Permit ci .: 4 :04.- 'n CITY OF TIGAR® E PERMIT
• ;... COMMUNITY DEVELOPMENT Permit #: ELC2010 -00274
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/08/2010
z. Parcel: 1S135CD01008
Jurisdiction: Tigard
Site address: 9946 SW SCOTT CT
Subdivision: SCOTT Lot: 6
Project: Coleman
Project Description: Replace feeder.
Owner: FEES
COLEMAN, TIMOTHY J & Quantity Description Date Amount
KLASSY- COLEMAN, TINA &, ABERE, KENNETH
J JR /JILL A, 805 SW BROADWAY 8TH FLOOR 1 ea Services or Feeders - 200 06/08/2010 $100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 06/08/2010 $12.08
Electrical
Contractor:
ROSS ELECTRIC INC
2870 SE 75TH AVE #203
HILLSBORO, OR 97123
PHONE: 503 - 642 -2800
FAX: 503- 642 -5815
Type of Use: MF
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 accord- • - 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: Oregon - requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -00 0 through OAR 952 -0 s ■ Y• ay obtain a copy of the rules or direct questions to OUNC by callin 503.246.6699 or 1.800.332.2344.
Issued = • A +� �L �.�.' , �' Permittee Signatur . / �'
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' ( 4 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.
06/07/2010 10:19 5036425815 ROSS ELECTRIC INC PAGE 01/04
Electrical Permit Application RECEIVE , t E t
��� o fi'z?it (1l' fi ll- d 1151+ !) 1V1.1 a k
.".:'!1'.'.: City of Tigard ��,.... �,... �.� � .. • ti --
Received A
r-* v 13125 SW Hall Blvd., Tigard. OR 97223 U N ®� 1 °ate ' �'. �� patron N o,:
gar �Y/ ��C Lr�U` l/ X2 7 ci
Phone: 503 639,4171 Fix: 503.598.1960 Day ew Other Permit:
TIGAII) Inspection Line: 503.639.4175 CITY OFTIGARD DataReady/By: nrir
Internet: tMww ngard orgov BUILDING DIVISI • otified/Method
Supplemental information
v ft „,,stY, 4 k.a4 ' i E 1 y ^ �'-: t e ' ? r� tit'
,3 ht �.
❑ New construction .x Addition /alteration /replacement Please check iii that apply (submit 2 seta ofplans w &ctns checked bemw)
,� Demolition ❑Other ❑ Service or feeder 400 amps or more 13 Building over three stories.
Fn"eel1, 4 e ,� Y� t i n9 ;"+ 'ir- S « / s + � + 1 i 7 r ” i i~o ' ° � -. Y ' ."::,;,-,-:17,,....1_,,f; wher th latent and buildings.
boatyards.
S the available &nit c 0 Marinas
th:Yi , h re ;i ,.r, -.c, . - ,,, 7,i„ , _: „,,,.,„a,.,.w,;_n .,..h.-- ; ), , �rti exceeds t ground, r exceeds at 130 volts or in Floating buildings.
ampsograii other exceeds 14,. ❑ Commercial use e�icuhural
0 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
amps for all ether iaaLBiladons buildings,
.`_ Multi- family ID Master builder ❑ Other ❑ Fire pump.
•---t r r^ �tsr -�tp r � 1 [i Installation of 75 [CVA or
I t{ . T ,,t7i ' 4 X 5 1 k S c,,, f ` u l ; Y 1 . / ti ¢ r` ❑ EmcrBCncY Syfi[Cm
;1,... •e,.:.. 94Li ro.4 .,,, K0 :: , :_ii?,.4 , ,....n ' , .t,,,. S . , , I , E a . «...y ; e j µ = "A " E", "I . derived SySlet
❑ Addition of new molar load of El "A", g + •f 2' • 1 -3 ",
Job no.: Job site address: $� 5c , w i
HP o r more.
t occupation.
- Q Six or more residential units. 0 Recreational vehicle parks
City/State /ZIP: C; _ C . , °Health -core thcitities,
Supply voltage for more than
0 Hazardous locations, 600 volts nominal -
Suitc/bldg. /apt. no.: Project name: C_OLt -7 0 Service or feeder 600 amps ormore.
Cross street/directions to job sitc: + - fi : ,�,i • • V� .• Doerr lien Otv. Fee Total •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less _ 168.54
4
Tax maptparcel no.: Ea. edd'I 500 sq. ft. or portion 33.92 1
f s "'�"t-Y • : ,, r T1 , r� .. r M: 'eras d tiV,.rr 7, G . r „? r - . .7 3 + r n � Limited energy. -
,,.Ja -...... na {c.,.0 , . ,� -. ;;; - \ - , h am .,. �... , :. •.�,.. n ' with above S • . ft- 67.84 2
D e a) (q �Q Q r � Y ~ '
i • L imit ed cncrfa mu Yarrtily
y -� residential (with abovo sq, A. 67,84 2
t - Services or feeders Installation, alteration and/or relocation
., s or less
��. f �� 00 atop 100.70 is 2
:27 ..,, „?1 fife r ra A I Y �,r I .,.2,. v :3, r_ � - ..,,...,,. .a . .,-_, . t, .. ' » 201 amps to400atn,:
Name: 133.56 2
401 amps to 600 amps 200.34 ME 2
Address: 601 amps to 1,000 amps 30104 2 -
Over 1,000 amps or volts 552.26 2
City /State /Z1P: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36
1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps III. 125 Min
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 arm to 599 amps 1.111 168_54 2
Owner signature Date Branch circuits — new alteration or extension, +erpaael
%+cv'�� - t� „la , ,( , , i' s i A. Fes for branch circuits with
,, »a , iI,,,,w'..,7„ i:4, 4 :,, .. ..„.,':: sn 3.w :i t ,tr ;.a,,.. . -.. � '� i :a, : : , :,) ., , ,,,L,.. , , .. t . '] i r cacti branch or feeder fee,
each branch circuit
742 2
Business name:
B. Fee for branch circuits
Contact name: without service or feeder fee, 56.18
first branch circuit 2
Address: Each add'I branch circuit 742 2
City / StatetZIP: Miscellaneous service or feeder not included)
Each manufactured or modular III
Phone: ( ) F :: ( ) dwelling, service and/ar feeder 67.84 2
Reconnect only
E-mail Pura, or irrigation circle
d 7,172 „- N �..t?f,A, .amp :a7, F FZ,�:! 1 t.1 f..P t ;� } Sign or outline lighting 6677:8844
,.:.:. ,.,.,.,- .,(;.C✓„.;7. . -_..T '1'. ..p - .,:. ,., rr +< t rte lighti
Business name: Ross Electric, fine Signal eircuit(s) or limited-
energy panel, alteration, or
Address: 2870 SE 75 Ave, # 203 extension. Describe: Page 2
—
City /State/ZIP: Hillsboro, Or 97123 Each additional inspection over allowable in any of the above
Per
Phone: (503) 642-2800 Fax: (503) 642 -5815 inspection 66.25
Investigation per hour p lit min) 1111 66.25
CCB Lic.: 157891 Electrical Lie.: 34 -436C Suprv. Lie.: 4232S industrial lantperhour 78.18
Suprv. Electrician signature, ' B� j f -1`� ” i ', ? ` s t 1:0
P required: i / 4 I'C�'
Subtotal: 00 tr
Print name: Stephen Ross Date: 2/8/2010 plan review (2595 of permit fee:
State surcharge (12% of permit fee):
Authorized signature
TOTAL PERMIT FEE: 1 a- 7 1
This permit application expires VA permit is not obtained with. 190
Print name: Date:
days after It has been accepted as complete.
lrltiuildinglp ih1ELC- Pt/mrApp.doc 10/01/09 • Number of inspections allowed per permit.
440-4615T(1 I/05/COM/11 'EB