Permit CITY OF TIGARD
PERMIT
tl Permit #: ELC2010 -00258
COMMUNI D EVELOPMENT
T 1GARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 05/27/2010
Parcel: 2S104CC06600
Jurisdiction: TIG
Site address: 13679 SW ASCENSION DR
Subdivision: Lot:
Project: SPOONER
Project Description: (3) branch circuits for crawl space.
Owner: FEES
DAVID SPOONER Quantity Description Date Amount
13679 SW ASCENSION
TIGARD, OR 97281 3 crt Branch Circuits 05/27/2010 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 05/27/2010 $8.52
Electrical
Contractor:
GARNER ELECTRIC
2920 SE BROOKWOOD AVE A
HILLSBORO, OR 97123
PHONE: 503 - 648 -4552
FAX: 503- 642 -7925
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $79.54
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 OA 52- 001 -0100. You m les or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ' i( f Permittee Signature: .iL� /_ �_ - ✓,_
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' 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 Applic. ' -gliincia,"417,AR77,7,11r'n'I'vr.'"i',9,-1,11f,WilrriAlIP::::'
Ci ty of Tigard
i*,41 Ci p i 'ik I
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ili on, n.wil : ..- p.. Permit. Nu.: S- (0,._.(13)
ex 4 13125 SW Hall Blvd., Tigard, i '' 3 '''--- '' . 'rt' '''' 1 :
._ ...
lan Review
Phone: 503.639.4171 Fax: 503.59kKie 25 •
zoi Da Pto/Bv: Other Permit: iyTa)10-(.116
inspection Line: 503.639A175 paw Iteady/By Julio. ll3 See Page 2 for
v'TA G li.D.
th;•,:44,41,C Internet: www.tigard-or.gov Notifiedllylmhod; Tr& Suppleinental Information
rygoiorvizvorovia, ,:,, vt160: EU
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.,,. , i 3t ,IK ''... , 41 - ‘.. ' ' / ' '
0 New construction 1'.1 Additimr.7 . ." . p accment Please chock all that apply (ubmil 2 eats of plane w/items cheard below):
0 Service ur focdcr 400 amps or more ID nullding ova three siories.
0 Demolition 0 Other; where the available fault erai out Divinities ADC] boatyards.
T1 ' 'Tar tyg'` '' ' * i 717 ctfogmcvni l'ill 19: .4..a, Jo 000 a 3 at 150volts or Floatin • din -
. W 1 1 7 ' %TM
;54662 '461101421fil ,,„,,,, 't• ' fl . - ■ '0 t Min ,pt ;i g . , mP 0 g bull gs.
Na . 1 i ' I.L.1.0 4.1tThrAfIlaill : .1 ita..1 t '1 1 i ..4 ' , ' less lc ground, or exceeds 14,000 0 Commorcial-usc agricultural
1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other 41011b1.1mA. buildings-
:3 Multi-family .. 1] Master builder 0 Other: OFire pump. 0 Installation of 75 KVA ur
. rferrwentovrwmarcisroimmumprim , 741. . mtl 0 F.,.... system, larger separately derived system.
d mort ,,,,'.11g; ..„ :, ,,,„ gc. u„, • valwalig g. da mhz,,,d• moa00 0 Addition of , IeW ruLotOr load of 0
_
100HP or more, occupant:I
lob no.: Job sitc address: jr? b
A, _ zottLI11.411111 MI IZI six or inure residential units.
0 Recreational vehielo p.,ricx.
City/State/ZIP: i 0 r--- /1 a s- ;- 0 A) 0 Heulih-cure fatilitles.
0 Hazardous lovatiOAS. 0 Supply voltage for more thun
600 volts nominal.
Suitt/bldg./apt no.;
Il ilaf ect nam
Pro e; ).(,
\,.. '0 rNI\-?...r 0 Seiviee 07 feeder )O amps
j or mute.
V A1 '4. . 4 rirkirr ' - 4,MOVIT
,,,,, 9,.(, . . ,k, A ..o.taix ... , '. .Jz.: ,,, it.i OA k .! ■414 d'
Cross s(reet/directions to job sitc: Description kill1MPft. mirmtm
..,..
New residential single- or multi-family dwelling unit.
Includes attached guragt.
_.....-
Subdivision: Lot no.: 1,000 sq, ft or less 145.15 j 4
Eli. add'l 500 sq. rt. or portion 33.40 1 . -- Tax map/parcel no,: Limited energy. residential 75.00 2
AV; tAtfittiltellitrir et ■4102Exedna,k, alsoldripz,fs ( with above eq. B.)
. 0 .0. „ !' , ,,,,,, • R,.' , : ' , • ,e, ,t 1 t ; , aul , ' - ,... - . - -
- Limited energy, multi-faMity
.b1 , 'AL 1/...171. Ar , 44WILifig(e residential (with above sq. ft.) 75.00 2
/ Services or feeders 1nstallation titeration, and/or relocato
1 1 k 4 IP lif , 200 amps or lees 80.30 2
r .
;Po , ', rnmripmpopom. L A
11 y - v 74'.1+,4 - •-,,ha21 tj -.,;,h,fflaiyiloi 201 amps to 400 amps 106.85 2
Name: f ' p P ' ' A I 14 ' / . 401 amps to 600 amps
- . 160.60 2
.• 601 amps to 1,000 atnps 240.60 2
... .
. . .. _
Address: Over 1,000 amps or volts 454.65 2
- .
Mt . -
...
Temporary services ur feeders installation alteration, and/or
m , at
o
relcion
-.. __,
Phone: i ) j i Fax; ( ) 200 11111p9 OT lcAs
i ____., 66.85 1
, . . ., __
am
Owner ns • Mon: This installat w it is ' g made on properly that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 • Branch circuits new, alteration, or o lellS101A, per panel
Owner signature: Date:
. .. ,. A. Fee for brimch circuits with
‘ NCi r ' ' ' li)1 s( riFft 'Y " 4 1 ' 5frairran a
siki ',, i -::, ."„ ., :.,,,,. i A IA , '4! j ' ' .%) , ' ,‘' hi" lam.. lb, t<68 . 4,..LAtiiiv,' •;" ... 4‘. Lo) i g b°ve se 'r v i" °r lealer C "' 6.65 2
'' '. • - • • ' ' each branch circuit ,
Business name: • B. Fee for branch circuits
• without service ur feeder Ice, ( „Attic _S 6,1r , 2
Contact name: first branch circuit
Address; - Each add 'I branch circuit 1 Jvis' , PI 2
- MiseellanFuus (service or feeder not included) ........
City/State/ZIP: Each manufactured ur modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: ; ( ) Reconnect only 66.85 2
E-mail; Pump OT irrigation circle 53.40 2
,
..',ZI l ' i . P ;, „„'. 7 ';if...' ' ,, MT( A Sign ar °utline "ghling 53.40 2
Signal circuit(s) or
Business name: name: Gfigs fiEyfe..1 C.-- energy panel, alteration, ot'
• Address: 2c) z oR az T.... p od A v . et_ 44.c- extension. Describe: - Page 2 • 2
_- .. .-- -...
City/State/ZIP: It I • • Om:. C i - j (23 Each additional Inspection over allowable 1 u any_ o f the Above
....- .. Per inspection 62.50
Phone: (5''-' )
4) ) k2. t :_ Fax: (5,1) (042,,:
• .._ - investigation per hour (1 lo nn) __...., 62.50
CCB Lie.: I2 i s..• Electric Lic.: if l iti t o5 St • . Lic.:3 200;7-5 Industrial plant per hour 73.75
-..
Suprv. Electric 4 : ire, reco I i 1 , fissonsmam,., ..., 'M lt_
Print
Subtotal: 7 , g
..,.: • _ .. ....,,,...... _ ...
_ Iv ,:,: 11,-,415.,r.*,- ..
pian review (25% of permit fee): 1
1.4 name: C ,,,,„ , •
. 4 .„. , State surcharge (12% of permit fee): TS 0 , 5)\
•
Authorized signature! TOTAL PE,RMIT Fla:. 7 7 , .
O This permit application expires If a permit is not obtained witiltp
Print name: Date:5_05.1 dayb after it has been accepted as complete.
, Number of inspections allowed per permit.
.._ .... ,..- - „.--..........
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