Permit 4 n CITY OF TIGARD ELECTRICAL PERMIT
'ref , '> COMMUNITY DEVELOPMENT Permit #: ELC2010 -00122
AI GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/17/2010
, _, -,,_; , Parcel: 1S125DA00200
Jurisdiction: Tigard
Site address: 9070 SW 66TH AVE
Subdivision: Lot: 0
Project: DeGiovanni
Project Description: (4) branch circuits for kitchen remodel.
Owner: FEES
DEGIOVANNI, DARCY Quantity Description Date Amount
9070 SW 66TH AVE
TIGARD, OR 97223 4 crt Branch Circuits 03/17/2010 $78.44
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 03/17/2010 $9.41
Electrical
Contractor:
SQUIRES ELECTRIC
PO BOX 16851
PORTLAND, OR 97292
PHONE: 503- 252 -1609
FAX: 503- 253 -5831
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $87.85
Required Items and Reports (Conditions)
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accorgance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTE N: Ore••n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 0D1 -00 through OAR -081-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 50 • ..6699 or 1.800.332.234$.
j ( IA
Issued v ,.. . �:_ 4 i.1.4 _.... Permittee Signatu e: __i' , itt ( !.: /t<�
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' , - v p
V 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 FOR OFFICE USE ONLY .
: &4C MAR 1 5 . 23tri s v":. e5 r‘ 10 .,,.
e k0 49-
u 2 Tigard OR 97223 1 Plan Review
C 3 i itY 5 s O w f H rr a !g B a i y r- d d .,
, .. • .• Phone; 503,639.4 )71 Fnx: 503.598.1960 . ' ' • • ' 1 / • • D. /f3 •
1111
AI, Pttunt Nic ev
Other Permit:
TIGARD inspection Line: 503.639.4175 , - .. : - ' Date Ready/By: i,4,,.---,-- El See Page 2 for
Int0rnet: WWW.tigard-Of.g0V : i. , ' ), ' • ' 1 ... ta Supplemental Information
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'1 ::. ' -,:,' ,•:. .. • ' ' . :: , :., TYPE 'OF ivOitk: ...... .. - " PLAN REVIEW : " •
-- nTNCw ccmstructior Pleasc check all 7i7 t};' isichinit :2. ye;: 01 plans wIltems checked
0 Servtce Or (ceder 402 amps ci• amrc 3 Btu ltiiilu OvCr StOrl3F..
0 Demolition 0 ()tiler: where the available Clitilt current 0 tvlannaS rind bOitlyards
— ---
.. " • • CATEGORY OF CONSTRUCTION , • •':. . • :' •- • enteds 10.000 amps at 150 yells Ai 0 Floating buildim;s.
le.% to , ,;iound, iir ex MUCt
ceedf 14,000 0 COMai-itSC aanixttiniii
( 1 and 2-family dwelling 0 Commercial/industrial 0 Accessory building i1-pi for itil other installations. buildings
D tviulti- lam ily 0 Maotcr builder
11' 1- • 1. .1 .1 srif
tik ,—.:
1__I Other: El Fire pump
11;CiCAltIO ne
:''.: ' l; ": •' ' i
ol'w mOtOr loud of 0 Instailation of 7.7 KVA Or
lar2ct separately derived system
0 "A'', "E'', " t-2"."1-2,
Job no.: Job site address: CIO Six or 7 ,,,...6 tAD i IALL 100HP or more. • occupancy.
0 S more Sid
rCC.:Ilal i units 0 Roe/cations! veh parks
City/State/ ielo, o Dk , 0, itiAttli.ctire lig:Milts. 0
ite/bId Supply voltage r ,,,,,,, Limn
-t - , D Hazardous locations. COO volts ricarinal.
Sugia.pt. no.: """) 1 l:15zrvice Or lezckr 600 amps or more.
Project norn71)at_ , ;4...60 _..,
....,
• • .. : ..' FEE SCHEDULE Cio. Cro trt/d ' -
:ss seeirections to joh site: ------- .
ne.cription i Otv. Fre. 1 (itrit 1 •-:
New residential single-- or multi-family ilwellint! unit.
Includes attached garage.
-
Subdivision: Lot no.: 1.00() sci 1 01 less 163.54 ' 4
.... ..
lat. add 'N. il. 0: portion 33 92 j 1
'fax map/parcel no.: Lirniied energy, residential •
07 ii4
. • . DESCRIPTION OF WORK • . . . (with above sq. ft ) _ . ___ _
. . ,
W; bL-- 1^ Ylt.-CC I ke- I
LI in ited energy. Mltmily
residential (with abOve SCI. ft.) 67.$4 2
Services or feeders installation, altcratinn, and/or reloCation
20C.' amps or less 100.70
„
•''' '
... .
,I=1 PROPERTY OWNER 1 . d 0 TENANT • ••,, • 201 amps to 400 amps 1 133.56
401 amps to 600 -amps 1 200..+4 . - 77
l.rne:
Li01 amps to 1,000 amps i 301.04
-
.
Address; I Over 1.000 amps Of volts I 6 552 2
• '. .._ 2
__... -'' • - Temporary services or feeders installation, alteration, and/o
City/Statc/ZTP: ,
reloc2tion ,
Fax: ( : ) 200 amp:: or less 59.36 1
201 amps to 400 amps I 125 OS 2
Owner instaliation: Thir: installation is beintz made on !property that 1 own which is not
401 amps to S'99 amps 1 160 .4 1 2
intended tbr sale. lease, rent, or exchange, aceordin Lo ORS 447, 449, 670. and 701. ,
Branch circuits - new, alteration_ or extension.per panel
Owner signature: Date; A Fee for branch circuiLs with 1 i
--- - - i above service or leeder fec, I
' :' • 9 APPLY:ANT ' : .9 coNTAcr,TERsoN ::;: 7.42 i 2
. .. each branch circuit I
usiness name: FS Fcc for branch circuits svithnia ■
A
/
Yer or ft:eclat fee. first
Contact name: . branch circuit i i 50.13 i g 2 1
.
— • - • -- Each acid:lb/a:1th eirraiit 5 7.42 ' . t 2
-'
Address: • Nitscenn ricotta (service or feeder not included) _
_.... .. ._ . ..,______ _.
Ez.;h mmulactureci or modular l
City/State/ZIP: dwell cry= and/or feeder ' 67.:34 .;
—•
Reconnect on1V 07 54
Phone.: ( ) Fax: : (1 )
• POW/ or trrInti011 CITelo 67 13
E •)
,... ,.._ Sign or outline lighting 1 67 S4
' .: ' ,' • . CONTRACTOR - [ t ' • . • - . : Sional circuit(() or limited
...
pant]. alteration, or extension. l'au..: 2 ,..
Business nante‘, g L,L4 - 1 6 , 4 4_ ; e _ - M - 1,e_
Each additional inspection over allowable ill any Of the :!bov
AddreSrT O --- fA cx 1L e5 , Additional inspection (1 hr min)r i 111
-.
Investigation (1 hr min) 6t.25/ Iii
City/State/ZiT Die_ 9 7...)-9 -)- Industrial plant (1 hr min) 78.18/1”
p:±.
Phone: 6L3 —)..5.1- - 0,01 Fri: (61)3 .).5 -5/ repo for which no fee is
90.00/ hr
specifically listed ( lir min) .
COB Lic.: i0 I Electrical Licjt --/ /616 Soprv. LiC.:L,I ,.... _,.,...:.. ...1,F.,CTICCA I: pEamrr. FEES . .•
- .-.. ,.. —....- •
Subtotal:
Supr v . Electrician signature, reqtAf..?„. ; ...' 1
pin review (2.5% of permit tee): •
Print uatne Datt
, r_____
state surcharge ( I TY° or permit fee).
TOTA1. P1-.P.M11' FEE. I '5?1.2.
i
Anillorized sinaturc: This permit applijalitin expires Jr A pin'allt 0 nor (Attained ,ithin MO
' days after il has been accepted as complete.
Print 11;ITTie: I 1 Date: ' N ifill b sr o f irtst;,ttcounti. allowed pet ticttilit
111111ildirVetimIALLC-ttrrrnilittpp dei, 10;01/03' a4ts15T11 1 tOWOlsitWi-ti
300/ZOO'd 11.617: 31H10313 shlinos 1.88909Z80 I.:01. 0L0Z/gl/00