Permit •
• ry CITY OF TIGARD
ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00022
13125 SW Hall Blvd., Tigard OR'97223 503.639.4171 Date Issued: 01/14/2010
� 1 " Parcel: 2S104BB04900
Jurisdiction: Tigard
Site address: 13994 SW CHEHALEM CT
Subdivision: Lot: 0
Project: Knowlton
Project Description: Install (1) 200 amp or less sub panel in garage and (5) branch circuits.
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Owner: FEES
KNOWLTON, MARK Quantity Description Date Amount
13994 SW CHEHALEM CT
TIGARD, OR 97223 1 ea Services or Feeders - 200 01/14/2010 $100.70
amps or less
PHONE: 5 crt Branch Circuits w /Purchase 01/14/2010 $37.10
Service or Feeder
1 ea 12% State Surcharge - 01/14/2010 $16.54
Contractor: Electrical
ENDERS ELECTRIC
PO BOX 1661
BEAVERTON, OR 97075
PHONE: 503 - 626 -4813
FAX: 503- 646 -3871
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp: •
•
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Total $154.34
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 wit 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 OA 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.
San 14 10 10:47a ENDERS ELECTRIC 503 - 646 -3871 p.2
RECEIVE. .
Electrical Permit Application
� TO RUhIICLUJL;ONLI'; " ?�,, ap9 y t',
F ,t , :! r a'g lad',Z Ito" d I 7l.W°1
w yt , ,:;, Ci 13125 CIO of Tigard JAN 1 2010 Received
girl O (i
w Date /By: ci Permit No.: I . 00(Ty),
.' SW Hall Blvd., Tigard, OR 97223 Plan Review Y �C v `ll v""v
Phone: 503.639.4171 Fax: 503.598.19601 1 OF TIGARD Date /By: Other Permit:
Inspection Line: 503.632A175
:I 1,..., Li
1, It 1) to R 7ltis
Internet: www:tigard or.gov BUILDING DN' tiret y /uMelhod: 10 See Page3 for
-�, _. .- ppiementallnform un
'����."`"�� ,.. ..�`a ¢� .� q f t :h1,sa� '�x�i¢�� �� °a'+''�, �,,wh',ti a �.,"' '�' ,� tf Su dt
�.,tm7tl� t fi 4w. �iwlf�'�iv ittl thaw I'rIIls-u,��., ,'.tit i' 08 r3r rg i a
❑ New construction ® Addition /alteration/replacement Please check all that apply (subiuit 2 sets of plans wntems checked below) '
❑ Demolition
ID Service or feeder 400 amps or more ❑ Building over thew r stories.
❑ Other
mr f where the available fault current ❑ Marinas and boatyards.
' wKR, , R z. W i t) 9 T3 Q t" itil f y 1 " ` exceeds 10,000 amps at t50 volts or 0 Floating buildin s
El dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
1 - and 2-family
Y g ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder Other ire pum
�ttt� q ❑ ❑ F P. Q Installation of 75 K\ A or
' . 4•�wq . 8 �� ?�i Y"ti r , _ �� ❑ Emer nc s stern.
tI rD by s a + °""' . ,
tSe Y Y "A" E""1 2""1. system.
F2nlai ❑ Addition of new motor load of ❑ "q" ° g^ ° I _ .
r •• 1.7
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Job no.: Job site address: 13994 SW Chehalem Court IOOHP or more. occnpa„cy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard OR 97223 ❑, Health -care facilities. ❑ Supply voltage for uwic than
❑ Haxardous.locatiuns. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Knowlton ❑ Service or feeder GOO amps or more.
a 8t r x ";.:r,;"
Cross street/directions to job site: ... � °a ,� =.p
Desenptioli - Qty. Fee. Total .
New residential single- ormulti- family dwelling unit.
Includes attached garage.
Subdivision:
I Lot no.: 1,000 s q• [t. or less 168.54 4
Tax map /parcel no.: Ea,.,add'l 500 sq. ft. or portion 33.92 1
-
Limited enL , residential
:.0 : '`w&; . . „ �a a.. dads Fr. :.,.,. $ e i ' s �s s , ` .r i 4 p e �". ve s
r tg . =..- -�-t ��r T (w ith abo ve sq. ft.) 67.84 2
Subpanel in garage and (5) branch circuits, Liiiited energy, multi - family
residentialt(with, sq. ft.) 67.84 2
Services or feeders installation, alteration, and /or relocation
�- . , 200 amps or less I 100.70 100.70 2
.- "' �) �. °aiaf*M. -:.r , lu,..� i •M xat -tt 201 a s to 400 am s
- ,� � �,;��. I�Ir p P 133.56 2
Name: Mark Knowlton 401 amnps.to 600 amps 200.34 2
Address: 13944 SW Chehalem Court 601 amps to 1,000 amps 301.04
Over` 1,000 amps or volts 552.26 2
City/State /ZIP OR 97223 Temporary services or feeders installation, alteration, and /or
I relocation
Phone: (503)524.4531 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation. is being made.on property that 1 own which is not 201 amps to400 amps 125:08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amp's to 599 amps 168.54 2
Owner signature: Branch'circuits - new, alteration, or extension, per panel
Date
am r � A Fee for branch circuits with
f s all tf' v ... ,. z^ b am ' pJ 1aI�� y a a '> r; nboyearvt
ece or feeder 1'ee; 5 7.42 37 2
r
Business name. Enders Electric each branch ciicuit
B. Fee for branch circuits
Contact name: Allen G Robertson withour service or feeder fee, 56.18 2
' fitstbranchcircuit
Address: PO Box 1661 . Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not'includetl)
City /State/ZIP: Beaverton OR 97075 Each riianufactured or modular`
dwellin service and/or feeder 67.8 1 '
Phone: (503) 626.4813 I Fax :: (503) 646.3871 �'
E -main. Reconnect only 67.84
e
a ga r Pump oritrigation circl , 67.84 2
, E E' r d R IEM $3 . ' NN t ".a. ....1st W..d'' Sign oi'outline lighting 67.84 . 2
Business name: Enders Electric Signal circuits) or limited -
energy panel, alteration, or
Address: PO Box 1661 extension. Describe: Page 2 2
City /State/ZIP: Beaverton OR 97075 Each additional inspection over allowable in any of the above
Phone: (503) 626,4813 I Fax: (503) 646.3871 Per inspection 66.25
Investigation per hour (I hr min) 6625
CCB Lic.: 26728 Electrical Lic.: 34 -265C S ur . Lic.: 4685S Industrial plant per -hour 78 18
Suprv. Electrician signature, required: j G , o� / P�
lJ� `� Subtot 1. 137 80
Print name: Allen G Robertson Date: 01/14/2010 Plan review (25 %a of permit fee):
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Authorized signature:
State surcharge (12% of permit tee): 16.54
TOTAL PERMIT FEE: 154.34
Print name: I Date: This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
F.\ Building lPtrmits \ELC- PertnirApp.doc 10/0I/D9 * Number of inspections allowed per permit.
1' ^ 440- 45I5'' /05 /COM/WEB
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Cr.crs �.e�A C 'e/ ' i 1 / �Y c b bcilsol
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