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Permit CITY OF TIGARD ELECTRICAL PERMIT ii ; : <_,: COMMUNITY DEVELOPMENT Permit #: ELC2010 00680 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/08/2010 TI+CiARP Parcel: 2S110AA92411 Jurisdiction: TIGARD Site address: 10739 SW CANTERBURY LN 101 Project: Canterbury Crest Subdivision::ANTERBURY CREST CONDOMINIUM: Lot: 0 Project Description: Remove and reinstall 4 gang meter pack for sheetrock repair. Contractor: JARMER ELECTRIC INC Owner: SULLIVAN, RISA KRISTINE & 5105 SW 45TH AVE #200 WILLIAMS, RYAN BRADLEY PORTLAND, OR 97221 10739 SW CANTERBURY LN #101 TIGARD, OR 97224 PHONE: 503 - 246 -5381 PHONE: FAX: 503 - 244 -8037 FEES Quantity Description Date Amount 1 ea Reconnect Only 12/08/2010 $67.84 Specifics: 1 ea 12% State Surcharge - 12/08/2010 $8.14 Electrical Type of Use: MF Class of Work: ALT Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports (Conditions) This permi ' . subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be .. e in accordance • appr. . plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 d. s. ATTENTION: Oregon req you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR • 2- 001 -0010 trough OAR 9s +1 -V. . u may obtain a copy •f the rules or direct questions to OUNC by calling 503.232. •:7 or 1.88.r 332.2344. sued By: Permittee Signature: _ / � ..LL.. . _ 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 IN TALLATION ONLY / SIGNATURE OF SUPR. ELEC' ��� , 4V . v Date: „a /�w Awl— 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. • Electrical Permit A>plication I c f l: ()Hi( l to ,I. ( ) N I „1 • - -731 ; , :. City of Tiga d d. Received "TO .��o /o 68� o . balm; ; /A PcmdtNo --Q� 13125 SW !fall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax; 503.598.1960 D ; Other Permit; 1 \ i ,'; Inspection Line; 503.639.4175 Data Ready/By; NM 63 See Papa l information interact: wwW.tignrd- ot.gov Notified/Method: 5 upplemrntallnformatton • rot Oki won . • • • • • • ! ',AI•tAltVIEi1► 0 New construction AAddttion /altcration/repiacement Moan check all that apply (submit 3 sets of plus w /Items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories, ❑ Demolition ©Ot'hcr: where the available 14clt currant ❑ 'marinas and boatyards. .. - CATLC t OP irot�'11 tYJL".PIt31R . exceeds 10,000 amps at ISO veils or O Floating buildings. less to ground. or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ❑ CommerciaVindustrial ❑ Accessory building amps fur all other installations. buildings, Multi- family ❑ Master builder ❑ Olhcr: O Fire pump. ❑ installation of 75 KVA or - '. •3 , s alm k , toui X woman I ON D Emergency system. largo separately derived system. � ❑ Addition of new motor load of ❑ "A ", "E ", "1- 2 ", "1 -3", Job no.: IJ / / Job site address: /'p 735 <1,, i 9N ✓ < /1 /� S1 - j ( lOOYIPorm occupancy. ❑ Six or more midwife] units. ❑ Recreational vehicle Auks, • City /Statc/ZIP: 2 13 Hcelth -care Pscihtion. ❑ Supply voltage far more than CI Hazardous locations. 600 vets nominal. Suite/bldg. /apt no.: ! Project name: 0 Service or feeder 600 amps or more, Cross strt:ct/direetions to job site: • ' . ' ) bEJ Aenessiun Qty. I Purl I Total I - --- New residential single- or multi- family dwelling unit. includes attached garage. Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea. add'I 500 sq. it. or portion 33.92 1 Limited energy, residential 2 •• Desca rr'Y61$'oir vita ( with above . ft. 67.84 " L energy, multi - family k ,t C / 6 /Aga j - 7 - /9 - Z - t y �vt¢N 01E k ii residential (with above sq. n.) 67.84 z // t�O� /Y�� �I.2D cis to Service' or feeders Iastaltal on alteration, and/or relocatii►n / ° 200 amps er less 100.70 2 ,- '❑ P Y .0WNIER • F .. . , I • ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 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 relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 Owner installations This installation is being made on property that I 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 Owner Signature: Date Branch circuits, new, niterntlon, or extension, per panel A. Pee for branch circuits with ❑ CONTACT PERSON above service or feeder foe, 7.42 2 each branch circuit Business name: B. Fee for branch circuits Contact name: • without rttnviee or facder fcc. 56.18 2 first branch circuit Address: Each addi branch circuit 7.42 _ 2 Miseellauenna (service or feeder not included) City /Statc/ZiP: Each manutfohrrcd or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) . 1 Fax :: ( ) �' E-mail: Reconnect only / 67.84 67 2 Pump or irrigation circle 61.84 2 • CONTRACTOR • . • Sign or outline lighting 67.84 2 Business nam SAi2/y fL FLr-CTQ� & Signal circuit(s) or limited - Address: ,` 05 _ yam►, ' ,ks exten n. Describe:ion. or Page 2 2 City/State/ZIP: t OltrL.4 1■0 O c I Each additinnal inspection over allowable in nay cline above Phone :6k3) c4 . t p b 5.3/ Fax: (5037 Per inspection 665 °"�`e �d�� investigation per hour (i hr min) 66.2.25 CCB L ( ic,: a� ^ Electrical Lic.; , . + 4 Su! . Lic.: 0 y � industrial plant per hour 78.18 _ • Sum. F.lectr(oian signature, required: i _ I' 1PERAI[f9'RIRS° e� T Subtotal; Print name: •() A(Z1 h i t� / Date: /2 7,-10 Plan review (25% of permit fee): :1 / Stntc surcharge (12% ofpermit fcc): Authorized signature: TOTAL PERMIT FEE: , 75 b Print name: Date: This permit appiie,tion expires if a permit is not obtained within 180 days ftr 1* It after it Iwo been accepted as complete. 1;1n,dla • Number of inspections allowed per permit. NtllbrmieAELC•PermlNpp.dee 10/01/(19 440- 4615T(11/a5/COMMII