Permit ,� CITY OF TIGARD ELECTRICAL PERMIT
g COMMUNITY DEVELOPMENT Permit #: ELC2011 -00256
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503,718.2439 Date Issued: 05/13/2011
Parcel: 2S111CC08000
Jurisdiction: Tigard
Site address: 15795 SW GREENS WAY
Project: MORRISON Subdivision: SUMMERFIELD NO. 2 Lot: 107
Project Description: (2) branch circuits for hot tub and kiln.
Contractor: JARMER ELECTRIC INC Owner: MORRISON, SANDRA & JOHN
5105 SW 45TH AVE #200 15795 SW GREENS WAY
PORTLAND, OR 97221 TIGARD, OR 97224
PHONE: 503 - 246 -5381 PHONE:
FAX: 503 - 244 -8037
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 05/13/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/13/2011 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 52- 001 -0090. You may obtai , • •f the r - • • ' .-ct questions to OUNC by calling 503.23 87 or 1.800.332.2344.
4
Issued By: i� Permittee Signature: r `� i
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.
Electrical Permit Application 1•URR 01.1'1( 1: 1iSi.. ONI:V
City of Tigard ecru ved
II
. 13125 SW "fall Blvd., Tigard, OR 97 "
223 V) 0 ' ` J �
Plan Review
Phone: 503.639.4171 Fax; 503.59 DatetR ; Other Permit:
t ; \ i. r, Inspection Line: 503.639.4175 �1, I , Supplemental Date Ready/By: El Sec Paget for
interact: www.tigtltd- ot.gov J 3 Notified/Method;
E Information Pt oz woi o\ ? ' .._ P+
1 ' �_ �'
Q New construction ► Addition /alteration/ . , l Please, check all that apply (submit 3 acts of plans w/iteme checked below);
❑ Demolition ❑ Other: Cl ♦ N " ❑ Spa or facder 400 amps or more ❑ Building over three stories ,
CI where the available ihult current Wiens and boatyards.
.: CA'TEdbRy OP e . a' 1 ". - ON comas 10,000 amps at 150 v0117 or O Floating buildings.
i - and 2 - family dwelling ❑ CommerciaVindu.�trial l to gloried. or exceeds 14.000 Q Commercial -use agricultural
❑ Accessory building amps for nil other installations. buildinge,
❑ Multi- family ❑ Master builder ❑ Other: D Fire pump. ❑ Installation of 75 KVA or
Jo; MU , JNFOR s AdIOkl•' /N LOCATION ID Emergency system, larger separately derived system.
❑ Addition of new motor lord of Q "A° "H" "1- 2 ", "I -3"
Jab no.: cis" r Job site address: / �j 1o01.1P occupancy. D ` ` S`^' ( ve S " ❑ Six or more residential units. ❑ Recreational vehicle puks,
City /Statc/ZIP: vt o k Gp a � [.(. D Health -care 16clinics. El Supply voltage for more ihnn
j� D Hazardous locations. 600 volts no,niaai,
Saite/bldg. /apt no.: v 1 Project name: (n Q y - - _ . _ / LI Sctvice or feeder 600 Amyl; or more_
Croas street/directions to job site: U'V _ .,•, . . ' . •' • FLTD�f[:IE: : •_. '
nerettptton _i_9ty, .1 .tea I 'rein W I "
New residential single- or multi- family dwelling unit.
tncindes attached garage.
Subdivision: Lot no, 1,000 sq. ft or !ass 168.54 4
Tax map /parcel no. Ea. add'l 500 sq. ft. or portion 33,92 1
Limited energy, ft. residential
(with above sq. ft. 67 2
/, Limited energy, multi - family 6734 Z '
�a_ b a4,42_ kt kiln e i Ire- - residential (with above sq. n.)
Services or feeders installation and/or relocation
200 amps or less 100.70 2
'. PIi r!r•.Owlrl$A • f .. • ❑ TENANT. 201 amps to 400 amps 133,56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 55226 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax.: ( ) 200 amps or less 59,36 I
Owner installations 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 signature: Branch circuits- new, alteration, or extension, per panel
Date
A, Fcc for branch circuits with
• 0 AP)l NT . a •CONTACT PERSON above service or feeder fcc,
Business name:
each branch circuit 7.42 2
13, Fox for branch circuits
•
Contact name: without service or feeder fcc, 1 56.18 •-.Z. le 2
first branch circuit
Address: Each add'1 branch circuit / 7.42 1.4-7.-- 2
Miscellaneous (service or feeder not included)
City/Statc/ZiP: Each manufactured or modular
67.84 1 2
dwelling, service and/or feeder
Phone: ( ) Fax: ( ) Reconnect only 67.84 i 2
E -mail: Pump or irrigation circle 67.84 2
CONTRACtOR Sign or outline lighting 67.84 2
Business name: SARMre.2 £ lZ - ei C.. I NC- Signal cincttit(s) or limited -
.� energy panel, alteration, or
Address: 5I 05 (4.5-4-11 -s ODD extension. Describe: Page 2 2
City /State/ZI (� �1 P: �OIPSeJa � D O c � I 1 Each additional inspection over allowable in any of the abo
Phone: 03) c tL-j1p -. 5 ( Pax: (503j — l 'T Per ga 66.25
�d39' Investigation stitiInvestigation on per hour p hr min) 66.25 --h
CCB Lic.: Chat -I [Electrical Lic.: . 96• 1 4{ ,Su , Lic.:401.4 industrial plant per hour 78,18 • •. PLECTRICAL >ZEI tar FEES -
Suprv. Electrician signature, required: c ....--..-- 4. , - e. ----.. _�, Subtotal; („ 3.6
j / 1 SHCt.�y1t1_ ,
Print name: Date: Si_ i I _ I I Plan review (25% of permit fee):
State surcharge (12% of permit fcc): 6.., 3
Authorized signature: TOTAL PERMIT FEE: 1 .
Print name: Date This permit apalicatien expires it a permit is not obtained within 180
days after it has been accepted as complete.
' Number of inspections al lowed per permit.
t;lihdtd'Ru ittELC- PennttApp.dec 440- 4r,l rri1m5comma