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Permit • CITY OF TIGARD 11111 ELECTRICAL PERMIT �: COMMUNITY DEVELOPM Permit #: ELC2009-00348 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/16/2009 1 Parcel: 2S102CCO3301 Jurisdiction: Tigard Site address: 13950 SW 104TH AVE Subdivision: FRELEON HEIGHTS Lot: 0 Project: Specialized Housing Project Description: (2) branch circuits for replacement of furnace and heat pump. Owner: FEES SPECIALIZED HOUSING, INC Quantity Description Date Amount 4140 SW 109TH AVE BEAVERTON, OR 97005 2 crt Branch Circuits 07/16/2009 $53.50 wo /Purchase Service or PHONE: 503 - 469 -9248 Feeder 1 ea 12% State Surcharge - 07/16/2009 $6.42 Electrical Contractor: A -TEMP HEATING & COOLING 16000 SE EVELYN ST CLACKAMAS, OR 97015 -9519 PHONE: 503 -650 -5014 FAX: 503- 557 -2990 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $59.92 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. ATTENT • • • • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00 • through OAR ' 2 -. 101. You may obtain a copy of the rules or direct questions to OUNC by calling.50,3.246.6699 or 1.800.332.2344. C Issued =y: Permittee Signature :\ 3 + o! /e 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 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. 07/14/2009 06:38 5035572990 A -TEMP HEATING PAGE 03/04 Electrical Permit Application RECEIV I FOR OFFICE USE. ONLY City of Tigard 14 200 R.,civcd Permit No.: eLeg 9- 5 g JUL t t)ate/1sa, � p. n 13125 SW I-loll BM.. Tigard, OR 97223 plan Rcvicw �' '� Oilier Permit: Phone: 503.639.4171 Far. 503,598.1960 Date/B Inspection Lin: 503.639.4175 CITY OF TIGAR 1,4 ntc Randy /0Y: R1 Svc Pair 2 for ' TI G Arli? p ; liedltvlrthod $npptcmental Information interne., www.tignrtl- or,aov BUILDING DIV SI w � -- -- _�... "^ r PLAN REVIEW Cl°PE :OF W.0_ Q New constriction dd itiUll /altc ' Pleas check all that apply (submit , cis of plane w/item-• checked lwlow): (] Servicc o r realer .{eau amps or more ❑ Building over three stories. El Demolition El Other. where rho n 'tiiehic fault current El Marinas and boatyards. rtieaeds 10.000 amps at 150 Volts or ❑ Floating hu;lding•t. . C A1fI?C.ORY O:•t'(]NSTRiTC 7' .t ON _ _ .... lass to amtlnd. or cxccedc 19,(k)0 ❑ commercial-use arrieulwrni . 1- and 2- ft'f Ili ty d welling © Canimercial /industriaal 0 Acicssory building amps for all other intttallatiens. buildings. - 0 Mi.ilti- fitmily E] Mister builder __ El Other: - ._.._ ❑ Tire pump, Cl inr.tallnliott of 75 KVA or Q Emergency system, larger separntely derived system. ,T()13. SITE. INFORMATION AND LOCA'T'ION l alAddnion ol' motor road of ❑ "A" "E", "I "l -3 ^ ) salt or more. occttpnncy. Joh no a Job site address ( +. 5 (4 43(4 .10 - gl x armory ceaidcntinl units. ❑ Rcareaticmnl vehicle pnrf s. ❑ Ncnitlenrc facilities El Supply vnitnpe fen mare than C ity /Sli1tC/ 11 +: ©Elnzntdnus t entions. 600 volts nominal, Stlildhldg. /apt, DO.: inject name: r t "- l V (. r $ - _ El Service nr feeder 600 awn or mac. FEE SC HEDIlLE • Cross street/directions to j ob s1le: Dewohrtinn I OW, I F. I Total AEI ... W W M -" New residential single- or multi-famny dwelling unit. Includes attached garage. , Subdivision: M l.ot nn,: I. sq. or less III. 145.15 - ----- Ea. add? 500 Rq. ft. or portion IIIIII 33.4' el Tax map /parcel no - : _ Limited energy. residential III 75.00 • P 1xESCILTPfION. •t)F •WORIi . I • (with n e Limited energy. mulli- tensity ■ 75 III Limited tcsld> ntial (wish above sq. 5) — .. S � Services or feeder' Installation, alterutl . sled /oar relocation 200 amps or Icsr, 110.30 Ell ltOI+ tat T1 OWNER _.. 0 TP;•lANT . 201 rasps to 400 amps 106.85 mu 4U 1 amps to 600 amps MI 160.60 Name: �_�z �„ 601 amps to 1,000 amps . .111 240.60 Address; ^l 1 — ' LD� over 1.000 amps or volts 454,65 Ell C.i1v /Stote/Z1P: L 7' Temporary services or r edera installation, alteration, and /or d relocation Phone: 3 144 S # ! D Fax: ( ) 200 amps or less 6 � Owner installation: s installation is being made on property that 1 own which is not 201 amps in 400 amps intended for sole, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. 401 amps to 599 amps MI 133,75 2 Branch circuits - new, alteration, or extension r and Owner signs try _ _,_ „ _ D m c : A. , with �,.. � 1 Fee for ftranch circuit. C7 CON Pr l,c T 1 R5 N above service or feeder fee. Pl ? 6.65 2 — "' each branch cirttlit „ - Business name: a bee for branch circuits '-- - "' wIthnur vice or feeder fee, el ' Contact name. A first branch circuit �/, 4 ' 2 Address: 160()0 SE Evelyn St. Pesch acid's branch circuit 6.65 .r _ _ ,� . - -•r - -- bibecllnneons (servlke or feeder not included) City /StatdZIP: at Each nmnofitentred or 'nodular 90.90 _J"� e -., dwelling, service and /or feeder Phone: ( ) , Fax: ( < _� = - 1 ' 4 -1 U Reconnect only 66.85 E-mail: �� ��„ .-^ Pump or irrigation circle 53.40 ” � CONTRACfOR Sign or outlitte lighting rE • Signal eit'ctlit(s) or limited - liusincss nt_ttle: _ _ energy panel, alteration, Of ' MP HEATIN AND C 1lOLf+t+3 e D cxtenuion. Describe: Page 2 Ad - - - ' "'/ L\ c.Ty1 Inch additional tru __ e action over allowable in an - of the above City/State/ZIP: C�ackarrl. MI f 1 �1 , ° , f U Per inspection 62,50 Mot= ( � ) — 503' 50n5144 ) 1k PI Investigation per hour (1 hr min) V 6 2sn ill CC13 Lie.: (11 L ' Cf' Electrical Lie.: TSttprv. L Industrial plant per hrnv IEEE MI r^- `� Ltl :',EiCTRiCAL PERMIT 'FE" ' : Suprv. l :Itxtrictnn signature, n t)uircc _ b. , �^M Subtotal: f Print name: " U,t11!l rL 1 t,. 7 aI Plan review (25 °b of permit 1'00): ) State surcharge (12%ofpermit fee): It , rx Atllhorized si nal ^° - r TOTAL PERMtT FEE: L • Cf' This permit application rchilrra if n permit in nett n d n' .hilt 180 Print name: �, m Date: Me �J don Ater It has been xrrpte+l ra complete. * Number of iem:m litms nllowal per permit. 'Mailing \0toidifHi1.t'•1+ennitApp.dac 05 440.4615Tr.11/O5!ftir111VT8 07/14/2009 06: 38 5035572990 A-TEMP HEATING PAGE 04/04 • A-Temp Heating & Cooling, inc. SITE PLAN • Prepared by: 1-4 ;1. , Customer Name:...12," Address: L JO, Customer Phone: 5 9 7 Property Boundary Line 1 ) House /.• `Nr Street