Permit CITY OF TIGARD ELECTRICAL PERMIT
IIII
a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00543
T [G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/05/2010
Parcel: 2S112CC08400
Jurisdiction: Tigard
Site address: 15679 SW 82ND AVE
Subdivision: LANGTREE ESTATES Lot: 16
Project: Acevedo
Project Description: (5) branch circuits.
Owner: FEES
ACEVEDO, JOSE M & LAURIE A Quantity Description Date Amount
15679 SW 82ND AVE
TIGARD, OR 97223 5 crt Branch Circuits 10/05/2010 $85.86
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/05/2010 $10.30
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 $96.16
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 OA 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: / f.a �j Permittee Signature: 7 / _.
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.
09/29/2010 20:07 FAX 5035942873 PRECISION NW 2002/002
i 4S)
Electrical Permit Application - FOR OFFICE USE ONLY
City of Tigard
iu 3125 SW Hall Blvd., Tigard, OR 97223
III rA% Received
%% r t\1 a o . f .iy. ... _ q / M.712, Permt N„.:
i p 1 cod
47,i• : 1 • uvicw • • "
• : •
' Phone: 503.639.4171 Fax: 503.598.1960 4 <.° Other Permit:
3 ,,,,AC)t . :1 ".
T 6 . A p. E ., Inspection Linc: 503,639.4175 .0; \,.. ,A .: c Ready/By: runs: El See Page 2 for
Internet: www.tigard-or.gov O IVN'' Notitied/method: ..) suppicmentni information
"'....!?;:n.........,.:...: ,,....,.4.:,;■.4iiv.!:i."::;;;,!.' ', 7 ,, `77 41
iinV,'?:11 i ,l.,' -40 f PT: 1741,.. 1.•' r C; • .• -'''). .4 :
7 . .:-.' • ''',.'!..',:'::',=,,...;.::, .'." '.. '• I ' • itt-,,: l'iiharyti,24.4M, ),.!!. IP •k' . ..0 , ■% 1 ,.'''' " ... 1;14 ) ' " '''.' 1 '. • .: .',', ,,, 7';:n.tiA.7.i' ,, ) ! ‘, : (,;',/ i i
0 New construction fa' Addition/alteration/rep !,. 1 cut Please check all that apply (submit 2 sets of plans whims checked below):
0 SOIN'IO0 or feeder 400 amps or more 0 Building over three stories
0 Demolition 0 Other; where the available fault Gummi 0 Mar i1183 and bontynrck
, ,,., ,.. .?............... .,, „, ,..,,..,. . . .....77, ,, „InTr7-.7.17,..,„ 4* IWO I ( • • 4 , `, : I 4 i: i!iiiiltak11111144,20":'"r17140V77 E7CeeCIS 10,000 :rimer ji 150 Volts or Cil Floating buildings.
. - . • • ".• . '• • '. . •... '. , ' , ....CATF.,GRAF l'Air fit il " .1.01 'A , 11 , 7 I+ 1 V %i • ;i1;poopt ;IF • -. .wird■rlie! - '•maylt
, •,_...:. - . •• .: ..:•• ... .•'.' ,?;:...,,,'••••..... b. .... - — , 4:• , •fittErifeir'67 .ilif, ittin,li,:to74,'.■H!!;!rinik"'■ loss to ground, or eximads 14,000 El Commercialrum aLdioultural
X 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building anyi foi all other installations. buildings.
0 Multi-family I:3 Muster builder 0 Other: 1:1Fire pump. 0 installation of 75 K VA or
1 • k ''' •',. i' pi. 0 EllICTIWCy pywero. liner aemirately derived system.
' .. • • . • • ... .... ..'.49.k.gq,14EPOit :;.:.... :',',:fi p Addition of new motor load of
Joh no.: Job site address: % 5 Lel CI 'Sys( ei?..‘"° ik‘i t 10011P or more. occupancy.
In Six ur more residential units. 0 Recreational vehicle park.
City/Statc/ZIP: T1 se„,c?i (DYL et 1 2/41- 0 tinalth-can facilities. D supply voltage tot more than
InHazardous locations. 600 yeas nominal.
Suite/bldg./apt. no.: • • Project name: Nv.i.-yac ptc,<4.e.,00 ci Senvice Or feeder 600 amps Or Tor.
.j
.... i'qi: , U.'!i•! ,, :;) , ::.''.' , m14: , :'.77Art,. - 4'1' 4ile .."' ''!:.:''' . • '. .7
'''.1*.;',1 r ‘ ' • ' .• • •" • .. ''.; ' '..: ' . . ''''
CruSS Street/directions to job site: Deatriplinn Kirl. Fee. Twat
"
New residential single- or multi-family dwelling unit. i
Includes attached garage.
-.•
Subdivision: Lot no.: 1,000 sq. II. or less _ 168.54 4
• - •-• - F,a. addl 500 sq. 0. or portion 13.92 1
Tax map/parcel no. Limited energy. residential —
75.00 . 2
!;:".:',. ,.. •-: 7 : : : •::! ;■ ..... .....':10.:,:'....;;;;;$ ,,,, TrL J',...M :r., 1 ' '' .. g i "- Wiiiia . (With above sq. tf.)
•• -;...;.:;: • ,;;: ... .;,:... ..:•,-,,, -.:•,,-,..., ,'L. . tea. • % • ; 't.^.:!,:i; 4a:: •,... il. .. ). .. • '' ', ,.!”,
' Limited energy, multi-farnily 75.00 2
kAl Civ 0./.44 V 6 c,•... wl 4- residemial (with above sq. ft.)
Services or feeders installation, alteration, and/Or relocation
1 4 ^ ts- vr-e•-■ . 200 amps or less 10070 2
.. • •. . . .0. : ,•"; i , i IEVIV 4 ,7; -,!1 201 amps to 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/Statc/ZIP: • relocation
200 amps or less 59.36 I
Phone: ( ) Fax: ( . )
• — 201 amps to 400 amps 125.08 2
Owner installation: This instailatiOn is being made on property that I own which is not
401 amps to 599 amps . 168 54 2
intended for sale, lease, rent, or exellangc. according to ORS 447, 449, 670, and 701.
Branch circuits - new alteration nr extension pr panel ..
Owner signature: Date: A. Fce tor brAnch circuits with
' .* • .;.' . - '•' .. • • t' ' - ' , ,ii. , :.. . .....::".•. .;'...•:'•::::•:E;;; ewer.... Y" '''1,7 )7771', 7411.17.r.?.;;} above RCTV(CC or feeder fcc, 7.42 2
. $.,•;,.::.,:;!: , • -,,.„..m......: „..,;...... eSiteek :. ,,......:4 each braliCh COMIlit
— 11. Fee tbr bninch circuits without
Business name:
• — service or feeder fce, first 56.18 % r 1% 2
• ts
- ..re
---------.„ brunch circuit
Cii/ - -
,
•— ' - - -' . 0 — 1 ,.. v — ch add'I branch circuit c2 7.42
Contact n .
Add - ss: . .1 0 1 , --1_,. L )Cr -,-f- ,/ Mr eellaneons (service or feeder null included)
(
hac manufiretuted or modular 6784
1,42_ i-L)--cl iatWirt 1 i 'cz..../Sc _ . 2
City/.. • tern': 'ling, service arid/or feeder . —
Reconnect only 67.84 2
Phone: ( ) • Fax: : ) . ..
• — Pump or intgation circle 67,
2
..-
—.
E-mail: ,.,,,,. Sign or outline lighting 67.84 2
.,
.,..i.... ' • .. .... ....: .. • ' • .:. .......:; ...- 1 't Signal eireoit(S) ar lirniteil
panel, alteration, or extension. Page 2 2
Business name:9y -( e..% St C-J 1.3w ex Cc. f Each additional inspection over allowable in any of the above_
Address: IZO'1 S e A....7(V As, c er Additional inspection (1 hr min)
— 66.25/ hr
.. investigation (I hr min)
City/State/ZIF: cl■ W:14Alg., 10 , CI -- Industrial plunt (1 hr min) 7sAR/ hr
Arri
Phone: (SOS) 4%5- arb 0 Fax: cs. s ci 4.- . or-P,F A , 1 vinns for which no fee is 90.00/ hr
pecificallytisted hrinin) ,_,. .. . .., . ,
Electrical Lic.: c 4,-
i suprv, 1.... .:Go3t S ...,..,..".;,,,,,,,....,..,,....,. lottlt . ,, ,- „0.1 ..:............,:,. ..,.,..•...:..,
Subtotal: [Z s: e
Suprv. Electrician signature, required: cAAAAANIJAARA5 •P or . Plan review (25% of permit fee): ..
State surcharge (12% of pent* fee): /0 t C)
p nii e is A A., ID Date; el -3 0-2.01 b
TOTAL PERMIT PEE: • ' _/4st
Authorized )UNAPevC) I )atc: — Cr
signature:‘,.._1,„ '''
A C - 1 ‘,t This permit application expires if a permit is not .. mined within 180
Print name: \(4 p w1,1.4
days after It has been accepted as complete.
-- ----''-----_. ,..
el ,e 1 0 • Number of inspections allowed per Permit.
f\k., „, ,
07101110 140-40 m i 1 1/05/CUNVWF.11
hguild'ulg\PerrnitskELC
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