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Permit
���,�i CITY OF TIGARD ELECTRICAL PERMIT v COMMUNITY DEVELOPMENT Permit #: ELC2010 -00154 T [WARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04!06/2010 Parcel: 2S103AA00802 Jurisdiction: Tigard Site address: 11015 SW ERROL ST Subdivision: Lot: 0 Project: Olson Project Description: Add /alter (6) branch circuits for kitchen and bathroom remodel. Owner: FEES OLSON, RANDY S & NANCY Quantity Description Date Amount 11015 SW ERROL ST TIGARD, OR 97223 6 crt Branch Circuits 04/06/2010 $93.28 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 04/06/2010 $11.19 Electrical Contractor: CORNERSTONE ELECTRIC LLC PMB 453 12042 SE SUNNYSIDE RD CLACKAMAS, OR 97015 PHONE: 503 - 775 -0880 FAX: 503 - 775 -6006 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $104.47 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 0 R 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. I �r Issued By: Q 1 k l_1 \ ��/VVC A 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: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' '>��� n 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. Electrical Permit Application.- : _ 1 FoR OF'FHCE IJSE ONLY. • City of Tigard P: Received C 'n 0 ' R Permit No. O !• 0I (... u 131 SV.' Hall 13h d., Tigard, OR 97223 QPR 0 2 2010 Pla a \icvr 11 � v` Phone: 50'3.63 9.4171 Fax: 503598.196 Date 'B). Otber Permit p Zolo .60:3'15 TIGAR17. Inspection Line' 503.639.4175 I DateReady13y: funs: Fa See 'Page 2 for Internet: w vw.tigard or .gov '-'; J ; 1 1 Notiffedi Jethod: of plans Supplemental InfInformation �..'ar'i,,. "ii'Ei''f!'idSUt �: t • t ^:9t S,R:::t,:irn�n..� t � 1 .. - i .. i &.. , , tt .1 i 4L �t, , ,. , i .t. .4 ,., � . l 4xupvt � t o : . n:y�� -•.� �}, ' ;, u�. , i:'I :• rn�„ +, : .Er...n.. ;t ., : > ?�:i rrcr: •:3 tr. : .,....•..,.... t .a: R....Lr:rx:• , +r t • „•• .,...: .:,;;. ^`r.'rs .. ., ,,, .. ; .. 1 4,, l .102 •i i�(( II ., 11 /P ,., SE :..: �tt . E ?�I u t , �1 ,k1: Sf ,t+b 4WW,. ,: �t E i ..1::nax „t r ti Il it • f!ft... I :.,:•,1 iRI t :. , ., F. , ( x . t.. I I I I,,1 , t ..ixin;f .,gum.,-' {t , 0 1401'', .Afirii.. , .. ;'7l;'''''''' " u , '' . lint. " e,nlf.. ? / dill/ illI ,.r•t IIIII! ,,:1 J:.•:.ut • .E.rl:.Ii•ii ..,:,t,l,.�l.r r :f• . 711E oa.... ,ihitlt „,iiif4e. t,: ,14- .•-[r::. ill�:t4 {I7: = { P.,:::I JI, 1117 f� , . 'iJ�1Pi>; ,�t,r::.7m,nr” I'. yy, ,� 1 �!1; - „ ft I,t, ( I t1•, ,1,('itlrm.. r, n r$nr f0. , � , i .t,i .z ::$:L•1•tt:tnhr IE,E �'�E�r �11'%: y1Jl irr10t.7. Ft , ,tr r , . r.o-1 r t. t.{flal',.,..hh. _,., r .. , t r,ifh,�,,,•,,.,. �f.. .. >.l..�t. #,. f.. . �nEEll! ., r:r.,r .:.; , � let?? I: . ^.tlEl trr.��lor,,"�7.t:::.�r,.• ..,.t..l.._.'lL�i � 1_ , ,,lit" .+x:x, ._. ,.,,, 1...,�,t,,.t. S. ua•;: ,. i, fur,;:;: »tt,,..:,.,:. New construction Please all thar apply (submit Q :et: w ;tein checked belo\t ). I (� Addition /alteration /replacement i ' ❑ Other i ❑ Service or feeder 400 amps or more ❑ Building o■ et the stories, 1 ❑ OCtt'ion r': I H11cre the available fault current ❑ Marinas and boatyards. l :Ika; 77:; '1 moi :f Y - fr rirn ii l,,IIAi ' „t „aE .� ,,.r , •tr . .r . E RI 'in : i , 1° hit a, ili 7. iiliftiud_:t , ;•mg „„,,,.`! ' i- r „ li x�sr;aT , ;& ; ,, f '' lag - "'lll 1 ;4i I exceeds lU,0uU amps at ?SU colts tit � >'lOAttng buildin 5 u :itt •rGeW <E, «„ , lit; :,,,:�3 .,•'I ` :, �•,tp ur.,..: i � k ,ls;?' , ",IEi;E Ili / Tv, � i 'i e:ut J?: tE:t,•, ;a IeSS (0 ground, or exceeds 14,000 ❑ C'ommatcial -use agricultural • 1 El 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings, ❑ Multi-family 0 Master builder IJ Other: ❑ -Fire pump ❑ Installation of 75 KVA or ig , ofy t :gew , {p , l: i: r et:r:.:f:f ^ti; ;vg ti � iir:'• i..:.::o t .t,m,I:,va n•, 4..,7,ru• ..... i:... r. - s u ,•'• , �r tdt9 , ,Ni;N :,,,, s si "I 1j i :,, ,y i , 1 <i •: ,i . . , � ' ,.t j t { t«:d .. .r .Ili ., ::: 1 .I!:rG •, •.'..:.dt ait'i''E .! , 1 .`r .., , .,3yrrf,. t ❑ Emergency S S . 11. larger r.apararrl)' (ien \'Cd St'sFClil. ii II H • '1IsE i1 • i uk dri3t i, t I, 411 1 n t , t r •0 hl of isnl i" t t rialEiiltElid: k r :,,a: ; I;,Brti,. . 7. r1� €.Il.'�i «,:i,rkt,,r,!�a t r•t ,rm yrt Giemutl�r +:l,Ew,ft� I t•;i yy t;_3.... q•,n?; i ©4ddiuoa of rev. moron load of ❑ °A" ' F 1_�• . 1 Job no.: Job site address: 11015 SW trrol St. 100HP Or more. occupancy. El ` SN or more residential units d . ❑ Recreatio,rai v,:cle park". City /State /ZIP' Tigard, OR 97223 ❑ dealt/: -care faculties ❑ Supply voltage fbr more than _ - 6 ` ... ❑ Hazardous locations. 00 yoEts nominal. Suite /bldg. /apt- no.: f Project name: O Service or feeder 600 amps ormore. _..",.. :i y1i Eli ril:. ,Ct aiM (,!°iii', 1 yr�i(4,r�,. i t :f4y'' ni,'t 1:n.;1EEifEi pea, . t iIIPi :.1r ,.h liiEE I.i ,ild.. cmra.X, IE'�3!fE+R4', i••�,';. .,� .� �f' « tl'1.'31'a!ia :d <rl�.tuli l:�i!;JI LI;�f, CrOSS streetidirections to job site: ' ° ' r e . , I De ?cw : h' Fr. Taal 1 f New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision Lo[ no.: 1.000 sq. ft. or less r I i i63 5 14 Es. addt1 500 :,c1 :,c1 ft. or portion 1 33.92 I 1 i Tax map /parcel no.: — - ,.�� .:r :r :�).,., ,tiE1 ., :•, .. r.t. til, ii '.,., , t 1.•,e. , ; . • ,., , ,•,• :... ... .. r !_ ctg\, residential i I fnliFcd CO r �t a ; i' 7 ?! ,.tl'E €E'I J• :Ef '0ii -F1,L• �.:.. � 7'e•i:o • ' i.;?i ; , y, alt i,n _t •lt •t to ut•;I':a ttc t.,,., .. . : :i: :i I 0 7 g4 I E€Ej f 1 :11 t nit 1:• iiPil.! ■I! s ilti . i l ii11 „ iliq S. Itil; P ,r i ,4 1E; 5t f i aii :ti : tt t - 1,.1 t} T. i t; :fil, pp ,. :4; 1., 11 L talt' i : S;a gyy,�„��Rqq , 1/713 i :i , .. "if •••:∎ ∎ pp E: 7 5:: i (with ti n.) - • - ,�it tiTii 51fi tf'xak ,.... ,.,.,.� fi�!S :ftiw.. ,� ,�� ,.,.alE�€t, €gyiE1 . EI , i , , ip>1 ' f i•.i,ti.+t,t,r`�, sq. i I Limned cner6y main family - 81 2 i I Kitchen and Bathroom remodel E residential (with above ;q. ft.) 1 I - .. -H Services or feeders installation, alteration, and /or relocation 1 t i 260 amps or less 100.70 x..,iF.« -lit „� �. y< 1 i t , ;•r r . „ tr , f ,- .�I_ t afE 36 'i+ ;t nr1. r 'rr, y, , • - --- I ;;iii i tiin1 t?f:Iti!E ft',. „ 1 ' 1'i i ;,� ,,: �ii i f!i;ii;l Q t i: 1' 1 , a ll 1 r 7sli ,iiE s x a r.; 1 :tuaa+a+ S'I i A 4 t a i 2 :.n1, :,,, :. t : E it :.t Eoi r, i : u1:ur. 5. EgIl∎ ii o . .. $ .Al am p s o GG - 3 >5 j •, ..1 �. � � ' � ��:: i i5� " !} , : ?. :i;pV «'lac : :t ~�r1�� - 1 11'���t • «t1a�!�,;.. � -1 ,. v S , --�.. __ l 401 alnpS to 600 amp 200.34 ' 2 ' Name: Randy and Nancy Olson I -- i -` 601 amps to 1,000 amps 1 301 04 121 Address: 11015 SW Errol St. ' Over 1,(i01 ;imp, or Volts ! ' 25; 2 6 1 2 I ' 1 /City /State / "LIP: Tigard, OR 97223 — � Temporary scnices or feeders installation, alteration, and/or relocation Phone: ( ) , Fax: ( ) 1 200 amps or less • 1 5936 I 1 ` r 1 201 amps 10 400 :imps 125.08 1 2 , Owner installation: This installation is being made on property that 1 own which is not — 401 amps to 599 amps 168.54 r 2 i intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. 1 i Branch circuits - nett', alteration, 01 exrengion, per panel Or, tier signature: Date: branch I Fee for bra ., C rc'uits + irk iG, r , :nit :' it .....�.; „ - i ,. •�• r , , : TI , N ,. « ..,, .. ,•li , : : :� ,,,.., ,,,rlx• l t.. tl• , ti,tr r ( >- !.' i t f y: ,.•:t•'i:F••:• 7, 1'••• 3bo'. ECr.,c .. OI ' l teedef ie@, , i , t , « il • l it ll I , r.,. i ; :.. ,.�`', E ,,,,,,,,,„, i..t..,, 9 j „; j , o , 3{i1 ,,'E1 it' ° €i €ita :„„ , „. u €1 Pa. • te'ct 1 1• 77n ••«•• I < ' ...r ,i i , : n f 1 'i E •'1Efpr, /a lit, 7.1� _ 4i , •, —fi •..,,..,.,. vigiiki,n. �; cot :«,n� i ..0 !,.,. t h ' f . : iii k, I >, „ k E a;E €i,`„ ccc b rewt , _ Business name: Cornerstone Electric LLC I B. Fee' for branch circuits ,, idwtu 1 - ser,icc or f•edi fee, first 1 i 1 Contact name: Jack Brockway II branch circuit i on. ` 1 I 1 Each add'l branch circuit 5 � 7 42 , 2 Address: PAM 453 12042 SE Sun nyside Rd. Miscellaneous (service or feeder not included) - Each manufacturCU or modular I ,i 1 City/State/ZIP: Clackamas, OR 97015 67.84 I... dwelling, service and /or feeder _ I Phone; (503) 490 -9471 i Fax:: (503) 775 -6006 I Reconnect or,h' 1 67.84 _ 12 1 I I— I - 7 Pump Or irrigation circle I I 67 R4 1 I _ E -ma j ack '�u cornerstone- electric.corn n � ,Itt; :, :u '/ x” i iT :• +;t : : :T r :ei :, al:y tf :w. :, :. :ar, t,,.... , I Sign or outline lighrirt; 67.81 1 12 � :Kalil tit ;Eta •,i.a { ,,,.: ,u }t. Il l. k . ;;;41 .fiUil r.. 4 iis,.:Ig:N it tE iiien ; n ,I filii r P neeli :: 1Pili'r ii iii 11ii :!1 —_ l _ - ' 7 t 1! 14r,,,a 1 !!vet: :;, f $1' ... ,,. r: t t i 13H,. Fi vr .,, u i I n E,1 Sl,r• tE: i•• ^ ^•'. •• ^•,•• ltitlx4z t : : :.,!. :'rE!e•ra �lht „! }t ,r ian,�,lii : : :1;,, t' ;E Pf �E.I „i•L.,(., .i4ilSi:E�,,, sicmal circu li mited- enCrp\ ` i Business name: Cornerstone Electric LLC r panel, alteration or extension. ± Pazc 2 , 2 I Each additional inspection over allowable in any of the above I Address: PA/1B 453 12042 SE Sunnyside Rd. I Additional inspection (1 hr min) I 66.25/ hr I I 7 Im estigation (1 hr mini 66 25i ht I City/State/ZIP: Clackamas, OR 97015 I .— , — JL Industrial plan[ (1 h mm) 78 18/ hr i � Phone: (503) 775 -0880 1 rax: (503) 775 -6006 Inspections for which no fee is g(_00,' hr 1 I • 4199S 3•t r i, nlic " l[.IIii 11 ( * i `mir, l it it F lif.PN '.t 'i CCD Lie.: 158917 1 Electrical Lic.: 26 -12030 Stipp, 110- . 4199S ; ?. a r1. r si i•,.r : zi, oar;; " Subtotal: 1 Suprv. Electrician signature, required: I --- .33...33 Plan review (2 :� of permit fee). I ` � Print prune: Duane Prou Air Date. 4 /2 /10 State surcharge (12%ofpermit f c); f TOTAL PERMIT FEE: 1 /11A. 41 Authorized signature: -- yv • �� Thii: penrrir application arpirtx if a pa is not obtained within 180 daci alter it hub been Accepted as complete. Print nam, Date . Number of ini:pect,ons allow,[ per permit. 128t,i.dii ,7e:miiiELC- PrrniitApp537 1(/51 C1,COAsWl13 - C-L C \C S lifo C ZO /TO 39dd OIdl0373 3NOlS'I3Nc100 09SLLE05 E5:ST OTOZ /EO /bE