Permit CITY OF TIGAR® ELECTRICAL PERMIT
IZ 'r; COMMUNITY DEVELOPMENT Permit #: ELC2010 -00291
,� Date Issued: 06/16/2010
,T f G AR D' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S134AB01200
Jurisdiction: Tigard
Site address: 11334 SW IRONWOOD LP
Subdivision: ENGLEWOOD Lot: 11
Project: Freeman
Project Description: (2) branch circuits for heat pump and furnace.
Owner: FEES
FREEMAN, LINDA M Quantity Description Date Amount
11334 SW IRONWOOD LOOP
TIGARD, OR 97223 2 crt Branch Circuits 06/16/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/16/2010 $7.63
Electrical
Contractor:
ENGELMAN ELECTRIC INC
PO BOX 451
HUBBARD, OR 97032
PHONE: 503 - 981 -8041
FAX: 503- 981 -4026
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 e rules or direct questions to OUNC by calling 503.24 699 or 1.800.332.2344. `
Issued By: z/ Permittee Signature: 4
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.
06/14/2010 09:02 5039814026 ENGELMAN ELECTRIC PAGE 02/02
Electrical Permit Application-. r,, ; -- ; FOR OFFICE, USE ONLY
Received
of Tilyd DateB : a i = Permit No.: ^ , . 10 W 1
13125 City SW Ha
ll Blvd., Tigard, 1
t OR 97223 Plan ltaview — li Phone: 503.639.4171 Fax 503.598.196Q) UN 1 5 2010 DateB : Other Permit:
Inspection Line: 503.639.4175 Date Ready/BY; Icrl. r/ ® See Page 2 for
T 1 Cir�Rl)
Internet www,tigard- or. gov -• :, iv Notified/Method: Supplemental Information
'I : ' r - , ; TYPE 0f,WPRIC
PLAN REVIEW
❑ Ncw construction ® Addition /alteration /replacement Plehae cheek all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available faul t current ❑ Marina and boatyards.
r 'i C:ATIE�Q)I�Y CO1V &TRUC')('ION "
: . " " exceeds 10,000 amps at 1S0 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
y
tF . ❑ Emergency a stem. larger separately derived system.
" ' J6S SITE INFOlt�1VI: E1ON AN» E OCATION ❑Addition of ne v motor load of 13 "A ", "E ", "1-2", ' l r ivt
100HP or more, occupancy.
Job no.: 22317 f Job site address: 11334 SW Ironwood Loop ❑ Six or more residential units. 0 Recreational vehicle parks.
Et Health-care facilities 1:1 Supply voltage for more than
City /State/1P: Tigard OR ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Wolfer's/Ereeman 0 Service or feeder 600 amps or more,
FEE SCHED11LE
Cross street/directions to job site: Description i Qty. I - Fee. 1 Torah f •
— — New residential single. or multi - family dwelling unit.
Includes attached garage.
'
Subdivision: Lot no,: 1,000 sq. ft. or less 168.54 4
Ea, add'l 500 sq. ft, or portion 33.92 1
Tax map /paroel no.: Limited energy, residential 67,84 2
\';)1!Y ,: '@ DESCRIPTION ;OR:; W,ORI
t (with above sq. ft.)
Limited energy, muiti- family 67.84 2
wire for beat pump & furnace residential (with above sq. fti
Services or feeders inetallation,alteration, and/or relocation
200 amps or less 100.70 2
.... •, ' 201 amps to 400 amps 133.56 2
.
(] pIiQP�RTX; OWNER 0 ' TENANT P P
- -- 401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 L 2
Temporary services or feeders installation, alteration, and /or
City/State /ZIP: , relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447 449, 670, and 701. branch circuits– new, alteration, or extension, per panel
Owner signature: D att : A. Fee for branch circuits with
•, , above service or feeder fee,
7.42 9
0.: #X"1PI,)G. , ❑ .CONTACT PER50 each branch circuit
B. Fee for branch circuits without
HttSinesS name. service or feeder fee, first 1 56.18 56,18 2
Contact name:
branch circuit
_ -- Each add'I branch Circuit I 7.43 7.42
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: dwelling, service and/or feeder
Reconnect only 67,84 3
Phone: ( ) Fax:: ( )
— _ Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
''.',.:CONTRACTOR ; ; y .:: _. . . Signal circuit(s) or limited-energy pie' 2
Business name: Engelman Electric Inc panel, alteration, or ext n9 on.
Each additional inspection over allowable in any of the above
Address: P 0 Box 451 Additional inspection (1 hr min) 66.25 / hr
Investigation (1 hr min) 66.25 / hr
City /State/ZIP: Hubbard OR 97032 _ Industrial plant (1 hr min) 78.18 /hr
—
Phone: (503) 981 -8041 Fax: (503) 981 -4026 Inspections for which no fee is 90.00/ hr
ical L 24 - s cifrcall listed 14 hr min
CCB Lic.: 9458 - Elect 46C ELECTRICAL PERMIT. FEES 0V Subtotal: 63.60
SuprV. Electrician signature, required: Plan review (25% of permit fee
Print name; Ron Thunderbird Date: 6/14/10 State surcharge (12% of permit fee)! _J.r64' 7, 6,'3
_. i _ TOTAL PERMIT FEE: 70-1
(Authorized signature: " - OP ' • This permit application cxpites if a permit a loot obtained within 180
s
days after it has been accepted as complete.
Print name: D a te: ' Number of inspections allowed por permit.
S Uioilding1PermitsELC •PermitApp.doe 10/01/09 440- 4613T(1l /05/COM/WER
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