Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 00467
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/01/2010
Parcel: 1S135CA90137
Jurisdiction: Tigard
Site address: 11048 SW GREENBURG RD 137
Subdivision: ASH CREEK CONDOMINIUMS Lot: 0
Project: Ash Creek Condominiums
Project Description: Units: 137, 243, 345. Replacing (1) service and (1) branch circuit per unit due to fire damage.
Owner: FEES
NESS, RUSSEL B Quantity Description Date Amount
11048 SW GREENBURG RD #137
TIGARD, OR 97223 3 ea Services or Feeders - 200 09/01/2010 $302.10
amps or Tess
PHONE: 3 crt Branch Circuits w /Purchase 09/01/2010 $22.26
Service or Feeder
1 ea 12% State Surcharge - 09/01/2010 $38.92
Contractor: Electrical
SQUIRES ELECTRIC
PO BOX 16851
PORTLAND, OR 97292
PHONE: 503 - 252 -1609
FAX: 503 - 253 -5831
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $363.28
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 s. - • • - • - • direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B ii — 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.
08/31/2010 16:26 5032535831 SQUIRES ELECTRIC #6195 P.002/002
Flee teal Permit Appli FOR OFFICE USE 0:\ L1'
City of Tigard Received ; // t No.: iz 10 — CJ v `l ., 7
Permi
13125 SW Hall Blvd., Tigard, OR 97241) G 3 1 2 010 Perna Permit Plan Review
.114
Phone: 503.639.4171 Fax: 503.598.1960 nee B :
T r G AI: n
Inspection Line: 503.639.4175 CITY OF TIGARD RD °at �o Y d ` ® Page 2 for
Internet: www.tigard-or.gov i C` SupplcaacoalInformation
❑ N construction II:: Addition/alteration/replacement 'Please check all that apply (submit a seta of plans wraams checked below);
ID Service or feeder 400 amps or more O Building over three stones.
O r . linen ■ Other. where the available fault current 0 Marinas and boatyards.
,,i >� -J1: t , ti r I� -.-7:9; �; 1 exceeds 10,000 as at 150 volts or ❑ Floating buildings,
.._ v _._ _n.. ... _ _<. _ lees to ground, or exceeds 14,000 1:1 Ceaunercild -use agricultural
0 1 - 1 d2- family dwelling ❑Commercial/industrial ❑ Accessory building amps for all other installations. , buildings.
P I Mul family ❑ Master builder ❑ Other ICI Fite pump. 0 Installation of 75 KVA or
larger separately derived system.
_.., ' u .�. _.- ❑Addit of new mote lord of ❑ "A ^ ^."E", "l- 2 ", "1 -3,
I , 1 100F1P or more. occupancy.
Job no.. Job site address: /f ) 0 g q6 4 s :O g o r more r esidemial units ❑ Roaeatiomat vehicle parks.
City /S ., e/Z ` + • b f 9 , ? 3 I ❑ Health-care haloes. Q Supply voltage for more than
❑ H locations. 600 volts nominal
Suite/bl r giapt no.: Project name' //� C � i C LC 113 $ice or feeder 600 amps or more.
Cross __ directions t o job site: (a J y. -fry^ inmiotiem oa Fee Total •
New residential tingle- or mult dwelling un
Includes attached garage.
Subdivi. ion: Lot no.: ;1,000 sq. ft. or less 168.54 4
:Ea. add') 500 sq. R. or portion 33.92 1
la:Mt/parcel no.: !Limited energy, residential 75.00 2
- .a - y ,. . •-- I p
_-�,�__ —___.. ' r r: M ? l� 7 1 :- . :• , L J ^Y (With �Ve Sq. l..)
_. - � d ' Limited energy. mufti - family
Pe - e, it@ii 1,tG tvii , t� *1 4 1 ,37 i residential (with above sq, ft,) 75.00 2
/ i rvices or feeders installation, alteration, and/or relocation
p e. i re- 'Juke, . ,,..k. -- /-v fi ✓e 4� 'tit or kis ' 100.70 `l2 / G 2
%i,c �
' :P, 120 to400 133.56 2
:401 amps to 600 amps 200.34 2
Name. 1601 amps to 1,000 amps 301.04 2
Ad. -� : I Over 1,000 amps or volts 552.26 2
City /S : e/ZIP: 'Temporary services or feeders installation, alteration, and/or
I relocation
Phone: ) 1 Fax: ( ) • 1200 amps or less 5936 1
Owner installation: This installation is being made on property that I own which is not I201 amps to 400 amps 125.08 2
intend- u for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 1401 amps to 599 amps 16854 2
!Branch circuits — new, alteration. or extension, per panel
Owner ig(tature: Date: � A. Fee for branch circuits with
, r ,^y^, hbrancha feeder fee,
7.42 ^.,
7 � o� • elte 2
I3usm `name: !B. Foe for branch circuits without
service or feeder fee, first 5618 2
Con naive; branch circuit
I Each add'l branch circuit 7,42 2
Addr-. : !Miscellaneous (service or feeder not included)
City/S ZIP: Each manufactured or modular 67.84 2
I dw - -- e16 service and/or feeder
phone: ) I Fax: : ( ) ; Reconnect onl 67.84 2
I Pump or irrigation circle 67.84 2
E-mail
_�. _ . 1 Sign or outline lighting 67.84 2
tiN7* ..r.'. -r.1 _ '.':4- . ; .._ ::. :IL: . _. . !Signal circuit(s) or a
Burin=:. name: L , e & 4- . `. , y ' ILL Pte, at Paget 2
'Each additional inspection over allowable in a . of the abov
gddr., x *26 i ;Additional inspection (1 to min) 6625/ hr
City /S ' IP :} 9 7�9 I investigation (I hr min) 6625/ hr
Industrial pram (1 hr min) 78.18/ hr
Phone: +• � �/ , l Fla: (60.7 � -5 g/ i for which no fee is 90,00/ hr
2 listed (Y hr min)
CCB L c.:' 3 5086 Electrical Lic�. 1 a 1 G Suprv. L i c . : 4 e g c 1 ' t < aa . : r y a . 4 7zit .
Suprv. icctrieian signature, requ, a Subtotal: a3 oat()
Plan review (25 /o of permit fee):
(�
Print n - : t t U r + ` Date: g o A E ( tin )- �� • "I a_ State surcharge 12%of fee
AtrthO : • Si arias: TOTAL PERMIT FEE: A t
Ilia permit application expires If a permit is not obtained within 180
days after it has beta accepted as complete.
Print ...it . Date: • Number of erections allowed per permit.
440.401Yr(1 1iO3/0O>vi/wm