Permit 1 11111 CITY OF TIGARD ELECTRICAL PERMIT
8 COMMUNITY DEVELOPMEN Permit #: ELC2011 -00138
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/16/2011
Parcel: 2S110BB01900
Jurisdiction: Tigard
Site address: 12425 SW CORYLUS CT
Project: Minter Subdivision: Lot: 0
Project Description: (4) branch circuits to reconnect (2) heat pumps and (2) air handlers.
Contractor: ERIC OLSON ELECTRIC COMPANY Owner: MINTNER, THOMAS E AND SANDRA T
10013 NE HAZEL DELL AVE PMB 432 12425 CORYLUS CT
VANCOUVER, WA 98685 TIGARD, OR 97224
PHONE: 360-609-4901 PHONE: 503 - 639 -9597
FAX: 360- 693 -2980
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 03/16/2011 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/16/2011 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 O.: - 001 -0090. ou py o - • or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ■
/ n
Issued By: 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.
Electric Per mit Application o�
FO1t OFFICE C E USE ONLY
City of Tigard l� Received
i . � III 13125 SW Hall Blvd., Tigard, OR 97 � Datchl : 3 i ' 1 i Permit No ; FC- c.-a__ji/ _ i3g L t ) 6 Ply„ Review
Inspection Line: 503.639,4175 „ + . - , t) ateh3 Other Purmir. G� )) _�j� �OS"— i l Phone: 503,639,4171 Fax: 503,598 p
Internet: www,tigard.or.gov \C) t Method 0 Sae
Supplemental Information
• '�ledl
for
F '� swop I l r tan
t d New construction � Additiolvaltnratioq / rerpi� Neese cheek an that apply (submit 2 arts of plena Warms i:brcked below)
Q Demolition 0 Ot her: ' 3 CI or feeder 400 am or mare
Building
V cu 0 l over three atprins.
where h
ere te available fault current
.1''4 .. Sr:. ? i .1•, . a 0 Marinas and boatyards.
1 •x : 'T= 7`'.'IiR� "•`MO.�.� , ° V i^1.,, .1 {a.a:,ot�.,�,. , :. N..• . : exceeds
• •'' •' • �,.c•.;. ,.. •,i O,OW amps atlSO volts ar ❑ Floating buildings,
.‘..:1 l - and 2- family dwelling C ,. .....
B 0 Commercial/industrial [] A building lass fo graced, er exceeds 14
t Multi-family —t C7 Commercial-use agricultural
t-.I amps for all Other installations. buildings,
❑ Master builder (] Other: 0 Fire pump, 0 Installation of 75 KVA or
0» SJ4el;':,1NRQR.MATUN `AAiI+ ' Emergency syslun,,
LrQ °frfA� #QN'' :::, � huger separately dcrivcdsYwc
0 Addition a1' now elamr load or 0 • A ••b•' -i -2 •.1 - 3„
Job no,: ' Job site address: 12425 SW Corylus ct I00HP or mere, occupancy,
City /State/ZIP: Tigard, OR 97223 El Six or more residential milts, 0 Recreational vehicle parks.
CI Healthcare iactitttos, 0 suppl voltage tar more than
Suite/bldg./apt /a ❑ Hazardous locations. 600 volts nominal.
8• P L n0,: f Project name: 0 service or feeder 600 amps or more,
Cross street/directions to job site: r ? ' ,. ".;:.;;:.•: kj �r' . I , ' +. r
&NC' dam i 'v - I _ Pee n Tota
Right on to bull mountain then right ontp hazel tent ter than left o »toCorylus New residential single or multi - family dwelling unit.
-
Includes attached garage.
Subdivision: I LOt no.: 1,000sq. ft. or less
168.Sa •
Tax • + Ira. ad 0 sq t or portion EMI
tra�t�� QQ'' p x d'I ne a pu io 33.92
+.9° '.;iR • ° `' �. "' I:�. . C •. ;:', ..... »ty ; .. Limited energy, residential . � ., ' ° `• . ,Y.` • '•�k ,. witlrabave •.. rt. .
reconnect two heart pumps and two air handlers ` Limited rages(, multi - family
67.84
residential (with above sett.)
Services ofeeders installation, alteration and/or relocation
200 amps or less 100 70 El 2
' _ ' ?" ...Q.' TENANT „ ' 201 amps to 400 amps 133,56 2
Name: Thomas Minter - 401 amps to 600 amps 200, 2
—
— — Address: 12425 SW Corylus et
- - 601 amps to 1,000 amps 301,04
�. Over 1,000 amps or volts 552.26 7
City/State/ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)639 95 97 Fax: (503) 200 amps or less 59,36 1
Owner installation Th 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 tit ;Imps 168.54 2
Owner signature: Brunch circuits - new alteration or extension, . r and
�-. Date: A. Fee far branch circuits with
,,. 'E°. ' s1 s.••'.; • .:.: ' '''4 ', ' r^,::•"::: : i �. • 4 '.. above service or feeder fee. 7.42
��� "''' f each branch circuit 2
Business name: Erie Olson Electric, lac. B. Foe for branch circuit: without
service or f'cr fee, First
1 56, Contact t name: Erne branch circuit oed 56.18 2
Contact
Address: 10013 NE Hazel Dell Ave PMB 432 Each add'I branch circuit 3 7.42 22.26 2
- Miscellaneous (service or feeder not included
City/State/ZIP: Vancouver, WA 98685
Each manutheturnd or modular 67,84 I `
dwelling, service and/or feeder
Phone: (360) 609.4901 Fax:: (360 -) 693 -29130 _ Reconnect only 67.84 2
E-mail: triC015onelectrie 1 * Pump or irrigation circle 67.84 2
®gmail.com
.:.'' `'.: ;•.i:;:. • �`:.K ,!. .... .' "',01ylaX.4:3 s .•Y, a•v - n ' ^ ;: Y . Signalcir circuit(s) lighting 67.84 `: : ` " y ;• " ; ; `` : ' ... 4 Signal o� outline
or t ing gage fry IIN
Business name: Erie Olson Electric el, alteration, or extension. Pa. 2
Each additional inspection over allowable in any of the above
Address: 10013 NE HAzel Dell Ave PMB 432 Additional inspection (I hr ntin) 66.25/ hr
City /Statel2lP; Vancouver, WA 98685 C I
Industrial slant (1 hr min) 28.18/ hr � I
�
Phone: (360) 609-4901 I Fax: (360) 693 -2980 Inspections Mr what n n fee is
ttcall listed Si hr min) 90.00/ hr
CCB Lie,: 179408 Electrical Lic.: 37 -10530 Suprv. Lie,; 49105 t � l ;.''. 1 l . ,:E C u, PE
Suprv. Electrician signature, required: 78.44
Plain review (25% of permit fey):
Print name: Eric Olson bale: 3/15/11 State surcharge (12%ofpenult fee):
Authorized signature:
TOTAL PERMIT FIi6: r , BS
— 'fhb: permit application expires if a permit is not obtained within ISO
Print name: Eric Olson Date: 3/15/11 days after It has been accepted as complete,
" manner of inspections allowed per permit.
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