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Permit k ;• CITY OF TIGARD ELECTRICAL PERMIT •- ' ^' COMMUNITY DEVELOPMENT Permit #: ELC2009 -00367 Date Issued: 07/24/2009 TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 25111 CC04400 Jurisdiction: Tigard Site address: 15945 SW CENTURY OAK CIR Subdivision: Lot: 0 Project: Cox ' Project Description: Change Electrical Panel. - 200 amps or less Owner: FEES COX, RICHARD R & SHERIN J Quantity Description Date Amount 15945 SW CENTURY OAK CIR TIGARD, OR 97224 1 ea Services or Feeders - 200 07/24/2009 $80.30 amps or less PHONE: 1 ea 12% State Surcharge - 07/24/2009 $9.64 Electrical Contractor: OREGON ELECTRIC CONSTRUCTION INC 1010 SE 11TH AVE PORTLAND, OR 97124 PHONE: 503 - 234 -9900 FAX: 503 - 535 -2763 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $89.94 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 95 - 01 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: t� �" 6 79-iaLe•-a/t 6 40 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 an inspection that business day. 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. " -22- 9 12:25 FROM- OREGON ELECTRIC -MAIN 5032349900 T -983 P.001 /004 F -423 Electrical Permit Application i l FOR Ol l lc 1. (ar ONL' emormemom . `�„ , s Received City of Tigard • , r 5� Date/B . _ • q 13125 SW Hall Blvd, Tigard, OR 97'2 q 2j Plan Review III n Phone: 503.639.4171 Fax: 503.598,1960 \ a ey Dale/13 , Other rcnnir 7 Y(A R I) Inspection Line: 503.639.4175 f - `��jP�1J t, ( pate Ready / By: Jeri: El See (age 2 for Internet: www,tigard- or,gov ��.r\f 0C� ''Notified/method: Supplemental Information • TYPE OF WO' , , , ` VP \t PLAN REVIEW . • - Please check all that apply (submit 2 sets of plans w /items checked below): 0 New construction ® Addition /altetatio 0 Service or feeder amps or more ❑ Building over three mottos. (❑ Demolition ❑ Other: where the available fault current © Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ID Floating buildings. - less so ground, or exceeds 14,000 ❑ Commercial -use agricultural ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family [] Master builder ❑ Other; ❑ Fim pump. ❑installation of 75 KVA or BPS SITE 1 NFOR]tIAT xON .ANT) LO CATION _ . . - ID Emergency system. larger separately derived system. _ 1:3 Addition of new motor load of ❑ "A", ">: ", "t - "1 - ", Job no.: 74102 Job site address: 15945 SW CENTURY OAK CIRCLE r 1QOHP or more, n��p�cr- El Six or more reaidential units. ❑ Recreational vehicle parks - _ City / Statc/ZIP: TIGARD OR 97224 ❑ Health -cam facilities. El Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg_ /apt_ no.: I Project name: RICH COX ❑ Service or feeder 600 amps or mom. Cross street/directions to job site: FEE SC Q'y. I DeSCipdOn I Qty. I Fe 1 Total I ' " New residential single- or multi - family dwelling unit_ Includes attached garage. - Subdivision: Lot no.: 1,000 sq. ft. or less 145,15 4 — Tax map /parcel no.: — Ea. add'I 500 sq. ft or portion 33,40 1 Limited energy, residenial 75,00 2 'DESCRIPTION OF WORK • . • (with above sq. ft.) CHANGE ELECTRICAL I RICAL PANEL Limited energy, multi -family 75.00 2 residential (with above sq, ft,) Services or feeders instillation, alteration, and /or relocation 200 amps or less 1 80,30 80.30 2 ❑ PROPERTY OWNER ( • El TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 _ 2 - 601 amps to 1,000 amps _ 240.60 2 Address: Over 1,000 amps or volts 454,65 2 City /State /ZIP: Temporary services or feeders installation, alteration, and /or . . .. relocation Phone: ( ) 1 Fax; ( ) 200 amps or less L 1 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: Date: Branch circuits — new alteratio or extension, per panel — - -- - A. Fee for branch circuits with ' 0 APPLICANT . • -- I . : ❑ CONTACT PERSON above h branch circuit i r feeder fee, 6.65 2 Business name: B. Fee for branch circuits Contact name: wisltour service or feeder fix 46.85 2 first branch circuit _ Address: Each add'l branch circu 6.65 2 Miscellaneous (service or feeder not included) City /State/ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) I Fax:: ( ) Reconnect only 66.85 2 E - mail: Pump or irrigation circle _ 53.40 2 . C ONTRACTOR' • Sign or outline lighting 53.40 2 • Signal circuits) or limitcd- Business name; OREGON ELECTRIC GROUP _ energy panel, alteration, or - Address: 1010 SE 11 t AVE extension_ Describe: Page 2 2 City /State,/ZIP: PORTLAND OR. 97214 Each additional inspection over allowable in any of the above Phone: (503) 234-9900 I 'Fax: (503) 535 - 2763 Per inspection 62.50 Investigation per hour (1 hr min) 62.50 CC$ Lic_: 203 1 Electrical Lic.: 26 -95C I Suprv. Lie.: 4549S 14, /, lndi ial plant per hour 73.75 'D i f � u I v ! E LECTRICAL PERMIT FEES Suprv. Electrician signature, requix `r �t� Subtotal: 80.30 Print name: RICHARD MCELLIOTT Date: 7 -6-09 Plan review (25% of permit foe): - - - -- State Sulcliarge (12% of permit foe): 9.63 Authorized signature: q4 - TOTAL PERMIT FEE: 89,93' 71 Tills permit application expires It a permit is not obtained within 180 . Print name; RICHARD MCELLIOTT Date: 7 -6-09 _ days after It has been accepted as complete. • Number of inspections allowed pe permit. t;\ a vilninu\Pmnitt\ELC- PamitApp.doc 05/23/06 1 t� / J / 4a0-ustar(II /O5ICOM/WES JP b� I 0-J' Lt., es- r--- R 1,-