Permit CITY OF TIGARD ELECTRICAL PERMIT
;1 1 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00685
TIGARID 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2010
Parcel: 1S134CB02400
Jurisdiction: Tigard
Site address: 12305 SW SUMMER CREST DR
Project: LOVETT Subdivision: SUMMER HILLS PARK Lot: 11
Project Description: (5) branch circuits for panel, furnace and heat pump. 12/15/10, reprint to revise scope of work to (1) 200 amp
service and (4) branch circuits.
Contractor: A & J ELECTRIC Owner: LOVETT, JANICE
PO BOX 330 12305 SW SUMMERCREST DR
FOREST GROVE, OR 97116 TIGARD, OR 97223
PHONE: 503 - 359 -5891 PHONE:
FAX: 503 -359 -1981
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 12/15/2010 $100.70
Specifics: amps or less
4 crt Branch Circuits w /Purchase 12/15/2010 $29.68
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/15/2010 $15.65
Electrical
Type of Const:
Occupancy Grp:
Total $146.03
Required Items and Reports (Conditions)
This per • is issued subjec the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be do e in accordance with appr -d plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
day . ATTENTION: Oregon law re. ires you to follow the rules adopted by the Oregon Util • . -- n Center. Those rules are set forth in OAR
95 001 -0010 thro gh OAR 952 -00 ,4 Y • may obtain a copy of the rules or direct questions to 0 C by c• ling 50 .• 2.1987.er 1.800.332.2344.
/ i ••
Is ued By: Permittee Signa
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 INSTALLATI • N ONLY
SIGNATURE OF SUPR. ELEC' � Date:
-
1
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
'� COMMUNITY DEVELOPMENT Permit #: ELC2010 -00685
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2010
Parcel: 1S134CB02400
Jurisdiction: Tigard
Site address: 12305 SW SUMMER CREST DR
Project: LOVETT Subdivision: SUMMER HILLS PARK Lot: 11
Project Description: (5) branch circuits for panel, furnace and heat pump.
Contractor: A & J ELECTRIC Owner: LOVETT, JANICE
PO BOX 330 12305 SW SUMMERCREST DR
FOREST GROVE, OR 97116 TIGARD, OR 97223
PHONE: 503 - 359 -5891 PHONE:
FAX: 503 - 359 -1981
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 12/14/2010 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/14/2010 $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 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 -0090. You may obtain a cop e ru - . or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. -
Issued Permittee Signature:
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.
Dec 14 10 11:09a Leeann Greason 503 - 359 -1981 p.2
Electrical Permit A licati ``
..
4 ®
1 r : FOR OFFICE USE °No.
( ' Received
City of Tigard O nn �p ateJB Permit Nu.: ��&t �` .s-- b�
• 13125 ,SW Hall Blvd., Tigard, OR 97223 \ \�` r c(;:n Review
Other Perini::
1 - ' Phone: 503.639.4171 Fax: 503.598.1960 f�� t \` A Date,By:
i h
TIGAAD ins Line'. 503.639.4175 C,\' S r o�` Date Ready /6y: tens: i Frs See Page 3 for
interact_ www.tigard or.gov • \ \\ \,t • Nctifted!Method: Supplemental Information
h, i ll:
N r ; apt # .1 - A-iti 'PU' RCNi b
! 11 New construction Addition /alteration /replacement Please check all Chet apply (sub nil 2 sets of plans wiitelIlS checked belov j:
❑ Service or feeder 400 emps or more ❑ Building over three Etorics.
I ❑ Demolition El Other: where the available fault current ❑ Marinas and boat yards_
S L I and 2 : , � dvvelll it - - # 99 * �:l' h. .' - .. exceeds 18,000 amps al ISO volts or ❑ Pleating hni dines.
less to ground, or exceeds t'�,000 ❑ Commercial-use a�riculhiral
1
ing ❑ Commercial /industrial ❑ Accessory building amps for all ether inslallano's. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ =ire pump. ❑ Installation of 7s KVA or
1 - w E] F,merbtn larger system_ lar� r se aratc :y derived system.
1 „ 4iv,r , vet )l t '{ it i '7 r -t r -
. +: r e. , ;° . ❑ Addition of new motor toad of ❑ ., . ., , 1 „
Job no.: Job site address: \ `� c"' IOCHPorrnore. occupancy
` J V� ❑ Six or more residential units ❑ Recreational vehicle parks.
Ci lv,'S[atc //.l It: c ��QS��` ❑ H altb ca a facilities. ❑ Supply voltage for storc than
��Q ` mi l �� �� -
� � ❑ Hazardcus locations GOC volts nominal.
Suite/bldg./apt. no.'. Project name: i ❑ Servic or feeder 500 amps or more.
Cross street /directions to job site: Description I Qty. Bee `° Total 1 •
i New residential single- or multi- family dwelling unit.
•
Includes attached garage,
Subdivision: 1.nt no.: 1,000 sq. R. or less 560.54 4
Ea. add'l 500 sq. ft. or portion i 33.92 1
as loop parcel no.: Limited energy, r
i t s
w Gi .' [07 x d. � , +i (with above s R.) 61.84 2
ti C
Limited energy, multi-family Z`- ` C�'Zt:, S\'' \�Z� *`C �,j �?JZ \ -- '03 r j residential (with abovesc. CO I 61.84
\ - Services or feeders installation, alteration, andior relocatio
CD Q -� V: 200 amps or less N, 100.70 \ \U3
D RROF '- 4lyl:.» wt :.. r ®*'1' A«N -. 201 amps to 400 amps 133.56 2
Name: � �_d • 401 amps to 690 amps 200.34 2
Address: , r � 601 amps to :,000 amps 301.04 2
�� ?� `7 �� \_ RC' e ' �C Over 1,000 amps or volts 552.26 2
Citp'StateiZlP: I • Temporary services or feeders installation, alteration, and/or
�• \:�.� relocation
Phone: ( ( �P&i —72,-7-,0'S Fate: ( ) 200 amps or less 59.36 I
Owner installation: This installation is being ma on property ifhat I own - which is not 2 '1I amps to 400 amps 120.00 2
lt:
intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670. and 701. : 4 01 amps to 599 amps 168.54 2
Bra nett ci rcuits - new, alteration, or extension. per panel
Uvencf signature: Date
A. Fee for branch circuits with
3 ¢ _. * ...ems Vi a_ _ lsf r . : : above service or feeder fee. 7 42 '�(�b'' 2
each branch circuit \
Business name: B. Fee Per branch circuits
Contact came: �
vilhour service or feeder fee, 56 18 2
first branch circuit
Address: Each add'l branch circuit 7,43r . 2
ibtiseellaneous (service or feeder • not included)
City'Stat.1 . Each manufactured or modular
Phone: swelling, service and /or feeder 0784 2
( ) Fax ( ) Reconnect only 67.84 2
E nail: I Pum p or irrigation circle 67.84 2
gi
.,. ,r,,, Oli: 'aft. ", t . - Sign or outline lighting 67.84 1 2 i
Business name: �--\ ZS �^ Signal circ'aitfs)or limited -
`� �-' energy panel, alteration, or
Address: ' —3-
37 , extension. Describe: Paget 2
Cityitittac)7,IP: ` —
� "' '«:1 �� ��� \ action Each additional inspection over allowable in any of the •above
---)--l'..--'1--c-N,', \ ?crins o
Phone: ( 1 Fax: ( ) ` J�� ~ nr'cstiP 66 _.S
r
gation ptr hour it Is silo) : G6.25
CCB L Electrical Lic .: St rv. Lic.; �r�,,yy Industrial t per hour slan
\� � i P "i 3 l �� giant '8 18
Suprv. Electrician signature, required: ` ` ' f , ' Xe�� — ° k ": �C
44 �. '
Print namr:
7.;1.i 9 i i /t note: ,\. Plan rev iev: (25% of permit fee):
J f State surcharge (12° 6 of pe m, it fee):
Authorized signature:
TOTAL PERMIT FEE:: \\-\\c, Q-7.�
Print name: .. Date: late: T is permit application expires if a permit is not obri ,,,eu nirhiri I sll
days after it has been accepted a - . compute,
Number of inspections altowod per permit. r : , .uuimiuutrenr; a,E[.c- Vermnnpn.000 14:1411/09 4 10 - -OIST('I 1,05/CUM/WEB \ Q \ '
Dec 10 10 02:22p Leeann treason 503 - 359 -1981 p.2
:rn,ECEIVED
. ,
Electrical Permit Application DEC 1 O 2010 FOR OFFICE USE ONLY,
City o f T i g ard I Received ) ��il ! , .1►7
13125 SW Hall Blvd., Tigard, OR 97223 CITE 0� T IGARD DateBy. v' =f'
Tigard, PJ R
°, N. a : Phone: 503.6 Fax: 503.598.1 Caller Permit.
�IILDING DIVISION Date/13v:
TIGARD InspeeliOn Line: 501639,4175 Date Ready/By:
uric. i El See Page 2 for
Internet: m% vw.tigard- or.gov NatiFad!Mcthod: �.b 1 Supplemental Information
, -.. - .,...:. /..... . •µ`: �,�'." i t'�. r b2 ItialtiI, "tiP8�' gi)"' - e 'b` ia PRh! i `Y ...... M #' �C _.. � �' d. - ii,^E''JLLrlel4* . ._.
New construction Addition /alteration /replacemen(
Please check al: chat apply (submit 2 sets below): of plans , iterns checked below
❑ Service or feeder 400 crops or more ❑ Bnildrng over three stories.
C Demolition Other: where The available fault current ❑ Marinas and hoat)atds.
-y-' j`y z. ' ` 1 4.i l „i a t ; caceeds 10,000 amps at 150 volts or ❑ Roaring hru'di ,gs.
� �� -
leas to gro or exceeds I A,UOD ❑ Lon'anzrcal - use a2ricahurd
\tPti and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
Multi - family ❑ Master builder El Other: ❑ FireN111p. ❑ Instillation ot'75 KVA or
J 4 I a SST z. r 3 Q Fnteryency system. larder separateis derived system.
' yil �•LrCir- , :re a l .tl t`7! § y , . 4:4 , :t ❑ Addition of new motor load of
Job no.: J Job site address: \�`�� S' �� lOe HP or more. ❑ ncra:pancy.
�C1Q ❑ Six or more residential units. ❑ Recreational vehicle perks.
(.i1 /51atC: %I P: \ v ❑ Health -care faeitaie.t. ❑ Supply voltage lot more than
❑ Hnzmrdous locations. WC volts nominal.
Suite/bldg./apt. Ili.: 'Project name: ❑ Service or teeter GOO amps or more.
.. W..
Cross street/directions to job site: • Description i of ( pee • � Toast lm •
New residential single- or multi - family dwelling unit
Includes attached garage.
Subdivision:
■ Lot no.: 1,0;)0 sq. ft. or less 168.54 4
Ea. add'! 500 sq. ft. or portion 33.92 i I
Tax mapparcel no.: Limited energy. residential
. - ... ; .. .li 'a" �'._ ,t(3'Y sr (with above sq. R.) 67.84 I 2
Limited energy. multi family
' as , ���QS°� \�`\C -.; � - - residential (with about; s !I.) 67.8. _J._.
s \ . \ Services or feeders installation, alteration andinr relocation
1:::1 "14"44". =E=l v� 20O 2
amps or less 100.70
1 amps to 400 amps 133 -56
Name: _ '\ '\ `SON, Q 4Ut grips to 6UD amps 2 ,0.34 2
601 amps to 1,000 amps 301.04 2
Address: N, `Jc 1 - - --
S \� � 1\ _ --C........; --C........; --C........; \, or C Over 1,600 amps or volts • 552.26 1 2
City /State /ZIP: --..�� ..c. , Temporary services or feeders installation, alteration, and /or
�l relocation
Phonc: ( ) �O& - '?..c -�Q Fax: ( ) 200 amps or less 59.36 I
Owner installation: 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 sigr:aitrre: Date: Branch circuits - new, alteration, or extension, per panel
s .,
A. Fee for bench c rcuttss wait
II 1- Cam'" „ " „ .:, S : U1V`l('AC9[ SON j 4 tf A above service or feeder fee,
7.42 2
Business name:
each branch circuit
B. Fee for branch circuits
Contact name: wirhou: service or feeder fcc; 56.18
•
first branch circuit S� \ � `
Address: Each add'l branch circuit �� 7.42 �4taF6 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
Phone: ( ) Fax:: ( )
dwelling, service and /or feeder 67.84 2
Reconnect only 67.84 2
E-mail:
_ Pump or irrigation circle 67.84 2
r
I�19n1T `fJ$':,..., !, Sign or outline lighting 67.84 _
Business name: '� NQ`\� Signal drafts) or limited-
�� energy panel, alteration, or
Address: '--■.` :L ?- 7� � extension. Describe: Page 2 2
C1ts,Stntz-JZIP: ����` � JJ ���� � �
Per inspection 66.25 c ��� Each additional inspection over allowable in any of the ahovc
Phone: ( ) c�c ti Fax: ( )`-�� \� \<::''''''..,,„ \
��1 � \ Investigation per hour (1 hr mar' l 66.21
1 CC13 Lic. r" Electrical Lic.
: ......
���C____ ' Sti}an'. Lic_: r- t ey Industrial plant per hoc- 78.18
Suprv. Electrician 1 a . equated: r ` �'�� 1 r 1 1" .:7 .' }.M.GAL:11LY`>.S Subtotal: •W .._
— —. -. Su
y i�'r`/� �� c btot. '`�
././.*,,,,,_ '
I tint name: f/ A ./ / Date � Plan review(25 %ofpermitnee): �"�� ��
Authorized Signature: 6 State surcharge (12•;6 of permit fee):
TOTAL PERMIT FEE: 2 ' ��
i Print name: 1 Date: Ibis permit application expires if a permit is ant obtained within ISO
days after it has been accepted as complete.
runnwr .ctrearirs'.FX- rerr51 pc. Jo. 15(01,00 Normberellnspe.t1505allowcdre permit.
n- 10.45: 5T(i 1 /O','Co\4M'En
'C� UtqS