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Permit . • Y' . CITY OF TIGARD • ELECTRICAL PERMIT 1 :: 1VIMUNIT DEVELOPMENT C� Permit #: ELC2010 -00334 131 25 SW Hall Blvd., Ti ard.OR 97223 503.639.4171 Date Issued: 07/02/2010 ?1 GAFC 9 .. Parcel: 2S 102C D04300 Jurisdiction: Tigard Site'.address: "13800 SW COWLES CT Subdivi LYNZ 'COURT Lot: 4 Project: Brumbach Project Description: (2) branch circuits for furnace.and heat pump. Owner: FEES BRUMBACH, ADAM Quantity Description Date Amount 13800 SW COWLES CT TIGARD, OR 97223 2 crt Branch Circuits 07/02/2010 $63.60 wo /Purchase Service or PHONE: 503- 840 -8862 Feeder • 1 ea 12% State Surcharge - 07/02/2010 $7.63 Electrical Contractor: COLUMBIA NW HEATING PO BOX 622 . SCAPPOOSE, OR 97056 . PHONE: ,503-543-3624 FAX: (503) 543 - 6285 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $71 :23 Required Items •and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit. will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-0100. You may obtain_a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: 1 <••�� -� /F J`a"'� v Permittee Signature: L / e � /U • OWNER INSTALLATION ONLY The installation is being made on property`I own which is not intended for sale, lease or rent. • OWNER'S' SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATUREOF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each Inspection. 07/01/2010 14:07 5035436 8.5 PAGE 04 ,A, 11 'ryr Electrical. e1rRR1 it App ca /I i CF V fl i ' ' as/ F(*' ( 1 1 5 i (11\ 1 1' ` ; �' 1 3 1 2 5 of 7C al I 1 3 Ivd Ti JUL ®1 2 10 nm ed ' - / 0 d7 - r _ Ferrel lvo.. lc of Dal cA • 312 SW h 131vd, gsrd OR 97 Pint Review M ® ` Phone: 504 6 4i.71 Fax: '5 K �p `� / �+ p Other ,Permit' t Ir6crnct:- www.ti rd:Otgov BUILDING 1 1V�c�ll ® No c'210r Gf T I < tt 1 i Tnspection Lino: 503.6:3 Ready/By: : mss' nr: Tr .�� ,.:o ,w , . i pp nn . . ., TYP1 OF Wtt . _ PLAN K�~�w 1=1 New construction ' m e Pi aiiA that apply b 2 y (submit sets nfpitins w /itcmv decked below): ® Addition/alteration/replacement cck'Il ) ID Demolition ❑ .�t1lEr: 0 Service a rfender 400 / mr or fnnrC l Building OVCr three dtnrics. whcro the nvnilrtblc rnulc current Q MArinA$' Ik;LLynrds. CAtiteGO1ty - OF C.ONST] CTiON • • • • exceeds 10,000 nmpn nt,150 rmltc or ❑ Floating buildings. - loss to ground, ore.- ccerein 14,000 ❑ commercial-use agricultur:1 d2- family dwelling Q Commercial/industrial 17 Accessory lnlilding amps rnrn11 ether installations. buildings. ❑ .Multi- family ❑ .Master builder © Other; ❑ Fire pump. ❑ Tnetauntinn or 75 KVA Of in . ,Apt 'Silt iNFORMATtb.N AND Y,;OC"At1t7N : . Inrgcr ser , nrntrlydctivcd system. Emergency system ._ ClAddition;ofni;wmowrinnd ❑.A• ',P•• "1-2", "1-3" ,Tob no.: , site addrless: 13800 SW Cowles Ct 100TTF or mare, occupancy: - _ l] Six ormore residential unit.. 17 Recreational vehicle prtrkk. City /State /ZIP: Tigard, OR 97223 ❑ HeaI1}1-care ffcilities. 0 Supply voltage air mere then in Hazardous locations. 58) veils nominal, Suit (bldg. /apt no.: Project .rain: D Service or feeder 600 amps or MOTO. . F 1; r sC'IE1}LTT,t Cross strcet/d.irections to job site: we onircri l t219 1 Ern l otal 7 Ne n i widentfal single- or multi - family dwelling unit. _ Inclnd s attached garage. Subdivision: �. Lot no.: 1.000m. ft. or Icss 168.54 4 Ea. add'l 500 sq. R. or portion 33.92 1 Tax map/parcel. 11.0.: TLittiitad energy. residential 17TtSC'3t)PJ703Y "OF WO (with above sq.ft.) 67.$4 2 - - Limited energy, multi = family 67.84 17 Install Gas Furnace & Heat Pump residential (with above sq. ft.) , , "" "� Scrviccs: feeders installation, alteration, and /or rclocnl:ion f 200 any,: tn. lea,' 300,70 2 SI 1 °RGPE TY'OWNJ R . .,. LL 1.. 0 T 201. ampe t 4)0 amps 133.56 2 10i amps to GOO 'snips 200.34 2 Nome: Adan1 B1'umbatlt _- 601 ampyto 1.000 °,mpa _ 301,04 2 Address: 13800. SW Cowles Ct Over 1:000 amps or volts .552.26 2 City' tTIGe' Ip: T igard; OR 97x23 Temporary scrvwvx or feeders installation, alteration, and /or r,eiocation ' Phone: (503)8404862 Fax:: ( ) (io' + amps or lets 59.36 1. - ' "• ^,. - 201 stints to 400 amps 125.08 2 Owner installation ; - T7 This installation is being made on property that l own which is not intencled:f it sale, lease, rent, or exchtmge, according to ORS 447, 449, 670, and 701. 401 ,mrn lr, 599 amp 3614. 54 2 Branch dreulty new, alteration, or extemlon, per panel Owner signature: _ _ 1)ate: A. Poe ,fm branch circuity with • above soviet or feeler fee, _ • ID APP1 TANTi L7 CC}� . ACT i' 42SON 7,42 2 each hrmch circuit: Business name: Same as Contractor H. Fcc:for branch cirunits without yervicer rr'fonder fee, finzt. 1 56.18 56.18 2 Contact name; branch circuit Each add 'I hmoch circuit 1. 7,47 7,47 7 Address: M scellaneonS (service or feeder not Included) Each ured or modular - Cily /St6tCiZll'; , dwelling, se v icc and/or f ccder _ 67.84 2 1 Reconnect only 67.84 .2 Pump or irrigation circle 67.84 2 T- mail; Sign or outline lighting 67.84 2 CON : • :` ; . ' Signnl circnil(0 Or 1imD tcrgy . • Business name: Columbia NW Heating - St Helens Electric panel, alteration, or cxtcnaion. Page 2 2 Each additIn iatinspectinn over allowable in any of the above Address: PU BAR 622 - Additional inspcclion. hr min) 66.25/hr City /State/Z1P: Scappoose, 97056 Investigation (1 hr min) 66.25/hr Industrial plant (1 br min) 78.1g/ br I'hotic: ° (503) 543.3624 Fax: (503) 543 -6285 Inspection for which no foe is 90.001 l r specifieAliy listed (Ys hr min) CC13 T 1c„' 619.47 Electric-91 Lie, 18135 Suprv, Lic,: 5 qL /A... ,:. . tL&.i'RJCAL 1!V.RMIT :TrL1s 1`.., �� subtetntt: 63.60 Suprv. Electrician signature, r>:quircd: 9/1/1;/ o • . , _ /x Plan review (25% of permit fee): Print name: Bernard C. Japs i Date: 7 -1 -11) State surcharge (12 %of permit fee): 7.63 • TOTAL PERMIT FEE: 71.23 Authcri7,,Cd Signatiire: , i 4' ® , J ; M ,4` ` /. 01 Thiw permit application expiresirapermK1r not obtained within ISO Wt.' . er � . / der; after It tom been accepted FM enmplete. Print name: Genf Jacobson Date: 7 -1 -10 ,. Nvmbct of inspeetirms allowed per permit, I' 1'emit\f314- Pcrmitnpp.rinc lain I/09 410- 1615T(11/05 /COM/WEll 07/01/2010` 14:07 5035436285 PAGE 05 ,Electrical Permit Application, - City o>F Tigard. Page 2 . - 'Supplemental Information, LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined $67.84 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* X I- Leafing, Ventilation and Air Conditioning Systctn* ❑ Vacuum ,System~* ❑ Other: CCIMME CJAL WO ONLY: Fcc for each commercial $67.84 system (SIsli (0)AR 9•8- 309 -0000) Check Type of Work Involved: ❑ . Audio and Stereo Systems ❑ Boiler controls Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ IIVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1: \ Building \PcrmiIAl LC- PermilApp.doe 10 •