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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2010 -00087 T (G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/23/2010 Parcel: 1 S 133CD03000 Jurisdiction: Tigard Site address: 13665 SW ASHBURY LN Subdivision: COTSWALD MEADOWS Lot: 28 Project: Hamilton Project Description: Add /alter (2) branch circuits for furnace and a/c replacement. Owner: FEES HAMILTON, JOHN & NANCY Quantity Description Date Amount 13665 SW ASHBURY LN TIGARD, OR 97223 2 crt Branch Circuits 02/23/2010 $63.60 wo /Purchase Service or PHONE: 503 - 524 -6270 Feeder 1 ea 12% State Surcharge - 02/23/2010 $7.63 Electrical Contractor: A TEMP HEATING & COOLING INC 16000 SE EVELYN ST CLACKAMAS, OR 97015 -9519 PHONE: 503 - 650 -5014 FAX: 503 - 557 -2990 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 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: a _ _ - • . f_ &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' Are 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. • 02/22/2010 13:57 5035572990 A —TEMP HEATING PAGE 03/04 .�,<�uan • >t rerm>It.,A,ppiicat>ipl[><t. , . -. r k F . � i i s r . a '' r .s .T I ( 1 if t l jltj t 5C f 7:-'t E• .v City Of Tigard t] _ 1 t , - j Ro c3 d _____ - . . _ . -- _ 1r r P ' , i ? ;: 13125 SW Hall t31vd,, Tigard, OR 97223 Pcnnit Na vicw - �� Q�� `°' Phone: 503,639,4171 Pax: 503,598,1KB 2 2 2010 °"" Inspection Line: 503.639.4175 1r CL 6 !d Date/13 : other Permit: trt nrlt� p i Interact tvww ttgard or gov Noti fied/Method: Date Rcady/By; 6 Ito n cP Q t fied/Method; Sae Page 2 for y } 1 ti t _� p t9's . / 5 �nptementat Information M�;�ttd£ lAi1 F i )" i'" N +F, t ' '` ` 0 7 }1� ap F 11 i o t x pK t i 7tr ti F j ' '. }F �c!r� } y Y.: u ai• ItAtt G ..�o. `�J. SrwE' hit i filaw 4. k4s'��r ip. i t eN.'/ �{'� '�1C Cl lr Y' i `f• Li4 : i.: 8 4e o . ''' • s Y , '''A it . V "` " ' Y [] New construction � f { f �� ^ ^ i:l Addition/alteration/replacement Please check all that apply (Submit T sets of pit n s w /items chocked below): amps U Servica , rfccder4O nt a p D M iding over three storlea. ❑ vemolitton M Other r• ,41,- t r ` is f r t ✓x 3 . et. , 1A " i r, ` r``°� fm pr it ,k miarF t v , µ y where volts 0 M rims and in gs. boatyards. • " �d , N , 4ktiN+.aa� � r °l'So. ❑ Ft, .atin & " �` �,I�i.n �,. to t' . �?r °. amps B buildings. 0 I and 2- family dwelling j] Commercial/industrial loss to ground, or cxcae& 14,000 0 Cc nmercinl -use agricultural ❑ Accessory building amps for alt other inetnllations. • Multi- family 0 Master builder In ' 'A l..' `� � ` 1 r.'. ?i; . r ' Sir 6 ❑ Other; � Fire pump, a � �. 1,' !.. h�o�4 : , v d r g' 1 70 ' c t : i'' 'a a ' = 'r '„ a ! O Emergency system. Cl In! e rls epa at 75 KVA or A ;'ai I:ir address: ' ,, �� mom* ,," Ar , r�� 1 r � tar or separately danvcd sy om. Job no 13 j �-+ ` ©A or.ip or of new motor land of � ` cc ••F•^ ss: ' 100HP or more. ocr pricy City /�tA /zIP ©Sht or more rcaidmttinf units. 0 Re, •eational vehicle parks. l P �j /J i 72 0 Health -care facilities. 0 Sul niy voltage (br more than no.: d Hamden!: locations. GO( volts nominal, Suite/bldg./apt. Project name: t ! L r ' Service of fccdcr G00 amps or more. r af✓/ �. 0 S Cross street/directions to job site: st'i , ,. iFf r v rr.,. Duerr Ilea + l dina l . a .' • New residential tingle - or multi -family d yelling unit, , Includes attached garage. _ Subdivision: Lot no 1,000 sq. ft. nr less I , 111 68,54 j I 4 Tax map /parcel no Ea, add'1 500 sq. R. or pdriion 33.92 �z3i!3yt�ii +r m mr�-y� : �n v:� t.,r ,r r a, �` r Limited energy, residential 67.84 1 e �; a x. : rialr?� Suiuls w rt ti watt nbovc 1t 1111 2 l✓<zli'tldf t' at AN Limited energy, multi - family III residential with nhovds.. ft. 67.84 2 Services or feeders instalI8tlon. alteration IAnd /or relocation In " .� �e , a , r �' ,, ,'i Mari � s. a� ; r ,° rI" tm 200 amps or loss :' X0,10 2 m mw.,„ .at t, t a 3Yrl,- tiStf. � '? ` 4rNnt I x 'i t 1't'i rk x � , '' � 201 amps to 400 amps i 13.56 a Name: Dkh ; an_ art a r, 401 amps to 600 amps a ; , )0.34 2 Address: ' 601 amps to 1,000 amps 9 11.04 2 Over 1,000 amps or volts ' ;2,26 2 City/Statc/ZIP: . t Temporary services or feeders installnlior alteration, and /or /-1t rel0 t Phone. G .� I Fax: ( ) 200 amps amps or Icss I 9.36 1 Owner instaliation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 1 '5.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps ! 1 8,54 2 Owner signature: Branch circuits - new alteration m p panel Date: extcn per .� y 7. r A. Fec for s ..1 -„ e„,C ?. Eta • 'psi F T 5 il ryr s' , ... a u n r r r� n I i1+75 , ;.., branch circuits with i g'^ get x f . fir, " ^�> w l cc nr feeddr f ab ove semi , rl4 .w .1 r x„yli!wt, 7.42 2 Inch branch circuit Business name: ` V a A tr��i ._ M 11 t F�.r A. Fee for branch circuits �� • Contact name: without service or fecicr fee, ill ...P . first branch circuit : 'i• I8lQ 2 • Address: Each add'I branch circuit' LA r,42 �4� '"1 �'� �� 4.//////— _ „_ 2 it • Cityl5tAtc /Zi Miscellaneous service +r• feeder not lnclud d) � 4 ._ . �;• Each manufactured or modular - � r 6 ' 2 Phone; ill q j� dwelling, service and /nr teeter 7 Fax:: E-mail: �� �^ • "-' Reconnect only 6'.M 2 � ( * ' AA �J • ,t C Q _ Pump or irri circl ;gip 6 .84 2 t � »1f 11, ` ;, ; 4? h , - . 7 - , �� "J W1 �.rsn � ' u�ur, z r,e : ik ", ti C .1. ,y ,"�F'C � yi _„�;�t't,�w�'t'h'^��•`�;;2 Sip[ or outline lighting 6 .84 2 Business name: = • • `• 1-����++'' 0 Signal circuits) or limited- a� _� energy panel, tian, or Address: �� L '' extension. rl extension. Describe: Pa c 2 2 City /State /7,1P; A` COY it • -1 L h) Each additional in ectlon over allowable It an ' the above Phone: s1 , of `14 Fax: r PCT 6r 25 •- a 0 investigation per hour (1 lir min) 6t 25 CCB Lic.: ti,6/," Electrical Lic.: Cr Suprv. Lic.: ` 9(. 1 . 7� Industrial plant per hour 18 �` t Suprv. Electrician signature, required:' '� • t 10 - 1 • t r 6 f h " i' i� r) ?��" Subtotal .'� `' :ls d ■ ""' `""~'4 Subtotal i Print name M / A ni 3S Date 0 2- r � •Z. /D _ Plan revictiv (25 %of permit fcc) . — ' !� Salle surcha °/a o f permit fen) ,�'5 AuBtorircd signal c: Print nom • IN ..0 Date: TnL PERMIT i'pSP_ �' �'�� This V permit application Wires If n permit la ant , owned within iAI O� • D trays after alias been accepted as em, ,plete. ! vmltaltiLC•Pe "` Number of inspections alyowcd per permit. I;1Rulldin FS` nnlinpp,doc Fri /0u09 440- 401OT(t v05 /ComAvon t (1 ' ch