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Permit . ' q CITY OF TIGARD ELECTRICAL PERMIT i i pi :' a COMMUNITY DEVELOPMENT Permit #: ELC2009-00599 T i G Aft. L7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/05/2009 Parcel: 2S104DB00800 Jurisdiction: Tigard Site address: 13039 SW BROADMOOR PL Subdivision: AMESBURY HEIGHTS Lot: 8 Project: Liles Project Description: Install (1) 200 amp or less sub panel, add /alter (10) branch circuits. Owner: FEES LILES, TODD V & SUSAN R Quantity Description Date Amount 13039 SW BROADMOOR PL TIGARD, OR 97223 1 ea Services or Feeders - 200 11/05/2009 $100.70 amps or less PHONE: 10 crt Branch Circuits w /Purchase 11/05/2009 $74.20 Service or Feeder 1 ea 12% State Surcharge - 11/05/2009 $20.99 Contractor: Electrical ROSS ELECTRIC INC 2870 SE 75TH AVE #203 HILLSBORO, OR 97123 PHONE: 503 - 642 -2800 FAX: 503- 642 -5815 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $195.89 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 -0100. You may obtain a of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: v �l Y �pK Permittee Signature: 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: 1 A w) CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' CJ V(1(1 _ "4' ' \ 6 - Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. l i 11/@4�G2009 17:51 5036425815 ROSS ELECTRIC INC PAGE 02/02 • cat[o � Electrical Permit �� 4 i ` be. } o ! :• >- j ar b` i .{ L'.....' �7 ,.., • City Of Tigard '— )received (is 13125 S W gall Blv '1 ig+i d� II— DdH ,� Permit No.:� I' _on ,�i • r `� • 4 ` Phone: 503.639,4171 Fax: Squill Pfau at Revi ew I N ' � `�"" Inspection Line: $03.639 41751'1 � 2009 Dates Other Permit: 71� A D P tiktiniteataN Internet www.tigard- or.gov Date ed/M tri d Nonadllv[eth ' gee Page 2 for wW� �s } ``'� `y ', ! 1 Sapplentar Information _. �� `�"" y3✓i a 1".. §. rcla a 9 f� ..+: �"�'-^� t� +� ,��rv� � G � 'r >'" ` ►• Al i i t s 11111 1 ► F ` ( .. - ki A`.-�� � m , k.:! }:r.�-A•x u , 4 0. rr�?• ..ri f c 5 s^` +'t'r`'JjG_' r'+ ia' ❑ New construction � ! 2 du , _ t s . , f ; «riz . to S �`d e p : ce ment Please cheek all that apply (submit sets of wtitems checked below): a of more ❑ Demolition 0 Ot er: 0 Service or feeder 400 am r •z <: r`. " :? = '�" e Q �'t r,f�c� -;x:r n "s :;, a - �� - ' i .. ^, - cam,,,:,.. x,Y_ where fi available fault current Marina over three sw. t gig . iv. :-- T�kd . 3.�r,� -- aut :�m.r-c) ti,,- 0 buildin gs boatyards. F.- ezv"�z:;- ,,,. ;,�A'�!3.„,9 r -i �.i+,<c e 10,000 amps at 150 volts or ❑ floating buildig �' 1- and 2 -famil dwelling � tessto Y ? ❑ Commercial/industrial El building gtnuad, or in e ste000 0 Commercial -uec egriculh,ral ❑ Multi family G Ps for ell other installations. buildin s ❑ M ter builder • [] Other ci Fire m t ' 7j. � r r- (r '" �J: ' ^^ Pu p' 0 Installation of 75 KVA or ,�lt: ?-� �... r :: ^.., .*vK, gm--- g.iF ll n�ta` IS''"N,.�P '.,��'l `i i D Xm rge w n ofnew e motrn load oF larger- tetieds yster, Job no.: Job site address: q 1.,..) q "A" an t separ ' ►-�° lyderi -3 " i� a , lY' l� { ° 1001 F or more. occupancy. City /StatE/ZIP: c? 2 Q six or more residential units. Q ltecraatlonel vehicle parks. A D U` C) Healtho u S locations. a facilities. 0 Hazardous ❑ Suppl voltage for more than Suite/bldg./apt. no.: Protect name: 600 volts nominal. 1� Swvice or fader 600 are or more. Cross street/directions to job site: iv ,' .c_ ,, /4 e . 1' 1 t ,,, `i, = '•'a; i g' : , _. a +: _.. „- t £ r a F r � }�s t ea 1 % ' tsar) h : . .._.,, �- �v�..r., W > ,,.a New residential single - or multi - f dwelling uni sal t Subdivision: Includes attached gars, e. L Lot no.: 1,000 sq. ft. or Tess 145,15 4 Tax map/parcel no 13a. add'I 500 sq. ft. or portion 33.40 r,E::_ pL t i:, ,2,.F'':, v c- �.�^ ar "S',..' +i+^ ...• }ry a? ' kr..,° n . n �'..5 41 �..� f� r "-+ kz, q>:", .;:ii2 i ,Y '�'� ,+ ' S�..� Limited energy, 3. residential t ti f�,� .> r.� ) _w dt .x14,, -. Z.,Jo�Y �N ,'b• , 1 .�.� y with above 8,. AI. 75.00 2 ter. '” n• 3 -// d; s" ( re, r Limited energy, mufti- fiimity l - C ter residential with above s ■ . 6. r 75.00 2 3e �:` �� p LJQ� Z y — ♦ d Services o f Installation alteration an ti relocation EE '� 'r� � e. � C ceders 1 d/or cation 2 3's� ;;: * l i.. �"� i� T �w' G °C+ �� ., n"_. C r. . r ,+ N,� a I � 200 ant.S.or less 80.30 ,-r ..._ c�,_d.i.,.._,,, W'.cc a ;? g- : :; •�., ��Kir, ./"nxaL+�n.� 3:ttri S r 'fY 4 ,1,�, :+. r � i 4 � a . 201 p Ell 2 Name: - , y -, .r, . • ;r, 3 amps to 400 am a 106.85 2 401 am.s to 600 am•s r 160.60 2 4ddress: 601 amps to 1,000 tamps 240 60 2 -- �.� Over 1,000 amps or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation, alteration, and /or Phone: ( ) relocation Fax: ( ) 200 am r s or less Owner Installation: This installation is being made on property that 1 own which is not • 66.85 1 I intended for sale, least, rent, or exchange, 201 am •s to 400 amps - 100.30 MN 2 ge, according to ORS 447, 449, 670, and 701. 401 am. signature: 1 • 40 to 599 amps 133.75 Owne Date: new alteration 2 Branch circuits i ., awr :rz -'� ;a; -.,,.. -;s �, A. or , er anal ` c4 ..,w ; . '� ,•�C :•R''r:.::N7 -1, N 6a� ,.1- ° li w , '",, Fee for biotic)) Circu wltlt t .r.: , r� , ° „s ^ = above service or feeder fee, (C50 III Business name, each branch circuit • 6.65 B. Fee for branch circuits Contact name: left/tour service or feeder fee, ill first branch circuit 46.85 Address: _ Each add') branch circuit City /State /ZIP: Miseeltaneove service or feeder not clud Each manufactured or modular III Phone: ( ) Pax:: ( ) dwellin_, service arid/or feeder 90: 90© E-mail: Reconnect only 66.85 m _ Pump or irrigation circle 53,40 1111111 > ti.4;� � F: 0gtr �r �.4^ >Ap ��mm.RE c:.,,:,?� r:.,7,..: L M +mowpa s.. St or.°Uf ghti S _ . ; �., { -,,, R11 line 1i 53.40 Business name_ Boss Electric Inc. Signal circuit(s) or limited- Address: 2870 SE 75 Ave energy panel, alteration, or extension. Describe: Page 2 III 2 City/Statc/ZIp Hillsboro, OR 97123 Each additional inspection over allowable in an of the above Phone: (503) 642 - 2800 Fax: (503) 642 -5815 Per inspection 62.50 Investigation per hour (1 hr min) I� CCB Lic.: 157891 Electrical Lic.: 34 - 436C Suprv. Lic.; 7232S industrial plant per hour �r�fi'! Suprv. Electrician Signature, required• r i f! .�,... ,. r ti i :�I �r Subtotal: 1119 ,i .q 0 review 25% of • emlit fee): � - Print name: Stephen Ross Date: 01/15/2009 PIa+t State sure 1, Authorized signature: surcharge (12% of permit fee): �T7 iii • `Pi TOTAL PERMIT FEE: w R Print name; Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete A ci 1: 1BLIIdinglPa3niLS16LC- Penni lAdoa OS/a3/o6 • Number of inspections allowed per permit. I a 4a0.a6I 57(13 /OSlCOM/WQn TariS fl ` & /Qo sEto rem , lrtc