Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00323
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/14/2011
Parcel: 2S 103DB03800
Jurisdiction: Tigard
Site address: 11275 SW QUELLE PL
Project: Speth Subdivision: GENESIS NO. 2 Lot: 36
Project Description: (3) branch circuits: add recess cans in dining and living rooms, adjust conductors for various circuits.
Contractor: GAW ELECTRIC Owner: SPETH, JOHN J & NANCY
21215 SW MARTINAZZI AVE 11275 SW QUELLE PL
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 482 -5213 PHONE:
FAX: 503 - 268 -7554
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 06/14/2011 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/14/2011 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
Required Items and Reports (Conditions)
This permit issued su.l-: to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done accordance with ap: oved pl.... This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. A TENTION Oregon law e. ' es . . follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fort in OAR
952 -001 0010 throu. OAR 952 - 001 -0r. •0. Y• , ay • a copy of the rules or direct questions to OUNC by calling 50 .1987 or 1.800.3
Issue. :y: / // . _ 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:
_tom ' i� -. - � �. ���
LICENSE NO. /G s
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.
I') .,r IR
Electrical Permit Applicatio C i nt f-i-- , E
1,Lt. L,, v D FOR OFFICE R ived ... _ E O ,
1Sl..1
City of Ti d ty ogar
IN Dat - & iarprignI151 Permit No.: ELe .„.„,
q 13125 SW Hall Blvd., Tigard, OR 97223.JUN 1 4 2011 Plan Review
' . a l, - • : Phone: 503.718.2439 Fax: 503.598.1960 Date/13 : Other Permit:
TIGARD ' Inspection Line: 503.639.4175 CITY OF 'TIGARD , Date Ready/By: Jwis El See Page 2 for
Internet: www.tigard-or.gov nm
III niN1r rYiiip Notified/Method: Supplemental Information
RI i,i
_Q' ':' ,,-*?...'''';':'•,, --.- ' •-i- '
TYPE OF :vvoute,',:: ' 7 : ''-'- ' : "--. - '. :': = - v: , "*:' '• `.,
D New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
1:21
El Service or feeder 400 amps or more 0 Building over three stories.
o Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY Or coNkriitie-rioN'.:....'"! , • ; : "`...' ,-'• exceeds 10,000 amps at 150 volts or 13 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial-use agricultural
IZ 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
larger separately derived system. '
e '.: ''.: JOB' !Stit 'INi'ORNIA 410W\ANW • -‘, *; , - • .'; , ',. ' DEmergency system.
0 Addition of new motor load of
100HP or more. occupancy.
Job no.: Job site address: 11275 SW Quelle Gem* r - . 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard, Or 97223 0 Health-care facilities. 0 Supply voltage for more than
['Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: Speth Residence 0 Service or feeder 600 amps or more.
y*E';[$eittri0;E:. .';.---1,
Cross street/directions to job site: Description . Qty . I Fee. I Total I *
New residential single- or multi-family dwelling Emit.
Includes attached garage.
Subdivision: 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 no.: Limited energy, residential 75.00 2
41ESRIPTION OF WORK , --. `x , 47,1.:" . ; :tr - , ', , ,' 1 " ' (with above sq. ft.)
Limited energy, multi-family
75.00 2
Add recess cans in dine room and liv room, adjust existing conductors for variou residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
3 circuits 200 amps or less 100.70 2
El . PROPERTY OWNER .. a '"'-,-..:' " .',, '. ' 4 .: -'") I'' ' El TEN'ANT:'. - `, ,.; 7::VLo , ' 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
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: ( ) Fax: ( ) 200 amps 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 - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
f
d
f
I above service or feeder ee,
.`crF ,.' ::,.. , : .i , .i.,.' • %.'ci CONTACT PERSON '',:).-.„-- 742 2
_
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18
56.18 2
Contact name: branch circuit
Each add', branch circuit 2 7.42 14.84 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP:
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 2
Signal circuit(s) or limited-energy
Business name: GAW Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 21215 SW Martinazzi Ave Additional inspection (1 hr mm) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Tualatin, Or 97062
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 482 F (503) 217 /894,6 Inspections for which no fee is
90.00/ hr
specifically listed (LA hr min) ,
CCB Lic.: 182016 Electrical Lic.: C 12 Suprv. Lie ..16905 P' .: s - -7 '•'!:' , '`"i*LECTRIc:8 - 1 , ::"PERS'Er.r.F.EKS ,t . e'
Subtotal: 71.02
Suprv. Electrician signature, required: A / Plan review (25% of permit fee):
Print name: Gregory SchpanIcyn Date: 13 Ju : 01 State surcharge (12% of permit fee): 8.52
do TOTAL PERMIT FEE: 79.54
Authorized signature:
An. Ai (-"e- AI .... Ali This permit application expires if a permit in not obtained within 180
V ' days after it has been accepted as complete.
Print name: Gregg Walther / / Date: 13 June 2011 * Number of inspections allowed per permit.
IABuildingTermits\ELC-PennitApp.doc 07/01/10 440-4615T(11/05/COM/WEB