Permit CITY OF TIGARD ELECTRICAL PERMIT
'�� COMMUNITY DEVELOPMENT Permit#: ELC2020-00453
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/21/2020
Parcel: 1 S 125DA05900
Jurisdiction: Tigard
Site address: 6740 SW ALFRED ST
Project: Karlson Subdivision: KINGS VIEW Lot: 45
Project Description: Replace 200 amp service and(16)branch circuits for remodel of kitchen, laundry, bathrooms and bedrooms.
Contractor: AZOV ELECTRIC LLC Owner: KARLSON, RUVIM
9920 SE CITY VIEW DR 6125 SW 32ND AVE
HAPPY VALLEY, OR 97086 PORTLAND, OR 97239
PHONE:
PHONE: 503-880-4845
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 09/11/2020 $100.70
Specifics: amps or less
16 crt Branch Circuits w/Purchase 09/11/2020 $118.72
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 09/11/2020 $26.33
Electrical
Type of Const:
Occupancy Grp:
Total $245.75
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. T•' permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires y, • follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Y•.. • obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987
or 1.88000.333322..22344. L //•
Issued By: ,..//%/I� Permittee Signature: U/Y /7��/�GL�%7(L /
OWNER INSTALLATION ONLY
The installation is being made on pr••erty I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Appficarior /� (�jq yI 1)0 E® •t.m 's FOR OFFICE tl�s-EONLY
„" 13t25 i1f�,antil19 Fax: 511R4722 AUG 31 202� sec ,er.� ��/.� 'C3� � 6r.�-� `- oQq53
City O ( igard Permit#
a„ metlty.
!3t.sS\V lialE It id.,Tis,arti,OR 97,._3 1 :nr tteviesv
. 1TY OF TIGARD atenty Related Permit C.
'•Pr IMpculinrt Line; st13,4?9.4i75 Rauh Una nv I haw Sd See Page for
`=„' 'W Internet: ww+w.uuard-w•.gov BUILDING DIVISION t Atw a ,\I„, t1 1 f Jt j? 40 0 Supptemeetal Information
TYPE OF WORK e31f4 YtsL4VI Pi PLAN REVIEW ,t "a f,',
'�; New construction ,.' Addition/alteration/replacement
meal please check all that apply(submit 2 sets of plans w/items checked)
D service or feeder 400 amps or more 0 Building over three stories,
COIDemolition ❑Otter: where the available fauncurrent D Marinas and boatyards.
CATEGORY OF CANS 192UC"IIf1N . exceeds 0,0ou amps at 150vohsur 0 Floating buildings.
' :-and 2-Iiunily dwelling O Coi nnerctal/industrial ❑Accessory building e s no ground,or excteds 14000 ❑Commercial-use agricultural
:Amu nir/7 other installations. buildings.
E Mufti-family ❑ Master builder 0 Other: Li I Fee pump. 0 Installation of 150 KVA or
-_ --- 3013 srrE INFORMATION AND LOCATION - i D Emergency system. larger separately derived
❑Addition of new motor load of System.
Jl,h It: 1 Job site address:&78 d 50 $ fail" 51- 100HP or mare.
D s;x or more residential units. occupancy.
�C1t1 tit nt.!`/,lI': pQ�'� ,s. Oa_CI ��, O1 CHeaith-care facilities. D Recreational vehicle parts.
i Ii,mrtr is Ira a airs, 0 Supply voltage for more than
Suu,I.ld,/apt.ik project ro ect name: 600 votes nominal.
r� �— 1 rvidC or t'Ccdel 600 attics or more.
('rr,s`street/directions to job site: C� ),:. 5. i 'c-{ l FEE SCHEDULE
c .�-�y ,,)L ,,y�/ y! ,,i Ila,+en�u ,n 1 Qty. 1 Each I 'total l •
! 7 1 e'T�I 1X Cy ►'t,i -1 IVtw residential single-or multi-fatally dwelling unit.
Sit ,bvi i011: 1 Lot p: ! fin:holes attached garage.
1-" !unit ui.it.or less 168.54 4
I Tax map/Parcel tt; I
Fa.odd'1500 sq.R.or portion 33.92 I
(-� `gyMp t�,(�,,'' +��/ DFSC�Uill'TIIOJ O'[Fj WORK
��-(�, ,�y{''f I ! !,inn,rcd ette rev.residential
c2LI 00 C'V uc Y'-��/�Ix+�- ) c'✓r"q.+c.s-1 0 r'" ! !with stet ve ni ih 75.00 2
tl mule!eau;y,„,taut-funnily 75.00 2
fI/ r y��,a 1PT/7a1 ,r7n11al C• f7 t�(1a'?coin . rc+ldemnu!with above sq.11.1
7laCrY li O" i�✓tiG.-C Jf+i Ci LL.Vyl1�lJ t�V1/� Reitetvuttie t nergv 0 See Page 2
Dit PROPRRTY OWNER 0 TENANT 1 Services41r fuders installation,alteration,and/or relocation
V uner h ii 1 it '„!� y_ 50� , 20fl amps or less 100.70 1,(' ,'"CJ 2
�� l91 ZS c vj 30_1, �� 2n1 amps tn41>r);uttps 133.54 2
Address: 1 c7 - . 201 am
(� dal amps to fAN7 only,. 1 200.34 2
C.ind�tafel7,lP; 5'Q(� �O) d� `i 7 9 ! 6ul snips to 1,000amps 301,04 2
l
!'hone:(503) 33.0 ---k 1\(c> Fax:( ) - , Over hoop amps or volts 55226 2
1 I Temporary y services or feeders installation,alteration,and/or
Fo lit: CON S �7'�-u e-F ,C 1 i relocation
t)wr ati cr 4W:111nn:-this installation is being made on property that I own which is not txt amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, t 201 amps to400 amps 125.08 2
Owner signature: Date: 1401 amps to 509 amps 168.54 2
i
t, PERSON
Branch en•cuiIC-new,alteration,or extension,per panel
nl I I-ICA�T 0 cON TACT t--- h
.+- ,/, A.Pee for hooch circuits sett i 7
�lilts:netts ism Isle: 4- \( t•+� (f� E t-....e clove service or teener Ice, \( 7.42 {,.V�2(rr 2
_. `' Y x.r • �.� x.""`— �r� f such haunch circuit
Cttnl:et name: V tit.,..0 -,5`,µ'e+ ',,,r i 1 D. Fee.for branch circuits without
Address: el C I Vv 9S Ct� VI ♦ service or weeder fee,near
Ad
YV A� luane:ln eir:uot 56.18 2
Citv't tier/IP: 0-'�.7Ptr{ vh 0` �„ ���j ! ! Iclladd'I butnchcirctit 7.42 2
(�Q� f i Wseell:meows(.ervice or feeder not Included)
Phone:(9Z3,) Vxjex-' .- �vis I Fax::( ) I L=meh Manot:laured or(nodular
1 dwelling,service andlor feeder 67.84 2
I nit:. IReconnect only 67.84 2
CONTRACTOR I Pump in o'rnealton circle 67.84 2
I3tlCmess name: Ai G � Lt.-C. .. ( Slim or outline lighting 67.84 - 2
! I Stenal vircuil01 or limited-energy See Page 2 2
Address: 't Cl --to ¢ 'C / ITV' V IVkd De. p nel,attemon,nr extension.
J v is , '7 I
Each additional inspection over allowable in an of the above
' I y
C'ily/Si:tie/71F: VA oa- 7 --
�`t�'P� i1 [ �/iJ I Additional inspection(i ter min) 64.25/ter
Phone:('.)1)) .-. A Cj t) I Fax:( ) ( I Investigation(I ter min) 90.00/hr .
I- '-'-1` ( I Industrial plant(I hr min) 78.18/hr
Crn:11,. I InspeCaun.for which no fee is
Cat 13 I.ic.: 1 (c. a0 Electrical Lie.: CrCi 1 Suprv, Lie.:3s.-77s
sporilic:Illy!islet IV,ter min) 90,00/ter
ELECTRICAL PERMIT FEES
Snprv. Electrician signature,required: 14/ / Subtotal: 2.101 ,'4 2..
Print name: Sideu�,� ate: Z,�j.`2.0 I 1 O Plan Review Required(25%ofpermitfee): �p� .�•�
I State surcharge(12%of permit fee): ! �J
I TOTAL PERMIT FEE: 2i-�jt 4/Aal!nat2ul signature: .- •,'��-"e-^-"{ I Thus permit anplicaiiun expires Ha permit is not obtained within 180
i Print mime: �f uL- Dale: dys a after it has been accepted as complete.
Via
"'^• "`��"� ,A^J ~��-�� ' Number ofimltrciionnt allowed per permit.
F,taut.t.,vNiroh,IditI.C_nerm,iiApp„F.LR_ERF..doe Roe rah l 7r101„C 44(14615T1 I I Al i1CO S4lWF_11