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Permit �` tier CITY OF TIGARD ELECTRICAL PERMIT . COMMUNITY DEVELOPMENT Permit #: ELC2010 -00306 1 3125 SW Hall Blvd., and OR 97223 503.639.4171 Date Issued: 06/18/2010 T 1G ARD Bld Tigard 9 Parcel: 1 S 133AD 11300 Jurisdiction: Tigard Site address: 10690 SW 127TH CT Subdivision: AMART SUMMER LAKE NO. 3 Lot: 169 Project: Bennett Project Description: (2) branch circuits for heat pump /air handler Owner: FEES BENNETT, DANA Quantity Description Date Amount 10690 SW 127TH CT TIGARD, OR 97223 2 crt Branch Circuits 06/18/2010 $63.60 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 06/18/2010 $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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: 1 C Permittee Signature: '� /9/97-. &" (i 77 ON 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. 4 Electrical Permit Application L i 1 FOR OFFICE USE ONLY City JUN 1 2010 Roo eivr a Ci of Tigard DateB : /O to :ire• Permit 14 Other Permit; /0 i .,,,,, 0 52 s lig ° 13125 SW Hall Blvd„ Tigard, OR 97223 Plan Rev 1 ' Phone: 503.639.4171 Fax: 503.598.1960 i> �... Date/13'': 1'IGARIJ _ inc; 5 lnSpection L03.639.4175 ' 1 '� Date Ready/By: 7 � El See Page 2 for lv I Internet: www.tigard- or.gov ._ t ' °, •' , r Notified/Method: l( Supplemental Information n 1 i' itti t+ei N e.,,'r:rej,;,tt'' t 9 . 7 Mr. L 4 l G 1tyr14 ht �, L, �, 1 ,'..,:,..:;..,,,,...),;.-4,0;,..,...:, '. art „i1Jti. s ... .i, 10 Sys, 7 •'.h∎ , ?.r .« : o.;eda 1.-s i . t<” 1 ':. ; �"!.i , vr , k,y.1 .v1 .!,,IM:' .,v pt1i ...!.!:.:0: t �i k. .! I . , New construction ❑ Addition /alteration/replacement q' Other: Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ building over three stories. oo r6t� Wr-� r t .,:,,.. N where the available fault current ❑ Marinas and boatyards. ?n°ffati,'>^7! ,,,,, „ t; ox',a: ., arc r.., :mw kigeti i�`,k`;;A� . 'ra exceeds 1 0,000 amps at 150 volts or ❑ Floating buildings. 1- and 2- family dwelling 0 Commercial/industrial Multi family ❑ Master builder ❑ Accessory building [) Other: less ro ground, or exceeds 14,000 ❑ Commercial -use agricultural amps for all other installations. buildings, © Fire Dump. ❑ Installation of 75 KVA or `> e) i o i u - o k ur'r ,�r"r' VTb)�* „7ii°f rtl .+ � - Emer+enc s stem. larger separately derived stem. s iiM,� " �. + r. t a asrs£vv�.x zi. 4 . r a d e Y Y g P Y Y Job no.' g � Job address: s� � � ❑ i °'dditioo m oew motor load of ❑ o • " E", " 1.2 ",'' 1.3 ", 109HP or more. occupancy. 1 o Six or more residential units. ID Recreational vehicle parks, City /State /ZIP: / / ai did' 0 ig In Health-care facilities. ❑ Supply voltage fo: more than Suite/bldg. /apt. no.: f tiJ f Project name:WO',�e c e y^ne 0 Hazardous locations 600 volts nominal Y / 0 Service or feeder 600 amps or more. Cross street/directions to job site: ` 4 ,k M nil t ] e..'` . I 1 � ,ei,..,v 3 .r l.t.li3TL ;," . i a Dacriptio„ New residential single- or multi - family dwelling unit. Subdivision: i Lot no.: Includes attached garage. 1,000 sq. ft. or less 163.54 4 Tax map /parcel no.: Ea. add' I S00 sq. ft. or portion 33.92 1 4 . t '. •• t�. F A o a ' ,' tes, 1, • Sr r . 4 F i "yR" " Limited energy, residential 67.84 2 Zr. ° ? � - (w above sq, ft.) A J , tM , Limited energy, multi - family `' residntial e (with above sq. ft.) 67,84 2 Services or feeders installation, alteration, and/or relocation A,ur ' . 4 tat, . R - 45 +t ',t"WOW 200 am s or less 100.70 2 , d a l, t, ] l , ! „ ; h3, a p x, „ 4.��iRP� .. A ,. .t . . c � yl;w� . ry,.�.,,,,,; Ate 'r .r. . 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 • Address: 601 amps to 1,000 amps 301.04 2 — City / State/ZIP: Over 1 amps or volts 552 J 2 Temporary services or feeders installation, alteration, and /or Phone: ( ) 1 Fax: ( ) relocation . 200 amps or less 59.36 1 Qwoer installation: This installation is being made on residential or fnmt property owned by me or a member of 201 amps to 400 amps 125,08 2 my immediate family. This property is not intended for sale, exchange or rent, (01[3 479.540(1) and 479.560(1) 401 amps to 599 amps 168.54 2 Owner signature: Date: - Branch circuits — new, alteration, or extension, per panel ' 1,',5.Ne t , v r , " i , y :r o i` r i .a" A , Fee for branch circuits with tea_ t : ' ugg a s 4 ',1 9i•. �y� - +"�.i�c ; .. f, at,, r.: .,rt, ,..,, r '•' , � �' . .,._: above ServiCeor feeder fee, Business name: each branch circuit 7.42 2 B. Fee For branch circuits without Contact name: service or feeder fee, first I 5618 r- I / � 2 branch circuit Q Address: Each add'l branch circuit 7.42 Y-(f2 2- City/State/ZIP: Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 Phone: ( ) k Fax: ( ) dwelling, service and/or feeder _ - Reconnect only 67.84 2 E-mail: +p 5 µ Pump or irrigation circle 67,84 ' 2 7 art :"n #a l: r . c G Oki r"�44' ? ru•u �ir4tr ., t ..: '..�•ax,�,eSS,�i�'[a:�,'�f'�� �w A ="�'” .j "�"�«� `,5.� 1N;t° r ,.at4� *� =f n, �S>�w%+IAw r,•��t�U sign or outline lighting 67.84 2 Business name: It . J .�i Signal circuits) or limited-energy panel, alteration. or extension. Page 2 2 Address: • I 0 C)\4_ 4 I Each additional inspection over allowable in any of the abov I b 0 , O ) 0 t '1 Additional inspection (1 hr min) 66.25/ hr City / State/ZIP: � ,/ s _ Investigation (1 hr min) 66,25/ hr P one: '�l � • lT. i /rW /�'rl - 0 h / Industrial plant (1 hr min) 78.18/ hr 4 I � � f �' ( �' ? Inspections for which no fee is E-mail kri, Ei'K�d {�G ed vi . 0y cal 11c no 1��, l b l �+ �,.. " J1 1 stecaficall listed h hrmin 90.00/ hr .,:1:717! , , , v i s ' yr 11 •G,F a . S'li : i , Electrical tic. no.. �r:� (� /,f' , City or metro tic.: -� Subtotal i , Supervising electrician . signature, reg41.: Plan review (25% of permit fee); r 0 State surcharge (12% of permit fee); 7, Print name: a m g low - , f A Date: r >r 6 TOTAL PERMIT FEE: t Authorized This permit application expires if a permit is not obtained within 180 signature: _ days after it hos been accepted as complet . A...3 Print name: Date: • Number of Inspections allowed per permit. �, EO /E0 39 d DIi'11D313 NVW739N3 9Z0VT86E05 8T :0' 0T0Z /8'/90