Permit . .. CITY OF TIGARD ELECTRICAL PERMIT
IL
; COMMUNITY DEVELOPMENT Permit #: ELC201000416
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/12/2010
Parcel: 2S111AA02600
Jurisdiction: Tigard
Site address: 14325 SW 86TH AVE
Subdivision: GREENSWARD PARK Lot: 12
Project: Broudous
Project Description: Reconnenct only.
Owner: FEES
FANNIE MAE Quantity Description Date Amount
14325 SW 86TH AVE
TIGARD, OR 97224 1 ea Reconnect Only 08/12/2010 $67.84
PHONE: 1 ea 12% State Surcharge - 08/12/2010 $8.14
Electrical
Contractor:
PHONE:
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports (Conditions)
1
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes an. 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 work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cente • • = rules are set forth in OAR
952 - 001 -0010 through OA: ,- - 001 -0100. You ma o • -' • - - •, . e rules or • 1 = • questions to OUNC by calling 503.24 • : • • 9 or 1::00.33..2344.
Issued By �/ %� - Permittee Signature: , ,d∎ ^�
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.
AUG. 12. 2010 9:26AM REMAX EQUITY GROUP NO. 6039 P. 2
Electrical Permit Application ° r OR 01 T h (N1:1 _
r . otia ` Received
City of Tigard f' �,, - � Dathm erB ; ANT= = PermitNo.: E ,, — y
■ 13125 SW Hall Blvd, Tigard, OR 97 .s
i . q P Review
Other Permit
Phone: 503,639,4171 Fax 503.598.1 • .
I N
' 1 Y `�,�� 0 Date/B :
'''� - `\ ' Inspection Line: 503.639.4175 e Ready /By: Juris: 0 See Page 2 for
...___ , Internet: www.tigard or.gov \' � , , -., `, Ik¢' • ed/Method: 7-& Supplemental Information
� A,pl. 'W"' - ''' 4+ . ,, a 3 1 {. • :- x a. 6 li d t. ` . , � rF • —1 e1. , .. .4 ? ' t , .I 5 fir ., :u
Grrn . ri , tM�J �--- "',,�.... �1 ` 1f1_�I IO � t J �2 I ;tti k r 4 ,,,k2- , w'• •.4+. r t r f' � g;/, • � ., ! .,k �. /'� ". "fir � , laa
EJ New construction ❑ Addition /alteration /replacame'l`t \v - Please check all that apply (submit 2 seta of plans w/items checked below):
1 0 Service or feeder 400 amps or more Q 1:lulling over three stories,
❑ Demolition ($_Other: I t y b elf where the available fault cultent Q Marinas and boatyards,
t 'art 4 r t
/+^r"�'' i � I • n^ n 1 I� `)r . "" r;, T 0 I n . x :„4' xs ;,an "' -'' i 1" °' exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commeroinl•use agricultural
❑ 1 and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fun pump. ❑ Installation of 751CVA or
a V o ti t i` t, ° .r ❑ Emergency system. larger separately derived system.
i �` r .v �'� ,� _q 1.'.1, �.,: N 1u� d i ' I �
rd)� �
r � / ` o rI• f .,,, , S I +i; I , I: Jr ❑Addition of new motor toad of ❑ "A ". "E". "1 -2" '
A ve.
100HP or more. occupancy.
Job no /DOA Job site address: /1/ o N.,-/t, 0 Six or more residential units. ❑ Recreational vehicle parks.
City /Statc/ZIP: / T 9 7 �7 <1 ❑ health -taro facilities. Q Supply voltage for more than
G� „rd t � D` a Q Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: J Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: ": r 7, .° t i x r g 4: i _a¢ sl[ �<<,:;r , fir I, ,.''
• ofstriplion Qty. tree, Torsi
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 1613.54 4
Tax map /parcel no.: , / r ' </g" Ea add'1500 sq. ft. or portion 33.92 1
p h ; - Limited energy, residential
i,i,
... ' ' (with above ft. 75.00 2
I�t N . 1'i i "t f', � •u I)I,ia`/ f t' � GI U1 yy `•�,�r f
:ud9:1. hrt>Jti .w?c._. A��. �" ... "v:.. ,'ry4��it.. �tJ�LL��i. .w't'A� , )
�,r I- / ]halted energy, multi - family 75.00 2
?O l.� 5P� ����)) rt° a'k /�, � tn2A s . /.J ( residential (with above sq. ft.) _
l "l Services or feeders installation, alteration, and/or relocation
s -6" f' n E i ti l ii Q3'1 P uXv- 200 snips or less 100.70 2
;ti: ; '" t,:•' w- l , i ti ,, e p !„..s,a Oi ° i ` IT" u. , .. '" 201 amps mps to 400 amps 133.56 2
, a • •� I 1 y �a; ���. "�.l,,I�I 1',, i� ��tY���',I- ,� ,�il � � . � . d, t,
� I 401 amps to 600 amps 200.34 2
Namc: F r1 r)12 9 ! r el tail 6 all amps to 1000 am 301.04 2
•
Q �� q 601 am , amps
Address: U ecyx C2 a 7 (9 796 ma e � 4' nib , ( ,�t,(p 1 over 1,000atnpsor 552.26 2
City/State/ZIP: Pt;? t, Rd C (9 7 D ' � -6-- relocatiTemporary services or feeders installation, alteration, and /or
Phone: (505) 4/q5 -- 4 94/ ' I Fax: ( .gam r505 z 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 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, per panel
Owner signature: Date: A. Fee for branch circuits with
r { „ a . v above service or feeder fee,
:(� ?,�.• ,� F r-.44: _R�ilC'r 1450,, "9"" it r I11,1V k;,,Q.0 s "J ¢.'� 00.. ' k. 7,42 2 • a ea Ch branch circuit
Business name: M eJ j i' h b j,rsr, (40 f.c. D. Fee foe branch circuits rvithoat
service or feeder fee, first
56.18 2
Contact name: " 1 J rr1 /,�,���� branch circuit
'�J" Each add'I branch circuit 7.42 2
Address: -5../1-71(1 e 45 4,bpn/Q Miscellaneous (service or feeder not included)
Ciry /State /ZIP: Each manufactured or modular 67.84 2
dwelling. service and/or feeder
Phone: (503 ) '95 —4i &5 A P , : (5) q 5 - 5C5 2_ Reconnect only I 67.84 4,7,E 2
✓�'l eel 0 l , y c. - 14 ;111,!.._ • C (J C 0T i Sump r irrigation
tl i ne lighting t i ng a 67.84 2
E r.T Sign or outline lighting 67.84 2
v / ' 11.1 z = "1 y i ! I' ! II �r + I W Signal circuits) or limited -energy
Business name: panel, alteration, or extension. Paget 2
Each additional ingtection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: Investigation (1 hr min) 66.25/ hr
_ _ Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00/ hr
s. kcal listed )5 hr min)
CCB Lio.: Electrical Lic.: Suprv. Lic.: t ";¢•',,: 4s 1;; ,,• b is ,ni i .i u , t i,, ; Y) tt, , y ,__ _ ._!r ,E`!,"'*il Tit
Suprv. Electrician signaN required: a Subtotal: - (a,,,
Plan review (25 /s of permit fee):
Print name: , Date: State surcharge (12 % of permit fee): 1 It
Authorized signature: TOTAL PERMIT FEE:
1 ` This permit application expires ira permit is not ob ed within 150
/ days after it has been accepted as complete.
Print name: rN if J i J �. , DdtC: /I , Number of inspections allowed per permit.
t,\Epi1dmg \P mils\EIC- PmnilApp,de° 07/01/10 440A61ST(11 /05 /CQM/WP8