Permit f CITY OF TIGARD ELECTRICAL PERMIT
-! . . C COMMUNITY DEVELOPMENT Permit #: ELC2010 00370
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2010
Parcel: 2S114BA16700
Jurisdiction: Tigard
Site address: 9750 SW DURHAM RD
Subdivision: Lot: 0
Project: Clary
Project Description:
Owner: FEES
CLARY, RHONDA V Quantity Description Date Amount
9750 SW DURHAM RD
TIGARD, OR 97224 2 crt Branch Circuits 07/21/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 579 -6354 Feeder
1 ea 12% State Surcharge - 07/21/2010 $7.63
Electrical
Contractor:
TYLER ELECTRIC LLC
PO BOX 807
MULINO, OR 97042
PHONE: 503 -829 -2498
FAX: 503 - 829 -5747
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: / t�C Permittee Signature: Zr/t/ I91/ 1. l Cc/ i 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 603.639.4176 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.
2010 -07 -16 16:55 GRF ELECTRIC 5038295747» 5035981960 P 1/2
Electrical Permit A h() l, 111 l' II 1 tit ( 1\► )-
City of Tigard Received 7 'VA() eVrPermit No re6 /4 ' eai711
1101 • 13125 SW Hall Blvd., Tigard, OR 97223 C [ . (j iQ Plan Review
>z ; Phone: 503.639.4171 Fax: 503.598.1960 j , ) L. 6 Date/By: Other Permii/yEra20/0 'Q .e .3°2.2
Inspection Line: 503.639.4175 Date Ready ctlxi /isy. i mi E1 See Page 7 for
i t c nitu' Internet: www.tigard-or.gov CITY OF TGAR N �/ (� Supplemental Information
I
/
TYPE OF �. T 1 ' • PLAN REVIEW
I
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ Service or feeder 400 amps or more ❑ Building over throe stories.
Lri Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to Found, or exceeds 14,000 ❑ Commercial -use agnctdtural
I 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire Pump ❑ Installation of 75 KvA or
❑ Emergency system. larger separately derived system.
.108 SITE INFORMATION AND LOCATION Cl Addition of new motor Load of ❑ "A - ,"E","1 '1
1 DOHP or more. occupancy.
Job no.: Job site address: 9 7S d 3 ( Q iA. Y L G y ,,, ❑ Six or,nore residential units. ❑ Recreational vehicle parks.
C ity / State/ZIP: -r- - 7 L Z ❑ Health -care facilities 0 Supply voltage for more than
■ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt, no.: Project name: G 1 G ❑ Service or feeder 600 amps or more.
_ _ FEE SCHEDULE
Cross strect/directions to job site: tkteriettee 1 Qre. 1 Fee. 1 Total 1 •
New residential single• or multi - family dwelling unit.
Includes attached garage. _
—
Subdivision: Lot no.: 1,000 sq. R or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: ' Limited cncrgy, residential 67.84 2
DESCRIPTION OF WORK (with above all) r ,
�,'"`. Limited energy, multi - family 67.84 2
if , residential (with above sc. R)
• Services or feeders installation, alteration, and/or relocatio
],." - 200 amps or less 100.70 2
L`J PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name: r� -
601 a mps to 1,000 amps 301,04 2
[ L
Address: Cl � Lt) a �r 4(4 44 _ Over 1,000 amps or volts 552.26 2
- f Temporary services or feeders installation, alteration, and /or
City / State/ZIP:
`1'-] LL �- relocation
Phone: ( ) 5 7 r,.....,„..._
A s , Fax: ( ) _
200 amps or less 59.36 I
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 46D amps 12508 2
intended for sale, lease, rent, or exchange. according to ORS 447, 449.670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, . r panel
Owner signature: Date: A. Fee for branch circuits with
W ❑ APPLICANT --- ❑ CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fcc for branch circuits
- without servioe Or feeder fee, (
56.18 cl f A 2
Contact name: first branch circuit
Address: Each add'I branch circuit 1 7.42 1 `f Z. 2
Miscellaneous (service or feeder not Included
City /State/ZIP: Each manufactured or modular 6784 2
dwelling., service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
w
CONTRACTOR Sign or outline lighting 67.84 2
,r L. L. 1. Signal circuits) or limited-
Business name: i t J ` r � e_ j- - ( , / energy panel. alteration, or
Address: extension. Describe: Page 2 2
1
City /State/ZIP: 44 ., 2 Each additional inspection over allowable in an the a bove
d Per inspection 66.25
Phone: (5 ) 9 Z ci - t f Fax: (l ' T) 7Li ' S Inyc tigntion per hour (1 hr mm) 66,25 - _
t Lie.: (i{. + 0 V G ' Electrical Lie.: 3 i f C s'i + uprv. Lie.; t} 7 0 9 5 ndustrial plant per hour 78. l8
/ �� ELECTRICAL PERMIT FEES
Suprv. Electrician signal ,t �,M _ Subtotal: rt, 1, Plan review (25% permit fee): - `f' 4°''C
Print nam e: ,Gt ,/ u i (? Y te: I " f State surcharge (12% of permit fee): r /
Authorized signature: ' ' 1 l / / ToTnh rittnu�r ILL i 4 � - /
This permit application aspires if a permit is not obtalr4witLin IRO
Print name: , ic , - , 1116,5 ) e r Date _ days after it has been accepted as complete.