Permit 111 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00519
Date Issued: 09/22/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S 22/201 0200
Jurisdiction: Tigard
Site address: 13611 SW TRACY PL
Subdivision: HILLSHIRE ESTATES NO. 2 Lot: 101
Project: Cerbone
Project Description: (2) branch circuits for landscape lighting and outlet.
Owner: FEES
CERBONE, ROBERT REVOCABLE LIVING Quantity Description Date Amount
13611 SW TRACY PL
TIGARD, OR 97223 2 crt Branch Circuits 09/22/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/22/2010 $7.63
Electrical
Contractor:
PRECISION NW ELECTRICAL
12020 SE ANNA CT
DAMASCUS, OR 97009
PHONE: 503 -413 -9870
FAX: 503 - 594 -2873
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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 of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. ^ /
Issued By: A CV 2 , Z€/-1 -.2— Permittee Signature: Q 6 „' /
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.
09/21/2010 00:35 FAX 5035942873 PRECISION NW fi1002 /002
Electrical Permit Applicatio I O R orru_'E tht: Oi \I.\
City of Tigard EC E V E D '- r Peenit No.: E 74 �' eceve Datol 9/07.2//0 �: LC� /C) -005./9
i s ' 13125 SW Hall Blvd., Tiga O R 97 Plan v iew
Phone: 503.639,4171 Fax: 503.598.1960SEP 21 ZO D 8[`/BY' OilierPmnii•S /7 0/0 -106/0/Y ' I' l<_ AKL1 InspeciiOn Line: 503.639,1 75 Date Ready/By: Juri 6;„.. H See Page 2 fur
Internet: www.tigard or.gov Notified/Method: Supplemental Information
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❑ New construction . '0:1 Addition/alte it t • p acemcnt Please check all that apply (su brnd 1 sets of plans w /items checked below):
❑ Scrvie0 Of feeder 400 amps Of more ❑ Building over three atori s .
0 Demolition ❑ Other: when: the available fault current
❑Marinas and buatya„!s.
,.,.::...... ,. . ... ' w: • , r i. ?.+ 4451 , I ire, i +'.' .S t ir° ti' l{ eereeds 10.000 amps at 150 volts or ❑ Floalin buiidin
• £ , tt ' L nlh'"A is ` �ii ii ,' 0 a { l ,' MI PSI - f;:..,
lest to proud, or exceeds 14,000 ❑ Commercial -use agriauhural
I _"f 1- and 2- fancily dwelling ❑ Commercial /industrial 0 Accessory building amps fig all other installations buildings.
❑ Multi- family [] Master builder ❑ Other: ❑hi pump. la installation of75 KVA or
"., N i ) r, ; ' ,+:r ; ' °fBY system. larger separately de d cyst
:. .7f, r L A . rive
.,IWRF.,. +;' i,� ' 'i7.p of 1 t1 ... N1 ,., .N ( : tti -� MOW( load f 2 1
,... ... ., ., "' sits � o• ■ ..... r'.... :' , ., .� r.:.. ❑ A ition of OM t u ❑ _ l _ •...:.,
JO nu.: Job site address: 13 (P ' 1 _ . 'IA L1 I P 1001.1P or more. occupancy
❑ Six or molt residential unite. ❑ Recreational vehicle parks.
City /State /LIP: + � � � 1 V /h oil -L-0_,_ ❑ Health -care facilities. ❑ Supply voltage for more than
❑ I larvdOUtloOatiOns.
-.. ,..!.. 600 volts nomina i
Suite/bldg. /apt. no.: Project name: �VNa �' �S ❑ service ar fee 6 .. amps amps nr more
Cross street/directions to .lob site: ''' t 1 ''' r; "`" "' '` . , ° . ..
.) u Qty. 1 F �. 1 . ..
Tidal l. •
New residential single- or multi- family dwelling unit,
includes attached garage.
Subdivision: 1 Lot no,: IMO sq. 0. or less - t 1ti8.54 _ - 4
- . . . . . . . . . . . . . . . . . . E a . udd'l 500 sq. tt. or portion 33.92 1 r
Fax map /parcel no.: Limited energy residential
�w,n,�Y a r�g,+,n� +nrTrp - Vii 75 f,10 2
iGa ui144 ;�?a`81�:fc� 1:;, ;CI !;i!k:9r':.... .7. ::, ah<rvc aq ft.) •
n _ _ . ._.._. , , _..
iaa4L'14•�!Hi`i:.'] f? pi7+ ;'fti Pi%ili' ". _
--7
Limited energy, mull i.family 75.00 2
. At T I+f ..4 V tav 1 �.s C-r)1/ 1'411 S� e re sidential (with above sq. R.)
r -- ° - --- - � --
Services or feeders Installation, alteration, audio
r relocation
\o 'VI�w► � T S amps - ...... 2
200 r le,5g 100.70
": 1 ! E i'i' ' f v ' `'� ,,:'iii p I ,,, i.iiri6. _• rP.,' :` 2 01 stn 10400 am .,_.•• - -- 133 2
1,. , ,:1'I a . ( ii s �� r hot M>:lxf ps V 6
401 amps to 600 amps 200.34 2
Name' -
601 amps to 1,000 amps 101.04 2
Address: . Over 1,000 amps or volts 1 552.26 2
-- 'temporary services or feeders installation, alteration, and /or
City /Stale /ZiP: relocation
Phone: ( ) , Fax: ( ) 200 amps or less 59.36 I
201 umps to 400 amps 125.08 2
Owner installation: This installation is bcing made on property that I own which is not 401 amps to 599 snips 168.54 2.
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. -- -•• - •- • •
Branch circuits - new, alteration, or extension. per panel
Owner signature: . _- Date: A. Fee for brunch circuits with
�- - ---- f , 7 42 2
-
above
• ..... �:', .. ... _'f''" ` each branch circuit .., ..
Business name: I s. Pee for btartdl circuits without
service.or fader fee, first 'r 56.18 5i; l% 2
Contact name: branch cinto it
- • Each add'l branch circuit 7.42 1, 47_, 2
Address: Miaccianeuua (service or feeder not included) ..__,
.. Each manufactured or modular 67.84 2
City /State /ZIP: dwelling, service and/or feeder
1'honc: ( ) `Par:: ( ) Keconnect only 67.84 2
-. -. Pump or irrigation circle 67.84 _ 2
F.-mail: , or outline lighting 67.84 2
amm�o� ,. ,,:,� 02.:. c - -
..... • "t , . ; nr.. 9'' t " SPl''I' " ':ri ii;': 7,' , . r, •,:' p 1 i1', , 1 1 °i 1 Signal circuit(s) or limited - energy
Business name: c � �
S t a) . l c r\r 1 ( Panel altatadon, or extension. Page 2 2
Each additional i�eetlon over allowable In any of the above
Address: %►LA' _0 S s j lv y®, err Additional inspection (1 hr min) 66.25 / hr
-
�y investigation (1 hr min) 66.25/ hr
City /Stale/ZIP: b /ItASto S t. (_bt ,,� -70 , c Industrial plant (1 hr min) 78.18 /hr
Phone: ('0", - ti O 1 Flax: (SS) se T 3 Inspections for which no fez is 90.00 / hr
r specifically listed (Y. hr min ;
C:CB Lic„ 1(4'3'5 1 Electrical Lie.: ,�.' 1 Su Li c.: C,p3 ( , iS,t ` ^i 1 �` 'lfi "ikL 143144 ;i !:
Subtotal: (e z ._
Suprv. Electrician signature, required' Plan review (25% of permit tee):
Print nacre: M1 1�ate• t '7.%- 2.1)4() _ _ State surcharge (12% of permit fee): . 7 . (A
.. - TOTAL PLRMIr t'k:F:
Authorized signature; N
``��/ This permit application expires ifs permit is not obtained within 18
_. days after it has been accepted as complete, ✓
Print name: t,s.A NW� ,6 Date''•• `,,1- -. l I . Number of inspections allowed per permit. '2f g
1.tauitding\Pem+itiar .e- rcrmitnpp.d0C 07/01/10 440.4615T(1 lro5/eQM/wrd