Permit CITY OF TIGARD ELECTRICAL PERMIT
Permit #: ELC2010 -00305
_ .: COMMUNITY DEVELOPMENT Date Issued: 06/18/2010
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S103DC00806
Jurisdiction: Tigard
Site address: 11385 SW FAIRHAVEN ST
Subdivision: VIRGINIA ACRES Lot: 4
Project: Topf
Project Description: (2) branch circuits for A/C and furnace.
FEES
Owner:
TOPF, PAUL J CHRISTA M Quantity Description Date Amount
11385 SW FAIRHAVEN ST 2 crt Branch Circuits 06/18/2010 $63.60
TIGARD, OR 97223 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.
1 -- j Permittee Signature: /�/� /9 Z--0/ 9 7
Issued By: 4L
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.
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City of Tigard
M :�.
g t L Permit No. ���"
F t DeteB � t7 �o ; pCo /o — 0 t, a 13125 SW Hall Blvd., Tigard, OR 97223 1 Q
L t r- Phone: 503 Fax: 503.598.1960 � U N 1 O 201 Pla tev1" Other Permit:
`':*;;;,1'26r03 Date/8 ;
,,;,t,.;,..,,,:\ , i y , Inspe ction Line: 503.639.4175 _ Date Ready/By: el See Page 1 for
:!?: ^� : Internet: www.tt and -or, ov IG Not ified/M d: Supplementn i1nformation
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: y.� `q°n :? !a; } i ��..�'G r .. ,_ aP Y - . 1 . ` �/ . d '� f :� `'�+`'�^,�,i $kJ2.
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❑ New construction ❑ Addition/alteration/replacement V Other: Please check all that apply (submit 2 seta of plans w /items chocked below):
El Service or feeder 400 amps or more ❑ Building over three stories.
5 1 where the available fault current ❑ Marinas and boatyards.
;;a i; u u �y^•Sri: I ' � 71 �. Ell-77Z <-F i. ,+ t 7C:.ry 7 r q tr &+ 'V« g
1 . m.s..�t.,�s...�! a�.., ,��;, Rt kG . exceeds 10,000 am n: 150 or iw]Floativ buildigs. n
r 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
er ❑ Other; amps for all other installations. buildings.
❑ Multi - family [] Master b „ ,y. � , � � r i d (,� ❑ Fire pump, 17 Installation of 75 KVA or
i4't�;�pr�r;"Tl' wry, "_kt ,�? J),.,,R�,lN�t s } P, :. �.4"�� .11�l�, J, , t tea ❑ Emergency systcm larger separatelyderivedsystem,
s: (r ri6.>G , 0''A' - ., E „ "l -2", L'1_3„
( J � 1 , ❑ Addition of new motor load of
Job no.. 3 Job address: �
�..�i. �{ � I OOHP or more. occupancy.
City /State/ZIP: d / �,� • 0 six or more residential units. ❑ Recreational vehicle parks.
CJ ��.� ❑Health -care facilities. ❑ Supply voltage for more than
Suite/bldg. /apt. no.: Project name: ❑ Ha location,, 600 volts nominal,
[Zi Service or feeder 600 amps or more.
Cross strec /directions to job site + W j ti' na 1 4 ” i «i ° " r �,Tp `"Jrz kt YG ".1Za! rtaln
f iv v::'.1 l >_!t '�., uc� s "9 J£.','�� *�':f5at
Oeacrtptton qry. F. Tout -
New residential single- or multi- family dwelling unit.
Subdivision: Lot no.: I attached garage.
1,000 sq. ft. or Tess 168.54 4
'lax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
K. i t�s°°ss'A3 rt;; f EJ ''' c o , a ` I �7 n „ ")o i T x � ., . 5' " r+ a / r Limited energy,
s&. ss� .'rt 4. ialLic? : K� fib,..° residential
67.84 2
(with above sq. ft.)
N / Limited energy, multi - family
ei residential (with above so, ft) 67.84 2
S ervices or feeders installation, alteration, and /or relocation
::'; " a r J0 1 ' ar dtq "vtt m s or le" 100,70 2
st C4 -. .: -5 J .,7i A¢7fG�f,/ . } .a g ue" '3.f '�%1 200 ap
Name: 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301,04 2
City/State/ZIP: Over 1,000 amp or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation __
200 amps or less 59.36 I
Owner installation: This installation is being made on residential or farm property owned by me or a member of
201 am s t0 400 am S 125.08 2
m immediate family. This property is not intended for sale, exchange or rent. (ORS 479.540(1) and 479,560(1), p p
40 t amps to 599 amps 168.54 2
Owner signature: Date:
Branch circuits – new alteration, or extension, per panel
,:, ,.. t riT ` d gEsif f� cc{� y + gi Jt kA Y'fki �e 0 # i v w;,.y.��. �g u l rte, [ l 1 t
l , 1 •1 A. n circuits wit/[
.5'Y�r�rn ::.msv:t x;�J.']L .. ' a�n'�.�Y�` p, ✓ti� "..�$!9. .!�F.. t ,��'�n�Y 'J;. 7,14, w,.44'J &
above Fe: for service brach or feeder fee,
7,92 2
Business name: each branch circuit
B. Fee for branch circuits without
Contact name: service or feeder fee, first
branch circuit 56.18 ¢ 2
Address: Eac11 add'I branch circuit 7,42 / �.., 2
City /State/ZIP: Miscellaneous (service or feeder n.t included)
Each manufactured or modular 67.84 2
Phone: ( ) F ax: ( ) dwelling, service and/or feeder
' —
Reconnect only 67.84 2
E - mail
rt (° A r'rfu L,R, t ^ 9 is ur r Pump or irrigation circle 67.84 2
+%�: i R . a6? 'r sw: sY ° „q;a..,..'1jJr4'..Nr ,ll .`8kir. :t'r.�.'!a :+`, Sign or outline lighting 67.84 2
`i r exte
EIE nsion. Signal circuit(s) or limited-energy
penal, alteration, or extensioon. .
Page 2 1 2
Address: I■M Each additional inspection over allowable in any of the above
.1 , , �/ A ddi ti onal ins (I hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
P hone: tm-201• �'� �1 �/ M Industrial plant (1 hr min) 78,18/ hr
7 Inspections for which eo fee is
90 00/ hr
/ ► 1411 .. - r . s •eclf call listed % hr mm
Electrical lic. no.: W nf'.f��`.K_''"..° t 1� ( in�..+.:.,ti n y-� rt d� t.' ). :n3ii 'tali'
City or metro ti . rs_ s_ 3! z„ s,...,a 4
Supervising electrician
•
•
Subtotal: IIMAtabi
rk signature, re. .t r .: p Plan review 25° o of permit fee):
Print name: —
la ,. 1 * , r , EMI , Date: • , man
State surcharge (12% of permit fee);
TOTAL PERMIT PEE:
Authorized —�•
signature: This permit application expires if a permit is not obtained within 181
days after it has been accepted as complete
Print name: Date: • Number oil inspections allowed per permit. 2,
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