The URL can be used to link to this page

Permit CITY OF TIGARD ELECTRICAL PERMIT 1111 I ' COMMUNITY DEVELOPMENT Permit #: ELC2010 00480 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2010 Parcel: 2S102BD02600 Jurisdiction: Tigard Site address: 12979 SW PACIFIC HWY Subdivision: Lot: 0 Project: Kim Project Description: (1) branch circuit. Owner: FEES KIM, PENNEY Quantity Description Date Amount 395 NW SILVERADO DR BEAVERTON, OR 97006 1 crt Branch Circuits 09/08/2010 $56.18 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 09/08/2010 $6.74 Electrical Contractor: SANDY ELECTRIC INC 12130 SE VIRGINIA CT SANDY, OR 97055 PHONE: 503 - 961 -5140 FAX: 503- 668 -8431 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 • 2- 001 -0100. You may obtain a copy of the rule • •'rect questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: J ill- %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. Electrical Permit Application r i> 1. r., F r l i r. a (r t of �i rd Ci 1 31 S Hall d , Tigaai OR 9 :,'. .. . • DaB lLeoaivoa : Reoa:it No.: 1d - a ,t I Iii \i; I � ' Phone: 503.639.4171 Fax $03. 598. .1 ' • tl► 1%1° R � 7I Other Pamir: Dase Inspection Line: 503.639.4175 O D Data �' � a ' to $ Foge eLr Internet: www.tigerd- or.gov i \ kV ' Supplemental Information • • 1'R'IPE O WO T' . r • PLAN REVIEW ❑ New construction 1 /: Addition/alterstio „ � , it . Please chods all that apply (sebroit Z sets of playa Wheels checked bow}, Demolition ID Other: ©Service or feeder 400 amps or more ©13ailrbng over throe stories. *we the available fault current In Marinas awl boatyards. CATl6 ORV f1<F VONS7 RLJCI1 ON. meads 10,000 gaups at 150 volts or 0 Flouting buildings. • ❑ I- and 2- family dwelling • El Commercial/industrial rcial/industrial ❑ Accessory building to 4 a<e astall s 14,000 ❑ Commercial -use agricultural for all other ittatallartloaa, Luddingn. ❑ Multi- family ❑ Master builder CI Ocher: °Fire pump. CI Installation of 75 KVA• or JOB SITE 1lNPORAAA 1i IUN. ADM LOCA LION — El Sr cy syemot. larger separately derived sysresp.• n Addition ofaew motor toed of ❑ "A", "E","1-2"."1-3". Job n:o.:10 - 1155 s Job site address: 7 ry 10011P or mare. oceupaacy. I L Z� 5 ,� . TO !`` a C.. W n Sac or more readeatial traits. Q Recreational vehicle pia. City /State /ZIP: \ 1 %exr q`t LZ'..2 QHealtb -em facilities, n Supply voltage for more than Q n iLauraoos locations. 600 volts nominal. Suite/bldg./apt. no.: ; Project name: 0 Service or feeder 600 saps or mom. .FEE. vi<,E ... •..... Cross street/ditections to job site: oetoripttao j Qs,. 1 Fee. I Toms 1 New residential single- or atniti fawiIy dwelling unit . • Includes attached garage Subdivision: Lot no.: w 1,000 sq. ft. or les 168.54 4 Fa, WW1 500 sq. ft or portion 33.92 l Fax map/parcel no.: DESCRIPTION OF WORK Limited with energy, a . 8 tesmdtatral 75.00 2 1 t Limited energy. mutti-fmmily . Z, i�1r�S . 7 .. :�i 21 da . - residential (with above sq ft.) 7s.00 2 k r Serviette or feeders tastudadottodteration, and/or relocation 200 amps or lest, ' 100.70 2 IM PBOPRRTY OWNER • .• . . • f. 'A'>ENA.NT . 201 amps to 400 amps 133.56 2 Name l•m 401 amps to 600 amps 200.34 2 • t 601 amps to 1,000 mops • 301.04 • 2 Address: l �e•� rk c- ,wry, c Yt i �,,, YAL .tt Over 1.000 at or volts 552.26 . 2 City/State/ZIP: fir: \ Teary v or installation, alteration, and/or . �� 0, °I `1 z.Z� relocation Phone: (SEy'S ) E r , - I tkrz 41 1 F at: ( ') 200 amps or less 5936 1 Owner installation: This installation is being made on property that I own which is not 201 amps a 400 amps izs. 2 2 • intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps m 599 amps 168'54 Smack circuits - new, alteration, or extrusion, per panel Owner signature: Date: . A. Fee for branch circuits with above service or feeder fee, 0 APPLICANT • • • I a CONTACT PiERKIN • each branch circuit 7.42 2 µ t" - --t- . � B. Fee for branch circuits without Business name: e y � �p \ branch circuit t f oo foe, first L 56.18 ,13 2 Contact name: c _a c ... h . j M Each midi branch circuit 7.42 , 2 Address : 1Z t tp J * ', t ( Miscellaneous (service or feeder not included) _ • t Each ment facuaed of modular 67.64 2 City/Slate/ZIP: � �tw 1 �( �f 7 D `.. dwelling, service and/or feeder PlaOtie: ('5'M ) %E r -I n-l0 ( Fax:: (S'ib' ) to tot -1 Lt � Rosennectonly 67.84 2 .Pump or irrigation circle 67,84 2 E -mail: __ _ CONTttACI OR Signor outline lighting 67.84 2 Signal circuit(s) or limited-energy Business name: zt cwt t__ —s-- t/�C ,rid, alteration, or extension Page 2 .. 2 641 ..11 Ears additional inepeetiop over altosvabie in asp of the above Address: LZIl,C) _S &.. U .. r t 00._ Cir Additional inspection (1 hr thin) 6625/1w - City /State /ZIP: t x or o{ `'to sr V Investigation (l br min) 6625/ hr • p h o n e : ( • a ,s ) T a l .. i L i b [Fax: ( SD >, ) io421 84 Industrial plant (1 hr aria) 78,18 / iris CCB Lic.:11 l : , t 1 Electrical Lit.: Cp S' 1 Supl•v, Lic. :.S' S Inspections for which no fee is Y specifically listed (Si br rain) 90.00/ hr • Suprv: Electricians : • , required_� 7 , � � ' / � / 7 , • • ELECTRICAL p 1I PEES ` err • ' • • Print name t Subtotal: '•� (n , VS' � : �, D ale; 1 ' b PM review (25% of permit too): Authorized signature: `] State surcharge (12% of permit fee): ( y . 7- , Print name: I Date: TOTAL PERMIT FEB: i /�y��0�. 411 1: V9uttmog \rerinkeEl.arersuippp.s0) oiromo 44O- l61Tr(tvosfCwWwen