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Home My WebLink AboutPermit Electrical 2003-10-23 / : . ,:., CiTY'OF ShL<INGFIELD OREGON'P ,( i" . . .' ~ " , '" ~.....,.. '. . ... ~.' ubmitted has the following 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54I)726-3753 ~~541)726-3689 quire specific land use ELECTRICAL PERMIT APPLICATION Zonin" C <!.- Ci~ Job ~u:~e:. ~?/f[)S-O 10.. ~~.D:te 1'(:}1:..~=orized~i~atur:~,-.~,~-.O~.. ~t.. L '-LOCATlONOFINSTALLAnON 3. COMPLETEFEESCHEDULblJELVW.,.., ;;& "~~~3~~AF~~S 3/7 ~:':;.~:~~W",S~.?'~M;,"-;~"i~~~ JOB DESCRIPTION 100 ft1.1p eweST 1000 sq. ft. or less h ... h)_ Each additional 500 sq. ft. or yuW~ elJi(S~ortion thereof 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. CPJlfTRfiC1.'.()l{.cNSTALLATIOl'f ()!'lLY . , \ _...:....~ _._:~.....:......_..".-'-.._. _~___ _.. _ __h_ _ ':'_ ~ _ ---""_.._... Electrical Contractor LA' rfi ~ C..- Address p- 0 . ho;< r J ( 34 Ci~ (;::0 b . Phone hf[-~q fo Supervisor License Number '"3 c:;- -c; '3 $ 10/0 tf- C;17\{f C;/ () f Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician fr !~fC/ (/ Owners Name ~NI4/Kr " . , Address -Cd",f:;, /:.d~~<;;T_ Ci~ ..j~p;;v91t;;-6ne Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 -,-- - ---.." "-"-. -, -..- ~. --~ -,_.',~_._. - - 1 . .' B. )~e.rvices.or Fee<jers -"Installaiiop, A!terations orJl.elocation:: '..;,_......;~--.._._.~ " --,,--_.._~----"_...j_:'---_.""';'_':-':,,- . ',' 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only r::-... .. ... -.-. .-- .- --- '..- C. Temporary S~nices or-Feeders :,. . -..--"-'- - . ~.,--"._-- .--.--.#_-',.'- .~-- Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps ~.':er.~OQ AI11ps ~.~OOO_Volts ~:.e '~B~: a~ve. D. ' Branch Circuits' . I $ 63.00 frJ J/..(j $ 75.00 $125.00 $163.00 $375.00 $ 50.00 '-', ---,.--',-- -i.:.IL... .' , - - - _.. --" New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or o'T~e{:ennit $ 3.00 E. rivu;ce~ajl&'I?~~~~~J;:j.,,~~fl~~~~J:~~~~~tauati'on --.,tillTHOR1ZEi}iJNOt'K In .:>nT<. .... - - - .. Pump or ~1\\1tNCEO OR IS ABANOON~90Fo~R ",;' Sign/Outli1/Fli{igiOOlilAY PERIlJu. $ 50.00 OWNER INSTALLATION Limited EnergylResidential $ 25.00 The installation,;..hBi!1!fil1(ij~~ii.)prnp~r~he&k'i~~S YOU.I'.Ot Limited Energy/Commercial $ 45.00 . . 1-\1 '1-.: d b the aragon Uti I Y IS not mtendedl~rd%"r~~~e aU!l\lf\e Y -Mi.pJ11um Electric Permit Inspection Fee is $45 00 + Surchar"es "1~5i~ication Center. Those rUhleos :~e 9S;.Cft..... _.-- __ H ___ _ H" '.__ 0 Owners Signalifl A: R 952-001-0010 throug "4. , SUBTOTAL OF ABOVE' (' (0-.0 1 b . copies of the rules .' ___ __ .-- _ -- .. .... . A __ 0090. YOU'lm..a~^~.~~I~Note: the telephone7% State Surcharge d. <II Ci:11l1l1\j' .- ~- Tt Notification . "'(, mberfor the Oregon Uti I Y 10% Administrative Fee ~ .,.1 0 nu _^'^' ;0. 1.~V1fV>.~?:?~44)' Inspection Request: 726-3769 TOTAL $ 50.00 $ 69.00 $100.00 .-----, $ 43.00 73,71 Shared Drive(T:)IBuilding Fonns/Electrical Permit Application 1'{)3.doc C~B - Find A Licensee - Res, SEARCH BY: - LICENSE NUMBER - TELEPHONE NUMBER -NAME OTHER SEARCHES: - OCHI NUMBER -OCHI TELEPHONE NUMBER - OCHI NAME SEARCH BUILDING CODES DIVISION FOR PLUMBING & ELECTRICAL CONTRACTORS " . Page 1 of2 Find A Licensee Contact Us Other Links About the CCB Programs Consumers Contractors Laws WNhat's Const .,' ew Find A Licensee - Results Click HERE for a printer friendly version LICENSE 59748 NUMBER: NAME: TONY KOTH ADDRESS: PO BOX 11139 EUGENE OR 97440-3339 WORK PHONE 5414858669 ENTITY TYPE: Sole Proprietor NUMBER: LICENSE STATUS: Active EXPIRATION 5/4/2004 DATE: DATE FIRST 5/3/1989 LICENSED: CONTRACTORS BOND COMPANY: BONDING & INS CO BOND AMOUNT: $ 10000 BOND EFFECTIVE 5/4/2004 TO: VIEW BOND VIEW CLAIMS HISTORY HISTORY VIEW VIEW ASSOCIATED SPECIALIZED NAMES TRAINING ASSOCIATED LICENSES VIEW BUILDING CODES DIVISION LICENSE DETAILS STATUS CHANGED DATE: LICENSE Specialty CATEGORY: Contractor/All Exempt (Cannot EMPLOYER Have Employees - STATUS: Has No Workers' Comp Coverage) INSURANCE STATE FARM FIRE COMPANY' & CASUALTY . COMPANY INSURANCE $ 500000 AMOUNT: INSURANCE EFFECTIVE TO: 5/1/2004 VIEW INSURANCE HISTORY VIEW SIC CODES OTHER CCB LICENSES [ Home] [ Up ] Send mail to Web Administrator with questions or comments about this web-site Or~~OnJ:bI~ @ .- Stale of Oregon Liability Statement http://ccbed.ccb.state.or.uslNew_Web/asp/new _search Jesults.asp 10/23/2003 ~ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1 078 COM2003-0 1 078 COM2003-0 1 078 Payments: Type of Payment Check "J&~'!.."'.o~._. .... WiL. . . '....-.. - - . . .....,,0 ...~. .., . -"c.o ".. Receipt #: 1200200000000002362 Description Perm Serv/Fdr 200 amps or less + 7% State Surcharge + 10% Administrative Fee Received By dIm l.:heck Number Batch Number Authorization Number Paid By LITE ELECTRIC SERVICE 6299 City of Springfield Official Receipt Development Services Department. Public Works Department. Date: 10/23/2003 11:43:02AM Amount Paid . Item Total: 63.00 4.41 6.30 $73.71 How Received In Person Payment Total: Amount Paid $73.71 $73.71 . .