Permit ELECTRICAL PERMIT
;� _ CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00105
IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/04/2010
T
Parcel: 2S111DD12800
Jurisdiction: Tigard
Site address: 8620 SW HAMLET ST
Subdivision: MILLMONT PARK Lot: 5
Project: Swanson
Project Description: Add /alter (2) branch circuits for furnace and a/c installation.
Owner: FEES
SWANSON, JOSEPH Quantity Description Date Amount
8620 SW HAMLET ST
TIGARD, OR 97224 2 crt Branch Circuits 03/04/2010 $63.60
wo /Purchase Service or
PHONE: 503- 684 -5002 Feeder
1 ea 12% State Surcharge - 03/04/2010 $7.63
Electrical
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO ST
PORTLAND, OR 97239
PHONE: 503 - 234 -0611
FAX: 503 - 234 -0439
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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 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.
Issued By: 1 t \ x /�M/ V" Perm ittee 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' QQ :P /� / Date:
LICENSE NO. (�� I
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 PermitAuLlici41tio ' ,'"Vli -.;--`` • FOR OFFICE IISE ONLY
City of Tigard ,i ', . . -' • ' . Received
.- " 13125 SW Hall Blvd., Tigard, OR 97223 , . AR 0 4 2010
IN Duioa :
Plait Review ... ,1111 Permit No,. C2C10. 0 41141
.
Other Permit:
' 1 Phone: 503,639.4171 Pax: 503,598.1964V1 Date/By;
inspection Line: 503,639.4175
path Ready/13y: turfs: 0 Sec Page 2 for
1 1)
Internet: www.tigard-orgov ' y 0 .: -, ': - ,, =. ) Notitiod/lVinthod: • Supplement.' information
- "T'77,7:Trj7 - 7777T7.7.ilio,t''..',..,.tii .:t:,. '''., - , trV''''} - 0'.44,P , '"q■kt ■-• rOP' l'pir.W ,,,,': ; .:1;-)1:,: ,,',...;, Y t: ,I.: -:1;',;;:!!' ifeli$6080(06,"I'Icr,;, '„:;' :Y , ir.: -:
.. ' : ..:•:.-,3119M10:A.5144'1*.41..?t'.0: rf '; . )VJ:0 ,; • ; ( , ;0 ;i'd ';'- ; ' ' ; '... 1 ' ; '' ' '''‘ ''''' .; ''';'. ;!'''''';';'''''''' '-'
0 New construction F.I Addition/alteration/replacement P1 eas. cheek all that apply (tiubtliit 2 den of plena w/items clicokedllselow);
1:1 Service or feeder 400 amps or more 0 Building over three stpriea.
0 Demolition 0 Other: whore the available fault current 0 Marinas and boatyordii.
'','. ',' .. ,•,, ''.:' .;';',',:';;J..,::,';.14■:!,■;`,;.CAltwptiVigilr.i7Vg01*Vctgortr,.. ., ,,, , ...,■.i, , ,.. , 4:, ..,. . ,:,..: execs:di 10 am
,000 ps at 150 volts or 0 Floating buildings,
104* tu ground, or exceeds 14,000 El Comuiereial-use ogrieultural
19,1 1- and 2-family dwelling 0 Commerciallindustrial 0 Accessory building . amps for all other installations. buildings.
CI Multi-family 0 Master builder 0 Other: CI Fire pump, 0 installation of 75 K1 or
•,,,,, , ,: • , 0 Emergency system. larger 6uptuatniy derived qatent.
r./1.4iiP0i)01413' 6-i"ti"'00160ligl! P . ':'''' , ''. 1 akddition of new motor load ef
Job no.:0215 % Job site address: 2,(02) ,SUJ 140.4rn Leyt 91 . i0OHP or mom. occupancy,
Ci Six or morc residential units. 0 Recreational vehicle pits.
City/State/ZIP: --rV9 CyR C1122.4 13 Health-eare tacilities, El Supply voltage for more than
CI Haaardous MentionS. 600 volts nominal. .
Suite/bldg./apt. no.: , name; IMA A/O/WI 0 Service or feeder 600 amps or more. .
ik!Zt;':"""r! N,V;Ett:'.0101,1,(i:l'eA:::■:■:'";:.',7,.."..6t'':f4
Cross street/directions to job ste: murintiou _ 17.. $8105611111111;11
New residential single- or inuiti-family dwelling unit. 1
Includes attached garage.
-_..
Subdivision: Lot no.: 1,000 sq. ft. or less IIIII 168.54 4
,
- Ea. add'i 500 sq. It. or portion 33.92
Tax map/parcel no Limited energy, residential 67.84
7'!:.:".:'''.i0`0,4■;0:'"ii'1'3.0!''.4;:60^1.4SCP...1111PNi94;591efkli*A10ii4!':';:;''';4■1.' ( with ah° " ft ') ■
Lannud energy, multt-tamily 67.84
-Zorbai-s-f (.4.6LE__k_, _______ residential with above s- , R.
- Services or feeders installation alteration, and/or relocation
200 am s or less 100,70 T 2
201 amps to 400 amps 133.56 . 1
401 amps to 600 amps 200.34 ! 2
Natne: 0 , tA) L. •
601 umps to 1,000 amps 301.04 1 2
Address: 41 / 0 . j ' ., •
_A: t• Over 1,000 amps or volts 552.26 1 2
- ,
sgd"s in" ' and/or
Cit2/tatf/zlli*:L_ Temporary ervices or le
alterati"
- - relocadou _
Phone: ( ) tot 4.- 6 oz2. Fax: ( ) 200 umps or less 59.36 Mil
Owner installation: This installation is being made on property that 1 own is not - 201 amps to 400 amps MI 125.08 NM
intended for sale, lease, rent, or exchaage, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 111111 168.54 MUM
Branch circuits - new alteration or extension, .er panel
Owner signature:__--- Dule:, A. Fee for branch circuits
i,. t;i4.:PATVg..,'"I,.:?,1a*:C.A.00414$4*.k!;.?:::: .,:,! above service or feeder Ice, 7.42 1 2
each branch circuit -
Business name: B. Fee for brunch circuits
-- ` ividrour service or feeder tee, Contact name: first branch Circuit 56.18 '" ; .t 2
.-- . Each WV brunch circuit MB 7.42 Imo
Address: -_----, Miscellaneous (service or feeder not ineluded)
City/State/ZIP: Each manufactured or modular 67.84 13
--------- dwelling, service and/or feeder
• ( ) J
Phone. F ax:: ( )
-----.--__ Reconnect only IIINCII:1
E-mail: Pump or irrigation circle , 67.84 =IMO
-------,,,--_-,..".1- ...rrv7 ; ,1; ■ ,, ,,..,..,„., ry. ,.(;,777.77F I ;;•,. f;,..,0.;'1 il;ft ;. ; ;;1 ';; ';" 1
Sig ' '',"7::.,:;m•"::''' :1.-.:rActOoNwitmgrog.:, • .., ... ,,:, .,,,,,,,, , .,,,,,,:v . .,,,;.,.,, , ,‘!,,.,,,.,,,,,,,,,, ii . or outline lighting 67.84 2
Signal cucatt(s) Of limited-
Business name; Sl e:1- Ileiit:17V ? C CD i lett: energy panel, alteration, or
extension. Describe! Page 2 2
Address; 0 i I T-7 s ii , j , i 0 ,Q , . _
City/State/ZIP: 1./(W.1.14i,u1 LT, g7,2 :_L____________, Each additional in . ection over allowable in an of the above
- Per inspection ll 66.25 III 1
Phone: (603 ) j,3.1 .. Obi i 1 Fax: (5 ) 2 3L - _H .31 investigation per hear (I la. min) 66.25
CCB Lic.: 1 i Or Electrical Liu.: (4 11 1 Suprv. 11 Z ) industrial plant per hour 78.18
2
- 1?'•,!::!!!(2,.,!!*,111101.1100;0.'APE ' . ' 1 ItrEES,0.,;:l:,0;!
''' ., e
Suprv. Electrician signature, requir 1 ed: 1....-••• Subtotal: ,
..7
,.i... 0 F 6 5 ate: gi LA to Plan review (25% of permit fee):
Print name: .
.---------
State surcharge (12% of permit fee):
-
Authorized signaturca Al!--..--"' TOTAL PERMIT FEE: 71 .,(7z -
- ..),, A . This permit application expires if a permit is not obtained within 180
Print name: S tultce, I-1 1111')V2 V61PA-.• Duce: 3141k
--I days offer it has been accepted irs complete.
• Number of inspections allowed per permit.
1.muildin2acrmitte.C.PerailtApp.dos 10/01/09 /'-‘ 440 itOS/COM/WED
OUO\, Ck U J2}1 \aC)C
ZO/Z121 9NIIV3H 13911S 6E1701,EZEOS /_12 :Z0 0I121Z/170/E0