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Permit n CITY OF TIGARD ELECTRICAL PERMIT 1111 2 ` COMMUNITY DEVELOPMENT Permit #: ELC2011 -00531 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Date Issued: 09/28/2011 Parcel: 2S 111 CA04900 Jurisdiction: Tigard Site address: 9560 SW LAKESIDE DR Project: MINNICK Subdivision: SUMMERFIELD NO 12 Lot: 669 Project Description: Electrical for interior remodel Contractor: VAST ELECTRIC Owner: MINNICK, CHRISTINE 1525 SEATTLE SLEW DR. SE 8420 SW 89TH AVE SALEM, OR 97301 PORTLAND, OR 97223 PHONE. 503 - 566 -7274 PHONE: FAX: 503 - 585 -8828 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 09/28/2011 $78 44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 09/28/2011 $9.41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 • ' '52- 001 -0090 You may obtair - • • • the rul= ct questions to OUNC by calling 503 2f21 87 or 1 800 332 2344 1� Issued = . _ — Permittee Signature: vl f /.' / . ✓Jt 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. Sep 27 11 09:15a Vast Electric Inc. 503 - 585 -8828 p.2 i ■ FOR OFFICE. LSE ONLY Electrical Permit Application � d �{'��{(�" g Rece�d �" 3 l� of Tigard P t t ' � !� ��n }1 �l� s • bate/8 n Permit No L _ ...c/0 ` _ ...c/0 o ' . v 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review � Phone' 503.718.2439 Pax. 503.548 -I Other Pernik: s7 t f Ll O 2011 011 DateB TI G A R U Inspection Line: 503 639.41 Datc Ready/By FM E] See rage 2 for . Internet www.ligard or.gov Notified/Methods Supplemental information "I.1.0 1��Vi TYPE OF WORK v t t 1 / •� V r�r !fill? i'1lePSCh'Thi PLAN REVIEf,Y ® w 1 �.+.-e..; w r v , a v i v ... • + Ple check all that apply plans ) ❑ New construction Addition /a1E pply (submit 2 sets of any w/items checked below El Service or feeder 400 amps or more 0 Building aver three stories ❑ Demolition 0 Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION 7cceeds 10,000 amps at 150 volts or ❑ Floating buildings ® I- and 2-family dwelling El CommerciaUindustrial less to ground, or exceeds 14,000 171 Commercial -use aeraeultural ❑ Accessory building amps for all other installations. buildings ❑ Mufti - family ❑ Master builder ` Fire pump. ❑ installation of 75 KVA or ❑ Other; ID JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "l - 3 ", Job no -: Job site address: 9560 SW Lakeside Dr. t00HPormore. occupancy. U , vvvv ���• ❑ Six or more residential units ❑ Recreational vehicle parks. City /State /ZIP: Tigard, OR El Health-care facilities. El Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: Bruce ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I New residential single- or multi- family dwelling unit. includes attached garage. Subdivision: I Lot no.: 1,000 sq flt or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. &) 75.00 2 Limited energy, multi - family 75.00 2 Moving bathroom lights down, replacing master bath vent fan, adding plugs, residential (with above sq. ft) Services or feeders installation, alteration, and/or relocation _ switches, lights in kitchen and livingroom. 200 amps or less 100.70 2 ❑ PROPERTY OWNER © TENANT 201 amps to 400 amps 133 56 2 Name: 401 amps to 600 amps 200 34 2 601 amps to 1,000 amps 301 04 2 Address: Over 1,000 amps or volts I 552 26 2 City /State /ZTP: Temporary services or feeders installation, alteration, and /or . relocation Phone: ( ) Fax: ( ) 200 amps or less 5936 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. 441 amp to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, Err panel Owner signature: Date: A. Fee for branch circuits with 1 ® APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, each branch circuit 7.42 2 Business name: Vast Electric, Inc B Fee for branch circuits withaat service or feeder fee, first 1 56 18 Contact name: Tim Vander Stoep branch circuit 56.16 2 Each add'l branch circuit 3 7.42 22.26 I 2 Address: 1525 Seattle Slew Or SE Miscellaneous (service or feeder not included) City/State/ZIP: Salem OR 97317 Each rnanafachued or modular 67.84 2 dwelling, service and/or feeder Phone: (503) 566-7274 Fax:: (503) 585 -8828 - Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: vastelectric(eomcast.net Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited -energy Business name: Vast Electric,Inc panel, alteration, or extension Page 2 , 2 Each additional inspection over allowable in any of the above Address: 1525 Seattle Slew Dr SE Additional inspection (I he ria) 66 25/ hr City /State /ZIP: Salem, OR 97317 Investigation (1 hr min) 66,25 /hr Industrial plant (1 hr min) 7818/hr Phone: (503) 566 -7274 Fax: (503 ) 585 8828 Inspections for which no fee is 90 00! hr specifically listed (l: hr min} CCB Lie.: 175531 Electrical Lic.: C - 280 Suprv. Lic.: 51865 I ELECTRICAL PERMIT FEES Suprv. Electrician signature, required I// Subtotal. 78.44 Plan review (25% of permit fee): Print name: Tim Vander Stoep Date: 9/27/11 State surcharge (12 % of permit fee): 9.41 Authorized signature: i TOTAL PERMIT FEE: 87.85 I This permit application expires if a permit is not obtained within 180 Print name: Tim Vander Stoep Date: I days after it has been accepted as complete. e: 9127!71 . Number of tnapecnons allowed per pennn. I \Buildmg\PcrmnslELC -Pemm App doe 07/01/11 440 - 46157(1 I /OS /coal/WEB