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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT COMMUNITY ELC2011 -00429 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2011 Parcel: 1 S125DB09700 Jurisdiction: Tigard Site address: 7110 SW LOLA LN Project: KAUFFMAN Subdivision: Lot: Project Description: (3) branch circuits for air handler and heat pump. Contractor: ERIC OLSON ELECTRIC COMPANY Owner: KAUFFMAN, GAYLE I & 10013 NE HAZEL DELL AVE PMB 432 FREWING, JOHN L VANCOUVER, WA 98685 7110 SW LOLA LN TIGARD, OR 97223 PHONE: 360- 609 -4901 PHONE: FAX: 360- 693 -2980 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 08/02/2011 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/02/2011 $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 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 952- 001 -0090. You may obtain a copy of the rule • direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. l A Issued By: /II. - Permittee Signature: 1- — //'/ 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 , t 1 1012 OFFICE USE ONLY �- City of Tigard D''''''' : . /'��' i�� rnl'n,itNo„ w (r — 't 13125 SW Hall Blvd., Tigard, OR 97223 AUG ®1 2 Plan Review ° Phone: 503.639.4171 Fax: 503.598.1960 Received i)ule /13v, 00,er Perrr. i t: '1 Tic ARD inspection Line: 503,639,4t 75 CITY ©F o TIGARD Da, r ead /B 61 See Pszo 2 for Internet www tigard or gov ottG d/ cthod t , • n a r n � + row..., nl �rl �' i� N � M , � t �r l >�tin .t `t t . 1111 h, r >+ k 'i - , 4 skY.t :" :( 't�'.. ".. . . > „ ,,t,:; � Ad1�0 F"1 {. t '4k ' { J 1,. '�. � . �.f '4fli �� a :l ul - r . i. :,*.P. TM,11� 1 ,.. � '° .Ak.7. 5' p New Construction . ddition /alteration /replacement Please l>noh drat apply (eubmit sets ul'plas w /ila,ue checked below): ❑ Service or feeder 400 amps or Idurc ❑ Building over three stories, ['Demolition 0 Other: where the available fault current ❑'Marivas>tud boatyards. ��+ y" utttJr ,'t,, „''; ' • tt 0y , ' pt 'k9” „` %'1 ," + _' , ;�-' exceeds 10.000 amps at 150 volts or D Floating buildings. :Uii`: kt�� "4 T .''i�i rem` W e C +: ', - ` 4 less to ground, Or exceeds 14,000 ❑Commercial -use agricultural ft)l- and 2- family dwelling © Commercial /industrial. ❑ Accessory building amps for all other installations, buildings. 0 Mu lli- family 0 Master builder Q Other: ❑ 1'6N pump. ❑ installation of 75 I(VA or tP. ; 3 : a. , p 7 . 7 . . .g ..,, ..: �, '' ' t' 7:a t�, : . .,r: x ,: - -r— ❑ EmervticY system. larger separately derived syxte>u. 'tr sr <; :4 :"ii : 1';'' ry w� , :�la .,.'�1. , �... i��t +h'�::'�'� :. "ci's;; :. " ❑ � uotorloadof ,. „E„ „ „ 1 - F r •, . � : � , �: ;1' .; ;. ' , , ;? -r., w ' , . Addition of new ❑ r� 1001 or more, occupancy. Job no.: Job site address: l <. - I]; y,x pr 1,101'C residential units. 0 Ileert:flf1011fl1 vehicle pulls, City/State/ZIP: (.y_-C ! _ __ ❑❑ Healtl•ca> facilities, ❑ Supply voltage or more thus !Le ila W ,�„ • " Hazardous Li/Cations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: p Service or r GOO amps or 1110e m 6 ^ _� ...._... --- �illw' ttlr , ;t� } 111 it� r ';.r��, . ,.4 �/r a;. r ",.e. *- Cross street /directions to job site: Doerit >dun I ntv. ( Vvv, I Taal i ' New residential single- or multi-family dwelling unit. _ Includes attached garage. Subdivision: Lot no,: 1,000 sq. II or lets 168,54 4 --- Lu. add' 1 500 sq. a.. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 67.84 2 . Nt ± *t,rr p mr r fr "' "r (with above s ft.) . . ` ' x,' c Wei a r; „xt' 1 Alid o , ,w r I 1 I P 1 ( q . G: : nr l F4 ,..._ .,11 ., t_.,t•a u 1, k,.!� Y 4, } 5 1 i r tx C OL /� Limited energy, rnuhi • eve s i. 67.84 2 t G ..r.;_,,$ tdendal (with above sg , _ i' L services or feeders installation, alteration, and/or relocation 200 amps or loss 100.70 2 t , ',t :,trt r a 400 2 ," Rt t, .�.i�� '� " �' " 201 'raps to 1 33 ' ^ ' � ^' A�;',�itk ' �., + .. 1 " , ti chk � �� Z ,�.:Iv�t+ar'u er, t.l.! "' " " w dr t hn� S t ., a ,a . '�i N #f - ' 401 amps to 600 amps 200.34 2 Name: ' fi 4 - 9 / e2 y /pv P �0 601 amps to 1,000 amps 301,04 2 7- / , cam Address: j 4 rj � / Over 1,000 amps or volts 552,26 2 C G Temporary services or feeders installation, alteration, and /or City /State /ZIP: • 0 i relocation _ _- 200 amps or loss 59.36 I Phone; (Set r7 Fax: ( ) — 2 201 amps to 400 , 125 naps ,08 Owner installation: This installation is being made on property that 1 own which is not 401 amps l0 599 amps I= (68.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. nrriiiC14 circuits — new, alteration ur extension ser uncl Owner signature: _ Date: A. Fee for branch circuits with g . t..n^ ,a>a �, t'+ „ + Mauve service or feeder fee. 7,42 2 & 'n:,;'l , :L'r:U n 14F tr "' s F ti 1 ' J;44„ 01 ^I i•' II i. m der P;?, It � ii iu a Bus in name: Eric Ol ..., ���` '., £ d.ti'1 each branch circuit son Electric, Inc. Tnc. B . Fee for brunch circuits within:: C ; service or feeder i'ee, first 56.'16 2 brunch circuit Contact name: Eric 7.42GJ 2 Each add'i brunch circuit Address: 10013 NE Hazel Dell Ave PMB 432 Miscellaneous (service or feeder not included Each manufactured or modular 67,84 2 City /State /Z1P: Vancouver, WA 98685 d wnllin „service and/or tttod Reconnect only 67.84 2 Phone: (360) 6094901 I''ax :: (360 -) 693 -2980 Pump or irrigation circle 67.84 2 E ericolsonelectriC d Corn Sign or outline I ghting 67.84 „ k' ,4 tl = fi Vin: S nal l ci rcutt s) limited•uner gY � nr !+'" �t_,t2 �> � mu �,1 pa,"� °„ wok, wok, -; ' ttl .,., +:. ..,�'S'4't ,": `�i ,.B'��", + � L[ ( 2 snot alteration or extension. Pa e 2 2 Business name; Eric Olson Electric Each additional ins ectiun over allowable in rlu ur (lie above Address: 10013 NE HAzel Dell Ave PMB 432 Additional inspection (1 hr ruin) - 66,25) hr °"- Investigation (1 hr min) 66.25/ hi' City /State /ZIP: Vancouver, WA 9$ industrial plant (I hr mint) 78.18/ hr Phone: (360) 609 - 4901 Pax: (360) 693 - 2980 inspections for which no lee is 900 0/ hr s iscilictdly listed (V3 hr min) � �yM1 C CCB Lie.: 179408 L' ^lectrical Lie.: 37 -10530 Suprv. Lie.; 49105 '�:„. „. :'_^.1: : :. :14 .,' lA•Isitaderai diVirVir&DliMI��,i Snl> L:l'» +3t}'h-':: Subtotal;�'T Suprv. Electrician signature, required: . L. Plan review (25°4 of permit fee): • Print name: Eric Olson Date; I State surcharge (12% of permit fee): L Authorized signature: This permit application expires ifs permit is out obtained within 1.0 days after it has been accepted ns ...plate. Print name: Eric Olson Date: > .. g ” Number of inspections allowed per permit. 1 i ?Lc.eutnib,pp.dw: moo 440.46I5'r(1 • ZO /t0 3Ddd 0I610313 NOS 086ZE6909EI EZ:St TtOZ /IE /LO