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Permit w ,s CITY OF TIGARD ELECTRICAL PERMIT C COMMUNITY DEVELOPMENT Permit #: ELC2010 -00219 n Date Issued: 05/06/2010 TIGRD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 kr::=: -sqp. Parcel: 1S135DCO2601 Jurisdiction: Tigard Site address: 11767 SW 91ST AVE Subdivision: MLP85 -0007 Lot: 0 Project: Wafford Project Description: Replace panel Owner: FEES WAFFORD, ROBERT W & CHRISTINA M Quantity Description Date Amount 11767 SW 191ST AVE TIGARD, OR 97223 1 ea Services or Feeders - 200 05/06/2010 $100.70 amps or less PHONE: 1 ea 12% State Surcharge - 05/06/2010 $12.08 Electrical Contractor: RK ELECTRIC INC 24495 NW OAK DR HILLSBORO, OR 97124 PHONE: 503 - 640 -1344 FAX: 503 - 356 -0513 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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: ! `� v Permittee Signature: .SCE An) 1- ;ITC 14 TLrC) 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. May 05 2010 9:19RM RK— Electric, —Inc. (5031 356 -0513 p.1 Ele ctrical Permit Applic MCErVED l e)u 01 .1.10.. 1.1.; t,,N1,% City Tigard Ltaosived h' g Data/By; Permit rro.:44.. !O — do a. I tr 13125 SW Hall Blvd., Tigard,OR 9nlw _ 5 2G1G piw Review Phone; 503.639.4171 Fax 503.598 Dare/gy; Other Pruner: r: i . l r ;; 1 , i: , Inspection Line: 503.639.4175 Duo Roue /By ru<i l /IU Bee Pape 2 for Internet: www.tigard- or.gov clay v . Thin t' NatiliVMatbod: i WS Supplemental Informatlor v® 1:3Lf, tt ' ... . . . . ?.i.., rltti ... " a`.= ``•:.i''3. check : i.I' su b 2 twt sets l2+v'I ❑ New construction n Addition/alteration /replacement x m P a or nil a sat nm m ❑ leas w/ m a checked below); D El Demolition Q Other: where the available .....L. r ^ d, over boatyards. in erodes. ._ available fhb current 1:1 Marinas andbo .: r a ,e e -.:: "" r ll 7 t t s +reel a t, ' +' exceeds 10,000 imps at 150 yoke or ❑ Floating buildings. less to ground, or waved. 14,000 ❑ Commercial •use Agrieuit„raI © I- and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building atnpa for all other Inotallattons, buildings. ❑ Multi-Tamil ❑ Master builder ❑ Other: ❑ Firo pump, ❑ 4utallatton of 73 KVA or l« e M y}+a�yry r , ❑ Emergency system, larger separately denved system. • , ' . �., Ada ;u& °. .-: ra , ._ :` ❑ Addition of now motor load of (] "A" "E" '14", " Job no.: 2389 Job site address: 11767 SW 91st Avenue 100HP or more occupancy. Cl 51x cr more residential units, ❑ Recreational vehicle pmts. City/State/ZIP: Tigard, OR 97223 ❑ ldoalth •taro facithioe. ❑ Suppty voltage for mars than ❑ Hazardous locations, 600 volts nominal. Suite /bldg. /apt. no.: Project name: Robert Wafford ❑ Samoa or feeder 600 amps or room, 1: ,arm �... .. ?S x r,4 .:7A;1 } t A: .. , ..` = Cross street /directions to job site: KM tee. r :. New residential single- or multi - family dwelling unit. Includes attached garage Subdivision: Lot no.: 1,000 sq. ft. or lees 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map/parcel no I d residential ht��a „m „ Limited energy, re en n. ;;P-..a:1.214.4:. d 4 41 l .: »��N : 4 a' :4 "S 41'grs:.� li - (with above a R. ) 75,0 2 s 0 Limited energy, multi -tinily Panel change residential (with above apes ft.) 75.00 2 Services or feeders Iastallaflon alteration, and/or relocation If�� u _100.V Ildi "m a oMa , _ .,' ".. '!, ® , l' :. y�,�.... 201 am to 400 am a 106.85 '�0 2 1 _° sc acusr . _ . 9 . ,� t . _ P P 2 Nnmc: Robert Wafford 401 amps to 600 amps _ 160 60 2 _ 601 amps to 1,000 amps 240.60 2 Address: 11767 SW 91st Avenue Over 1,000 amps or volts 454,65 2 City/State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alterative, and/or relocition Phone: (503) 754.7935 I Fax: ( ) 200 amps or less 66,85 1 Owner Installation: This installation is being made an property that I own which Is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, a,Oording to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or emersion, per panel Owner signature { Date A. Fee for branch circuits with a i _ ".._ t „ �uv r ° �` i� ,u _i :fF Y 11f "' r P ... L4� tN_U_" uY at above evlee or feeder fco, ' each branch circuit 6.65 2 Business name: RK Electric, Inc. H. Fee for branch circuits wtmoui service or feeder fee, Contact name: Zach Milton first branch circuit 46.85 2 Address: Each add'1 branch circuit 5,65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Each manuflictured or modular 90.90 2 Phone: (503 ) 640.1344 (503 ) 358.051 dwelling, t only 66.e5 I 2 E -mail: Pump or irrigation circle 53.40 1 2 7 gli!i? ,. . tR �' % „F ,1ii; ' :,b`.__ r,Irw W t _:_,__1 Sign Or outline Lighting 53.40 1 2 Business name: RK EI9CtrlC, inc. energy circuit(,) or limited - energy panel, alteration, or Addle”: 24495 NW Oak Dr, extension, Describe: Paget 2 City/State/ZIP: Hillsboro, OR 97124 Each additional Inspection over allowable in any anise above Phone: ( 503) 640 -1344 y Fax: ( 503) 356 -0513 Investigation per hour p hr min) -' 62.50 - CCB Lie.: 94275 Electrical Lin. :34-375C Suprv. Lie.: -S Industrial plan per hour 73.75 Suprv, Electrician signature, requires kjc /. A subtotal. 1 $89'38 -- )07.76 Plan review (25% of permit fee) 80,00 Print name: Ron L. U rtZ llV// ate: 5/5/10 State stn harge (12% of permit fee): $13,63- 1.0a Authorized signature. C f � pe TOTAL PERMIT FEE : i $88,83- 1 Thla permit application expires If a permit is not obtained Is Ohio 180 YIO�' 76 Print name: Ron L. Kurtz Date: 5/5/10 da after it Lae been acoapted as complete. • Klauber ofinspectloae ellcmod per permit. 1 \ Build ln0,Pae PermikApp.dos OS1.3,06 44046 IST(11 /a5/COM/WEHI