Permit CITY OF TIG 4RD
ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00344
13125 SWHallBlvd., Tigard OR 97223 503.639.4171 Date Issued: 07/08/2010
T1GAR 9 Parcel: 2S110DD12300
• Jurisdiction: Tigard
Site address: 10720 SW HIGHLAND DR
Subdivision: Lot: 0
Project: Sunby
Project Description: Panel replacement.
Owner: FEES
SUNDBY, HERB & RUTH FAMILY TRUST Quantity Description Date Amount
10720 SW HIGHLAND CIR
TIGARD, OR 97224 1 ea Services or Feeders - 200 07/08/2010 $100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 07/08/2010 $12.08
Electrical
Contractor:
BOONES FERRY ELECTRIC INC
PO BOX 628
WILSONVILLE, OR 97070
PHONE: 503 - 682 -4936
FAX: 503 - 682 -7946
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $112.78
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 bf Efts r les or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. • Issued Permittee Signature: 2 '� `.
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.
Jul. 7, 201.0 12:44PM 503 639
Phone No 4353 R. 1
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ii Date/By: I 9 6 Permit No..
• 131zs SW xall 131�d T;gard, OR 97' �C.i 0 - av4
' , ` «7i IN l one .4171 Fax: 503:598 0
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aam/B other Permit: -
2010
Dam/By:
c +� writ Inspect L 5 Date Ready/By: Sufi ES` See Page 2 for . - -
x; lrltemet www.tigatd f.gbv Ci -- a NetifiedlMethod: Su lemental Information
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w. „,a., U��R t r 6 r” . t ✓s wrr r ,�.A,r t " j:'"""� a s' r ''r,Fl r �r"'i"a ESQ M . "/p w r'k""" �M . r r,u cr *r 0 • "4
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Plesse•eheck ell that I submit seta construction >i Addition/alteration/replacement a y{ � sera of Pali w ditema checked below):: '
❑ Service or feeder 400 amps or mote ❑ Building—Over three stones.
0 Demolition ❑ Other where the available fault current D Marinas and boatyards.
. r rr , ` ti r 7 r r , < v 5; j* a r t "' { r rs > r ra 2 ' ; ,. r n ? iltf3> ar exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
1 - and 2 wellin Comm ercial/industrial less to gonad, or exceeds 14,000 CI Commercial -use agricultural .
y g ❑ ❑Accessory buildin amps for all othcr installatioas. buildings..
❑ Mult ifamily ❑Master builder ❑ Other: 0 File pump. ❑ installation of 75 F:VA or
-;•-•• r- ,-- r^ r / + r yw ,,. y •a ., y:ra .« ❑ Emergeneysystem mtel derived tcm.
''.:2 ,,?., Yl4 ,w ' r r e 71 d . "v . "r r! 7 9 a I'll G 9 • 1r . r >• 'r..r a P SY?
w,.,;rr;a � + , n ar e � > ^r , aw. r r r r 1 r,r now motor load Of
- - - _. � .,:, t..,.:.... t.r t A..r�, r .. � .,...... s . ...... , .. , t.t :;2r,.... ' 1] Addition arger 5e a of m Cl O .. _ j> ... 1 . 3 ..
Job n0:: / 6 $ 21 0 Job site address: / 6 7 2 6 S L./ 1-1 f g i l 1001 -1P or more. occupancy.
l A h `+ ` [] Six or more residential units. O Recreational vehicle parks.
City /Stafe/ZIP: 1 1 1 � �
p r 0 Health care facilities. ❑ Supply voltage for more the*
,
/ 0 Hazardous locations 600 volts nominal.
Suite/bldg. /apt no.:. i Project name: 0 Service or feeder 600 amps or more
s >' rrwnraw .'"
Cross street/ 1irections to job site: D •• • •w r •, w., "cn..;,; x . „x. ... �aa f. rx a t t ..
j Description O t,: F. Mal _ .� ^"
New residential single or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add 'I 500 sq., or portion 33.92 1
Tax •trap /parcel no - - -
r •s t 7ru 7 Limited energy, q ft) nits] 67 "84 2
'r , 1� s, f y r. N ., b *. r r C b, r ^;+ j 1 n
r, , u t �„ ,�• �, a � (w alcove sq. ft.)
Jr.F,Y� J...�: .�r.: ". ,^�. ...�. ..r_, . .... _.�_._c.,. .. .,.".wf);;. r ,.,r,,,., .rf�t,.,a.. ,,
Lim energy, mult - fam
r e sidential (with above ft.) 67.84 2
Porgy: I c h�,. sq.
a. Services or. feeders installation alteration, and/or relocation
200 amps or less 1 100.70 ((1.10 2
C. Y Y2 a 1 a4i,", .YM l H` h •. . , h m. T . ! _ _
, raft r t M C :. e t : �' , x yr . 201 amps t0 400 amps 133.56
....., „.,.,. . i. t 9d*w..,, 9^*” „ ':� ,..Sr �?�- ^,.!.r �. r..r r .�, � w , �: J ) .� ... ... ti 3+xm�. ^ °U.. ,oA�l,',I, ?r� „t. :i
2
401 amps to 600 amps 200.34 2
Name. c v: n 4 b f - 601 amps to 1,000 amps. 301:04 _ 2
.ddress:' . p A Over 1,000 amps or volts • 55226. 2
- Teiuporary services or feeders instillation, alteration, and/or
-
City /StateIZIP: - ) relocation
Phone: ( ) F ( ) 200 amps or less 59.36 1
Owner` installation: This installation is being made on property that I own which is not 201 amps to 000 amps 125.08 2.
intended.fotsale,.1ease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 am to 599 amps _ _ 168.54 2
Branch circuits new, alteration, or extension, per panel
. Owner signature;'._ :' _ Date: A. Fee for branch circuits with
%r _..a ✓1 r ; � rzz, ' r . d t s ',W, r 'r a wav ` above service or feeder fee, 7.42 2
. r.' CZ i :S•,'r�IiL-,.... .,: , _ k;:i.....,1
, a ' _no:
.„!..«Z ..4',. ,,. .'
._. Z::;..< -{ each branch circuit _
Business names B. Fee for branch circuits without
- service or seeder Fee, first 56.18 2
Contact name: _ branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included) _
City/State/ZIP: Each manufactured or modular 67:84 2
ty /State /ZIP: dwcnia , service and/or feeder
Phone: ( )
Fax:: (• ) Reconnect only 67.84 2
Pomp or irrigation circle 67.84 2
E-mail:
o
sign g<l r outline lighting 67,84 2
. s , > ^-.- •c, { .. c 4 , a ^T•rm e �+. . ,c } nth .. 1 r « , ,lnx : v
) 7, .
,: ,• r •5 r *w ..rc ..__....7;* —a ,.� Signal circuit(s) or limited - allergy
,...«....:.wa..,.,,�.�. _ - panel, alteration, or extension. Page 2 2
Business name: Booties :Ferry Electric
Each additional inspection over allowable du any of the above
Address .P.O •Box 628 Additional inspection (1 hr min) 6625/ to
City/State/ZIP: — ]rry ®susa?on (1 to min) 66.25/ hr
Wilsonville OR 97070
Industrial plant (1 hr min.) 78.18! hr
Phone: (503) 682 -4936 Fax: (503) 682 -7946 Inspections for which no fee is 90,00 / hi
s, - ciftcally listed % hr min •
CCB Lic.: 88482 Electrical Lic.; 3 -223C Suprv_ Lic.: , /.95 ':'..0:E. n I,is„ y!.;c r " , ,,,,l n,.RS L a ? T
Suprv. Electrician signature, re aired: AS / Subtotal: l 0 0 , 77)
Su
P Sri q for ;E Plan review (25% of permit fee):
Print Warne: ' ” , � / ,/�„ �,_„_, Date: 7/4/ • State surcharge (12% of permit fee): /Z , U Z
TOTAL PERMIT FEE: i / 2 , 7
Authorized signature: This permit application expires if a permit is not obtained within 180
--- - days after it has been accepted as complete
Print name: Date: ' Number of inspections allowed per permit.
(:1BuifdinglPermit6FLC -Perrmi paler 10/01/09 410- 4615T(11 /05 /COM/WEB
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