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Home My WebLink AboutPermit Electrical 1991-8-20 '" ,p;il 225 FIFTH STREET SPRINGFIELD, OREGON 97477 INSPECTION REQUEST: 726-~769 OFFICE: 726-3759 1. LOCATION OF INSTALLATION 6 -?;:2.. /) I'\.-cl <!.r ,$'erx.. t.. 01.-. r-, LEGAL DESCRIPTION /7o~ 33 1-4 QDZ-c:::ro JOB DESCRIPTION l' e I~ /a.ce. e/~ .jh 'f:- 'P0;.r\.~ r I / Permits are non~transferable and expire if ~ork is not started ~ithin 180 days of issuance or if ~ork is suspended for .180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor 5'e/.F Address-.t /' 2. Afld~7~ /.-~ r ('/ J h..., c; ';Zg"'o City J~rfd Phone I~ ( I Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician O~ners Name ~>It~ 1, /;;6/e- Add res s c;; 72 If (t cl e..r .> Q;y" L a.,,,- e City S"''p{ Ic! Phone, ? 2~' Z9 /0 .j OVNER INSTALLATION The installation is being made on property I o~n which is not intended for sale, lease or rent. o:z~e:~~ f?? - 2() --'71 21(;Jr:~ t /..1 K~dlJ\.P -<.{ DATE: RECEIPT 1t: RECEIVED BY: $I""NGt'.'I.:.LU I!"'''''-~'''''f City Job Number 710eJ77 , I' 3. COMPLETE FEE SCHEDULE BELOV A. New Residential-Single or Multi-Family per dwelling unit. 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 $ 40.00 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 amp~/volts Reconnect Only $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 5DOD C. Temporary Services or F~eders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B" above D.Branch Circuits New, Alteration or Extension Per Panel , One Circuit Each Additional Circuit or with Service or Feeder Permit ~ $ 35.00 $ 2.00 &~ E. Miscellaneous (Service/feeder not included) -Each installation. Pump or irrigation $ 40.00 Sign/Outline Lighting $ 40.00 Limited Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL OF ABOVE .<~ t70 5% S ta te Surcharge ,?_ Bo TOTAL .<::'~ .f3v 9c:J1f&B . r Permit No: 9//JO 77 . ~ 7 2 AwJ./!i:7&J'/Cl 1;Pd5 /~ Date: .,B--;20 -j I - t' Address: Issued by; STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applieants who are not registered with the Construetion Contraetors Board to sign the following statement before the building permit ean be issued. Lieensed Arehiteet and Engineer applieants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applieable blanks, and initial box 1 and either box 2A or 2B: 1: c::><:L I own, reside in, or will reside in the eompleted strueture. 2. A. I My general eontraetor is Contraetor registratio_n number I will instruet my general eontraetor that all subeontraetors who work on the structure must be registered with the Construetion Contraetors Board. OR B.J:::><-i.. I will be my own general eontraetor. If I hire subeontraetors, I will hire only subeontraetors registered with the Construetion Contractors Board. If I ehange my mind and ao hire a Qeneral eontraetor, I will eontraet with a eontractor who is registered with the Construetion Contraetors Board and I will immediately notify the offiee issuing this building permit of the name of the eontraetor. 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 on the re.e~orm. ~7 &~A Signature of pern~canl D~ Y' / CONSTRUCTION CONTRACTORS BOARD 0244J 10/24/89 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT @. ~ .. INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIB~UnES " '\ . . NOTE;~"......:..:this-lrlformatjQlfiNofiee to. Property Owners About Cop~t6jcfl()n;.".- .Responsibiliti.es. was developed by the Construction Contractor~.:;l'iQatd, :i~.,,::~:. ~ ~~. -"'acc0rd~nce .w~th'~o.RS 701.0ffi5(5);"passed;'by the 1989. Oregon Legistalu,~e~~:':'. .;:.~,:\.\ ,: ' \\ ,'~. .,:'..'.' .. ". ,., ',.-C,... "., . ,'.. r=.:.,~",.;~...-/.~',.~T';,::;:,.. 'if you iireaeti-ng as yo,kown.contrac.todo~ construct a hew homeor:'makea SUbst~lI,iianrnprovement to an existing structure, you can prevent many problems I:>Y being. awa:re of the fo"oY{!ng're~ponstbmties and areas of concern.. . . ,."..., ,-:<.' r,,",' . .'.... .. '--'=.'.'-,'."... " . " ~ .. -.' ~,~...... . ~'. "- . EMPLOYER RESPONSIBILITtES:...:'~-: .. ". .':.". ,J -. ,.>,r!~'~>.." ',"".:':4.' ~..c.-: :- . '. .':; ". .." '. '. .~~ "._ ," "U":l-' ,r ..... J. ': ..~)-~ ~~" If you hjre persons nofregistered with the Gonstruction Contractors Board to do labor In constructing . or assistil}Q~n ttl~ c~nstructiQnor i~provem,ent ot,.a. ~~~identialstructur~, ;y~u w.iU, in most Instances, be ruled to'be'an "erripl'oyer" and the p~.ople you hIre WIll be "employ~es": As the employer, you must comply W!th, the following:. :., . , '..:.. .', '. .'" " ::' .., .... , . -' " .~ ," . t'~ ':' . .' . j ~ t .:. ~..'. .... ,'. '. Oregon's Withholdin9Tax Law:.As an employer, ,you. most .wltnhold 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 inforlTlation. call the Oregon Department of Revenue at 378-3390. Unemployment InsurS.nceTax: . As an employer. you are required to'pay a taX' for unemployment insurance purposes on the wages of all employees. For more information. call the Oregon Employment Division DHR at 378-3224. . :. ~ ," .. :- 10. " ,;'..J:.' :. . .: \:.' " ;Jo.... .' ~ ";. ----~..-. --- Workers' Comoensation Insurance: .As an ~mployer. you are subject to ~he Oregon Work~r$' Compensa- tion Law, and mustobtaln workers' compensation insurance for your employees. Ifyou'fail to obtain workers' compensation insurance, you may be subject to.,.penal~iesanc;l wUt be Iiable.for,all claim costs if one of . your employees .is injured on the job. Formor~ informafion'~' call the Workers' Compensation DMsion DIF i at'373-7434. '... '. '. . ... ,..... , .:. . ,.; .. . . . U.S. Intemal.Rev~nue.Service: As an employer, y~urriust wIthhold federal inco.me tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more informa- tion, call the Internal Revenue Serviee at 221-3960. . .. '. OTHER RESP.ONsBBILlTlES AND AREAS OF CONCERN: ....---...... - .,.. . Code Comoliance: As the permit holder forthis project, yo~ are responsible for resolving any failure . to meet9o~e requireme.n~~ that ma~ be, broUght to, you~ at'.8ntion through inspections. . Co... '. . . i liability and Prooer.ty:OamafJeinsurance:'Corltactyour rnsuranc~ agent to see If you have adequate insurance eoverage for accidehts andomissioils such as falling tools, paint overspray, water damage . . from pipe punctures. fire, or work that must be r&dorie. . , . .. . Time to: Supervise: Employees: Make sure you: have sufficient.time to sup~rvlse your employees. . . . . . ,'. ". . .... . , :... ....c.'! , ..,' .t'.. :. Expertise: Make sure you have the expertise to actl as your own general contractor, to ~Qordinate . the work of rough-in and finish trades, and to notify, building. officials at.,the appropriate times so . they can perform the req~ired inspections. ' , ~ . '. '\ .~ ~ ....-...... .... " .'\ :< . ~ ....' ...... .. .. ',:, . . .:,..... ":.01 1; If you have addttionalquestions, write to: Construction. Contractors Board 700 Summer St. NEt ,Suite 300 . Sale.fDLO.AJJ7310:-Q151, .., '. :,' .:. :.. :; Phone 503-37&4.62l j;',:.' . Q244J 10/24/89 '. f".: or ....-., - ."" _. t-.: ,I .... ~',,: .;:,~~.,,\ .' ;c. ,:.. < , .... :,. ~ HI.,:. ~ , r...,..