Permit •
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELC2008 00651
DATE ISSUED: 11/26/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 CB -01711
SITE ADDRESS: 10125 SW HOODVIEW DR ZONING: R - 3.5
SUBDIVISION: HOOD VIEW LOT : 010 JURISDICTION: TIG
PROJECT: SESNON
Project Description: (4) branch circuits for bathroom remodel.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/ SVCI FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
ROBERT & KAREN SESNON OWNER
10125 SW HOODVIEW
TIGARD, OR 97224
Phone: 503 - 684 - 0173 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 11/26/2001 $66.80
[TAX] 12% State Surchar 11/26/2001 $8.02
Total $74.82 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 th- • : • •ays. • ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR •.2- 001 -0010 throu• - - • - - 001 -0100. You may obtain copies of these rules or direct questions to OUN t 503.246.6699 n or 1.800.332.2344.
Issue• By: I Permittee Signature: Q.t,rti �73, r�
OWNER INSTALLATION ONLY
The installation is being made on pr. .erty I own which is not intended for sale, lease, or rent. l /
OWNER'S SIGNATURE: dr . i DATE: / 1 / Z�! ee
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: 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 ,��I �� ! ' �� oR o I it E•lis O NI N 1 ''
City of Tigard Received �� ���
114 `1 DateB : Permit No.: �/ a /I
' ' ° 13125 SW Hall Blvd., Tigard, O t�' ' E �.. �� Plan Review
C Phone: 503.639.4171 Fax: 50 - :. 960 D ate /B y: Other Permit:
T l GAR IDS Inspection Line: 503.639.4175 9 6 200b Date ReadyBy: 1 El See Page 2 for
lntemet: www.tigard- or.gov • ` ,.' Notified/Method: `r ICi Supplemental Information
TYPE OF.c 1 ®r, PLAN REVIEW
❑ New construction ®Addition/a€Rt T� 'Et¢111�'tti Please check all that apply (submit 2 sets of plans w /items checked below):
13 11"`11))) 1 -, � ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job no.: Job site address: 10125 SW Hoodview Drive IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97224 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Hoodview Dr & Kable Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
Bathroom remodel- relocate several outlets and switches, add recessed lighting residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Robert Sesnon 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 10125 SW Hoodview Drive Over 1,000 amps or volts 454.65 2
City/State /ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)684-0173 Fax: ( ) 200 amps or less 66.85 I
Owner installation: This i stallation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2
intended for sale, le nt, or ex aw, j Date: according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: innt D / / / o2(/l'O, Branch circuits — new, alteration, or extension, per panel
1 X A. Fee for branch circuits with
® APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: Robert Sesnon without service or feeder fee, 46.85 4.(<
2
first branch circuit
Address: 10125 SW Hoodview Drive Each add'I branch circuit ,) 6.65 / 9. g5 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Tigard, OR 97224 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 684-0173 Fax: : ( ) Reconnect only 66.85 2
E -mail: rksesnon @hotmail.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: D ( A ) 13 CA/ Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES ff
Suprv. Electrician signature, required: Subtotal: (..�
Plan review (25% of permit fee):
Print name: r 1/ Date: State surcharge (12% of permit fee): q b
Authorized signature:" A.A..( ✓ S6l 117l "I
TOTAL PERMIT FEE: . 0 9
This permit application expires if a permit is not obtained within 180
Print name: X te -A) S ESN e NJ Date: /1/26108 days after it has been accepted as complete.