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Permit CITY OF TIGARD ELECTRICAL PERMIT o • COMMUNITY DEVELOPMENT Permit #: ELC2010 00630 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/05/2010 Parcel: 2S114BB14200 Jurisdiction: Tigard Site address: 10432 SW KENT ST Subdivision: SWANSONS GLEN NO. 2 Lot: 83 Project: Fisher Project Description: Reconnecting gas furnace. Owner: FEES FISHER, PAULA K Quantity Description Date Amount 10432 SW KENT ST TIGARD, OR 97224 1 crt Branch Circuits 11/05/2010 $56.18 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 11/05/2010 $6.74 Electrical Contractor: BEN'S HEATING & AIR CONDITIONING LLC PO BOX 80607 PORTLAND, OR 97280 PHONE: 503 - 233 -1779 FAX: 503- 651 -3345 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 obtai = of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By. `/ Permittee Signature: = . .� — u 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 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. 01/03/2007 17:45 FAX 5036513345 BENS - HEATING&AIR al 009 Electrical Permit Application RE CEf, f E r i.,,lt t►l l I(r. (Iyt•: ()NIA City Of Tigard Received _ M Date/3 : 11 10 j Permit No.. _ 13125 S Hall 131vd., Tigard, OR U7223 NOV 4 2 1 D HIO / by: ! plan Review T c l.Car)16 ( n i i Phone: 503,639.4171 Fax: 503.598,1960 Oth Permit- V " • t o _ u 1 �,/ '1 I c.: A It n Inspection Line: 503.639.4175 o ars Ready/By: 1 ;,: F TIGARD % See Page 2 for Internet: www,tigard- ot.gov CITY —• Natificd/Melhod: • - 6/ Supplemental information ' T YPE Op WO C DMSIn ' PLAN REVIEW ❑ New C011$1ruction Add ition /alteration /replacement Pleose check al) That apply (submit 1 sets of plan, whining checked below). ❑ Demolition ❑ Other: S ervice or feeder 400 amps or morn ❑ building aver three slimes where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts o1 ❑ Floating buildings. les, to ground, or oxceeds 14,000 ❑ Commerc;al•use agnwullur al 011- and 2- family dwelling [] Commercial/industrial ❑ Accessory building amps far all other inatallationc. buildings. q Multi- family ❑ Master builder _ ❑ Other: 0 Fire pump. ❑ Installation of 73 K VA ur JOB SITE INFORMATION AND LOCATION • ❑ Emergency system. larger separately derived system -- D Addition of new motor load of Job no.: Job site address: / AI f�3 2 .sw J/ 100H1 or more. occupancy. X >Z y , tr 5>� _ •_ Q un Six or more les;dentml its. ❑ lircrrauunal vchlcle parks City /SIutC /111' % ^ba 7r��✓ p M D 9 P , 7- El Hoatth -care facilities. ❑ Supply voltage fur mule Ihan y r 13 Hazardous locations. 600 volts nominal, Sulte/bldg. /apt. no.; Project name: ❑ Service or feeder 600 amps or snore. Cross street/directions Wjob site: — FEE SCHEDULE INUrlpllon 1 Qty. 1 rat. To0a New residential single- or multi - family d welling unit. — Includes attached garage. Subdivision: Lot no.: 1.000 84.11. or less � 168.54 ' 4 Tax map /parcel no.: _ Ea. mien 500 sq. (1. ur ponlon 33.92 .. Limited e nergy, residential 67.84 DESCRIPTION OF WORK (with above sq. ft.) - Limited energy, multifamily 67.84 ^ a __ �.„nna. (rae.�_ •• 4,4_ „ residential (with above sq. ft.) — Services or feeders installation, alteration, and/or relocatlm) 200 amps or less 111 100 70 2 Ja PROPERTY OWNER ❑TENANT 201 amps to 400 amps 133 56 , Name: { 1 401 amps to 60(1 amps 200 34 2 "� r WI amps to 1,000 amps 301.04 .. .... _ddress: / o T, ?1 S ) i 54— Over 1,000 amps or volts 552.26 - (lty /State /l,IP: g 7 Zy Temporary services or feeders installation, alteration. and /or relocation - Phone; LtY3 ) , / - VI / / Fax: ( ) 200 umps ur less 5'i 36 -- I -- . Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps I25.08 intended for sale, (case, rent. or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 stop 168 54 Branch circuits - new alteration, or exlenatun, per panel (oner signature: Date: A. Fee for branch circuits with gif APPLICANT aov service or fee fee, ^' 1 Cl CON TACT PERSON' b each branch circus 7 42 2 1 Iiu.htcss name: 415 - e. d .4e t,, C- 13. Fee for branch circuits without service or feeder fcc, first 96.18 2 C 01110 t name; branch circ �o• l J c/ _el i A ._ � Each add'I branch circuit 7.42 ` Addr "' Miscellaneous service or feeder not included Each manufactured or modular City/State/4P: dwelling, service and/or feeder 67 84 Phone: 1,5 ) /3 .. also ]a (,Sp3) / 33 y s' Reconnect only TM 67.84 . .. 1•.- mail): Pump or urtgation circle 67.84 - • CONTRACTOR Sign or outline lighting 67.84 .. ,I Signal cirtuit(s) or Iimited.cncrgy I3usincss name: 13e4,3s 17CA 4., e4 C LZ 'rncl alteration, urextension. _ P;,_e 2 II Each additional ins' ectlon over alluwable in an of the above, Address: Pa Gog g o e , /7 r Additional inspection (I hr min) - 6(i 25/ hi _ I nvestigation (I hr nun) 66 35 ht City/Stale/ZIP: Po rt11 . ©eli: c? r ., Industrial plant (1 hr min) 78.18 / hr II I'hone_I ) a / 777 Fax: (03) 6S1" 33 4 Inspections for which no lee Is • _ specifically listed (IA hr min) 900.00! / hr ( 'C14 l.ic.:4 7 Electrical Lie.: 49 ZliR Suprv, Lic.: 4k/ L/ik ELECTRICAL PERMIT FEES. t Subtutul: � , tr Suprv. Electrician signature. required: - t • — Plat) review (25 %of permit ice): erint name: di of It t, r' , N J Date; 1 %y/ State surcharge (12% of permit fee): Authorized signature A illi' Tarim, PERMIT FEE; This permit application expires it r permit is not obtained d w ithin 180 Print name: t ( �C days after II has been occepled as complete. f-' p + ` Date //j Number of inspections allo■ed per prrmu J 1 nuilnintefer ilS'1:I.C•rermiiApp doe I U/UI /aQ 445. 4415'I'(11 /03 /CUIN /WIi4