Permit � � CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00144
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/31/2010
Parcel: 2S 111 AA03300
Jurisdiction: Tigard
Site address: 8635 SW GREENSWARD LN
Subdivision: GREENSWARD PARK Lot: 5
Project: Sellers
Project Description: Add (3) branch circuits in garage.
Owner: FEES
SELLERS, KENNETH STANLEY Quantity Description Date Amount
8635 SW GREENSWARD LN 3 crt Branch Circuits 03/31/2010 $71.02
TIGARD, OR 97223 wo /Purchase Service or
PHONE: 503 - 849 - 9020 Feeder
1 ea 12% State Surcharge - 03/31/2010 $8.52
Electrical
Contractor:
ALL AMERICAN ELECTRICAL CONTRACTORS
PO BOX 1426
GRESHAM, OR 97030
PHONE: 503 - 657 -4351
FAX: 503 - 496 -3995
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $79.54
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 copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / e" - Permittee Signature: 8A/ r/n "4✓ e 4 77O' ^ " /
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 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.
Twit OFVYOitK : ..-
❑ New construction
El Addition/alteration/replacement
0 Other
• Demolition
0 1-and 2- family dwelling
❑ Multi- family
CATEGORY
OF CONSTRUCTION
Commereial/industriai
Master builder
ION
0
Accessory building
Other 1
•
❑
■
JOS WTI INFORMATION AND LOCATION
Joh no.: I
Job site address: 8‘, 3 5 5.w. 6 r 0 t4l �
City/ State/ZIP: " Ti I V't7 OPt- 9 7
3
Suite/bldgJapt. no.: 1
Project name:
Limited energy, multi- family
resklcntial (with above sq. ft.)
Cross stieet/directions to job site
75.00
fJ I
Subdivision: Lot no.:
200 amps or less
Tax map/parcel no.:
80.30
DESCRIPTION OF WOiudK
2
4-Joli 04 3> O..: G..CS
lti
1 (((
i rt C? o.v'R -1-e-
T . 0 ..._...._
. , . ,, ❑ TENANT
Name: 54 s 41.
Address: g a y 3C $ t . b o r . . e . s s Wavct b l o c _ -
City/ State/ZIP: "Try et V'C/i ok 97 � 3'
Phone: (So3) 8 t 'tQ - 9o26 I
Fax: ( )
Owner Installation: This installation is being made on property that 1 own which is not
intended for sale. lease. rent, or exchange, according to ORS 447. 449, 670, and 701.
Owner signature: Date:
❑ APPLICANT. [ ❑ CONTACT PERSON
Business name:
Contact name:
Address:
City/ State/ZIP:
Phone: ( ) [ Fax: : ( )
E -mail:
COPrTRAC OR
Business name: j 1- ll 4 4 eiv (4fri `12 E f (a` C Orr �
Address: d e IJ o c /'IZ {D
•
City/State/ZIP: �C1 !c.c.s (^ r 4' to'i OA- 036
Phone: ( S ' $ ) 6 5) — V 35 1
:(5 ?6-34//c.
Suprv.
/CB Lic.: 652 4 ^l D e lectrical Lic.: 2,(p -/i y
Lic.: co 3/..5
Suprv. Electrician signature, required: 0, L4i
Print name: 0 e ry\ay. k (...10 4 04 i
I Date: 3 /2946
Authorized signature:
Print name: Ge 9 fr G • Id
1 Date: I / Z-q//0
Please check all that apply (mama a sets of plans w /items chocked below
o Service or feeder 400 amps or more ❑ Building over three !tunes.
where the available faith current ❑ Marinas and boatyards.
exceedss 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 0 Commercial -use agricultural
as for all other installations. buildings-
(] Fins p ❑ haul ion of 75 KYA or
o Ennitnity a ye„ . larger sepanmety derived system.
❑ Addition of new motor load of O "A" "E" "1 -2" "t -l'
100HP or more. °tenancy.
❑ Six or more residential units. ❑ Recreational vehicle perks.
O Health - vole facilities. ❑ Supply voltage for more than
O Hazardous locations. 600 volts nominal.
❑ Service or fa+dx 600 amps or mare. .
.. .FIKE ,SCHEDULE ..
Descrintioa ., 1 pt. 1 Fee. 1 Total 1 •
New residential single- or multi - family dwelling unit.
includes attached garage.
1,000 sq. & or less 0
145.15
4
Ea. add] 500 sq. R. or portion
33.40
1
Limited energy, residential
(with above sq. fl )
75
2
Limited energy, multi- family
resklcntial (with above sq. ft.)
75.00
fJ I
Services or feeders installation and/or relocation
200 amps or less
80.30
2
201 amps to 400 amps
106.85
2
401 temps to 600 amps
160.60
2
601 amps to 1,000 amps
240.60
2
Over 1,000',amps or volts
454.65
2
Temporary services or feeders installation, alteration, and/or
relocation
200 amps or less
66.85
1
201 antes Ur 400 limps
100.30
2
401 amps to 599 amps
133.75
2
Brooch details — new, alteratl s or Mendota, per panel
A. Fee for branch circuits with
above service or feeder tbe.
each branch circuit
6.65
2
,
B. Fee for lamb circuits
without service or feeds fee,
first March circuit
(
46.85 yN,87
2
Each add'I branch circuit
t
6.65 (3.30 .1
2
Miscellaneous (aervke or feeder not included)
Each maadact rod or !nodular
dwelling. service and/or feeder
9090
2
Reconnect;only
66.85
2
Pump or irrigation circle
53.40
2
Sign or outline lighting
53.40
2
Signal circuits) or limited -
energy panel, alteration, or
extension. Describe:
Page 2
2
Eneb additional inspection over allowable in any atilt above
Per inspection
62.50
Investigation per lour (1 hr turn)
62.50
/ industrial plant per hour
73.75
ELECI'R1CAL PERMIT FEES
Subtotal:
Gk. IS /
• Plan review (25% of permit flee):
,e
Stan surcharge (12% of permit fee):
1.2. Z-. 3
TOTAL PERMIT FEE:
G'2. 3? ,
Electrical Permit Application
City of Tigard
13125 SW hall Bivd., Tigard, OR 97223 MAR 2 9 2010
Phone: 503.639.4171 Fax: 503.598.1960
Inspection Line: 503.639.4175 CITY Or: "I icfiRD
hornet: www.tigtrd•or.gov
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446-06137[1 Intl asttanB
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11ta permit eapbeatea aphis ifs le rot ebb:kW wttllib v
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days after it has been accepted as complete.
• Number of inspections allowed per permit
£LH7T6t'£04 XVd T£:60 0T0Z /6Z /£0