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Home My WebLink AboutPermit Electrical 2007-8-27 ZON ~ INITlALS tJ M ~ DATE)( /l..1 ;,u' 'YAJI SOURCE 6'- r ~ {/ ~ ..D~. ~7 (':7 3. . C~~PLp'TE FEESC~JJ.DULE B,ELOW 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 Installation, Alteration or Relocation A'fIc"NTlUI\j: OregolM~~~"m you to $ 55.00 foll.~w \I'~ie$ adoPte~YA~~ QJ~ij&9..Mt.Yity $ 76,00 Notlfloatlon Center. sa rulE!~ !l,I;~ ~~ forth In OAR 952-001-001 r~ OJ(I1952!lJ01- $110.00 nnQn . Vo.u-may obtailD~~ilO3J\rtJthe>flll~J~1Its see "~': above. callmg the centeb. (~~t~oQe ". .... . number for the Oregon"tJtilitY"NotifiCaticih~" . Center is 1-~e.t:.~""J.or Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Permit ELECTRICAL PERMIT APPLICATION City Job Number CoAA z...o~ 7-01 Zb ( r'-' W' ...-:: - . .. -~. '~,>~-.::.-."- -""~'.'.~.::-_~ ~..:'., -C"--,,'''':: "'-_-- "."r 1. ; LOCATION OF INSTALLATION' 'j F:~j~"^;s""71t:. ..\.,. '%5', ~ LEGAt70c~T2b( ~ JOB DESCRIPTION: kJJ o ZtOD z c:.... I. .r c:..,&.A-, ~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ~'_:;','~ ~~ ...,~, ..___~.~~:;.. '_~ ..~ .._. _ ~'~_r<' 2. 'CONTRft:(?~Hf!:I!f~,!,A.L,.Lf1TIPN ONLY Electrical Contractor Address Phone / {Iv l0 Supervisor License Number .. J r (}V V City Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician OwnersNamef/-at6>fd- D. M ~ f1. t'-, ~t Address 18'"7_1 1/0. 7 ~ .:sT City .:51' r ) ";~.--(&? Phone 7.".1 ~ - 7 37 'I OWNER INST ALLA nON The installation is being made on property I own which j, ntnt intond,d fn, <aJ,. J"" n, ,onl. Ow ,ers Si~a~re:{) 1/// ...... Jt~ 01- /,//( ~~ I I Inspection Request: 726-3769 A. l'Ie~'Residenti~l- Stngle, or Mu!ti-Family perdwellillguni~.;. . . :.... :.......h ,..~~..n ...... '-""",,_^ " .... . "...l_;,~.".~,.~. .._-,/ "'" ..w".'^~,:,....:..::,..jy;V"" _ .~._ '_,.;.. ..'<.'-"'';; ....' .~"i '.-_,". "... _w,',_' ,.";~,,,~. . _ ~ ~_//.._.-..... ^ :,.".".. d.h..':.v.;-~ Service Included 1000 sq. ft. or less Each additional 500 sq. ft, or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 $ 21.00 $55,00 ., -"_:?:" '~~:':':_7"'" :',,",;;:!;' "'r'f<(':,:;.,-,u"""",,:;{:;v<.,,:'<"-t"< ',"~:'^-f-""'~"~":""::~(>T-^-:~-~'i B.~ervice~" or F:ee~er,s~7Jnstallati~??,~lterations orRelocation: . 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 70,00 $ 83.00 $138.00 $180.00 $413.00 $ 55,00 f""~~'\'~~~-,;y-'--:}<-" " ,;:;.".', , ,'. _ _ ,_ .,"A c. i"1'eD1PoraryService~or Feed.ers,..';> .....h.: __"",,~,A'.", ._.' ...-'""." ..o'"j..J.._... .._....~.;.;.:.,'..A.-.'.. $ 48.00 1Y <( I $ 4.00 E..;Miscelia~eol!Ks (Service/fe~der'not included}-Each Installation , '. <', .K,," .,i;'0--".. '. .... _' .._ ~-'- ,,' ~_,...;"".' ~.. " . <'. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55,00 Limited EnergyfResidential $ 28.00 Limited Energy/Commercial $ 50,00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges SZ"'c/ V/6 '52..0 AUTHORj~11~~ ifJdIS PERMIT IS NOT z/.,u COMMENCED OR IS ABANDONED FOR b3 96 ANY 180T&AtpJ:Rlon. T IB 'Id' 'F lEI 'I P . I" ' ~arecrJjnve( :) Ul mg orms ectnca enrol App lcal10n 7-07,doc 4. SUBTOTALOFABOVE. '. Nl[>>l~C~--""'" .../._. .:..,... . THIS PE~Jf~~a:i&s1JaE If THE WORK Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01261 ISSUED: 08/27/2007 APPLIED: 08/24/2007 EXPIRES: 02/27/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1895 7TH ST ASSESSOR'S PARCEL NO.: 1703261302100 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install Heat Pump & Air Handler Owner: MANNING HAROLD D Address: 1895 7TH ST SPRINGFIELD OR 97477 Phone Number: 541-726-7374 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Contractor License OWNER ASSOCIATED HEATING & AIR CONDITIO 106275 BUILDING INFORMATION I Expiration Date Phone 08/31/2008 541-683-2590 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Sidewalk Type: ATTEtffJQh~paM~dbW: requires you to fo:'.~w r~les adopted by the Oregon Utility ~~ollficatlon Center. Those rules are set forth . In OAR 952-001-0010 through OAR 952-001- NOTICE. 0090., You may obtain copies ofthe rules b THIS PERMIT SHAll EXPIRE IF THE WORK callmg the center. (Note: the telephone Y .~UTHORIZED UNDER THIS PERMIT IS NOT number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR Center is 1-800-332-2344). ANY 180 DAY PERIOD. Storm Sewer Available: Special Instruction: Notes: '~'--JJ .1i:i" Pae:e 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project ~ Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Amount Paid Date Paid $20.00 $5.00 $2.50 $4.00 $9.00 $14.00 $27.00 $5.20 $2.60 $4.16 $48.00 $4.00 8/24/07 8/24/07 8/24/07 8/24/07 8/24/07 8/24/07 8/24/07 8/27/07 8/27/07 8/27/07 8/27/07 8/27/07 Total Amount Paid $145.46 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01261 ISSUED: 08/2712007 APPLIED: 08/24/2007 EXPIRES: 02/27/2008 VALUE: Value Date Calculated Receipt Number 1200700000000001089 1200700000000001089 1200700000000001089 1200700000000001089 1200700000000001089 1200700000000001089 1200700000000001089 1200700000000001095 1200700000000001095 1200700000000001095 1200700000000001095 1200700000000001095 To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. ~~ouireCUnsDections . Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Pae:e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01261 ISSUED: 08/27/2007 APPLIED: 08/24/2007 EXPIRES: 02/27/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I 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. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, 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 remain on the site at all times during construction. .i/~ O)1{ ~ O~ner or Contractors Signature ( :;Y-;J-7-07 Date Pae:e 3 of 3 . . . ' 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 Permit #: c OVV\ z...c c>7- 0 I Zb ( / <67 J 7fl.....s t ''p,~ ' Date: , / ~h7h 7 I / 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 requiredfor 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 appropnate bl~s and initial boxes 1 and 2, and either box 3A or 3B: Hi. V--.2. . 1 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. . , o ,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 ~ 3B. I will be my own general contractor. In 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 iinmediately 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 do understand the Information, Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ;j~,tf' Ef- j1(~'--ca {f-;Z7-0? (Signature of permit ap,.rtcant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner. doc 06-01-04 .... ", , . \, - \' A~t~hg'_~S?Your:'0wn General Contractor? , ~" \. ,,~.., '. . . . ~ : .' INFORMATION NOTICE TO PROPERTY OWNERS ABOUT'C'ONSTRUCTION'RESPONSIBILlTIES \ .... \. - ~ r. -.., -" . - ... . '----'. . '.' ( ,.' 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 'ofthe following responsibilities and concerns. Employer Re~pon~ibilities ., . You will, in most instances, ,be ruled to .be an, "employer" and the contracto~s you. contraqt with will be "employees" if you u.se c9ntractof,s not licensed with the Construction Contractors Board to ,do labor in const::rncting or to assist in the construction or improvement ~f.aresidential structun;, ~~ ~~e employ~r"you must comply with the fOllowing: s.. ... ~. . ~ . . '.. . . ' ~ . Oregon's Withholding Tax Ijnv: As an employer, you mU,st withhold income taxes from employee wages at the time employees are paid. You will be liab~e for the tax payment~ even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue ilt5'030378-4988. ' U HllemploymelIll.t Insurance Tax: As an employer,. you are required,to pay a ,tax for unemployment insurance purPoses <.. on the wag~s of all employees. For more information, call the Oregon Employment Department at 503-947-1488, .......... - The Oregon Business Identification Number (BIN) is a comb.il1cd ~1;1umber , fpr ,bpth Oregon. WitW19Iding and" Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or \\T\vw.doLstate.oLusiformsnav.htmll for the appropriate forms. . , Wor.kcrs'Compensation llnsnraHllce: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' cUlUpensation insurance for your employees. If you fail to obtain workers'. cVlHpensation insurance, you could be subject'to pen~ltles- and be 1i~bie for all Claim'costs if one'ofyoqre'mployees is injured on the job, For more information, call the Workers' Compensation DiVision at the Department ofConsuriJer md Business Services at 503-947-7815. U.S. Intell'naD Revenue SCll'vice: As an employer, you must withhold federal income tax' fromclilployees' wages:"'" . ' You will be liable fOf the tax payment even if you didn't actually withhold the tax, For a Federal EIN number, call the IRS -at 1-800-8294933 or visit their \veb site -at v\('\vw ,irs.,gov. ' . . Other ~e~IP>on~ilbiliitiie~31Imdl,AJre21~ 011' CO~CerIDlS Code Compliance: As the permit holder for this project, you are responsible for re~olving any failure tbrrieet code' requirements t?at may be brought ~o your attention thJ;ou~h inspections. . ".":..r. ,'.. . \ \ + . . .:'.: Liability andlP'roperty Damage Insurance: Contact 'youflnsurance agent to :~e~ 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. . . ' I ..... .... '. . . ...."' ~ -..., ....... ..... :\ , ' Time: Make sure you have sufficient time to supervise your employees: Expertise: Make sure you fia~e the ~kilis to act as your owngerieral contractor, to ~oordin~te the work of rough-in and finish trades, and to notify building officials as the appropriate 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 Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01261 COM2007-01261 COM2007-01261 COM2007-01261 COM2007-01261 Payments: Type of Payment CreditCard c Receint 1 RECEIPT #: 1200700000000001095 Date: 08/27/2007 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By HAROLD MANNING Item Total: Check Number Authorization Received By Batch Number Number How Received djb 00660C In Person . Payment Total: , Page 1 of 1 12:10:57PM Amount Due 48.00 4.00 2.60 4.16 5.20 $63.96 Amount Paid $63.96 $63.96 8/27/2007