Permit CITY OF TIGARD ELECTRICAL PERMIT
.74
a . ' COMMUNITY DEVELOPMENT Permit #: ELC2010 00484
T I G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/09/2010
Parcel: 2S 111 AB08800
Jurisdiction: Tigard
Site address: 9435 SW VIEW TER
Subdivision: PENROSE TERRACE Lot: 33
Project: Takeda
Project Description: Grounding for water service.
Owner: FEES
TAKEDA, JENNY & CHIJO Quantity Description Date Amount
9435 SW VIEW TERR
TIGARD, OR 97224 1 crt Branch Circuits 09/09/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/09/2010 $6.74
Electrical
Contractor:
CONDUIT ELECTRIC
19461 SW 89TH AVE
TUALATIN, OR 97062
PHONE: 503 - 692 -1428
FAX: 503- 692 -3652
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 952- 001 -0100. You may obtain a copy o les or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 1 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.
From:CONDUIT ELECTRIC 5036923652 09/08/2010 12:58 #386 P.002/002
RECEIVED
Electrical Permit Application I OK t)l rlt t t sI ()NI I
1, . City of Tigard S E'p 08 2010 Reece % a Gig
13125 SW Hall Blvd., Tigard, R 972 Plan Review Other Permit:
Phone: 503.639.4171 Fax: ' I F TIGARD Date/B ar
.l. u , A 1: 1, Inspection Line: 503.639.4 $UILDING DIVISION Nme e R dd/Me / n Supplemental f aformation
Internet: www.tigard- or.gov
TYPE OF WORK PLAN REVIEW
❑ New construction [ A ddition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings,
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
Q 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of
j.,-- � ) J / 7 p .� ��y l 00HP or more. occupancy.
Job no.: •-5 3 ( site address: 7 3S 5, ' i Vi-e)--- ! "r �- t ❑ Six or more residential units. ❑ Recreational vehicle parks.
❑ Health•eare facilities. ❑ Supply voltage for more than
City /State /ZIP: �)/IIrL� Z y 600 volts nominal.
as ❑ Hazardous /actions.
Suite/bldg. /apt. no.: Project name: 7/;.k..e./tt— ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Vtr. 1 Fee 1 Total 1 •
_ New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1 sq. ft or less 168.54 4
Ea. add'/ 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family
f1 75 00 2
/1 7� ` 6 s pe / --- , . Cy- -I--A .,--, � ()i f7 F., e v ( residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation _
kV A-T�. n 200 amps or less 100.70 2
PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: .,1 t ;u -1—A ` F I' �k 601 amps to 1,000 amps 301.04 2
Address: 7y3 5, y ../' ( tom--.+ �7-'e f -E Over 1,000 amps or volts 552.26 2
? Temporary services or feeders installation, alteration, and /or
City /State /ZIP: 'j rr g^4 - etc ( 7- z_2. y relocation
Phone: (� (
3) s / e j , / 12 t Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, ear panel
Owner signature:" Date: A. Fee for branch circuits with
•
above service or feeder fee, 7,42 2
❑ APPLICANT 1 ❑CONTACT PERSON each branch circuit
Business name: B. Fee for branch circuits without /�
service or feeder fee, first i
branch circuit / 56.18 2
Contact name:
Each add'/ branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City /State /ZIP: dwelling, service and/or feeder
Phone: ( ) Face.. ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
0...A6---6..,_) CONTRACTOR Signal circuit(s) or limited- energy
Business name: k.1 E-Lf. C Tv-t panel, alteration, or extension. Page 2 2
Q 4 Each additional inspection over allowable in any of the above
Address: / / e V co / 5', (..../, 8 / r/ v < Additional inspection (1 hr min) 66.251 hr
q 7,, Investigation (1 hr min) 66.25/ hr
City/State/ZIP: 7Z-)4 Q f T` Z ' � Industrial plant (1 hr min) 78.18/ hr
Phone: f 7
( 5 f 5 ? Z — / 1Z E Fax: ( ) Inspections for which no fee is 90.00/ hr
specifically listed (% hr min)
CCB Lic.: /C (tz c � Electrical Lic.: Suprv. Lic.: Snf5 ELECTRICAL PERMIT FEES 90 j tS
/� Subtotal:
Suprv. Electrician signature, required: I C � Plan review (25% of permit fee):
Print name: C..ikvellt 'g (p Date: y /i / State surcharge(12 %of permit fee): Co 1.1
TOTAL PERMIT FEE: (4 Z 9
Authorized signature: C9 ( T h is permit application expires if a permit ti not obtained within 180
0/ Print name: T� •� days after It has been accepted as complete.
Date: • Number of inspections allowed per permit.
1\ Building \Permns\ELC- PermiiApp doc 07/01/10 440 - 461 ST(11 /05 /COM/WEB