Permit l0 /2 G 6 -. - ) b J 1,' ► (cc (73 - lam pcve f' /e f vc 7 ".)
CITY OF TIGARD ELECTRICAL PERMIT
o . COMMUNITY DEVELOPMENT Permit #: ELC2010 -00445
T 1 GA R LD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/26/2010
Parcel: 2S114AB00400
Jurisdiction: Tigard
Site address: 9290 SW DURHAM RD
Subdivision: Lot: 0
Project: Strothers
Project Description: (1) 200 amp service and (10) branch circuits for addition and kitchen remodel. 10/26/10 added
(22) branch circuits for panel relocation B.T.
Owner: FEES
STROTHERS, HARRIET A Quantity Description Date Amount
9290 SW DURHAM RD
TIGARD, OR 97224 1 ea Services or Feeders - 200 08/26/2010 $100.70
amps or less
PHONE: 818 - 203 -0658 10 crt Branch Circuits w /Purchase 08/26/2010 $74.20
Service or Feeder
1 ea 12% State Surcharge - 08/26/2010 $20.99
Contractor: Electrical
CONNECTIONS ELECTRIC INC 22 crt Branch Circuits w /Purchase 10/26/2010 $163.24
PO BOX 7136 Service or Feeder
SALEM, OR 97303 -0026 20 da 12% State Surcharge - 10/26/2010 $19.59
PHONE: 503 - 390 -7914 Electrical
FAX: 503 - 463 -6863
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $378.72
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, .• •se, rules . =re set forth in OAR
952- 001 -0010 through OAR 952- 001 -0100. You may o f the rules or direct questions to OUNC by calling 503.246.66, , .800 2.234
Issued By/ Permittee Signa 4 11111111P' o f Amor
OWNER INSTALLATION ONLY
The installation is being made on property I •wn which is ;.- inte ; - - ease / rent.
OWNER'S SIGNATURE ter Date: 10/2 L ' (7v
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.
•
CITY OF TIGARD ELECTRICAL PERMIT
n
2 .:- COMMUNITY DEVELOPMENT Permit #: ELC2010 -00445
Date Issued: 08/26/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 8/26/2 B00400
Jurisdiction: Tigard
Site address: 9290 SW DURHAM RD
Subdivision: Lot: 0
Project: Strothers
Project Description: (1) 200 amp service and (10) branch circuits for addition and kitchen remodel.
Owner: FEES
STROTHERS, HARRIET A Quantity Description Date Amount
9290 SW DURHAM RD 1 ea Services or Feeders - 200 08/26/2010 $100.70
TIGARD, OR 97224 amps or less
PHONE: 818 - 203 - 0658 10 crt Branch Circuits w /Purchase 08/26/2010 $74.20
Service or Feeder
1 ea 12% State Surcharge - 08/26/2010 $20.99
Contractor: Electrical
CONNECTIONS ELECTRIC INC
PO BOX 7136
SALEM, OR 97303 -0026
PHONE: 503 - 390 -7914
FAX: 503 -463 -6863
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $195.89
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 0 9 1 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
By: Issued
B : 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 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.
08/25/2010 08:07 5034636863 CONNECTIONS ELECTRIC #1252 P.002/002
. win r. , ,-- „-- -,
• Electrical Permit Application FOR OFFICE USE ONLY
Received •. ��
City of Tigard AUG 5 2 011 Dot ` r' ��/� Penni: No.: ,� / Ze - 0,0 / / Al
u 13125 SW Hall Filed„ Tigard, OR 97223 Plan Rev Other Pennitr /.STaQ /Q --,40,0 Phone 503.639.4) 71 Fax: 503.598.1060 Darr/B :
• T1GAltD Inspection Line: 503,639,4175 CITY C F p ,,A . Date Ready/8y: MN 13 See Page for
Internet: www.tigard- or,gov RI { in rain r tit n Noe4rMethod: Supplemental Information
/i Clf ti0
• - TYltt :01?.WORK: _.
PLAN REVIEW
❑ New construction Ig Addition /alteration/replacement Please check all char apply (submit 2 sets of plans w checked below t
❑ Service or feeder 400 apps or more ❑ Building over three scores
❑ Demolition ❑ Other: •
. wham nhc available fault carrem 0 Marinas and boatyards
• • CATEGORY OF CONSTRUCTION • exceeds 10,000 amps at 150 volts or 0 Floating buildings.
. less co ground, ar exceeds 14,000 0 Commercial-use agricultu
XI 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pimp. 0Instauation of 75 KVA or
JOB SITE INFORMATION AND LOCATION Emergency system. larger separately derived
Addilian of new motor toad of
• Job nu.: Job site address: (32.90 51.ki Durham Rd 0 100 or oj occupancy
Sir or more residential units, ❑ Recreational ..einele parks
and tZ 9,7223 Ci[y'lState/ZIP: 1 ( 9 ❑Heokh-care facilities. ❑ Supply voltage for snorethan
❑ Haaaroouslocations. 600 Volts nominal.
Suite/bldg.,api. no.: f_PrOjccl name: 0 Service or . .. 600 amps or more.
FEE SCHEDULE
CrOSS street/directions to job site: ” oestrunion , 9rv. ) Fen, 1 'form 1 •
New residential single- or multi - family dwelling unit.
• Includes attached garage.
• Subdivision: 1 Lot no.: 1.000 so, ft. or less _ 168 54 4
Ea. add'I 500 sq. it. or portion 33.92 I
Tax map /parcel no.: Limited energy. residential o
•DESCRIPTION OF WORK (with above sq. rt.) 67.84
• Limited energy. multi - family 67 84 ,
• re- f e panel ep („ _ _ _ I _ � k e {.� ( Ep residential (with above sq. ft.) _,.„^
i
�e � • �"� / igt r Services or feeders installation, alteration. and /m• relocation
200 amps or less 1 100.70 1 c - 70 2
. ❑ PROPERTY OWNER I in TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200,34 2
Name: _
60 t amps to 1.000 amps 301.04 --
Address: Over 1,000 amps or volts 552,26 , _ :�
C ity' /State/ %1P; re m o f a y services or feeders installation, alteration, and /or {
• 200 am or less -_ - 59 36 I 1
Phone:( ) Fax:( ) —
_
201 amps to 400 amps 125.08 '-
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 ,
intended for sale. lease. rent or exchange. according to ORS 447.449, 670. and 701. •-
. branch circuits - new. aiteration, Or extension, per panel
Uttner signature: Date: A. fee fir branch Circuits Huth
❑ APPLICANT I ❑ CONTACC PE RSON above service OT feeder fee. (p 7 42 74.20 2
each branch circuit
• Business name: 8. Fee for branch circuits without
service or feeder fee. first 56.18 9
•
Contact name: branch circuit
• Each add'1 branch cireurt 7.42 1
. Address: Miscellaneous (service or feeder nor included)
City/State/ZIP: Each manufactured or modular 67.84
dwelling. service and /or feeder -
—
Phone: ( ) Fax:: ( ) Reconnect only 67 84 2
Pump or irrigation circle 67.84 2
E-mail: '
_ Sign or outline lighting 67.84 2
• CONTRACTOR' Signal circuit(s) or limited- energy
E(
•
1usiness name: Co ninecr-Eie>n_ e�.�-r�r_ _Inc, anel alteration,
dditi i peet ion. Page 2 _
5 � a Each additi inspection over allowable in any of the abate
Address: pp. 6x i t3C, Additional inspection it nr min) 66:5! hr
Investigation (1 hr min) 66.25/ hr
• City!State /ZIP; te i C - 13x3 Industrial plant (1 hr min) 76.I S/ hr '
P one: ( 50 3qp ] 9 w Fax: (,3 - Inspections for which no fee is 90.00/ hr
Z specifically listed (A hr min)
C CB Lic.: 6544.14.# ✓ Electrical Lic.: j,(f. _1C f4 Suprv. Lie.: ?At i 5 ELECTRICAL PERMIT FEES
Subtotal: (7g ,c
Suprv, Electrician signature. required:
Plan review (25% of permit fee):
•
• Print name: p va b • ��� Date: 8_2 to State surchare _e(12% permit fee)! 20_L I /
TOTAL PERMIT FEE: (
Authorized Signature: This permit application expires if a permit is not obtained rvitttin 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
• 1 auitdu,gJrennas,ELC- PermirApp doe 10/01/09 440. 46157(1 i/05ICOM/WEa
•
Electrical Permit Application Ft)R OFFICI:: ()NI
A City of Tigard C� Received
DatDate/By: jU
III 11w n III 6717 PermitNo.: FLL10' co 4�(�
13125 SW Hall Blvd., Tigard, OR 97223 Pla Review
' G Phone: 503.639.4171 Fax: 503.598.1960 j 0 6 20 Date/By:
Other Permit:
1-1 t ::� 1: i Inspection Line: 503.639.4175 OC Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard- or.gov .�/ OF ,TIG � Notified/Method: Supplemental Information
TYPE OF WORD { ti iN6 S PLAN REVIEW
❑ New construction ❑ Addition /alteratib?D`r' cement Please check all that apply (submit a 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
❑ 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qtr. I Fee. 1 Total 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add' 1 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
ad!g ItiJ p it 1w- P`"e. a chelie residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 20034 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Y relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit � 7.42 j (p 3 ? 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
tY dwelling, service and/or feeder
Phone: ( )
Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (I hr min) 66.25/ hr
City/State/ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr
specifically listed (V2 hr min)
CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES
Subtotal: t Ip 3 .
Suprv. Electrician signature, required: o
Plan review (25% of permit fee):
Print name: Date: State surcharge (12% of permit fee): II , SI
TOTAL PERMIT FEE: i 3-2_ , u
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
N um b er of inspections allowed per permit.
I:\ Building \PermitaLC- PermitApp.doc 07/01 /10 440- 4615T(I1/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building\Permits\ELC- PermitApp.doc 07/01/10