Permit o CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00151
4 [ GARO 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 04/02/2010
Parcel: 2S102CA00224
Jurisdiction: Tigard
Site address: 13227 SW ASH AVE
Subdivision: VIEWCREST TERRACE Lot: 21
Project: George
Project Description: Replace panel and add ground rods.
Owner: FEES
GEORGE, STEVEN MICHAEL Quantity Description Date Amount
13227 SW ASH AVE
TIGARD, OR 97223 1 ea Services or Feeders - 200 04/02/2010 $100.70
amps or less
PHONE: 503 - 956 -2694 1 ea 12% State Surcharge - 04/02/2010 $12.08
Electrical
Contractor:
ACCESS ELECTRIC & CONSTRUCTION
2870 SE 75TH AVE SUITE 108
HILLSBORO, OR 97123
PHONE: 503 - 642 -4333
FAX: 503- 642 -9699
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 accor ance 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. ATTE ON: Ore. law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set in OAR
952 -001 -0 0 through OAR 9' . ∎ 0 -0 to. You may obtain a copy of the rules or direct questions to OUNC by calling 503 .6699 or 1.800.332.234 .
Issued y: \ . / / i l/ L ���.. 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 INSTALLAT ON 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.
04/01/2030 13:32 1 ACCESS ELECTRIC PAGE 01/02
, . .
Electrical Permit Application 1, ()I( 111,1.1( F. Fs's: ()
City of Tigard APR 01. 20 9 10 fte,ei*cd
DEdda3 : / /0 11 Permit No.:
: I ..--• " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
I I ' Phone: ther Pcnnit; e: 503.639.4171 Fax; 503:598.1960 Datc/B :
1 1 k ; Aii -, Inspection Line: 503.639.4175 . Datc Ready/By: /,•.• tfi See Pape 2 fur
Internet: www.tigard ' Notified/Method; Supplemental Information
'. ' ' • . . . . . , -"Apt OP wcipx:• ... ,.:: ,”..-;:‘•:.:' , ' !,', ,' •
0 New construction kAddition/alteration/rcplacement '', • . :',-,....,;;.,;;-:),:,..., ..,,, . YAitalit 3;: r,P,..
Please check all that apply (submit a sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
11 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
,AlicOtek dONSZAtICTIOT ' ,'' : ': E.: ' . , ' '. '' exceeds 10,000 amps at 150 volts or ID Floating buildings .
tti and 2 dwelling 0 Commercial/industrial El Accessory building Ism to ground. or exceeds 14,000 0 Commercial agricultural
:imps for all other installations, , buildings.
0 Multi-family 0 Master builder 0 Other: 0 For pump. Inhisielletiv" vf 75 KVA or
.. ,_ _ .,_---_, __, ,. .. . . . El Emcrioney system. larger separately derived system,
! .• 1 • • ;.., • , ; Joit.:417E liNIEVEIMATION ANEr LOCATION i• '. .. . .: : '' El Addition of new motor lond of
tamp or more. occupancy.
lob no.: 5 1 .51 Jo site address: 13 7,1-7 6 m w At tG .
0 six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: - Ti C 4r7, 0 4 2.- Cl/ Z23 - 6, 0 (7 0 Health-cart facilities, 0 Supply voltage for more
t ... than
I 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: q d--Do4i6 0 Service or feeder 600 amps or mom.
, . , At 'SCHEDULg:::
Cross street/directions to job sitc: Description _lQ,ry. I F. I Total I •
New residential single- or muld-family dwelling unit.
. Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. addl 500 sq. ft or portion 33.92 I
Tax map/parcel no.; Limited energy. residential
- 67.84 2
• • • • :'DriscRyirrtori or *oak :. .*: : . .. •. • :.,,::. ' ..::! (with above .11,)
• , -
Limiter' energy, multi-family
• V-e-16,a.z residential (with above sq. ft) 67.84 2
Services or feeders installation, alteration, and/or relocation
Pri.44*--"" L, Ckiisa,b AO 6 1 kV iNAP? 4,65 200 mops Of less ( 100.70 f6to .7C 2
.::.. : :. rarilOrtirry OitIsttia .: .. * 1 • . , : .• a TirNgsrr :,' . ' :. :,.*': .. 201 amps to 400 amps 133.56 2
.
. 401 amps to 600 amps 200.34 2
Namc: nic e_______ -
601 amps to 1,000 amps 301.04 _ 2
Address: Ovcr 1,000 amps or volts 552,26 2
Clty/Statc/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( 6), _ciS (e - z, ( c i 9 Fax: ( ) 200 amps or less 59.36 1
mps to 400 amps 125.08 2
Owner Installation: This installation is licing wadi: Liu oloperty that 1 own which is not 201 a -
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to,599 amps 168.54 2
Owner signature: Date:
Brooch circuits - new, alteration, or extensioaper panel
... A Fee for hranch circuits with
. . . .. ' 0 potrtAND• • • I 0..cor■rAcr •:. ,::. , , . above service or feeder fee,
7
each branch circuit .
Business name: 13. Fee for branch circuits
•--'--
wit/Jura service or feeder fee.
Contact name: 56,18 2
first branch circuit _
Address: Each addl branch circuit • • " -- -- 7.42 - - -2
• Miscel lancous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67 84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 _ 2
. .‘:'. :' , , .:,;•., , . : . ,, , • :: • ':: „ : ,CoNTRArrolv •:, : ,! • .; .. , .: .., • :.: ..• '•1 Sign or outline lighting 67.84 2
Signal circuit(s) or limited-
Business name: ACC,.&--5S G- fer-"r12-1 C. energy panel, alteration, or
Address: 2.200 4 extension. Describe: Page 2 2
-.-,
ity/State/ZIP: 4...1 u PDT&O
Ph ,. u k
W one: (-0-3) Fax: investigation per hour (1 hr min) • Of?--- . er tit-3
(545) .1 4vocz0 Each additional inspection over alb:iv/able in any_of the above
Per inspection
. 66.25
66.25 _ ...
CCB Lic.: ( Ca, (6 ( Electrical Lic.: C i C Suprv, 1-ic.: (.4 1 i Industrial plant per hour 78.18
Suprv. Electrician s Or ignature, required: ---- rOmitICAL
, ,WEIgglOgsklEf2;c:Et; ii.;..
Subtotal: _
Print name: v- -
- / IA. ... Date: .4 . ib Plan review (25% of permit fee):
m. State surcharge (12% of pcnnit fre):
Authorized signature: TOTAL PERMIT FEE: 1
This permit applicatimt expires if a permit is not obtained within ISO
Print name; nate, days atter it has been aecepted as eompacte.
* Number of inspections allowed per permit.
I; \Building1PermitAELC.PerMitApp.doc 10/01/09 440.461 ST( I I/OS/COM/WEB