Permit CITY OF TIGARD BUILDING PERMIT
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COMMUNITY DEVELOPMENT Permit #: ELC2009-00282
, ' c `^ Date Issued: 06/11 /2009
T t c ARL)! 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S1 04C B04000
' Jurisdiction: Tigard
Site address: 13324 SW ASCENSION DR
Subdivision: HILLSHIRE WOODS Lot: 86
Project: Mills
Project Description: Install /alter (1) branch circuit for a/c unit.
Owner: FEES
MILLS, ALAN J & CATHLEEN A Description Date Amount
13324 SW ASCENSION DR Branch Circuits wo /Purchase Service or 06/11/2009 $46.85
TIGARD, OR 97223 Feeder
PHONE: 12% State Surcharge - Electrical 06/11/2009 $5.62
Contractor: _
HILLSBORO ELECTRIC LLC stsn'i i - 1j\f�4X `)� ! (.5 S O
21185 NW EVERGREEN PKWY #110
HILLSBORO, OR 97124
PHONE: 503 - 439 -9666 tS
FAX: 503 - 601 -3680 w
Specifics: `r YEA 1'tIvN__, BO ti h� C71 4 - 43 Ge:, •
Type of Use: SF
Class of Work: ALT Sc(-A)4 V' L • r
Dwelling Units:
Stories: Height: ft
Bedrooms: Bathrooms:
Value: $0
Floor Areas:
Total Area:
Accessory Struct:
Basement:
Carport:
Covered Porch:
Deck:
Garage:
Mezzanine:
Total $52.47
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking:
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: Permittee Signature:
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.
11111- CITY OF TIGARD ELECTRICAL PERMIT
:.. COMMUNITY DEVELOPMENT Permit #: ELC2009 -00282
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/11/2009
Parcel: 2S104CB04000
Jurisdiction: Tigard
•
Site address: 13324 -SW ASCENSION_DR
Subdivision: HILLSHIRE WOODS Lot: 86
Project: Mills
Project Description: Install /alter (1) branch circuit for a/c unit.
Owner: FEES
MILLS, ALAN J & CATHLEEN A Quantity Description Date Amount
13324 SW ASCENSION DR
TIGARD, OR 97223 1 crt Branch Circuits 06/11/2009 $46.85
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/11/2009 $5.62
Electrical •
Contractor:
HILLSBORO ELECTRIC LLC
21185 NW EVERGREEN PKWY #110
HILLSBORO, OR 97124
PHONE: 503 - 439 -9666
FAX: 503 - 601 -3680
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $52.47
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 *ea fi A_ r ( _ I . ♦ 1 _ 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.
1
r 1, ecc 3- 601 -3680
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06- 09 -'09 14:55 FROM- Hillsboric
' Electrical Pe rmit A P ...___ On il E ,9 IV � _ qq11 �, E:
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13125 SW Hall 131vd., Tigard, OR 97223 JUN 0 9 2009 In
Pff "I ,t No, Ca bQ4 `�� „
III
Phone: 503,639.4171 Fax; 503.598,1960 Plan Review �_
fl, ;l ' ? r',.6 Inspection Line: 503.639.4175' Ready/BY l�I t ► � I���D r othctt ,nir
Date s Internet: www.tigard -0r.gov BUILDING DIVISION . Nodficd/Metbod; 65 See Page afar
I
-- - � Supplemental Information
-. TYPE OI? WORK PLAN REVIEW �-
O New Construction Addition /alteration/replacement platy chaok all that apply (submit sets of plans w /items chccked Wow): t—► DCmolif ion Other: 0 Service or finedcr 400 amps or more ❑ Building over three Aeries,
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ls0 volts or 0 Floating buildings.
l - and 2- family dwelling ❑ ComtnerciaUindustrial teas to
Accessory building � - g °T 5 t ,000 d b Idin , al.use agricultural
❑ Multi family 0 Master builder F ire for all ot4er i bu
Other: 0 pump. 0 InstaUatioa 431'75 KVA or
JOB SITE INFORMATION AND LOCATION
❑ ❑ Emergency system. larger separately datived system.
Job n0.. � � Job Addition of new motor load or 0 ' A^ °B' ^1 -2» "1 -3"
i1 *1 site address: ' 1001W or mote.
.L �. ' ► may
City /StatC/Z1P: C7 Six or mom residential units. ❑ Reawtional vehicle parks.
7 j ❑ Health -care facilitie ❑ Supply voltage fir more than
Suite/bldg./apt. no Ptnjeet name. 0 ens locations. 600 volts nominal.
11/4,4116., ❑ Servicb or feeds 600 amps or more.
Cross street/directions coons to job site: FEE SCHETPULI,
1�> •
_ New residential single- or multi-fhmily dwelling unit.
Subd r ost1V n; Includes attached garage,
_ . I Lot no.: _1,000 sq. ft. or less 11 145.15 Ell 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.40
Limited en 1
DESCRIPTION OF WORK may, r esidential 75.00 2
with above y ited energy, , fl.2 -
i im multi- family
residential with above ... 8. 75-00 2
Services or feeders installation alteration and/or relocation
!PROPERTY O ER 200 amps or less 80.30 2
Name: Q TENANT 201 amps to 400 amps 106.85 2
2 amps to 600 160.60 2
Address: 601 amps to 1,000 amps 240.60 2
_ _ Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders inat*Uatlon, alteration, and/or
Phone: ( ) —
--
relocation
T Fax: ( ) 200 amps or less 66.85 1
Owner installation; This installation is being made on property that I own which is not 201 harps to 400 amps [00.30
intended for sale, lease, tt nt, or exchan f 2
sew according to ORS 447, 449 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: each d>rc��- new, alteration, or extensloo, per
A Fee for branch cir uits with panel
0 APPI,ICAiVj Q CONi1►4'r 70 0014 above service or feeder fee,
Business name: each branch circuit 6 . 6 5 2
B. Fee for branchcircuits
Contact name mogul Serv or lhuler fee,
first branch circuit I 46.85 g 2
Address: Bade add'! branch circu
City/State /UP: -
- Miacdlaneons (servlse or feeder not iadnded)_ 2
Each manufaCdtmd or modular
Phone: ( ) p ax:: ( ) dwellin service artd/orficder 2
E Reconnect only 66.85 2
COMPACTOR 1RA CrpR Pump ° f'Bion circle 53.40 2
Sign m outline lighting 53 2
Business name: HILI;SBORO E .Ec TC r r Signal circuits) or limited -
"' energy Panel, alteration, or
Address: 211 g 5 NW EVERGREEN PKWY #110 ension. Describe:
PagC 2 2
City /StateJZIP: H ILL SBORO OR 97'124 Each additional ins. don over allowable in a of for above
phone: (5 0 3) 439-966 ti Fa x : ( )601-36:0 Per insplsction d2 -50
5 0 3 Investigation per bout (i br min) 62.50
CCB Lie.: 134481
Electrical Lie.:
34_499 Su P rv. Lie.: 4 9 41 49415 - Industrial plant per hour 73.75
Suprv. Electrician signature, required: ELECTRICAL PERMIT FEES
Subtotal: 1
Print name: JO y� VI TALC P Date: Han review (25% of permit fix):
Authorized signatutre:` , , State sur (12% ofpermit fee):
�t TOTAL PERMIT FEE: 4
Tble
Print name: Per e ppl k fjon es re
` s ifs permk is not obq ned within 180
days after it his been accepted an complete.
t: lB�yildinglpenmUaV ?LC.PgrmitApp. 05/23R16 • Number of inspections allowed per permit.
440 - 461510 I /05 /COtut/WEH