HomeMy WebLinkAboutPermit Electrical 1997-3-10
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225 FIITB STREET .,\O~ 0\ le~
SPRINGFIELD, OREGON 974..(,1o\\O~,\tI}tlae.tI ,.D~
INSPECTION REQUEST: 7~6-";"~9 ~ f" '~ Ci Job Number CJ?fJ'352-
OFFICE: 726-3759 .,.99 '/.p,,\,:\r;, \ '). r, ,l,.
~\\D\~ ~ OHPLETE FEE SCHEDULE BELOV
1. LOCATION OF INSTAL ~~~ ....\ll"
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.H~t.I/~. --,,~e6 A. New Residential-Single or
. ;....' Multi-Family per dwelling uni t.
LEGAL DESCRIPTION Service Included:
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JOB DESCRIPTION
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Permits are 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
Address
City
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Nanie Jeff trej L P L.; 1I if5
Address C; ~6 Q......'....a It St.
City Sptl-t Phone 747-4&O~
OVNER INSTALLATION
The .installation is being made on
property I own which is not intended
for sale, lease or rent.
Owners t~ture:t ~~
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RECEIP=f!~ J \ "?q4'!{-
RECEIVED BY: - /~~~
Items
Cost
Sum
1000 sq.ft. or less $ 85.00
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations or
Relocation:
200 amps or less V $ 50.00 ."ltJ, ~
201 amps to 400 amps $ 60.00
401 amps to 600 amps $100.00
601 amps to 1000 amps $130.00
Over 1000 amps/volts $300.00
Reconnect Only $ 40.00
C. Temporary Services or Feeders
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 "Bit
above
D.
Branch Circuits
New, Alteration or Extension Per Panel
One Circu it ~ $ 35.00 ~
Each Additional
Circuit or with Service~ b~
or Feeder Permit $ 2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40,00
Sign/Outline Lighting $ 40.00
Limited Energy/Res S 20.00
Limited Energy/Comm $ 36.00
5. SUBTOTAL OF ABOVE .:;h. eft}
5% State Surcharge '2. ~
TOTAL ~(//.. ~
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Permit No:
Address:
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Issued by:
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, Date:
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FOR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
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 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 applicable blanks, and inilial boxes 1 and 2, and either bDX 3A or 3B:
1. ,-:><:'"""1 I own, reside in, Dr will reside in the cDmpleted struc1ure,
2. "I----=-==---I . I understand that I must register as a construction contractor if the structure is sold
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or offered for sale befDre or upon cDmpletion.
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3. A,I
I My general con1ractor i~
ContractDr registration number
I will instruct my general contractor 1hat all subcontractors who wDrk on the struc- '.
ture must be registered with the Construction Contractors Board.
OR
3, B~~~ ~ I will be my Dwn general cDntractor.'
'If 1 hire subcDntractors, I will hire Dnly subcontractors registered with the CDnstruc-' ,. . '-
tion ContractDrs Board, If I change my mind and do hire a general cDntractor, twill
contract wi1h a con1ractor who is registered with the Construction Contractors BDare
and I will immediately notify the office issuing this building permit Df 1he name of
the contractDr,
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
reverse side of this form. .
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SignatUre of Permit Applica'nt
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CONSTRUCTION CONTRACTORS BOARD
0244J 8/91 .
3-/()'9l
Date
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
. .
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INFOF&TION NOTICE TO PROPERTY OtNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information NDtice to Property Owners About Construction RespDnsibilities
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 tD construct a new home or make a subs1antial 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 nDt registered with the Construction Contractors Board to do labor in constructing or assisting
in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an
"empIDyer" and the people you hire will be "employees", As the employer, you must comply with the following:
Oregon's Withholding Tax Law: As an employer, you must withhold incDme taxes from employee wages at
the time emplDyees 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 Oregon Department of Revenue at 378-3390,
Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of all employees, For more infDrmation, call the OregDn Employment Division DHR
at 378-3224,
Workers' Compensation Insurance: As an emplDyer, you are subject to the Oregon Workers' Compensation
Law, and must obtain workers' compensation insurance fDr your employees, If you fail to obtain workers'
compensation insurance, you may be subject to penalties and will be liable for all 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 Revenue Service: As an employer, you must wi1hhold federal income tax from employees' wages,
You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call
the Internal Revenue Service at 221-3960.
OTHER 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.
Liability and Property Damage Insurance: Contact your insurance agent to see if YDU have adequate insurance
coverage for accidents and Dmissions such as falling tDDls, paint overspray, wa1er damage from pipe punc-
tures, fire, or work thaI must be re-done.
Time to Supervise Employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the wDrk
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 St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
0244J 10/24/89