true and correct, and 1 further certify 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 Services Division, Building Safety. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the o street, t t the permit card is I cated at the front.ofthe property, and the approved set of plans will remain on the site at all Ai~d I. t' V rIDg con ruchon. . 3/; /{J1 ( Pal!e 3 of3 Date -. . . . . . . 0.. .... ", ,.' . 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 Pennit #: (!.OjN'\ <'-0'" - OO'Z '5 J' I...{ 0 I.( j/Yl ,.4-,v 5 h f:::c... ~ b~ Date: >f~ r Address: Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare not licensed 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 licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the app'VI-,,;ate blanks and initial boxes I and 2, and either box 3A or 3B: %""1. gr 2. 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. D 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR g;B. I will be my own general contractor. If! 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 notify the office issuing this building permit of the name of the contractor. I hereby certif~ that the above information is correct and that I have read and do understand the Information Notice.t P perty Owners about Construction Responsibilities on the reverse side of this form. ~~l~~p",mt) ~/f~r (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 ...., . AdnlIDg tal~ @un!r OWlID GelIDeIr'talll (C@lIDtIr'tal(Ct@Ir'1 " ,I . INFORMATION NOTICE TO PROPERTY OWNERS ABQ..UT 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 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 concerns. lEmjpnoyeJr lResponsnbinities " You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the .. construction or improvement of a residential structure. As the employer~ you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes---... on the wages ofall employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for both. Oregon Withholding an~'" Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.htmlt 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 your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of yoUr employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wa~~ You will be liable 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 their web site at www.irs.<'OV. Other Resj[)onsiilbiilliitiies and! Areas of COlIJlcerllD.s Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requiremcnts that may be brought to your attention through inspections. - . Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the al'l',vl'.;ate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner.doc 06-01-04 225 Fifth Street Silliligfleld, Oregon 97477 541-726-3759 Phone . iraNlll'laJ;! , Ittiit" ~..,~. '.'"~. - '~.'~~.'..".'." I !.,._ .~. " i .~ ' ~j'-..'i .~......_---.""."" ,- ~ of Springfield Official Receipt ...eIopment Services Department Public Works Department Job/Journal Number COM2005-00258 COM2005-00258 COM2005-00258 COM2005-00258 COM2005-00258 COM2005-00258 COM2005-00258 COM2005-00258 COM2005-00258 Payments: Type of Payment Check 3/7/2005 RECEIPT #: 1200500000000000296 Date: 03/07/2005 Description Building Permit Penalty Fee - BWOP Building Miscellaneous Plumbing Penalty Fee - BWOP Plumbing Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Penalty Fee - BWOP Electrical + 7% State Surcharge + 10% Administrative Fee , Paid By CHARLES COY Item Total: l.:heck Number Authorization Received By Batch Number Number How Received djb 1067 In Person Payment Total: Page 1 of1 9:11:57AM Amount Due 45.00 45.00 45.00 45.00 43.00 9.00 52.00 9.94 28.40 $322.34 Amount Paid $322.34 . $322.34