Permit CITY OF TIGARD ELECTRICAL PERMIT
a
COMMUNITY DEVELOPMENT Pemtit #: ELC2010 -00410
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/06/2010
T I GA RT? 9 Parcel: 1 S 134AB90051
Jurisdiction: TIGARD
Site address: 11263 SW SPRINGWOOD DR, UNIT# 5
Subdivision: Lot: 0
Project: SPRINGWOOD VILLAGE CONDOS
Project Description: Additional inspection for electrical in kitchen.
Owner: FEES
SPRINGWOOD /MILESTONE LLC Quantity Description Date Amount
BY PRINCETON PROPERTY MANAGEMENT,
7831 SE LAKE RD STE #200 1 ea Per Inspection 08/06/2010 $66.25
PHONE: 1 ea 12% State Surcharge - 08/06/2010 $7.95
Electrical
Contractor:
CONNECTIONS ELECTRIC INC
PO BOX 7136
SALEM, OR 97303 -0026
PHONE: 503 - 390 -7914
FAX: 503- 463 -6863
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $74.20
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 cop • • = . - -r direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. "
Issued By: r�/ � Perm ittee 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.
08/04/2010 15:30 5034636863, R iik� ��CONNECTIONS ELECTRIC #1151 P.002/002
d11 '
Electrical: Permit A_pplicatio � �L' ' k I OIK 011 ' IC L USE
City of Tigard AUG 4 2010 Reserved Pennu No.. 0,(0
'+ 13125 SW Hall Blvd., Tigard, OR 97223 Datue
j,L
.rD Phone: 503.630.4171 Fax: 503,598.19 ¢Q Plan Review
� V f,r, y-1 I• A R D.
� t p Othu Pamtir.
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TtG{ iW • • IDSpeetion Line: 503.639.4175 t h Dat ug : Read /e El See Page 2 for
„:.•� Internet: www- tigard- or.gov BUILDING DlVl.S1 , Notified/Medwd: r SupplemcuaU lafarmation
`NL•Oi:.WOIrK PLAN REVIEW
. ❑ New construction Addition/alteration/replacement Ploase ahcck all that apply (submit g seise! paws w /iicrni chucked bctnwi
❑ Service or feeder 400 amps or more ❑ Building over three stoncx.
. ❑ Demolition Q Other: where the 141101a fault current ❑ MAMAS and boatyards
• CATEGORY OF CONSTRUCTION . exceeds 10.000 amps a1 110 volts or LI Floating buildings.
teas to ground. or exceeds 14,000 0 Commercial -use agricultural
• 0 1 - and 2- family duelling 0 Commercial /industrial 0 Accessory building amp for ell otheru,stallaiions. buildings.
• FMulti family C a Master builder 0 Other: ❑ F n a pump. Q Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION Cl Eminency system. longer separately derived system. I A*1'160n of new motor load of ❑ "A' ••E" ••1 -2'• -1 - i • '
Job no.: )ob site address: S J!• w 100HPormore. oceupmic
p ri ,3 woad Pr • • Q Six a• mere residential touts. ❑ Recreational vehicle parks
City/State/ZIP: t 0 Health -care (tteilities. Q supply voltage rot More than
Qrd / O� 7 ?�a' .3 LI Hazardous location, 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or mare.
FCE SCI-ICDULE
•
Cross streeudireetions to job site: oereriproo - 1' Qtv. L aK. _J.. Total )^•
New residential single- or multi - family dwelling unit. •
• Includes attached garage.
Subdivision: Lot no.. 1,000 sq, ft. or less 168 54 1
Ea. add'I 500 54. 11. or portion 33.92 1
Tax rnap/parcel no.. Limited energy, residential
DESCRIPTION OP WORK (with above sq. tt.) 67.84 3
- Limited energy. multi- family 67.84
C i a , u.'4 u • wi ,
, , . .. • • r o , er residential (with above sg. f1.1 _
Services or feeders installation and /or relocation
'S '0 , f dr ah5 . 200atnpsorless 100.70 2
0 PROPER OWNER • Q TENANT 201 amps to 400 amps 133.56 2
N ame: `A \ ( � , 401 amps to 600 amps 200.34 2
f- • V �
601 apps to 1,0 00 amps 301.04
Address: ` \` U �1 j ,, Over 1,000 amps or volts 552.26 2
Cit)iState /ZIP: j �J" � 1 �,t67`� 1- ! Temporar services Or feeders installation, alteration, and /or
` relocation
Phone: ( 1 Fax: i ) 200 amps or less 59 36 l T
201 amp to 400 amps 125.08 2
•
_ Owner installation: This installation is being made on property that I own which is not 1 i
intended for sale. lease, rent, or exchange. according to ORS 447, 449, 670. and 701. 401 amps to 599 gips 168.54
Branca circuits - new, alteration. or extension, Rey panel
Owner signature: Date: A. Fee for branch circuits with
0 APPLICANT 1 0 CONTACT PERSON above service or feeder fee, 7 42
each brunch circuit
• Business name: 8. Fee far branch circuits without
service or feeder fee. first 56.18 2
Contact name: branch circuit
Each WWI branch circuit 7.42 ,
Address; Miscellaneous (service or feeder not included)
Cir)• /State/ZIP: Each manufactured or modula 67 84
dwelling, service and/or feeder
Phone; ( ) I Fax:: ( ) Reconnect only 67 84 2
. E -mail:
Pump or irrigation circle 67.84 2
Signor outline lighting 67.84 2
CONTRACTOR'
Signal cimeit(s) or limited- energy •
Business name: , - � [�T 1 panel, alteration. or extension. Page 2 2
canine tpytf ClYiG, rnC . Each additional inspiecrion over allowable in any of the above
.Address: pd. 15fiK 7134 Additional inspection(I hr min) j 66.25/ hr l o,.
Investigation (I hr min) 66.25 / hr
City/State/ZIP:
Sal OR, 9730 5 - . -
Industrial plant (I hr min) 78.18/ hr
ne: 1(SD ) Fax: i nspections f or which n o fee is
3 .3 -7
Pho (I - S OS ��3 - 68�� 90.00/ hr
specifically listed (% hr min)
CCB Lic.; ( 4/9 Electrical Lie.: 2,4-3.448z, Suprv. Lic.: 34 115 ELECTRICAL FEES
Suprv. Electrician signature. required:,.... subtotal: ' 616' 1"5 Plan review (23% of permit Pee):
Print name: M A VVi ri £45GV;1'V _ Date; g_ `l - /0 State surcharge (12% of permit fee): "AI
TOTAL PERMIT FEE: '
Authorized Signature: This permit appolcariaa expires if a permit is not obtained within 180
days After it bus been accepted ns complete.
• Print name: Date: • Number of inspections allowed per permit.
. 1 iluddh Pa7nux,ELC•PrnaiLApp 10 4404615T1 105
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