Permit �t
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 00620
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TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.24
I Date Issued: 11/04/2010
Parcel: 2S111CB01721
Jurisdiction: Tigard
Site address: 10250 SW KABLE ST
Project: Dorr Subdivision: HOOD VIEW NO. 2 Lot: 20
Project Description: Panel change -out and (3) branch circuits for furnace, a/c & kitchen remodel. 6/7/11, reprinted to add (8) additional
branch circuits.
Contractor: GAW ELECTRIC Owner: DORR, PATRICK M
21215 SW MARTINAZZI AVE JANICE M
TUALATIN, OR 97062 10250 SW KABLE ST
TIGARD, OR 97224
PHONE: 503 - 482 -5213 PHONE:
FAX: 503 - 268 -7554
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 11/04/2010 $100.70
Specifics: amps or less
3 crt Branch Circuits w /Purchase 11/04/2010 $22.26
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 11/04/2010 $14.76
Electrical
Type of Const: 59 Electrical Permit 06/07/2011 $59.36
Occupancy Grp: 7 12% State Surcharge - 06/07/2011 $7.12
Electrical
Total $204.20
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 acc• • -nce with - • • oved 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. ATTE ION: Oregon law -quir -: y•u to follow the rules adopted by the Oregon Utility Notifica'• enter. Those rules are set forth in OAR
952- 001 -00 0 through AR 952- 001 -00• .. You ma in a copy of the rules or direct questions to OUNC by callin •61 987 or 1.800.332.2344.
Issued 1 (/ I � / Permittee Signat ?� /
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:
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LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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
. G COMMUNITY DEVELOPMENT Permit #: ELC2010 -00620
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/04/2010
Parcel: 2S111CB01721
Jurisdiction: Tigard
Site address: 10250 SW KABLE ST
Subdivision: HOOD VIEW NO. 2 Lot: 20
Project: Dorr
Project Description: Panel change -out and (3) branch circuits for furnace, a/c & kitchen remodel.
Owner: FEES
DORR, PATRICK M Quantity Description Date Amount
JANICE M, 10250 SW KABLE ST
TIGARD, OR 97224 1 ea Services or Feeders - 200 11/04/2010 $100.70
amps or less
PHONE: 3 crt Branch Circuits w /Purchase 11/04/2010 $22.26
Service or Feeder
1 ea 12% State Surcharge - 11/04/2010 $14.76
Contractor: Electrical
GAW ELECTRIC
21215 SW MARTINAZZI AVE
TUALATIN, OR 97062
PHONE: 503 -482 -5213
FAX: 503- 268 -7554
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
•
Total $137.72
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 ' ccordance ' h 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. ENTION: Oregon aw re• - s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 -0010 thr• gh OAR 952 -' , 1-' 00. Yo ay obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. � /
1
Issue By: ` � �i / _ Permittee Signature: ii.
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' t '� Date: r/( Cf/ / ��
LICENSE NO. _( 9<o9
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.
Electrical Permit Application ro k o r r C _ (, s . ( : .
City of Tigard Received „ a 9 /o / Pamit No.: EG v.,vo an Go de
13125 SW Hall Blvd, Tigard, OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 D , r Other Permit: XEt:►p OOSS4
T 1 G A \ R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 61 See Page 2 for
Internet: www.tigard Notified /Method: Supplemental Information
TYPE OF WORK PLAN REVIEW .
❑ New construction ® Addition / alteration /replacement Please check all that apply (submit 2 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: ❑ Fue pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Addition ❑ system. tlarger separately "1 -3”, system.
anew motor load of ❑ "A", "E", "1-2", °1 -3 °,
Job no.: I Job site address: 10250 SW KABLE 100HP or more. may.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: TIGARD OR ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: Project name: DU p.p.. ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. 1 Tom 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. L or less 168.54 4
Ea. add'I 500 sq. ft or portion 3392 1
Tax map /parcel no.: Limited
energy, 75.00 2
DESCRIP'17ON OF WORK (with above sq. ft)
Limited energy, multi- family
CHANGE EXISTING 200 AMP FEDERAL PACIFIC PANEL TO NEW 200 AMP residential (with above sq. ft.)
75.00 2
LIGHTING PANEL - Services or feeders installation, alteration, and/or relocation
NEW GAS FURNACE & A/C UNIT KITCHEN REMODEL 200 amps or less 1 100.70 (00.7() 2
❑ PROPERTY OWNER I ❑ TENAI 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/ State/ZIP: relocation
200 amps or Tess 59.36 1
Phone: ( ) I Fax: ( ) 201 amps to 400 amps 125.08 2
Owner installation: This installation 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 exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
1 above service or feeder fee, 3 7.42 ‘ ,9„g. 2
0 APPLICANT 0 CONTACT PERSON each branch circuit
Business name: GAW Electric B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: Gregg Walther branch circuit
Each add'I branch circuit 7.42 2
Address: 21215 SW Martinarzi Ave Miscellaneous (service or feeder not induded)
Each manufactured or modular 67.84 2
City/State/ZIP: Tualatin Oregon 97062 dwelling, service and/or feeder
Phone: (503) 482 -5213 1 Fax: : (503) 217 -6236 Pump or only 67.84 2
Pump orurigarion circle 67.84 2
E -mail: greggwalther@comcast.net Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
Business name: GAW Electric panel, alteration, or extension. _ _ Page 2 2
Each additional inspection over allowable in any of the above
Address: 21215 SW Martinarii Ave Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/ State/ZIP: Tualatin Oregon 97062 Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 217 I F . Inspections for which no fee is : (503)482 - 5213 specifically listed (Si hr mm) 90.00/ hr ,
CCB Lic.: 182016 Electrical Lic.: / 2 Supry � ic.: 18965 ELECTRICAL PERMIT FEES Q Z
P I %% fe
Subtotal: 2.2,-,410 Suprv. Electrician signature, required: �/ Plan review (25% of permit fee): 0.00
Print name: Gregory Schpankyn 1 Date: 4 N � 201 I State surcharge (12% ofpermit fee): 3638 /�
TOTAL PERMIT FEE: 3 f)r72' i 3 7/
Authorized signature: q,. �Gdik. This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Gregg A Walther I Date: 4 Nov, 2010 • Number of inspections allowed per permit. / / 2 77-)
IABuilding \Permits\ELC- PermitApp.doc 07/01/10 440-4615TO I /05/COM/WEB ( 7