Permit CITY OF TIGARD ELECTRICAL PERMIT
`' 1 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00297
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/02/2011
Parcel: 2S104BD00800
Jurisdiction: Tigard
Site address: 13590 SW WALNUT LN
Project: BROWN Subdivision: OBRS HEIGHTS Lot: 8
Project Description: Kitchen remodel.
Contractor: MCCOY ELECTRIC CO INC Owner: BROWN, DONALD B &
2014 SE 9TH AVE NORTON - BROWN, KATHLEEN A
PORTLAND, OR 97214 13590 SW WALNUT LN
TIGARD, OR 97223
PHONE: 503 - 234 -7521 PHONE:
FAX: 503 - 234 -9473
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 06/02/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/02/2011 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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. 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 •: - 952- 001 -0090. Y• • • . - • a copy of the • les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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.
r Jun. 1. 2011 3:40PM McCoy Electric Co. No. 5054 P. 1
Electricai Permit Application
City of Tigard
Tigard
, _ 4 Hell Blvd., . OP. 9 r 1
• 1 111
• hone: 503.718.2439 Fax: 503, 8 1 N
. 1 . 16ARE)
inspection Line: 503.639.4175 F-
597. 0 E \' EivEi ,,i, .
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Plan Review
1 2 Hate Ready/ I) ateDy:
tBy: FOROFFICE !ISE, ON IX
13125 SW He
' infirMil Permit No.: kC il-
P
Other Permit:
i
' funs: El See Page 2 for _ 7
Internet: www.tigard Notified/Method: P , Supplemental Information
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- liv - •, F,i' .• : : ,,rt.1 ' • .. . ., ' ' - ..,..:, • , . , ,;:-,... , ;7.,..:,. .
.. Op r 7::,.,i,\ ,r • :.'i.c : • '.., ' c 'l.';'M re . • PI", • . ; ',wilAtr.
0 New construction El Additionhiltera ibirtrepigCrncni • Please check all that apply (submit sets of plans wiiienis checked below);
0 Service or feeder 400 amps or more 0 Building over thre Sienna.
1=1 Demolition El Other: where the available fault current ID Marinas and boatyards.
irt.. . . ' ' '' .r.lka!: .. H exceeds 10.000 amps al 150 volts or ID Floating buildings.
' less to ground, or exceeds 14,000 0 Commercial-use acultural
El 1- and 2-family dwelling D Commercial/industrial 0 Accessory building amps for all other installations. buildings,
D multi-family 0 Master builder LOCATION 1:1 Other: 0 Fire pump. 0 Installation of 75 KVA or
larger Separately derived system.
i§ilprrE ii4i6iimiriiiiigat. Lo6A. . 17Q.:411, : 0,-, Emergency sYgem , „ ,__,.. „ , „ „
..... • ••:, -• • • .. ,• .,,.; -. ,,,,......1:::..... ' • • : , •;1,,:ii :i:ie L ., Addition of new motor t oad of u A", r, .1-2 1-3 ,
Job no.: D5624 Job site address: 13590 SW WALNUT LANE 1001IP or more. occupancy.
D Six or more msidentiai units. 0 Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 91223 0 health-care facilities. ID Supply voltage for more 111Pet
0 ilazardous iocations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: KENNEDY RESTORATION CI Senice or feeder 600 amps or more.
-
P,, . : 1 •- 5 , f , -1Pip. ' .cfrEtvo.I , 5 , , , iw , , 3'
Cross street/directions to job site:
Description I CAS. I Foe. i Total I •
New residential single- or multi-family dwelling unit.
_ Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft or portion 33.92 1
Tax map/parcel n - - ,
Limited energy, residential
DtAtIrirlDiCESVOR14E':;. . :.!in:4‘;';‘: (with above sq. it) 75,00 2
Limited energy, multi-family
75.00 2
Provide wiring of six recessed light fixtures In kitchen residential (with above sq. il,)
Services or feeders installation,alterationond/or relocation
200 amps or less 100.70 2
--•=t ",...a, . . :::,. • L f ; itk- • . :)...i,,i•-•,‘FA: :•
133.56 2
li IrROPER:1[BOWNIER ':i ., 1 •• :.:: - ,,,:,::::!:±;;;, AN T ,• •• 201 amps to 400 amps
N 401 amps to 600 amps 200.34 2
ame: •
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
relocation
Phone: ( ) 1 Fax; ( ) 200am/is or less 59.36 1
, 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - newo11 lion, or extension, per panel
Owner signature: Date; A. Fee for branch circuits with
.47 : - •:• ;4 E1V-APPI i a R . !Ii • -qqrj CONTT4MRSON '.'W above service te der fee,
7.42 2
' ' cach branch circuit
Business name: B. Pee for branch circuits ivfihour
service or feeder fen. first I 56.18 56 .
.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address:
_Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: 67.84 2
dwelling, service and/or feeder
Phone: ( ) Pax: : ( ) Reconnect only 67,84 2
Pump or irrigation circle 67.84 2
E-mail:
Sign or outline lighting 67.84 2
Mk ' 7 :' .. 1!:!kkr: • Signal circuit(s) or limited-energy -
Business name: McCoy Electric Co. Pat'tel. alteration. or extension. Page 2
2
Each additional inspection over allowable In any of the above
Address: 2014 SE 9 Tit AVENUE Additional inspection (1 hr min) • 66.25/hr
City/Slate/ZIP: PORTLAND, OR 97214 Investigation (1 hr min) 66.25/hr
Industrial plant (I hr min) 78.18ihr
Phone: ( ) 503 Fax: (503) 234 Inspections for which no the is
90,00/hr
Mean listed (14 hr min
q-C" ; 5 0.1 ' • Y ( • )-
CCB Lic.: 8277 Electrical Lic.: 26-82C Suprv. Lic.: 5 9.., ,. , 0 , u Q '7;,e, ' i. ' .:. ELEPlacAL PERMItin • ..
. • .
. •
Suprv. Electrician signature, required: ' 91,,_,_, i _ - Subtotal: 56.18
Plan review (25% of permit fee):
Print name: ZACK ARMSTRONG Date: 6-1-11
State surcharge (12% of permit fee): 6.74
TOTAL PERMIT FEE: 62.92
Authorized signature:
This permit application expires ifs permit is not obtained within 180
days otter it has been accepted as complete.
Print. name: 7 Date: • Number of inspections allowed per permit.
L'aullaing■Permital_C-PerMilAPP.d0C 07/01/10 440-45/ TO Ms/COM/WEB