Permit CITY OF TIGARD ELECTRICAL PERMIT
o COMMUNITY DEVELOPMENT ELECTRICAL
ELC2010 -00534
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/28/2010
Parcel: 1S 136AA01900
Jurisdiction: Tigard
Site address: 6807 SW OAK ST
Subdivision: Lot: 0
Project: O'Brien
Project Description: (3) branch circuits for heat pump, air handler and GFI outlet.
Owner: FEES
O'BRIEN, MARGARET E Quantity Description Date Amount
6807 SW OAK ST
TIGARD, OR 97223 3 crt Branch Circuits 09/28/2010 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/28/2010 $8.52
Electrical
Contractor:
SIMPSON ELECTRICAL CONSTRUCTION
2145 NE MCDONALD LN # C
MCMINNVILLE, OR 97128
PHONE: 503 - 472 -2530
FAX: 503 - 435 -0157 -
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
• Total $79.54
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 • • R 952- 001 -0100. You ma o i py of e or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By Permittee Signature: .' — _lli� ! .a
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.
Cali 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.
- . . - • - - . .
.. - ' R&VZW
Pis= elsek attest apply ofplans sedans ids:clad lbelom
a Sevin or fieder400 amps ar mom 0 &Meg overt= narks.
abse the mailable tai 0 blarions sal boatyards.
exceeds 10,000 amps at 150 volts or CI Hosting bulldogs.
Immo wound, er aaeab 14,000 0 Coassercini-ose agnaditual
smips Snail other lestallaicas buildings
DFlr 0 Inisallation of75 KVA or
DEramEmml system. largar separately dais= system.
0 Menton cfnew tootor lead of ErAr, 9
100HP mina= ammazzy.
gift ea mare reside' mid swim 0 Reematiseal sebicle pmts.
OHneltb-eare fonlitim 0 Supply Matagis for mons than
OH:undo= Mania= 600 sults ood.
0 Senders or feeder 600 amps annum
-:
141.2e11;the 1 QM 1 Fee- i lbw I •
- New risidastialsiogliwerewelframordwelling - - .
Init. -
Indmles altecleadl garage.
1.0011 sq. ft or less
16854
4
Ea. min SOO sq. It. arportion
33.92
i
Limited energy, residential
(with abase sq. ft.)
•
75.00
2
Limited eaugy, multi-Mmily
residential (wide above sq. ft.)
75.00
2
Services er feeders instaliatien relneafroo
200 amps er less 10010
2
201 amps to 400 amps 13336
2
401 snip to 600 amps 20034
2
-
. 601 amps to 1,,000 maps 301_04
2
Over 1.000 amps or volis - 55226
2
Temporary =vices feeders Installation,
ar alteration, andlor
reloads=
200 amps lakes
S936
1
201 amps to 400 amps
125.08
401 amps to 399 amps
168.54
2
Brandt times- altantion or extension, per panel
A Fee for broth circuits sritir
above service or feeder fee.
cab broth areal
-
7.42
2
B. Fee far branch circuits waken/
service or feeder fee, fizet
bode circuit
t
5618
s‘ 1 T
2
Eseli add! broth circuit
.2
7.42
I Li. it-
2
Nlisailancons (service or feeder aot Minded)
Each osamdbmined or modular
6784
2
1 dwelEag, service anifor feeder
Reconnect only
67.84
2
Pump or inigatien drcle . '
67.84
2
Si gn or =Om resins
67.84
2
repel cimultfa) or limited-anew
panel. altnation, or mansion.
- Fagc 2
2
Each schnibael inntection over allowable in env of the above
Additional imps:diem (1 In rein)
6625/11r
Investigatkes (1 brain)
66.25/ Ix
Minnie) obeli (1 br min)
78.18/ br
bspecitans for widths) fee is
wan* 90.00/kr
s fated( in rein)
. _..•
..:': :FnItin7.:
. Subtotat
-1 1 I . 0 2
Pio review czym ofpermft fte):
.----....
State surchmge 0296 ofpermit 04
j. S2
' TOTAL MART FM
e l C t Slf-
Electrical Permit A_pplicalibit
SEP 2'4
City of Tigard
13125 SW Blvd 1188rd Cat 972Z3 CITY OF TIGA
Pk= 503.639.4171 Fam 503.598.1960
Inspection Line: 503.6394175 BUILDING DIVIS
Internet www.tigard-otgov
El New contraction plAdilitionialterationIreplacement
0 ttatOlition 0 Othm:
eilEGORY
and 2-family dwelling 0 Commercialnadostrial 0 Accessoty building
0 Multi-family 0 Master builder 0 Other:
Job no.: 1 Job site a 69'01 5 tz- o4. s+.
Qty/State/ZIP:
Suite/bldg./apt. no.: 1 Project a=
Cross street/directions to job sit=
Subdivisiont
Tax map/pareci no.:
kb24- rump, a i citer, (0 F(
Na
AddreSs:
City/StatetZfP
Phone: ( ) IF( )
Contact namw
Address
City/State/ZIP:
Ph)
Print nun= rid
Authorized *gam=
Print name:
11MaldineamkAILC-Perzonappelse' 01/0010
d L9 LO
RECEIV
'OF :tV0iiir;
De=
Owner signahum Date:
•
Business nam= f SO" E tec Cea C II Si D
Addr/M A 1 Lt s i0G Odiu%kyi LA e
9 264
FOR OFFICE USE ONLY
SeePage2 Mr . -
Supplemental brformerson
Lot no.:
. . • • •
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701_
Business name:
sty r Ai; At-t 1). Ile, Da. Criace
acne: (9)3) 4 t72.-253c 1 FED° (9)3) - 0 tS 7 •
ccB Litz i338 I Elechical L Suprv. Uc.. 5b9 S
&pre. Electrician signature, required:
MatISISTOMISMCOSIVION
• This peankapplientiou expires if a pentift'fis antobtabsed within ISO
days after it Ian beacaosepted as ample=
• Number ofinspeetinas allowed prrperant.
leoupeo uosdw!S
01 VZ deS