Permit CITY OF TIGARD ELECTRICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: ELC2010 -00468
T I c AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/01/2010
Parcel: 2S102BC01400
Jurisdiction: Tigard
Site address: 10250 SW WALNUT ST
Subdivision: Lot: 0
Project: Frazee
Project Description: Rewire kitchen after water loss.
Owner: FEES
FRAZEE, JOHN & NOREEN Quantity Description Date Amount
10250 SW WALNUT ST
TIGARD, OR 97223 4 crt Branch Circuits 09/01/2010 $78.44
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/01/2010 $9.41
Electrical
Contractor:
SQUIRES ELECTRIC
PO BOX 16851
PORTLAND, OR 97292
PHONE: 503 - 252 -1609
FAX: 503 - 253 -5831
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $87.85
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 '• . +•r•ance wi .••roved 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. TTENTION: Oregon law equire ou to follow the rules adopted by the Oregon Utility Notificatio• enter. Those rules are set forth in OAR
952 .01 -0010 through OAR 952 -001 -0 • • . You ma - stain a copy of the rules or direct questions to OUNC by calla; 03. • • 6699 or 1.800.332.2344.
Is ed By: / � Permittee
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'
471 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.
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00468
Date Issued: 09/01/2010
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102BC01400
Jurisdiction: Tigard
Site address: 10250 SW WALNUT ST
Subdivision: Lot: 0
Project: Frazee
Project Description: Rewire kitchen after water loss.
9/22/2010: Reprint permit to add (2) 200 amp service and (8) branch circuits.
Owner: FEES
FRAZEE, JOHN & NOREEN Quantity Description Date Amount
10250 SW WALNUT ST 4 crt Branch Circuits 09/01/2010 $78.44
TIGARD, OR 97223 wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/01/2010 $9.41
Electrical
Contractor: 2 ea Services or Feeders - 200 09/22/2010 $201.40
SQUIRES ELECTRIC amps or less
PO BOX 16851 8 crt Branch Circuits w /Purchase 09/22/2010 $59.36
PORTLAND, OR 97292 Service or Feeder
PHONE: 503- 252 -1609 0 ea 12% State Surcharge - 09/22/2010 $31.29
Electrical
FAX: 503 - 253 -5831
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $379.90
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 0 R 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: f� /97 L✓ �i e / "/
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 603.639.4176 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.
/,
09/01/2010 16:31 5032535831 SQUIRES ELECTRIC #6202 P.002/002
Electrical Permit Application t FOR OFFiCE USE O\ Ll
City of Tigard c,'E.\\I 9' , /m r ,�) Permit No.: t. / ,e 13125 SW Hail Blvd., Ti d, OR 972 'lQ1 Q Plan Re w
` �`�" D 7(4
Phone: 503.639.4171 Fax 503.598.1960 .. Date/By: Other Permit
T 1 C.l'd. C., w Inspection Line: 503.639.4175 •... Ready/By; 'uric 0 See Page 2 for
Internet: ww.tigard- or.gov acII GAR1- fmd/Method: Supplemental Information
— 7
.. r e• C '� C C f t E , r .^,S_ . .�` �; T••v 5 ___
❑ New construction n.4 Addition/alteration/ ' • acement Please rdlxk all that,appiy (submit 2 scm of plans w�tems check ed below):
❑ Service or feeder 400 amps or more O Building ova throe stories.
Demolition LI Other: where die available fault current 0 'Marinas and boatyards.
r � 7 Y y h
x� 'r" ..: t ❑ Floating buildings. ding5.
i. exce 10.000 amps at 150 volts of less tog round, or exceeds 14000
11 1 - and 2 family dwelling 0 Commerciat/industrial Accessory building Cl buildings. Commercial agricultural
rY S amps for all other installations. blinrs•
(3 y ❑ Master builder ❑ Other: ❑ Fare pump. O Installation of 75 KVA or
Munn fa1rr11 th
z , ` 9 s :•;.:... t6 � ` O y hem. larger separately derived system.
�n > ^ e );, iri: e
Q Additive Qr.., motor load of Q «A° "1 -2° "1 -3
3013 no.: Job site address: 1 b 5b •6 ,. Mi. ■ _ - - 1 _ boor or morn, R
occupancy
.
❑ Six or more residential units. ❑ ecrcationsi vehicle packs.
City/State/Z1 �� Q Health-care facilities. ❑ Supply voltage for more than
v i Q a O hazardous locations. 600 volts nominal:
Suite/bldg./apt no.: ""' Project name r � ,e, t eg , ❑ serene or feeder 600 amps or more. _
Cross street/directions to job site. vcsc 4p1 o>+ 0c,. Fee. Total
New residential single- or mull- family dwelling unit
l includes attached garage.
Subdivision: J Lot no.: 1,000 sq. ft. or leas 168.54 4
Ea. add'! 500 sq. ft or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
v .7I Y ; ` art` ' . . above 75.00 2
:-- _1_.... �:_. <_ r ys.. � multi - fam
�rr�� a.- / r&Y>
p ei.„ t r e ► -, t _ , W 61- l p .5-6 residential (with above sq. R) 7500 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2 1
- ' .f!" 201 amps to 400 amps 133.56 2]
Name. 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1.000 amps or volts 552,26 2 if
1
City/State/ZIP:
Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 _
Owner installation: This installation is being made on property that 1 own which is not 201 to coo amps 125.08 2
rent, r exchange, 401 amps w 599 amps 168.54 2
intended for sale, lease
>y ge, according to ORS 4d7, 449, 670, and 701. Branch circuits — new, alteration. or extension, r panel
Owner signature: Date: A. Fee for branch circuits with
-- - — f
.
4 � - a . t .y r 1 ; V,",,,... - . A . .` , i _ 8 b0oC service Or feeder CC, 7.42 2
:. _i _. -�. -. �: _- •.- _� Y c,. eadl branch circuit
Business name: B, Fee for branch circuits without
_ -- service or feeder fee, first r 56.18 C�,, 2
Contact name: branch circuit t^
' Each add'I branch circuit `, ji 7.42 ...U.,...1,4 2
Address: Miscetlancous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( )
Reconnect only 67.84 2
E Pump or irrigation circle f 67.84 2
; ' f yrl '' F Sign or outline lighting 67.84 2
- � Signal circuit(s) or limited-energy
Business name 9 a r � 41 . Y t ' t- panel. alteration. or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address�b x i ( i Additional inspection (i hr min) 1 66.25/ hr
City/State/ZIP: • �' % l i / b � 9 7,01.94.1.... Investigation (1 hr mm) 6625/ hr
industrial pianL (I itr min) 78.18/ hr
Phone: ( )1,5...)_,14,09 Fax:( '5��3. l Inspections for which no fee is 90.00/ ix i
ifrcaTly listed (%hrmint ( ,
CCBLic.: 135 a'g...3r' I Electrical Lici ./ /D ie, Suprv_Lic. : ti.m.6 ' '` - = _:a o_+.0'. &% % ..,_ i•.a .�; :�
: •� , :1;:
Suprv. Electrician signature, req, _ S . , . A
Plan review (25% of permit fee):
Print name:,. e.• o� 1.tJ re, Date: 9 / ) State surcharge (12%ofpem t,
tit fee): l
/ TOTAL PERMIT FEE: s 1 n t$5
Authorized Signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: j Date: • Number of inspections allowed per permit.
I�.PniEitAppdoe O7/01/10 ���LLL 440- 4615T(ILW/COM/WE.B
09/21/2010 14:21 5032535831 SQUIRES ELECTRIC #5820 P.002/002
Electrical Permit Application FOR OFI lt.-:L t;SI. O.\i,l
City of Tigard PeenitNo,• C, 1l b
il
13125 SW Hall Blvd., Tigard, OR 97223 �• Review
Plan Other Permit.
Phone: 503.639.4171 Fax: 503.598.1960 t 51 Date1B :
T 7 G A n D
Inspection Line: 503.639.4175 � Nau a 6ed/Meth o: Jwis: Supplemental Information
Inlet www- tigard- or.gov . IL
t — —
` 1 _ —..w .. - ~ 'V
. _ — — Scrvioc or feeder 400 amps (submit.
❑ plans w
.____..-- __ - -- ..,_.._ - —�- . - rtte�ms checked below): Please El New construction lr i Addition/tiltesatton/ . aoem ' 1 1 t) kilns over /]were storks.
❑ Demolition • Other u ' where the available fault current 13 Marinas and boatyards.
: - _ t'- rri c - :" ' a_" ••�•.«■Ia 10,000 amps at 150 volts of ❑ MOW:inn buildings.
-
- -- -. _._._�.. _ __..,�_...... _.0 - �tos»4� exceeds rao00 Commercial-use attricultural
P. i 1- and 2- family dwelling ❑ Commercial mdustnal -' 11 :0.7- ,, . uilding am47s for all other installations. ❑ burl'
• Multi- family [0 Master builder • l e , - r ❑Flee p imp. ❑ Ins> Wn of 75 KVA or
. , - : 4 D Addttuon o new separately '+� �
_ _ _ _ _ _ _ _ motor [ou of ❑ , « _2 "," -3",
Job no.: Job site address: O ,..7 Q OLD l T. - l I00HP or mom. occupaocy,
1 , . ❑ Six or more residential emits. ❑ Reemstional vehicle parks.
City/State/ZIP: j y - / El H azardous facilities. ❑ Supply voltage for more than
L El Hazardous locations. 600 volts nominal
Suite/bldgJapt no.: I - Project name: o t o wag i ❑ Service or fader 600 amps or more
Cross street/directions to job site t in ` i;: o Ike - tutu New residential angle- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:
1.000 sq. R or lei 168.54 4
Ea. add'! 500 sq- It or portion 33.92 1
Tax map /parcel no
_, -:.. _ -
_
Limited energy, residential . w ;: .. Limited above
f
2
t
ligelD energy, multi -famly 75.00 1
, r J. ' residential (with above sq. ft)
Services or feeders installation, alteration, and/or relocatton
200 amps or less , 100.70 ,...X1,6 2
- ?: y 201 amps: ro 400 amps 133.56 2
.. _ -._ -.-_. - - -- - - - .. _:.-- - --- - -._.. - --- - 401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1.000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State/ZIP: relocation .
Phone: ( ) Fax ( ) 200 amps or less 59.36 1 "
Owner installation: This installation is being made on property that I 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 168.34 2
Branch circuits- new, alteration, or extension, per panel
Owner Si:. . e: Date: A. Fee branch circuits with
s —r — fee.
74
each branch circuit
Business name: _ B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: blanch circuit
Each add'i branch circuit 7.42 2
Address: Miscellaneous (service or feeder not indnded)
City/State/ZIP: Each manufactured or modular 67,84 2
dwelling. service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail Sign or outline lighting 67.84 2
:_,�... .._...- .: _.. > ' si cllCUlt(s)
Business name: 61 [ia r e_. 4- - ∎ Y i 'L 1 panel. alteration, d or extension. P n 2
� _�� Each additional inspection over allowable in any of the above
A d d r e s s � i f ' n ( • f t e $ 1 Additional inspection (1 br min) 66.25/ hr
: Mat, v n Investigation (1 hr min) 6625/ hr _
Cary /St2#e/aP
\ ,` 9 f° Ct� Industrial plant (1 hr min) 78.18/ hr
Phone: ( ,„/ 5,- - /470 ' Fax: 5). ' 6 , [ inspections for which no fee is 90,00/ hr
s.: ifi listed hr min
CCB Lic.: j g Electrical Lic. : • -j 161 Suprv- Lie. S g k 3 . -- - "� .,' ° -- - _ .
Suprv. Electrician signature, req - A + ^ Subtotal: ( t t (
Plan review (25% of permit fee):
ti
Print name 6 1 ua r Date: 9 j i '. State surcharge (12% of permit fee): al , ay
TOTAL PERMIT FEE: . „ 7 700 ..0, 5
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as eemptete-
Print name: I Date: • Number of inspections allowed per permit
rAguitdieg1PMacaLCFesmQAPP•dee 07/01/10 44046157(1 UOSICOMAw66