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HomeMy WebLinkAboutPermit Electrical 1992-12-14 Th~ following project as submitted.~as the f~Uowin~ " -, d- .oes nol require specllic lanBLECTRICAL 7 77 7,_o,ng, an u SPRINGFIELD, OREGON 9 4 ~pproval. INSPECTION REQUEST: 726-3769 ( C Zonino . OFFICE: 726-3759 Date Cd' r4-4i:)... 3. 1. ~ON~~~~oriZedSignalureS1. 225 FrITH STREET W,GAL D~CJP.:PTION nU3~/d--\3 ()~[::~.rJn JOB DESCRI~O~ f\. ~ ^ -l-'_ , t\\~(\^. r.-J VU~') Permi ts ..~ non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY . Electrical contractor~ Address43\4D a N'f\ f\tJY" Ci ty e Un Jl.o J Phone 1J4-4--Dfol cr superviso/~Licerise NUlI!ber 3lo I +5 Expiration Date J D . \.c:r:s Gonstr Contr. Number tob~crr. Expiration Date~~ ,,.Q;~. Cf.s .. .- Signature of Supervising Electrician ~f1~ Owners Na~Ll"rt r\ "\ den 0 ~ D. Address4RD ffittO~~ . - Ci t~~!)L . Phone=r1hlolSS oVNk\1NSTALLATION . The 'installation is being made on property I own which is not intended for sale, lease or rent. Ovners Signature: ~AT;~---------~-l~~~~~')~~~------ RECEIPT #: u...:....... -\ 1 O'1.'~1 RECEIVED B"Q.) )I_i. tt'A ) SI-'IING-FIELO City Job Number COMPLETE FEE SCHEDULE BELOV New Residential-Single or Multi-Family per dwelling Service Included: Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or .Feeder $ 85.00 $ 15.00 l $ 40.00 4D B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or tess 201 amps, to 400 amps Over 401 to 600 amps Over 600 amps or 1000 $ 40.00 $ 55.00 $ 80.00 volts see "B" above Branch Ci rcui ts . New, Alteration or Extension Per Panel One Circuit Each Additional' Circuit or with Servi~ , or Feeder Permi t. n $ 35.00 $ 2.001{Q E. Mi;c~llaneous ~Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Lim{ted Energy/Comm 40.00 40.00 20.00 not included) 5. SuBTOTAL OF ABOVE ' 5% State Surcharge TOTAL $ $ $ $ 36.00 &.cg ~% 'l .. ~ >-'....... . " ; . \ ' , , " . Permit ~o: . q ~IO~D . _0 Address: ~,\'\\nJ.Qo j) n Issued bY:~ frfYJ,. ) . Date: ~~~~ r . ~I.- . . ' . FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTIONRE8PONSIBILlTiES . '. .' '. . Note: Oregon Law, 'ORS 701.055(4), requires residential construction permit applicants who 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 b.uilding, electrical, mechanical, and plumbing permits: Licensed Architect and Engineer applicants, exempt from registration under ORS,701.010(7); need. not submit this statement. This statemerit will be' filed with the permit. ,. . :Fil~' in t e ,a~~licable blanks, and initial ~oxes 1 and 2,. and ei~~er box' 3A or ~B: , 1, " ';, 'I: own: reside in', or will 'reside in the completed structure. . - . .2, I . I.. I. understand that I' must.registeras a construction contractor if the structure is sold .r'/J or~reorupon-completion.., '. 3.A.r-r: 'I'MY~8~elalcontract9ri" ()^N,_~ . .' (,., Contractorr~gistr~tio~ number v>lo~4" . . - '. ..,.-... '.' '. .", . " , * -- Iwill instruct my general c'bntractor that all subcontractors who work on the struc-' . ture niust be registered. with the Construction CClritractors Board.' '.' ',:, OR 3, B,I I I will be my own general contractor. , . '~ . " If I hire subcontractors, I will hire only subcontractors registered with the Construc" tion Contractors Board. If I change'my mind and do hire a general contractor: I will contract wit Ii a contractor who is registered with the Construction Contractors Board and I will)mmediately. notify the office issuing this building permit of,the name of . ,. the contractor, ~' : I hereby certify that the above information is correct and that I have read and understand the' Information Notice to Property Owners about, Construction Responsibilities pn' the reverse side of this form. . . , . , ~~ '. : n\:' '. . . ..~ -.u-~;7~ ......'ign turictPermit Applicant ' ,. " ". I . . . L "L...c '-[':'-:''1 R. Date . ~:. . ," .. CONS 'RUCTION CONTRACTOF.IS BOARD 0244J ~191 '. '",,' . ' '''.~::; .t,.);~ .. ". ~'~ WHITE COPY TO ISSUING AGENCY, PERMITF.ILE . PINK COPY TO APPLICANT ~ t' . INFOR!TION NOTICE TO PROPERTY OtNERS A!lOUT CONSTRUCTION RESPONSIBILITIES ..-. ,-'. NOTE: . .. This I.nfor[TIation Notice ,to Property Owners About Construction Responsibilities was dev!'lloped by the.Construction Contractors Board in accordance with ORS 701,055(5), passed by, the' 1989 Oregon Legislature, . ~" . ". . . . " 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:, \-: -': , . - '. , If you hire persons ~ot r~gistered with the, Constru~!ion Contra<?"9rs,Boimj to do laborin constructing or assisting in the construction or 'iITlProv~ment ,of a residential, sfructure':.You wile in most i,nstances, be ruled to be an "employer" and tlie peopl~ ygu'hire wiJl be "e'mployees'''. As the'e,mplbyer,'you must c!>h1ply witli the following: _ . - . . .. J"~ '. . . .~. f ~. " . # " '. " - .;..,.' . " Oregon's Withholding Tax Law: As an employer. you lTlust withh,old income taxes from employee wages at the time employ~es ar~.paic;l. <you ;yill,be liable for the tax' pay,mE!!lts.,even if you don't actually withhold the tax from your employees. For more information, call the Oregon Depi!rtment of Revenue at 378-3390, " . """" -, . .1 ,..... ,,'- .. '.. .. " " . Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all e,mployees, For mo~e intormati/;m, call t~l!l OregonElTmloyment Division DHR at 378-3224, '''f';. ..,.... !) , t. 'I 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 qbtain workers' co'mpensation insurance, you may,be subject to penalties and wif, be 'liable' ftwall claim costs if one of your employees is injured on the job, For more information, call the Workers' Compensation Division DIF at 373-7434, . - .. .. . , '\. ..~ /'.' ".::~", . ..~ . U.S, Internal RevE1.nuedSeryice: As an"e:lTlph?y~r. ,yOU must ~i~h~ql~ te,ger~1 if}cRme tax. from employees' wages, You wiWbe liable/or the tax payment even if you,didn'tactfJ,ally't!'ithho!d !hf:qa~. 'For more information, call the Internal Revenue Service at 221-3960. .. , ". ,".' ,,"'''.. ", ' OTHER RESPONSIBILITIES AND AREAS OF CONCERN: ..: Code Compliance: As the per'mit holder.for this project. you'are responsible for resolving any failure to meet code requirements. that maybe brought ,t~ your, atte[ltioiuhrough inspections, . "1;.. ,.' Liability and Property 8amagelnsurance:: Contact your.insurance,agent to see if you have adequate insurance coverage for accicjents and omissions such as falling 'tools, paint overspniy, water damage from pipe punc- tures, fire. or work that must be re-done, '.~. - ~ "; .. '.; .../l I, '1 . ':;'" ' . Time'to Supervise. Employees: Make sure 'you ,have sufficient, time to supervise your employees, r !', ~',' . Expertise: 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 so they can, perform the required inspections. ., ,: If you have additional questions, write to: Construction Contractors. Board 700 Summer 51. ,NE, Suite 300 " ,.., . f . Salem, OR 97310-0151 . .. Phone 503-378-4621 ',' I.., "0244J'10/24189<" ,.';.", u. ..,~_ :',:.i ':..~4 ~:J:-'C:;'~ .J- ',:::;'O~J >:'..~l~,