Permit ' ELECTRICAL PERMIT
u CITY OF TIGARD
PERMIT #: ELC2007 -00634
COMMUNITY DEVELOPMENT DATE ISSUED: 9/11/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 111 C B -02601
SITE ADDRESS: 14925 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: MURDOCK HILL LOT : 007 JURISDICTION: TIG
PROJECT: YOUNG
Project Description: (3) branch circuits for electric furnace and heat pump.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FOR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
BECKY YOUNG CANBY ELECTRIC INC
PO BOX 68043 790 S IVY
OAK GROVE, OR 97268 CANBY, OR 97013
Phone: 503 - 352 -5177 Contact #: PRI 503 - 266 -7878
FAX 503 - 266 -5543
FEES
Description Date Amount Reg #: ELE 3 -112C
[ELPRMT] ELC Permit 9/11/2007 $60.15 LIC 26071
[TAX] 8% State Surcharge 9/11/2007 $4.81 SUP 2123S
Total $64.96 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 -001 e e e. rough OAR 952 - 001 -0100. •u may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B / Permittee Signature: - \ ...._. 9 .. ,(__- /4
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'N: 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.
(.147,ZQ/Al/04 IL An.a. 4.VV.v.mvy .
.
0 ,
.....--.. .
• Electrical Permit ,ApDlicaRECE I IV • FOR Qt:FICE USE ONLY
Ciity of Tigard p.d..i.d. D , iriy
zges : - / /.-■ rarrnit N o.; ei_c_.2 ,. .
13125 SW Hal121vci SEP 1 1 2A ., llgard, OP. 97223 • Plan•Review • .
Phone: 503.63,,4171 sx, 503.598.1960 CITY OE ft l' s l i• A' qit : . ' Other PArralt; • ,
. . InspeetionLihe: 503.639.41/5 - •••1.ral ' • ,.._„,,, . Daceltsorly/Byt
; ,' :, 1 Ve See Page 2 or . ;
• let met: veww:ci,ti,gard.or.us BUILDING s - --- • NosiSedMenvodl ("" 1 Su • larniAtal InTormAtiAn
• -
. i;v4.1-mseVitigattailiOgi,t,.., inrigvrofirie0 -
,.. 0 New construction aAddition/alteration/replacement Please check ail that apply:
• .• (2 Ddmolition 0 Other: CjService over 225 amps, comm.", 1:3Hazardcus location
EISEgvice over 320 Imps - rating CjBuilchig Ovcr 10,000 sq, t.,
' H T 4 Slial : .., I 'A,.. ' of 1• and 2 dwellings 4 armors new residential ..
• 7.;! •
1.. and 2-fainily dwelling EI Commerciai/industrial 0 Accdssory building °System over 600 volts nominal units in CTIC structure
°Building over three stories OFeeders, 400 amps or more
• E1 Multi 0 Master builder 0 Other..., • _, ,, 00ccuparr load over 99 persons alvtartufactured structures or . .
. ' V 4 -7, i'ioliWiftlitaaegi?;4g c ,Ni t- i4t, ' nEgressilighting plass. RV pa,r1c I
...
olicalth.care !Unity IDOther: .., • _ . !
• . •• job rio.: Job site address: 114 9 2.5- _ S. (1.) • 1'. 06 11 Submit 2, sets of pleas with Any of the above,
::. City/slur/11P: "e• t, ared • -2. The above ere no applicable to temporary oonstruction service,
Suiteroldgiapt, no.; Project name:
Deverlpel'om Q. Am TAW • - '
- _
• • Cross street/directions to job site; New residential "single or multi dwelling unit.
--- Includes attached garage, _
. . 1,000 sift. or leSS 145.15 : • ' 4
-".....-_-----.......-
• • • SUbeliviS104: Lot net.; Ea. add') 500 sq. ft. or portion - 33.40'.
Limited energy, residential 75,00 2
, . - . Tax mapIparcel no.: • • " „,‘„„,,, Limited encrry, non 75.00 2
. ET.V;IFSITHir,f1 n74,i,TV .1„Inff-LAIN:itEM PIN ,.:;:',, MM. Each rnantodular . - . '
2 -
• r----A . --c-ocz_, _.....,c..-A . --- \--- , --(2-4 . .. dwellink service and/or feeder • 90.90 _
services or feeder. installation, attars. ion, and/or relocatio
.. c .._ ,Ilforz.... a . _200 amps or less 80.30 2
t '0 rm. ' 'FAA "wyl . 3;1E1 201 ar5s to 400 amps
...1' '_,."....-ie,. - -kk.elk , - '-' ' ' s • ' ; ' ' l ' ' ''' "'''''''. • - .. ''' " . eoi amps to 600 amps I 60,60 '. 2
• • ,.Nitme: , •_. 10.Qtal---_ 601 amps to 1,000 amps 240.60 • 2
4e. -
• .....p_ . Ov 1,000 amps or volts 454.65 2 •
Reconnect only • 66,86 . 2.
. : City/State/Z: • 0 • i 2i0.. Temporary services or readers Installation, alteration, ad/or
relocation
. . 1 , • Phone: . ;‘) '2 6 2 ... - 7s 11 Fax; ( ) 290 amps or less _
66.85
jl
• : • 'Owner installations This installation IS being made on property that I own whien is not 201 amps to 400 amps 100.30
• r•F
• •. intended fbr•sale, lease, rent, or exchange, 7xeording to ORS 447, 449, 670, and 701. 40 * cps 1 133.75
• • • signanna: - _
Date: Ismael circuits - new, alteration, or extension, per pantl
• OtlkieF . ...
---- 1.73:-ppli';A: 7 1;,,li , •:■ 4 1 A, Fee Ihr brstch circuits with
r 7V-VT:,7147.412041,FOIFTITTWX 7,1 07 1 75 } 474 11 gts .44,11 .. , 0 - 4* , rt • • I
6,65 ' 2
• • Busizieas,nania: branch circuit
- ..
-,-- B, rce for branch ciroOilS
• . Cotitazt nerric: Without service or feeder fee, 4° . - .85 A ••••■■•".....
each branch circuit I LI 6 :6%
• . Address: Bath' add'Ibraneh circuit pj. 6.65 12.5o: in
_ _
......-
• City/State/Z: . mi,...... (service or feeder not Included)
..
• • _ - -- _ - , Pump or irrigation circle 53 .40 I I' 2
_
Phone: ( ) Fax. : ( • ) • Sign or OUt1iT Ming . ,.. 53.40 1 l 2 .
- -
• E . Signal circuit(s) or limited.
''.M 3 . 1 7:a ''.141a1 ''llf.P cner 136.n ° Il e rat im . or .
extension, Describe: Page 2 7
-
Business name: k..._ f_a_c
s -- ' ______
E.eh addttlonal impectIon OW ailoweD1e in any of the above _1
'Address: --- 9 Q ez: . .t . ._-_-). %- . .. le_ri 62.50
CIty/State/Z12! 7C .priyA \ c) 1/4 0 ,%? C I - 1 0 k 3 investiaar Wie__ bout (1!a min) t . 62.50 ___ ._
.... ..-.. ,
Industrial plant per hour l .. j 73.75
Phone: (S' -- )_.L (, - I . - 1 --- TFax: (S 6 - S `-‘ .." -,, - - .- -4. • ,„ , . g • , 2; .;':' ; ' ; '''.: ... "'
.1
CC.B Lie.: 2 (., 0 -1 k Electrica11.,k: 1, - \ 1. L 1 S' Lic.: 2.. k - 2_3 S Subtotal (0 e) . -• ;
---- _ ,
--$.7......, ____„- ......,
SUPS EleOrriCia71 signature, \ L ,A requited. ' _ d ^
• cu.......:„_ f L . CX,•-•■-- .-.-..- ----
Pier, review (25% of permit fee)
.7--
.--...-.
. --..-.
State sur (8% o'.'pertnit fee) • 14 4 3 I
Print nanar L . c..)...,._... 1c,,,i . I Date: ‘ \ S 01 ____.
•roTAL, rEKtvfIT FEE1 6., si , cr (9
r, (7-
Authorized sigoi
nre: L ..) • \ \_,...) C1).-----' Tbif parmit AppliAATTUO czptr 7s. i•F n vercnit Is not ob tlinett VAthin 110
uyi br( ta> bc1n ). qi complete
11 nartler r ' 1 . , , I - - . ) rs\ 5,1
, 4 . 4 Date: i t.. S (3 i ' • Pee ineibedoiNcy set .;,•,, 1 n :.....1i;:!;Dt t•how,r7: 5ctvtoe Hoard
- . ,.. •,....J./ 1. ,,.- 3----._ -......--- .• Numbez of irzper.t . 0!^ - '''' , •: ,. ....eu•
Td WcIST:20 LOOE TT •cias 217SS99E2OS : 'ON 3N0Hd ONI DI61031 E ASNUO : woad