Permit (2) CITY OF TIGARD ELECTRICAL PERMIT
mi 2 ry`- COMMUNITY DEVELOPMENT Permit#: ELC2020-00553
Date Issued: 11/19/2020
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S104AC07800
Jurisdiction: Tigard
Site address: 12734 SW MORNING HILL CT
Project: Hedgecock Subdivision: MORNING HILL NO.9 Lot: 221
Project Description: (1)branch circuit to move outlet.
Contractor: OWNER
Owner: HEDGECOCK, PETER&CYNTHIA
12734 SW MORNING HILL CT
TIGARD, OR 97223
PHONE:
PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 11/05/2020 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/05/2020 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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. This 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 you to 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. You may
obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332..233444.
s.
Issued By: /�.��) `��Q Qi. Permittee Signature: r1
OWNER INSTALLATION ONLY
The installation is being made on property 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.
I�t/E ' E- Io as �b
Electrical Permit Applicatio EC FOR OFFICE USE.ONLY
Cityo Tigard 0 C T Received
t 1315 Hall Blvd.,Tigard,OR 97223 2 2 2020 Plan ReY:��/,j/ZQ �yQ Fermit N�`c�T.n^ OG SS�
R Plan Review [��
Phone: 503.718.2439 Fax: 503.598. Related Permit#:
YTY C7�TIGARtea,By:
Int nww. god-orgov _IILDING DIVISIV7'a'e hod:jl/-'Z �.S+d lw 'ti'
l'IGAIiD fY 4 itY Y: ®See Paget for
RP. Internet: www.ti aril-Or.goy Supplemental Information
. j
a J "TYPE'OF.:WORfC e, 1: C 2 .i y. ,ii:::lij g i t
❑New construction Add Actdihon/alterauoeJreplacement
['Service Please
check all that apply(submit II sets of plans whims checked)
:
0 Demolition ' Outer' Service or feeder 400 amps or more ❑Building over three stories.
-- where the available fault current 0 Marinas and boatyards.
'". CATEGORY OP CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
1-and2-tacit dweliin' less enground.orexeceds14,000 ❑Commercial-uses cultural
y g ❑Commercial/imrlustrial ❑Accessory but ding tm
amps for all other installations. buildings.
❑Multi-family _____ ❑Master builder ❑Other: - ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE,INFORMATION ANI) LOCATION - ❑Emergeneysysteot. larger separately derived
Job#: Mr/�l. Job site address: 0/3y Sw rrv,., p!l( ri ❑Addition of new motor iced of system.
I 100HP or more. ❑.,A,,,"6.L.1.2",°I-3"
City/State/ZIP: `'j't crz CI. �1 0 Six or more residential units. occupancy.
!slot ` ❑Health-ore facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: C' Project name: lL ,4 4 ❑Hasordous locations. ID Supply voltage for more than
'�` ❑Set ice Cr feeder 600 amps or more. 600'lolls nominal
Cross street/directions to job site: FEF, SCHEDULE
Doc lion t Qty. I Each _Tool )
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.R.or less 168.54 4
Ea.add'1500 sq.ft.or portion 33.92 I
�! DE-sctufa[OR. .OF WORK Limited energy,residential
Ct2A - -- (with above sq.fl.) 75.00 2
AA
l eti't'fv't f9 G7tA1f tr --.- - _. Limited energy,multi-family
residential(with above sq.R.) 75.00 2
PROPERTY OWNER ___ - Renewable Energy El Page 2
_ ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: �(kr 200 amps or less 100.70 2
Address: 4 ..13y s—,„,,,., A•om.; (yrr f c , 201ampsto400amps 133.St5 2{ J`T `T �l `'r' 401 amps to 600 amps 200.34 2
City/State/ZIP: q'y .�/ a� (} �3 601 amps to 1,000 amps 301.04 2
Phone:( ) - qQi y, r ii��Fax:( ) Over 1,000 amps or volts 552.26 2
Email: , 7 t/ Temporary services or feeders installation,alteration,and/or
A...,"Lila.. 19 , t r • relocation
Owner In`al ation:TI's installa.• s being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,r o , cording to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: f 2.2 212 401 amps to 599 amps 168.54 2
IB APPLICANT "'--T , Branch circuits-new,alteration or extension er panel
._ / ❑. CONTACT -kSON A.Pee forbrancheircuits titration,
Business name: l( above service or Seeder fee, 742 2
each branch circuit
Contact name: pelt/ fi-e rack B.Fee for branch circuits without
Address: (( I( �tI service or feeder fee,first 1 C(a 1
�� 14�A L.,. 1 I; (.d'- branch circuit SG.IS I 2
City/State/ZIP: 'r rid u� 1, Eachadd'I branch circuit 7.42 2
Miscellaneous(service or feeder not Included)
Phone: e
( )3 ) sr - /6i4 Fax"( ) Each manufactured or modular 67.84 2
Email: //.. dwelling,service end/or feeder
1 .((a(tt_ Vies t r/. f O 14.1 Reconnect only 67.84 2
' 'ONTI2.ICTOR r - _ -
--- _— Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy
panel,alteration,or extension, 0 Sec Page 2 2
�yaNtE Each additional inspection over allowable in anyof the above
City/StatelZlP: q� p
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
Cat Lie.: Electrical Lic,: Suprv.Lic.: s.ecificall listed('/hr nsin) 90.00!hr
r ?,.s?" FLECI'RLCAL PERMIT FF,F`�
Suprv.Electrician signature,required: Subtotal: 16,1R
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: 62 4 4 2
Thts permit application expires if a permit h not obtained within 180
Print name: [kj� �r �j DgleaQ/�� � � days after it has been accepted as complete.
("1 l G ( • Number of inspections allowed per permit.
l:Building\PermoatELc_Perm6App_E ERE.doc Ray 06/1N2015 440-4 15T(I I/05/COM/WEB