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Permit
„ CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit ELC2009-00562 • e 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/23/2009 Parcel: 2S102BB00201 Jurisdiction: Tigard Site address: 10060 SW KATHERINE ST Subdivision: Lot: 0 Project: Fleming Project Description: (1) branch circuit to reconnect gas furnace. Owner: FEES FLEMING, PATTI Quantity Description Date Amount 10060 SW KATHERINE TIGARD, OR 97223 1 crt Branch Circuits 10/23/2009 $56.18 wo/Purchase Service or PHONE: 503-639-5408 Feeder 1 ea 12% State Surcharge - 10/23/2009 $6.74 Electrical Contractor: BEN'S HEATING & AIR CONDITIONING LLC PO BOX 80607 PORTLAND, OR 97280 PHONE: 503-233-1779 FAX: 503-651-3345 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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: Permittee Signature: 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. -44Mrical Permit Applicati City of Ti arid Received g DetolB / ; l y Permit Nil 13125 SW Hall Blvd, Tigard, OR 97?~f, 1i 2 2 2o0 Plan Review C' Phone' 503.639.4171 Fax: $03,598,1960 gato/6 Other Permi1'"1E 1 Inspection Line: 503,09.4175 [E Date Ready/By: ]arts ® See PRRe 2 for Internet: www,tigud-or.gov Nodf<edlMeri,od: 00tincrital Information 0i CYP MAN REVIEW ❑ New construction Addition/alteratioi repiacement Please check all that apply (Submit I sets of plans w/items checked hclcm ) ❑ Service or feeder 400 amps or more M Building over lhrce SIDTIOS Q 1]etnpliliUri ❑ Other: where the available fault current d NCirmac and boalvards CA1EfaU1t~ ,U~ • , ECIs1ti [ ~1 v q•; e 'y it n ,,;!li f exceeds 10,000 amps at ISO volts or El Floating buildi11WI less W ground, or exceeds 14,000 ❑ Commercial-use ovriculuirnl I- and 2-family dwelling ❑ Commercial/industrial [I Accessory building amps for allotltef installatimus buildings. Multi-family ❑ Master builder ❑ Other: ❑Fire pump. Installation o(75 KVA ur Ma 6rTF. INPORMATf4Tt. [3 Emergency system. larger separately derhed caste r pIYR I+QCI~TIQ El Addition of now motor load of ❑ "A" "E" "I -Y l -3" IOOHp .10h t10,: Job site fldd!'eSS: lC1Dl~f(1 urrnore. occupancy. ❑ Six or more residential units. ❑ Recrentional vehicle parkri t: {lyl$tuiclZlP: Or ❑ Health-taro facilities. E) Supply vnltaite for more Ilion i cllaA2 El Hazardous locariorm 600 volts nominal. Suite/bldgdapt. n0.: Project name: ❑Service or feeder 600 amps or more FEE, .SCHEDULE Cross street/directions to job site- uraxrl ,lay rv. FN. Tulnl New residential single- or multi-family dwelling unit. ineludcs attached garage. Subdivision: Lot no.: 1,000 sq. ft, or less 143.15 4 4 add'l 500 sq. ft, or portion 33,40 I w, x m p p rcc1 no.. Limited energy, residential 1 75.00 i with above s q. ft. n 6, Limited energy, multi-family 75.00 2 Qe_ C~ p=~ 19: /yvtkre residential with above s q. R.) Services or rccdera Installation, alteration and/or relocation " 200 amps or less 80.30 2 PROPERTY OWNER 201 amps to 400 am s 106.85 NtunC: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 24060 ldrd53; ~ P1Fl Over 1,000 amps or volts 454,65 2 r rty/StaEC//..IP: - Cl' a- Temporary services or feeders insltallotlon. alteration, andth relocation _ Phone; e-wog F.: ( ) 200 amps or less 66.85 4Q :1 Owner installatlou: Ellis Installation is being made on property that i own which is not 201 amps to 400 amps 100,30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch cireults.- new, alteration, or extension, per and Owner signature: Date: A. Fee for branch circuits with APPLICANT f{CUIV I ABC ' P6,iU1~ above service or feeder fee, each branch circuit 6.65 2 f3usineSS name: I1 w 'r liter t~ LL C 8. Fee for branch circuits ahour scrviQu or feeder fee, C'unUtcl name: e r h rI first branch circuit e Address: Each add'I branch circuit 6.65 2 Miscellaneous service or feeder not Included City/Stole/"LIP: Each manufactured or modular q0 90 dwelling, service and/or feeder (hone: t57:3 ) :3J3- 9kU Fax: (fin ) b S-7 g3 tj Reconnect only 66 85 I -mail; Pump or irrigation circle 53.40 2 CONTRACTOR I Sign or outline lighting 53,40 2 limited- Business name: / Signal circuit(s) or ~h f { E& ; w [ fir i L G energy panel, alteration, or Address: 4 07 extension. Describe: page 2 2 City/State/ZIP: o OL44 Li'7 Each additional inspection over allowable in an of the above Per inspection 62.50 33 Phone: Fax: (5713 ~r Investigation per hour (I hr min) 62.50 1 %r CCR Lis: 4 S , Electrical Lie, yg L/f,E Suprv. Lic„ Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Flcctriciun signature, rcqui 5 r _ Subtotal Plan review (25%ofpemtii lee): int name: ate: State surcharge (12% of permit fee): 7 r Authorized signature: TOTAI, PERMIT FEE: { Print name; 6 Date; Q This permit application expires it a permit is not obtained Within tau C 1 d e u r 0 days after It has been accepted ax complete. ' Number of inspections allowed per permit IluildinbtllennitslLLC•I'eruriiApAoc 03/23/06 4404615T(111051COM/WFU 700 in HIF7)_I1V3H-S\313 2fffT~9S0~ YF3 70:7T (300-,,77,' 0T i i: ELECTRICAL PERMIT � ,.,;� : I CITY OF TIGAR® d ' c ri Permit #: ELC2009-00562 COMMUNITY DEVELOPMENT Date Issued: 10/23/2009 TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 parcel: 2 /23/20 00201 Jurisdiction: Tigard Site address: 10060 SW KATHERINE ST Subdivision: Lot: 0 Project: Fleming Project Description: (1) branch circuit to reconnect gas furnace. Owner: FEES FLEMING, PATTI Quantity Description Date Amount 10060 SW KATHERINE 1 crt Branch Circuits 10/23/2009 $56.18 TIGARD, OR 97223 wo /Purchase Service or PHONE: 503 - 639 - 5408 Feeder 1 ea 12% State Surcharge - 10/23/2009 $6.74 Electrical Contractor: BEN'S HEATING & AIR CONDITIONING LLC PO BOX 80607 PORTLAND, OR 97280 PHONE: 503 - 233 - 1779 FAX: 503 - 651 -3345 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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. . y� Issued By: ,((. ." iie,_____. Permittee Signature: 2 N / /33 (�� e " 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. - Setrical Permit Applica tiaF , CEIVED FOR OFFICE I'Si; ONI.1' 1 , 1 111 q City W Tigard oil /D /d 3A t , 'trout Nom u'v7Op j+'�JQJC',� , 13i 25 SW Hall Blvd,, Tigard, OR 97 T 2 2009 Plan Review / Phone: 503.639.4171 Fax: 503.598.1960 otae/py. Other Pertnimye 99 ^9^ : /8 lurk , rltinten Inspection Line: 503,639 Date Road k See Page 2 for Internet: www.tigard- or.gov CITY OFTIGARI� Notified /Me 7/6" gr Supplemental Information - g t1ILI r� n 1 S 'CYPE'Ol? WCI, z '`.;r`,4., x �Zt .� .;i .,isr i,r s P1 AN REVIEW r i ❑ New construction ( Addition /alteration /replacement Please check all that apply (submit 1 sets of plans wincing dtecked below ) ❑ Service or feeder 400 amps or more I] Huilding over three stones Q Den El Other: where the available fault current ❑ Marinas and boatyards r -r ` K t �74V1 ri rrs�, t CATS{"e'1 0 OF•4`iP�)11 1,tyi lrt, };i"}I„ : ? CT.',;7, exceeds 10,000 amps et 150 v0115 or ❑ Floating buildings less to around, or exceeds 14,000 ❑ Comntercial.use agricultural a 1. and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings. E Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or °'^ + s + ' r c , b { ; + " ❑ Emergency system. larger separately derived system JOB SITE INFO1tMAT10TT ' ANA 'L ,O C K ' 1lO? !- . � , J ❑ Addition of new motor load of p ;a °E ° I -� I.3 , Job no,: Job site address: /QQtr/Q St f ,k 4peld _ I00 or ur more. occupancy. (r r" ❑ Six or more residential units. ❑ Recreational vehicle parks Ci /Stale /TIP: l , 1 q 6 ©r - ❑ Health -care facilities. 0 Supply voltage for more that — r IR„,2„.,? ❑ Hazardous locations, 600 volts nominal. S uite /bldg- /apt. no.: Project name: O Service or feeder 600 amps or more, ;w ":' ,''' ". . " FEE .SCHEDULE Cross street/directions to job site: Description 1 Qty. I Far, 1 - Tut.I 1 New residential single or multi - family dwelling unit, _ Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 • Tax map /parcel no.: Fa. add'I 500 sq. ft, or portion 33.40 1 W , Limited energy, residential ;. DESCRIFI701Y WO ,r t 1 «� Ir S res t 75.00 2 n7T1 v� K«,t fr{1S< withaboves .ft. ) Limited energy, multi - family ea. - N)Ve *' Geks l'5 /WVELe residential (with above sq. R.) 75.00 2 ' Services or feeders Installation, alteration, and /or reloeatiun 200 amps or less 80.30 2 R OWNER X77 �.� .'t' 201 am _ PROPERTY �;� r t_J/r0►.r�y p p ' r " "}i, , i!' ' 2 amps to 400 amps 106.85 2 Name: - $� �� f r 401 amps to 600 amps 160.60 1Yy 1 2 `� ` 601 amps to 1,000 amps 240,60 ' +Iciress: /oak a sw // melA6 Ovnr 1,000 nmE or volts 454,65 I 2 l , tty /State /TIP: --r ( le q 7 a e,,3 Temporary services or feeders Installation. alteration, and /ur t relocation Phone: al ) 639 i s910,g. Fax: ( ) 200 amps or less 66.85 ( I Owner installation: this installation is being made an property that I own which i s not 201 amps to 400 amps 100.30 12 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits •- new, alteration, or rx tcnsiun, per panel Owner Signature: Date: - A. Fec for branch circuits with - ❑ APPLICANT: • 1 '.I0:.CONTI I ;PcRSON above service or feeder fcc, 6.65 • each branch circuit Business name: r" If N �i r r r LL C B. Fcc for branch circuits r n without service or feeder fcc. C ., Contact name: C i J et L7ut r "1 - 6 first branch circuit e / k/i Address: Each add'I branch circuit I 1 6.65 1 2 ;Miscellaneous (service or feeder not Include, I Cit) /Stute /Z1P: Each manufactured or modular I 90.90 i z dwelling, service and /or feeder r j Phone: 1Sz_7 ) 31.3— .99k0 Fax: : (5.-b j ) 6 s7 , 33 yr Reconnect only G6 R5 W 1 2 E-mail: Pump or irrigation circle 53,40 2 . • CON't`RACCQR', , . , - . : , :',: : : , ,,....7..., • Sign or outline lighting 53.40 2 B '3! Signal circuit(s) or limited- Business name: �h J 1.44,44-;,,,1 -F AN- Coll d r t/ I dq 1 - 1 . C. energy panel, alteration, or Address: Cl extension. Describe: Page 2 ._ i °D . d»c �e,07 City /State /ZIP: A .,, 4 , , P2 - q Each additional inspection over allowable In any of the a bove Pcr inspection 62.50 Phone: (� 3) 3 3 _ Fax: (5V 3 ) 9 / — 9..y Investigation per hour (I hr min) 62.50 ke,B,,,c.:, y 5'4 7 , Electrical Lic, 1 l yq L#,e Suprv. Lic.: industrial plan) per hour 73.75 , rt ti' ELECTRICAL PERMIT FEES S uprv. Electrician signature, rcqui " ` .1 / ■ __ Subtotal' j ta!6 / � a Plan review (25% of permit Ice): int name: - - e N S late surcharge (12% of permit fee): �, r '7 Authorized signature: g ei i 1 Ip - TOTAI, PERMIT FEE: / , 9,1_ Print /� / / This permit application expires if a permit is not obtained within I8U i rint name: e 14 d e UtA T r ° I's] Date: /yl 4 0 ////// days after It has been accepted us complete. O ' Number of inspections allowed per permit 1 . Iluil4ing1Permiis1L 'LC•PennnAppdOc 115 /33/06 440- 16157(1I /05 /COM/WEU Z00ij HIV89NI,LY3H - SN3H SfiCCTS9CO2 TPd ZO :ZT 6002 /ZZ /0T