Loading...
Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 1111 = COMMUNITY DEVELOPMENT Permit#: ELR2021-00018 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/20/2021 TIGARD Parcel: 2S104AA09800 Jurisdiction: Tigard Site address: 12995 SW KATHERINE ST Project: Potts Subdivision: BELLWOOD NO.3 Lot: 118 Project Description: Hook up existing power to new gas fireplace. Contractor: OWNER Owner: POTTS, BRIAN A CAMPBELL,ASHLEY D 12995 SW KATHERINE ST TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Description Date Amount Specifics: Restricted Energy Permit 04/19/2021 $75.00 12%State Surcharge-Electrical 04/19/2021 $9.00 Type of Use: SF Class of Work: ALT Total Number of Systems: Audio&Stereo: N Security Alarm: N Garage Door Opener: N HVAC: Y Vacuum System: N Other: N Other Desc: Total $84.00 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 require ' ou 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. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.8000,332.22344��, ��/ Issued By: r/ Permittee Signature: _• 7n- 2.-c "7Tr// OWNER INSTALLATION ONLY The installation is being de 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. --- S . ,. Electrical Permit Application FOR OFFICE USE ONLY ,x, City of Tigard - Kccc'-d 0 ir; #_2/ if p,...r.a. ri,,,(?.202 I-'00.0 3125 SW Ilall Bled.,Tigard:OR 97223 71 Date.°11,-. iv- , .-- s -4 Km Review - --;1- Refriied 1 g Phone- 503 71/1.2439 Fax: 501 593 1057( - . osesiars Pcrmit 11BI:iceman Lino. 503(639_4175 Iterily Dade,IIiy: - ri..rP ..,,v.,...., TLIZ Set Page 2 for - inste R n, Internet. sssiewsigard-or not L e5edaMetheil` 111:5.- I Simplerrierital Information ---- Tr PE OF WORK i 1 '-PLAN REVIEW v.iire.i5ivvi,all mai apply Orkin:2 se is in plans isincittis checked): ri NeIV ColINInictian Lif A,,_1.5.iiirim,ili:101001-19..Vvicii110.:111 ET sno ina in feeder 100 apti,ti cf it n B.id,,,g,over three stories. ; L--Demo Mien rii oliter as tea the availthic ta id t surreal ID la annas and boatYasels- , CATE(TORY OF CONSTII EC flOc exceeds 10000 alnps AI i 5II sn is or El Flowing Said as less to ground,ea exceeds 14,0.00 0corniner,:iallat agritultaral and 1-fanul) dwelling 0 Commercial inatianal 0 Accessory build;im amps for all other incantations buildings. 0 Multi-femil> 0 Nlaster MI Is.lor D Other ID Fire pomp 0 fristallaraori of 150 KVA or JON,Sllikai INF ORM al II ON tkisiD 1,0CNTION __ 0 Fanergoiny syxtert. larger separately derived 0 Addiiicin of new 1110101°load of system , , Job#: Job site address.: 1 ,9`9S-' iir,} --IKiltt-e6r8:.-) .1,-. 1,01-0 ar more. OS or more residential units. occupancy. City./Stnte/ZIR: .-' ,. ,f(4 CP. °VA 22.3 DE rz:alth-care facilities, 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: ID Dannicoin recarlonS, C Supply voltage for more than ri 5e slcr,cyr•feeder riOn amps ea mere. 6051‘1'It'nominal Cross street/directions to job site: FEE SCHEDULE Ilcocritt lion ( Bo. j Each I Total r• , New residential single-or multi-family dwelling unit. 1 Subdivision: 1 Lot in. Includes attached garage. 1,000 aq it or Its j 16S 54 4 Tax map/parcel 4: Ea,add.1 509 sq ft or pernon 33.92 1 DpsozipTioN OF WORK - , ,p-pliT.,d,r,,,gy,,sidcnt,aI _ 73 03 5 ii k ct -,z(with abovcal (4) i I)It. -—- ) ..,Lxizated energy,nolo-terna) 751:10 2 1 , =residential(pith atoVe:W. Lkt..(j_rf:r._< JIC2L..,- el L 4,:e- /...,-9,_ut, 11tgiiiiesuable Energy 0 Bee Piage 2 I _ ; - islaMPFRT1"-OWNFlla , „...s 1L's A,'s 1 -Strsices er fee derie intaIlatiott,alteration,attains-relocation ss Name: - Wittengs or less CAldiydirSeSt -::=X46,60,1;-i;-13imm111ppps5 tf',a)„-610.i0.10 a0i nampii.p ii ..._' Ii 01_.'10_714_0. ate q i„I ( Ar Sr. 501 356 , 22 —7.20 Fax.( 1 Over OHO amps or vpirs 1 52.526 2 9; ie s. TtlilpOrPry Sertc'e%fn°fs-eiters iiistyalla lion,alteration,anchor LITtaill . 01:11: # 1„, 1, • 1 s : - at • ..td relocation Owner it 'illation: sin installa"ii i is being made.on property that I tram onich Is not 21-'11 mys Or leSti i 1 59 3f, i 1 1 intended for saM,leas rent,or exchange,according to ORS 447 449 670, / and 701i 101 limas io 400.amp, jai OX 2 Owner signature; i_,......,.. o ate:. yi/c2/02 t 401 amps to 569 branch sli-n m w,s 16S 51 Bnch cirenits e alter-anon,OE extensin o , see panel .-.:-.:i...:i...--±.-::.4)::.,,......k3Vf-AyPIAAN7-:'-',..-,•$:-?,,N.',1,:::=1:-,...-=.:-=-==..==,. com-AcT,, coN,,, _. . ,v „for briL„b ciccults.wim Business name; atose seis or or Mader fee, 1 242 - rash bremal circuit /I — - Contact nanle: gr„,i,,. pctits- B .1-?,10'tar branch careers. _ 5.515/ Address. s/ •-L ei.-4- l`5 ,,,,,,„,,f.d.,...,1 .fir-51 bum:1i 5.5 15 Cilyistalerzip: 1 ,5 4,, 0 iQ, ci2.2) iv:55h add°.b0.055.1i eircria , -142 I 2 • )41.i wellaneons iserviet or feeder not included; ; hrnau. bf clik 1102 fc,,6)ic,(1 ivcA,if c cam aph.:::,:mihhec;7:111,,,c;r:Ahrt or Ichder ] 6/64 I . - 2 . Business name: i 4 or;en°oleic li,I Orin 1 67 54 I 2 1 Address: " - ':a initaa n hull:td:Tmet,-, ' - 1 : a-ine Tay:ciao o)etteil,,1011 " , City/StatetZ Fact additkr mit inspection 0"er Aliso(dile in Ailk"of the alarise ( I Adhh<0.0./1 IhhArchoh(I hr Ili 1.. oh 25.'Os ( 1 — PlIone:( ) Fax:I 1 " ' hhostichlihn2:0'hr 1 Email; - Ihi-rrhht plarit I hr rmn/ LI ' I rAT0/1//00-Ira.thch no fee/A )2//hrh kr I CCB Lac.; T.:lei:trier:I Lie.: Supry lac.. saced,ral)heat i .nr nhh) ---- -- -/ 1 , ELECTRICAL PERNIITTLES Sup .Electrician sicncture,mg:aired. l Subtahli 71; . Print name: Dem- i 0 Mari ite)iao Reclr/red(23','a.c/,./rerrIntt t;ch i SrAhr,s1..0char4-./.{.%;PIc 1 4 Authorized signature: TOTAI 11:14)414 FEr--). " r-)41-).yra i Print name .1 I Date: , This permit applkZtiort es-vices if a permit iS tilt obtained%Ant ISO : days after it has been accepted as complete, " Number ef irsapechans a.11ov.ed pc: e'llt1:1 I ulIcIa-zI,P.!rmIt.FTI.,C_Parrmtkp2ELII.._ERELd,,xt Rc. eti IT.'2015 a iii-lie!II,I I,LII COMWILLI -—"""" ---- 'I. ,,, " ° - °°,,,,,,"ILL.::7',,,,7-7,77,7 -„,.'7.,,;,:,;.=I__-.,..-_:::...7 7---77':,-, e-,,,,-, ., LI•=,..°,°":I,L-,IIIT'="''I°I .„,....,e1„4„.,-., „2„1 Electrical Permit Application—City of Tigard Paget—SupplensentalInformation Limited Energy Permit Fees: Renewable Enerov Permit Fees: RFsSIDENTIAL WORK ON1.X: rEE sCFSE[SI i I> irxaripess Q,a. ( rsdi j Isis] 1 Fee for all residential systems eolnhined: $75.00 Renewable electrical energy systenvs: Check Type of Work Involved: 5 a le>s o0 70 2 .5(n to 15kva 133.55 ' 12 Audio and Stereo Systems* 1501 tans kva 200.34 I Wend generation systems in excess of 25 ksa: Burglar Alarm 25-01 to50 kva 301 94 2 50.01 to IGO kva 55226 ❑ Garage Door Opener* >100 kva(fee in accordaote with OAK 918-309-7040) 552 tiff 2 Heating,Ventilation and An.Conditioning Solar generation systems in excess of 25 kwa: S}Stenl Etch additional kva everts t 7,47 3 Vacuum Systerns'* 1ndksa n aid hatta charge / o,o s 1`ach additional inspection er allowable in any of the u6oVe; r Other: nnaddnlonal inspection is 6b2511v ru weed at an hourly(I hrNas n:isr) tins 1 which no fig,is 9t}.0'0:hr €sfia] -} fed 'h hr win) xt.E(21RICAl. PER\FIT FUFS _ COI1 1II?I2CIAf WORK Ql3l Y: Subtotal 1,Entor on Paga 1) Fee for each commercial system: $7 .00 tiam0u o n,regions Anov e3 pzr p€ism. (SF'E OAR 918-309-0000) Check Type of Work Involved: Audio and Stereo Systems ❑ Boiler Controls r Clock Systems D• ata Telecommunication installation ❑ F• ire Alarm Installation n 1• IVAC (_. Instrumentation ❑ Intercom and Paging Systems ❑ L• andscape Irrigation Conti o * n Medical n Nurse Calls U Outdoor Landscape Lighting* ❑ Protective Signaling C Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 'Fiui]dine,'Bern..-IIC i.q . '.; ELR_EREdoc RE-[del...:01>