Permit xq CITY OF TIGARD ELECTRICAL PERMIT
il
i ° - 1„ COMMUNITY DEVELOPMENT Permit #: ELC2010 -00358
, x.F Date Issued: 07/14/2010
T [ G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
v„, . , „ „ . , ,,,J. Parcel: 2S110AB05600
Jurisdiction: Tigard
Site,address: 11450 SW JACKIE CT
Subdivision: HAWK MEADOWS Lot: 9
Project: Shilliam
Project Description: Reconnect existing furnace and a /c.
Owner: FEES
SHILLIAM, RICHARD W & KAY F Quantity Description Date Amount
11450 SW JACKIE CT
TIGARD, OR 97224 2 crt Branch Circuits 07/14/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 591 -5223 Feeder
1 ea 12% State Surcharge - 07/14/2010 $7.63
Electrical
Contractor:
A TEMP HEATING & COOLING INC
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519
PHONE: 503 - 650 -5014
FAX: 503 - 557 -2990
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 thro 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. 1
Issued By: . J QX LMA 44L Permittee Signature: –12—___J
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' or', c 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.
07/13/2010 15:39 5035572990 A -TEMP HEATING PAGE 02/03
Electrical Permit A t10 D l � , g f * )12 (11 1.1 c 1 l ti i ( 1 , , ,I +
Dat /By; , i ? t0 , I, Pc rttlltNo.: ��� O b
N , . �� '; City of Tigard ° �� -� • • � W 17ato/B .
.,. r 13125 SW .
Ball Blvd., Tigard, Olt 97223 Plan Revlow Other Permit:
l' 1 o ' n to
4
Phone: 503.639.4171 Fax; 503.598.1960 UL 1 Daffy j RA .ee Paso 2 for
' t Ins tion Linc: 503.639.4175
Date Ready/By;
r 1'{ r /� la' �' Internet: P , 3 r OF i i �� q � U NotiRed/Method. / } S% D cntnl Information
Internet: www.ti8ard or Rov
CITY 1
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1�_Pt,'A r �:l"��3 i e 'e we,c ee olle,f.: e . 1 r e•',,e Fe:7 � { :T, '4',401,4 ",' ' 1,-, da ( • mlr.t, �
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Please dock all that apply (submit 2 sets of plan wl ohackcd below):
❑ New construction i1 Addition/alteration/replacement ❑ Service or leader 400 amps or tnoro l:3 BM ling Duct three stories.
❑ Demolition ■ Other: where the available fhult currant CI Ma nos and boatyards.
1 { � p'i� k ",y r i7. yti',.tai, 1 i r1 v~a r ig " 40 . 01 ; , r 4 .3 1 i Y ^ '� 1 a 1 ll11 i ii 44 .4,ee, eri; lvr i � k;. ' ' lei +r. a, I cs to Rrnun or accc or 0 Ca t mercial -uuse gricultural ■ 11 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all outer installations. bill linlh
Other: Op ire pump• ❑ Ins Makin of 75 KVA or
Ili Multi -family El Master budder El i tr separately derived tem.
mr 7Srt 0 t "� 1 ,r m -r w * ti 'mr ( r t hr ' r -4.1 /••(, if �h Cl Emergency system, >7 Y
o , r , {, j ! 1 1 t r 1 up,+ 1 r '1 4 7 r ' o r ° el .' ti;p i °i '
f env, "E 1 -2 , "t.3 ",
1, ,3th044, � iL i :Jr,�i o �. 1 .frio1 r : .. r.ia u J katrxw.. if t,,4•t:.dhrot +1.11�Cr�6lr It ,ip 7t ; Wt . (%l. ❑ Addition en motor load of 0 "A
ulast,,«,q M,ta?lliale �x•••na + / �' 100HPormore. occ it ncy.
.1011 no.: Jab site address: 4= "(f,0 f r ❑ Six or more residential units. ❑ Re : cntionnt vehicle park:.
�°" - / ` - � ' - { L ❑ Hcalth•care facilities. 0 ui F ly voltage for more than
City/State/ZIP: �_ / - ( a -� �Ct�� ❑Hazardolnlocations. 601 volts nominal.
1 0 Service or feeder 600 amps or mom._
Suite/bldg. /apt no.: Projcct / ii PliitA 11TpT`(r;37$,i1i "p "i"ii' � )i ^C( •
•01,(2100.4 let r :14'4' /nest tYdwn11i1* e' t. + tc 1 :Ad,i ,..S N'.i., l.d.�?.t
Cross street/directions to job site: rrcaerintbn 4 Qty - Tea Mill
New residential single- or multi -family t. welling unit
includes attached garage.
Subdivision: Lot no.: 1 ,000 sq fL or less c 168.54 4
P.a. add'l 500 sq. f. or pgrtion _ 33.92 1
Tax map /parcel no.: Limited energy, residential 67.84 2
-•-r T 5"' r 't? x 'C7 r c'^' t , •+z ru� x.1da ; r ' v ",y��,+ F'1 �y , t 77 nr n ) .. �� ��
4 41', C41,0zia; , rl:, � i VT,a,.l,C t p artr444 yl.a l tw',,,V %0!•47 1t .ucllr,L�1 it c +F ,t1 _lt11., t. �l.,` ii � s ' .ltrn•i,Fn:1 (with above °'tJ •sq. ft t
r
a 4 9 ,% w } , { rt t { ,' 4 }� a / �,., +„ 1 i u.. Limi energy, multi - family
Y � � �,/� � � � 67.84 2
r C c r `/v `_ P ■ ■ , �-.) I - residential (with above ._
Services or feeders installntion J and/or relocation
200 amps or less 100.70 2
M tale rn ! r n r ° .r yt �"M ' � ' h 1 4 l u 2
hF,TMd "a� a� *� , la ;: p'mr +ctli y t7.70 f a t + r o vrifr. n*tt1P4f lit t r i t 201 a m p s to 400 'PR 133
�,h; pG �+',G,n . �tA a t ., .: y ar a ` hl t i i. i ri W ,+lr,1 .B rnV. F tA9 c.ln ,tY,L r, . + /;u..i.
401 amps to 600 amps 200.34
Name - � ( , L 601 amps to 1,000 amps 301.04
Address: e__, _ j J ii sO SI.J .../194e-) E Over 1,000 amps or volts 552.26
___________„.
Temporary services or feeders installat.nn, alteration, and/or
City/State /SIP: t '+, relocation
Phone: ",Y ' AP I Sap' '! Fax: ( ) 200 amps or Icsa 59.36 Q
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps ! 168.54 II
Branch circuits -- new, Alteration, or ex, ensins , er panel
Owner signature Date A. Fcc for branch circuits with
MN:, 'r�"1 1''•^ yy l,� t r" r ,tl ,}' If ' r f :4'9 1 r , �^ 7 7'1 rt 1 , y , qi 7.717^ ic
ab serve or feed fee
1 %vfv ill 't'�'fC1t �ixr A ,F. inr+.I.l`erl L �1A r .{,k➢li'earl'tf 1�!r.Y1� 6!�6'0.,�f �7G 1:(il!'�ht1�4!; 'u � � ii Pd N"nY(�., L�i:r^ir} � .G �: �i,i a {i, ,,,4,,,.10 :ALu,:,,3,y 7.42 2
r � C.9C bran C
1 I . + A 11 41 , & B. Fcc for branch circuits y •�
�• � without service or fcc cr fee, 56.18 lei '�
Contact name: ; t i - '.'A first branch circuit `J�
Each add'I branch circuit; I 7.42 ado
Address: A �1 d_
T Miscellaneous (serv r f eeder not in laded)
City/State/ZIP: j - - ` 0 a Each manufactured or rrtodular 67.84 2
� y t ��++,, dwelling, service and /or jccdcr
Phone: � 1 1 ax: ' . r r� t ltcconnect only - 67.84 2
E -mail Pump or irrigation circle 67.84 2
y r ,� ti , r , f a: , m, w rt � ^� r „ „°l r ' rc 1 , I 1 ^ fit! t �' , :71 Sign or outline • lighting 67.84 2
: { a1i �+,l �,.l +t+s ATARlt� �e '�iv,e"+ ton. iw.�r.fi�l'ni,„c' �i.+ .iLk∎:14111i1 :14,1,,,o.4:lllto∎ ,a
Signal circuits) or limited-
L 0 S . 4 • al 1. ■ , k C .+• ' energy panel, alteration, or
Address: e► rii l extension. Describe: Page 2 2 -
1,i .. A, OA). / 9-7 Each additional inspection overallows alein any of the above
( 4 V 1 Per inspection 66.25
Pax. C I r , . C lnvcntigation per hour (1 hr min) 66.25 • per ho
t
♦ r✓ Industrial plan purs 78.18
Suprv. Lie.: plan p ..., u ti .i i ! l it i a r , y . r 1' (irJ�1 :�1;iJ
Suprv. Electrician signature, required: i
i CCB Lic.: ` Electrical Lie.: p �p
Vif tie{ � l�t al "frl I: '1�'.1, 11111' �ft y1A1 Jr;: ,n' e.t u.4�nb��aGl�
1
+ ru'i 4.u+.,'lwn.v *,xnv` <.t +uu .;,a,.o .
• St''ltotal: �r� er il
Date: •. Plan review (25% of pun t fee):
Print name: a 00: . 111 r State surcharge (12% of perm t fee): '
/ r 1 l • ; YOTAL PERM!' FEE: r
Authorized signature:
0. .! ��
This permit npplledtlon eptplres if a perm* is not obtain • Ithte 180 `-�
Print name �' 1 . x_ A..w �11 cM kd Date: 00 clays after It era been aeeepte 1 as complete.
Ar
r/� ' * Number of inspectio ly f owed DC
1. 1auiidlna \Permitx\ELC- PCrntltAPp.d•• 10/01/00 -- t. '(1l /05 /CO MIWea
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