Permit II q CITY OF TIGARD ELECTRICAL PERMIT
4 ' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00247
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/11/2011
Parcel: 1 S136CB06900
Jurisdiction: Tigard
Site address: 11235 SW 81ST AVE
Project: Ryan Subdivision: HERB + PEGGY'S PLACE Lot: 14
Project Description: Install new panel.
Contractor: RED'S ELECTRIC CO INC Owner: RYAN, KAREN
6336 SE 107TH AVE 11235 SW 81ST AVE
PORTLAND, OR 97266 TIGARD, OR 97223
PHONE: 503 - 233 -6467 PHONE:
FAX: 503- 233 -1281
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 05/11/2011 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 05/11/2011 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
•
Total $112.78
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 - • • - - • 'th 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. AT NTION: Oregon aw requir- you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -r010 through OAR 952 -1 r 1 -r t •0. .. -y obtain a copy of the rules or direct questions to OUNC by call' • 03. '2.1987 or 1.800.332.��
Issued :y: t / % � / " Permittee Signature: � \ '' " ' f ' v
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.
May. 11. 2011 12:44PM Reds r ;: : r�tr8 Iv �, D No. 4350 P. 2
Electrical rem Applicatio Icll; ()I r(c f; I tit: x) 1.1
: 71 City of Tigard M AY 1 1 2011 Permitl�Io ete�ol _ea
j y 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Poxmit:
Phone: 501639.4171 Fax: So3.59s.CgITY O TIGARD Dew
t lists . 21 Bee Page 2 for
Internet: www.tigard - ocgov BUILDING DIVISIO Notified/Method: Supplemental Information
� 3 . ��Y ,� Sh �,.Y !� ' i:Dti� t � ' r . ..
D _ r ti � ° S c '. ' d ^, . R, ,51 { , ir Y
I. , j G , t .. k .m :. t, C a • - . dog ■ - o,'"` > > .: : Z' �t a440,1 S4 i 3 « . . `v . ; &- ∎1 I - I : `,nom o , �a 4,..a.Nah .. ' , .s.
❑ New construction 1 • ddition/alteratlon/replacement Please check all that apply (submit a sets of plans w /items checked below):
1:1 Demolition ❑ Other: ❑ 5ersioe Or feeler 400 amPs Of more El Building ova three stories. „ ,... e Y AT,- where the available fault currant L I Marinas and boatyard&
'," tt • TI F s �,y:�5 4 . ,2' i �� • iA' i y M N ` .. " y , t w _ t ;f::•,..:‘. a 0 t r `� � . t : , r' < s exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
� : ' } ixf Il - less t0 ground, Or exceed$ 14,000 ❑ COmmereial•use agricultural
'1- and 2- family dwelling fl Commercial/industrial El Accessory building amps for all other installations, buildings.
El Multi- family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or
" t'' 4k } k . °;' ccSe ?L: F r ?� 1 t ? r ^- y n y> ❑Emergen s yst em. larger separately derived system.
ar.^,� .. ", !??4. e ` : ° ^''r ;i :�'' �?tlec t p I CI .1 1 '. o'f p, : r. a a-;r�..,:tk._,,,
. `w�' :., �:, k ur ri ' . ,r.: ; : ... °• , ,, ..i!r , ;;Na^ : ir::: ❑ Add iti on ofnew motor loa o f
,
Job no 5 � • I Job site address:// Z 3 ,6- ( a v/ toaHPormore. occupancy.
❑ Siz or more residential unite. ❑ Recreational vehicle parks,
City/State/ZIP: f (� - 0 Health -care facilities. ❑ Supply vplase for more than
/ /�) �� ` / � ! ` ❑ lluxmdous locations. 600 volts nominal,
Suite/bldg. /apt. no. :VVV Project name: 0 Service or feeder 600 amps or more,
-
000I Fa4 fi. lU42fi ?4'.i14if.�ri
' - De.. lotion
New residential stogie- or multi - family dwelling amt
includes attached garage.
Subdivision: Lot no.: 1,000 sq. R or less _ _ 168.54 4
- - Ea. add'I 500 sq. R. or portion 33.92 1
Tax map/parcel no.: -
i' • `.; i=litir:(:• '�»r�%Yi+i6- ' /�r�l. } ,. �{I }''i� ±_ E '•H, 4dt� ,r y . - M .. rt
• )rIn110Cd C bove rosidcndal 67.84 2
ii v. v�.r }, }:, 3::: ( , 01' ,P t,6: er i It t ' "� ' t- with above It)
- Limited energy, multi- family
-Services above sq.1l
�1 .r! G
•
.) _ 67.84 2
Services or feeders installation, alteration, and/or relocation
' 200 amps or lase / 100.70 /00. X) 2
Q'�, :� Vii,,, W >:ys: J,r_ r x, ".` -' , l.rbe.. 4i s!'
201 amps to 400 amps 133.56 2
.i.4a`V:�t ; car sK r;1f�, W .. t > 1.1:.'ajiv it ; 'fe „•' 4 itt f ,. , ...rti i d it '
�:oa �;f5i • Name: A J ` y r .. 401 amps la 600 amp 200.34 2 601 amps to 1,000 amps 301.04 2
Address: // 0 < - s^ 4� / \ g/ ,s -e Over 1,000 amps or volts `_ 552.26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
�/ u 4' *iv - ? 2. 2 relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: • Illis installation is being made on property that I own which is not 201 amps to amps 1 54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps m 599 amps 1.s i
Owner signature: Date: Branch circuits - new, alteration, or extension, Reunite!
A. Fee for branch circuits with
Pg *!(ik��!'�,'l r r „ ��p�.r.y�' r ;• '� Fi:Y '^� ' "•"�y:�i ` �;.����,,, ... r,��� . � �.. r ..s - ; _:�r� above seie or feeder foe 7.42 2
? � `' , `; : rla A,d , „`r11?' iw f i bn at { OaW: G�'�* * *f ry
' _ t, - t ' v�:t� �'' each b ran ch c crn:uit
Business name: A E .e C B. Fee for branch circuits without
service or feeder fee, first
Contact name: - . , . t . \(\. c • 1Z - branch circuit 56.18 2 • / _ 1 Each add'I branch circuit 7.42 2
Address: l0 - � Misc ( service or feeder not Included)
)
�
City /State/ZIP: R a � �` C� ^� '1 / - Each Manufactured or modular 67.84 2 •
•
l ! raf G, dwelling, service and/or feeder
•
Phone: (5 3)) 3 ,61-16- Fax :: (5 03) 'Z - 3 3_1'D �' I Reconnect only 67.84 2
• r Pump or irrigation circle 67.84 2
E - mail: •
r ,ii a t - . .. l 1 • e 1 w A • M Sign or outline lighting 67.84 2 , 1.
∎ 1J7Al:: �,,.�:t.• �3 I ';. �s . 1 . : :. -. 1 ' Y,: >=C1 wnvr--h X'7.77,7 ;i.`= Signal circuit(s) or limited-energy
Business name: A panel, alteration, or extension. Page 2 2
ri t y - Each additional inspection over allowable In any of the above
Address: " ' C , .s 1 O A , Additional inspection (1 I tr min) I I 66,25/ hr
City /State/ZIP: . l__J�. r 1 Investigation (I hr min) 66,25/hr
au., plant (1 hr min) 78,18 /hr
Phone: ( 2 j ) `1 _ 6„ - 7 F ax: (63) � '? J 3 - I� . '+ 1 Inspections for which no lee is 90.00/ hr
G specifically listed (s/: hr min)
CCB Lic_:
1 3 >rlectrical Lic.: y C Suprv. Lie.: 5 03 ,.}0 4.747! Lt. n'. "e.: li rr,' I.' - ..
Suprv. Electrician signature, required: . 2 � - Subtotal: lea
r Plan review (25% of permit fee);
Printname: t , e c f't Datc: State surcharge (12 %ofp foe); /2
° crrrlit �� f:
Authorized signature:
TOTAL PERMIT FEE: // 2 , ?. s
This permit application expires if a permit la not obtained within 150
Print name' days after It has beep accepted as complete.
pate * Number of inspections allowed per permit.
t:u 10/01/09 440-1615r(iI/o5/coMJWpa