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Permit
t q CITY OF TIGARD ELECTRICAL PERMIT "�z. COMMUNITY DEVELOPMENT Permit #: ELC2011 -00459 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/12/2011 Parcel: 25111 CB03100 Jurisdiction: Tigard Site address: 10111 SW LADY MARION DR Project: Salazar Subdivision: MARION ESTATES Lot: 4 Project Description: Installation of (1) branch circuit for hot tub. Contractor: OWNER Owner: SALAZAR, JOSE A 10111 SW LADY MARION DR TIGARD, OR 97224 PHONE: PHONE: 503 - 501 -0637 FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 08/12/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/12/2011 $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 •r•ance • 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. A NTION: Oregon - •ui'es you to follow the rules adopted by the Oregon Utility Notification Center. Those r les are set forth in OAR 952 -001 0010 through OAR 952 -r: 000... may obtain a o y of the rules or direct questions to OUNC by calling 503.23.1987 or 1.800.332' 4. i Issue By: - �L =�i PermitteeSignature: �� , „`__ OWNER INSTALLATION ONLY fi The installation is being made on property I wn which is not intended f sale, lease or rent. f j OWNER'S SIGNATURE x C �� _� V Date: I 7� -tip7 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 City of Tigard Received Permit Tigard, OR 97223 Plate/By. 8 « � Cell -QD y" • 13125 SW Hall Blvd., Ti g Plan Review ' C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: T 7 A RU Inspection Line: 503.639.4175 Date Ready/By: kris HI See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural l- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB. SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: / a j du.. t) Y N/igreil 100HP or more. occupancy. ❑ Six or more residential units. 0 Recreational vehicle parks. Supply voltage for more than ❑ H ealth -care f acilities. ❑ City/State/ZIP: 0 Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. • Cross street/directions to job site: Description FEE `SCHEDULE I Qty. I Fee. I Total I New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: • Ea. add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential 75.00 2 DESCRIPTION PTION. OF WORK (with above sq. ft.) . Limited energy, multi - famil 75.00 2 4-N CM' t ..- ii(e.LTnc./llt wtfLt y i 6 Fo(L residential (with above sq. ft.) rr �� '._ Services or feeders installation, alteration, and/or relocation Cu& \ 0 0 4fl - iji ( T us 200 amps or less 100.70 2 j OWNER - ❑ TENANT 201 amps to 400 amps 133.56 2 SA 401 amps to 600 amps 200.34 2 -- ,•h Name: S ice. S" P\ L! ^ \ 2. n -t(L 601 amps to 1,000 amps 301.04 2 Address: 1 0 t) y M A ILA 0 0 Q. Over 1,000 amps or volts 552.26 2 City /State /ZIP: T L `, �y n (� 11.0 ' ` ( „ 0 O f � ci 1 )_.. Temporary services or feeders installation, alteration, and/or relocation Phone: (i)'3) 'o t —. 0(2 / 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 or exc 1 . ge ccording to ORS 447, 449, 670 d 7 1. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, t er panel Owner signature: _ , A__ Date: Z ' A. Fee for branch circuits with [k APP CANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 r ` each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first l 56.18 5 ' 2 Contact name: branch circuit l �' L� Each add'l branch circuit 7.42 2 Address: j o c ( . ' 1 Oft, L D ' � i O N ;/fin Miscellaneous (service or feeder not included) City /StatelZIP: ! ^ 1 ` Each manufactured or modular 1 (' P110---0 © it S ) 2.24 dwelling, service and/or feeder 67.84 2 Phone: (u) 5 ( — /_2 Fax: : ( ) Reconnect only 67.84 2 u Pump or irrigation circle 67.84 2 E - mail: ; 3 ' o . , . ( s A L A i N t y e. r a . o p 1 P27 , C O 1v1 Sign or outline lighting 67.84 2 CONTRACTOR` Signal circuit(s) or limited- energy Business name: panel, alteration, or extension. Page 2 2 f Each additional inspection over allowable in any of the above Address: 0 t) � �� Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr . Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (%z hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PER MIT FEES Subtotal: ..^(o , i 6 Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): 4 t l if Authorized signature: TOTAL PERMIT FEE: e92...??- This permit application expires if a permit is not obtained within 180 Print name: days after it has been accepted as complete. Date: • Number of inspections allowed per permit. L\ BuildingTermits \ELC- PermitApp.doc 07/01/10 440-4615T(11 /05 /COM/WEB Wiring a Hot Tub - ElectricaI Installation and Wiring Diagrams http:// www. spadepot .com/spacyclopedia/wiring- hot - tub - spa.htm • • • • • • • • .qJ 6 of 15 8/10/2011 10:00 PM