Permit CITY OF TIGARD ELECTRICAL PERMIT
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g - C OMMUNITY DEVELOPMENT P ermit #: ELC2010 00675
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/07/2010
Parcel: 2S114BD03800
Jurisdiction: Tigard
Site address: 16560 SW COPPER CREEK DR \„,
Project: BREMNER Subdivision: COPPER CREEK NO. 3 Lot: 78
Project Description: (5) branch circuits for kitchen remodel.
Contractor: GARNER ELECTRIC Owner: BREMNER, CAROL D
2920 SE BROOKWOOD AVE A 16560 SW COPPER CREEK DR
HILLSBORO, OR 97123 TIGARD, OR 97224
PHONE: 503- 648 -4552 PHONE.
FAX: 503 - 642 -7925
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 12/07/2010 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/07/2010 $10.30
Type of Use: SF Electrical
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 - •r•ance • - approved plans. This permit will expire if work is not started within 180 days of ' uance, or if work is suspended for more the 180
days. ATT' NTION: Oregon - - qui -s •u to follow the rules adopted by the OregonAftility i on Center. Those rules are set forth in OAR
952-001-'010 through OAR 952 -r+ -009 ou may obtain a copy of th- rules or direct questions to 0 NC by calling 503.2 - x•87 or 1.800.332.23. •.
/ I
(/ % �� / .r /. �� P ( .01 ._____ Issue• By: • �� / _ Permittee Signature: l l
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 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.
FROM 'GARNER ELECTRIC FAX NO. '5036427925 • Dec. Dp4 2010 10:16AM P2
Electrical Permit Application REc9u9
,,
I N .. - i ii 13125 SW Hall Blvd., Tigard, OR 97223 — .._......... . . .... ....__.____............
". :I, Phone: 503.639.4171 FAX: 503,59E1,1960 DEC 72010 Nell Review
' Supplemental Information_ ..•
Please check all that apply (submil 2 Peti Df Maim WilleMS i heiliw
0 New construction Addition/alterationkeplacement
71 Service or feeder 400 amps or more 0 Building over three smile:.
0 De ..lition EI Other: where the avuilable fault etzront ID Marines and bcatyeitlit.
; ../ ' .ilii' ■ Liit lass to round, or exceeds 14,000 0 Commeroial-m,e op-it:Withal
0 1- and 2-family dwelling 1 Commercial/industrial CI Accessory building amps for all other inslidlations. buildings.
0 Multi-famil 0 Master builder 0 Other: Cl Aire pump. 0 Inatullation of 75 KVA or
3oh rill: I site address: /6 56 6 ( SlAi CO/pi Cr f.da...e_ D Six OT MOM residential mitt 0 Recreational vehicle parks
Suite/bldg./apt. r10.: Project name: pa,e4.,,rtej2_, El geTVIDO OT Ander 600 Alava Dr rnthe. , , . I 1 ,.
— - ' '' — - ' New residential single- or multi-family dwelling unit.
Subdivision; i Lot no.: 1,000 sq. A. or lesg
33 1
Tax map/parcel no.: Limited energy, residential
— Limited energy, multi-family 75.00 2
- Services or feeders Installation 'there Ion, audio relocaii
401 amps to 600 amps 160.60 2
Name: . 601 amps to 1,000 amps 240.60 7
Address: Over 1,000 amps or volts 454.65 ‘ 2 . _
- _..... . Temporary services or feeders installation, alteration, and/or
City/State/ZIP: rtliOcatIon
OWner Installation: 'This installation is being made on property that I own which is not
401 amps to 599 amps 133,75 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits now, alteration, or exteosion er a poi ___.
Owner signature: • Date: , A, Fee for branch circuits with
each branch circuit
BusinesS naMe: ' - . 7 . ,IcAAJ_. ._ B, Pee for branch circuits 54. t g 54.1
--- - - c I without service or feeder fee,
' Eneh manufactured or modular
' MO a A. A • Pump or irrigation circle 53.40 -
Signal circuit(s) or limited-
Business name: G. energy panel, alteration, or
Each addlitional Inspection over allowable In any of the a invi.. .
PI e 5b3 ) _0_132 / 1 , Fax: (SP (042...- , InveStletion per hour ( min) _62:0 .
73 71
COB Lic.: '2_ 1 Electrical Lie.: A t l i, i p .. ii. , S . v, Lic..:"? cfl—S Indusiri hour
• — - • P -' :. / . Plan review (25% of permit fee): SO
TOTAL PERMIT FPF
Authorized signature.
. This permit application explree If a permll Is not obtained within 116.
Print name: I Date: dor OW it has been Accepted IR complete,
., .. ---- ' 4 Number of inspections IITIPW6d per permit. (:5C4