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Permit CITY OF TIGARD ELECTRICAL PERMIT I I 12 COMMUNITY DEVELOPMENT Permit#: ELC2010 -00593 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/26/2010 Parcel: 2S104DA10600 Jurisdiction: Tigard Site address: 12865 SW BEAGLE CT Subdivision: QUAIL HOLLOW - WEST Lot: 92 Project: Condon Project Description: (2) branch circuits for new lights & outlet relocation. Owner: FEES CONDON, JIM Quantity Description Date Amount 12865 SW BEAGLE CT TIGARD, OR 97223 2 crt Branch Circuits 10/26/2010 $63.60 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/26/2010 $7.63 Electrical Contractor: BOONES FERRY ELECTRIC INC PO BOX 628 WILSONVILLE, OR 97070 PHONE: 503 - 682 -4936 FAX: 503 - 682 -7946 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: Permlttee Signature: t7" 19 e -i. v 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. CaII 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. Oct. 22. 2010 6:54AM No. 5188 P. 1 Electrical Permit Application NV FOR OFFICF 1'Sl: O\L1 Ci of Ti and ""c ` g G� Dmear. i /0 I Permit Ng4(�'� /O -Q 59 it 4 13125 SW Hall Blvd., Tigard, OR q 10 Plan Review / O 3 Phone: 503.639.4171 Fax; 503. .1960 P `1,\/ qg Other Permit T, c A R n Inspection Line: 503.639.4175 0'- • r r Date Ready/By: la H See Page 2 for Internet: www.tigard- or.gov . , G'` \v OR‘NodSecVmelaed: , 1 i Supplemental Information C, r.J,r r ,• 1 �' f :: .. . �:v'. .,, E -m ,..:' . ,.:.i ,._ . -` ._.._t.f..... .. ...j }•. (l . , :uu r ,•.,. , t c . .+. y •. ► — • - - • * Please check all that apply of te :. checked . . ❑ New construction � Addltron/aiteratl •' �� , aceIIlegt apP plan w�items chedcad below): ❑ Demolition El Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories. where the available fault current 0 Marinas and boatyards. j ` 5 )' , r ° ',:..(='.:. ' +_ c,„....,::,....,.2:2::.;.;:.1, ` exceeds 10,000 amps al 150 volts or ❑ Floating building.. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural c(„l and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other iastailations. • baildings. ❑ MuIti-family ❑ Master builder © Other: One pump. ❑ Installation of 75 KVA or 2 . r . � . i ' ` O Emergency system. larger separately derived sytem. r, .i : - r ... < > r.. r., , - _.... .. ) ,. O Addition di on of new motor load of 0 ..A,. -2 ". l Job no.: /'' 2 '7 2 Job site address: 1 z (3 6 5 s u e lOOHP ar mars. occupaaq. a� ❑ Sec or more residential units. Q Recreational vehicle parks. c lry /State/ZIP: r qq ❑ Healthcare facilities. ❑ Supply voltage for more than J r O Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: Project name: Co N b d'J ❑ Service or feeder 600 amps or more Cross street/directions to job site; Deseriatioa New residential single- or multi-family Fm ly dwelling nnit Includes attached garage. Subdivision: I Lot no.: 1 sq. ft or less 168.54 4 T a x map /parcel no.: Ea• d'1500 sq. ft. or portion 33.92 1 e ab e ove residential . 67.84 2 - " Gunned energy, multi - family 67.84 2 2.- c 1 s 'o N ew 17 h fr d 2eL p 4 12 c 1 o c o. 4 Vol residential (with above sq. ft.) Services or feeders Installation. alteration, and/or relocation 200 amps or less X ) 7 } F z i s h 20 amps to 4 0 am 133.5 6 2 1. :) -- ti ' ) lam ` f 2 401 amps to 600 amps 300.34 2 Natge: ? r ( e ul CI o h 601 amps to 1,000 amps 301.04 2 .ddress: fR A Over 1,000 amps or volts 55216 2 City/State/71P: Temporary o s or feeders installation, alteration, and/o Phone: ( ) J 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 168 54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 166.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with 7 ; r r r above service or. feeder fee, a ) , r . �ti. i ., c.y 1 . .� + . :: W each branch circuit 742 2 Business assns B. Fee for branch circuits without service of feeder fee, first ( 56,18 S r /, 2 Contact name: branch circuit Each add' 1 branch circuit 1 7.42 7, s/ 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: /State/ZIP Each manufactured or modular 67.84 2 tY : dwellmg, service and/or feeder Pax:: (. ) Reconnect only 67.84 2 Phone: ( pump or irrigation circle 6714 2 E C } . ` ! r '� ` 5 ` f _ - . ^ r r ) _ Sign or outline lighting 67.84 2 !.,.., _.. > ._._.. „ . ,._. �. _ , � tin :. ,.. . - _-- .. . . ,_ - M . ......_ _ Sigrial c of l .enerk;y Business name: Boones Ferry Electric _Lanel, alteration, i or extension. Parse 2 2 Each additional inspection over allowable io any of the abov Address: P.O. Box 628 Additional inspection (1 hr rain) 66.25/ hr Investigation ri plant (1 hr mm) 78. br City /State/ZIP: Wilsonville OR 97070 Industrial plant (1 hr min) 78.18/ hr Phone: (503) 682 -4936 I Fax: (503) 682 - 7946 inspections for which no fee is 90.00 / hr s • Titan listed Ys hr mat 6 �' - o 6 , CCB Lie.; 88482 Electrical Lie.: 3 -223C Suprv. Lic - / e ' ..,d..„ f .'. .: ,. :.{ N Suprv. Electrician signature, required: /�/ �/3 Subtotal' ' �Q� ' � 1 Plan review (25% of pet fee): -42 ?riot name: S / •4 Date: fe 7(x) State surcharge (12% of permit fee): . f /2 TOTAL PERMIT FEE: 7 1 , S `j Authorized signature: This permit application expires if a permit Is not obtained within 180 Print IIarlle: Date: days after it has been accepted as complete. • Nnmber of inspections allowed per permit. 7 cua+i izs�•� -dog 10/01/09 440 -c15T 11/ovCOMMBB / A