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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2009 00052 COMMUNITY DEVELOPMENT DATE ISSUED: 2/6/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 111 CC - 02400 SITE ADDRESS: 10390 SW CENTURY OAK DR ZONING: R - SUBDIVISION: SUMMERFIELD LOT : 047 JURISDICTION: TIG PROJECT: SPEILMAN Project Description: Reconnect gas furnace. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: ROBERT & BERNICE SPIELMAN BEN'S HEATING & A/C 10390 SW CENTRURY OAK DR PO BOX 80607 TIGARD, OR 97224 PORTLAND, OR 97280 Phone: Contact #: PRI 503 - 233 -1779 FAX 503 - 651 -3345 FEES Description Date Amount Reg #: ELE 49LHR [ELPRMT] ELC Permit 2/6/2009 $46.85 LIC 64597 [TAX] 12% State Surchar 2/6/2009 $5.62 Total $52.47 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. • Issued B y : Q-CIVibrU L t Permittee Signature: Q4 *1)1( ( -- 11011 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'N: 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. r Electrical Permit Application vol �>c I i:yi: ONLY v - - City of Tigard R g , Received (c e 1 • Q Q Permit Na �i' _�� M 13125 SW Hall Blvd•, Tigard, Plan Review .' !Pg. , 3 Phone: 501639.4171 Fax: 503.598.1960 6 Date/e : Other Permit �E' e • o c i • : I < t A It [ i Inspection Line: 503.639.4175 FEB 6 2009 Data RaadylBy: turfs; ® See Page 2 for �fi p Internet www Ugard- or.gov ��'yl��'{ \ � }^ � y y��^ �tayyr�pyy� Not ed/Method: �p , � � Supplemental ;TYPE O �` , .,,., Ef .1� - „ t,.. PLAN •REVIEW ❑ Ncw construction X- Additio �l V Please check all Ihat apply (submit Z sets of plans w /items checked Lei ❑ Service or feeder 400 amps or more ❑ Building over three stories, ❑ Demolition ❑ Other: _ wham the available fault currant 0 Marinas tend boatyards, CATEGORY OF. CONBTRUCI•IbN:.,; >��: a �:,. ' :: `''•A::0!C.: >;, . exceed. 10,000 amps at ISO volts or ❑ Floating buildings. � `t less to ground, or exceeds 14,000 ❑ Commercial-use agricultural I - and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for all other htstallatlons. buildings, Multi - fatally ❑Master builder ❑ Other: ❑Fire pump, ❑ Installation of 75 KVA or J SITE `INF RMATIOi AND L ION ” r .` "r " " ❑ E envy system. larger separately decked system, . ... ❑ Addition of now motor load o!' Q Job no.: Job site address: 10 9a S e it 0 c y M tt , 100HP or more. occupancy. ❑ Six or more residential suits. ❑ Recreational vehicle packs. City /State / '7 . A O • 7 1 In Health.eare facilities. Q Supply voltage Pot more than ❑ Mttxardous locations, 600 volts nominal. Suite /bldg. /apt. no.: Project name: 0 Service or feeder 600 amps or more. "1,7114` %., :.'';,,,:,,'': ' : ',FEE: SCHEDULE • . ••, ' . . Cross street/directions to job site: nearrtnuen Yee. l Qty. I ( 'carat I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: - Lot no,: _ 1,000 sq. fl. or less 145.15 4 Tax map /parcel no.; Ea. add'l 500 sq. It. or portion 33.40 1 Limited energy, residential 75,00 2 DESCRIPTION'..OP "WORK St , ' % "'; 1 ' ,iit',tv (with above 9. A.) I ✓ Limited energy, multi- family 75 Ot) 2 Re, -Cool " b Y (4/',t/y4[, residential (with above sq. (1.) Services or feeders installation, alterat and /or relocatio 200 amps or less 80.30 2 • ' . ($ PROPERTY OWNER ..',;. ` `:r.D, .TENAN'C;a i •,ii ?'.;' 201 amps to 400 amps 106,85 2 Name: Gerdf 4PI6.1m Ari , amps !60.60 2 601 amps to 1,000 amps 240.60 2 Address: /0370 'A,) Ce-wfivii g4'k Gkf Over 1,000 amps or volts 454.65 2 ity /State /ZIP: 7 ' yr Temporary services or feeders installation, alteration. and /ur reiocation Phone: ( 673) 63. - . gii © Fax: ( ) 200 amps or less 66.85 I Owner installation: This installation is being made on property that 1 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 Branch circuits — new alteration, or extension, per panel Owner signature: Date: APPLICANT.: I '.:; : ' : A. Fee for brunch circuits with ..' • •� ' In 1. fed- CONTACT PERSON : ?.., above service or feeder fee. ' 6,65 2 Business name: I each branch circuit • .$ w.a r .- . L r . r� LL C B. Fcc for branch circuits � -I. without service or feeder fee, 46 85 2 Contact name: d t I 'L rTb P l first branch circuit Address: Each add'I branch circuit 6.65 2 • Mlscellaneousservlce or feeder not included) City /State /ZIP: Each manufactured or modular 90.90 dwelling, service and /or feeder Phone: (5v3 ) 3/3-- 99 () Fax: : , ) d i7 — Y Reconnect only 66.85 2 E-mail: Pump or irrigation circle 53.40 . 2 ' ' CONTRACTOR ; t " (, ",k,, 't Sign or outline lighting 53.40 2 me: Business name: Signal circuit(s) or limited- e4,, r S /4 e • n . ,,4 - (.p d a ,,,, /�'q t! L' energy panel, alteration. or Address: 4 iJ extension. Describe: Page 2 2 P,0 Q� gnG, 07 City /Stale /ZIP: e, 444 ,,,1 _04, q 7,j Each additional Inspection over allowable in any of the above Per inspection 62.50 Phone: (W ) 0 _ 0 7 9 Fax: (yv, ) ts- /— 33q Investigation per hour II hr win) 62.50_ CC13 Lie.: G Lill 7 Electrical Lie,: ' L#,e Suprv. Lic.: RJR Alj Industrial plant per hour 73.75 r. ( ., '. ELECTRICAL PERMIT ' I Suprv. Electrician signature, requ .: _/ Subtotal • L. g 5 ''tint name: �/11�� f ate: , lJ b I �1 Plan review (25% of permit fee): State surcharge (12% of permit fee): 5 • ( o Z Authorized signature: . i Dale: $ TOTAL PERMIT FEE: 62-I..( - P ! �, I I This permit application expires If a permit Is not obtained within ISO 1 riot llattlr: f�)cl �u r�o days after it has been accepted as complete. d ' Number of inspections allowed per permit, i 'Itu hu ngIPcrraiuAELC•PermitApp.duc 05/21/06 440.t6151(1I/OStCOM/WF.e TOOT] ?IIVVONIZV3H — SNdg SFCCT59CO2 XFd ZZ :60 600Z/90/Z0