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Permit
,� CITY OF TIGARD ELECTRICAL PERMIT 1N l COMMUNITY DEVELOPMENT Permit #: ELC2011 -00535 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/29/2011 Parcel: 2S111BCO2603 Jurisdiction: Tigard Site address: 10310 SW CANTERBURY LN Project: John Tigard House Storage Shed Subdivision: TIGARDVILLE HEIGHTS Lot: 7 Project Description: (3) branch circuits for storage and bathroom Contractor: MICHAEL RAFFAELL CONSTR INC Owner: TIGARD, CITY OF P.O. BOX 1673 13125 SW HALL BLVD OREGON CITY, OR 97045 TIGARD, OR 97223 PHONE: 503 - 632 -6720 PHONE: FAX: FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 09/29/2011 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 09/29/2011 $8 52 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR Ai 952 - 001 -0010 through OA' • - 001 -0090 You may obtain a co. of the rules or direct questions to OUNC by calling 503 232.1987 or 1 800 332 23447 �/.... 1 Issued By: !��! �- -- Permittee Signature: —.....-:-•,, �G �/ .i.... 411101 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 09/28/2011 02:40 5036326732 MICHAELRAFFAEL PAGE 03/03 Sep 28 11 11s 48.0 Cathedral ParkP1ace 5032835740 p -1 i Electrical Permit Applicatifl EC E - . i tu: to h'it 1 USl t)IVI;s' ived City 25 of SW Tlall gmrd vd I ,, ua f � o/ // Pauli( No.' r v 131 H Bl., Tigard, OR 97223 Man Review ether Perms I N 13 r Phonc: 503.7I$.2439 lax: 51)3.5911 190 E P 2 8 2 0 11 r stcll3y: _ 1a G A''R D htppcotign Line: 503 639.4175 y Date Reedy/By: ludo. RI 6w Page 2 for . Internet: www.tlgard- or.gov CITY OF TIGARD Notfcd/Mcihod: T. ) ' _ (or Supplemental infonnatton E OFiROMING DIVISION PLAN REVIEW Ncw construction Addition/aiteration/replecement Plcoor check all Ulat apply (submit 3 acts of plans whtems checked below): 0 Service or feeder 400 amps or more [] Building over three statics. [] Demolition 11 Other: where the available fault current ❑ Marinas and hwtyards, CATEGORY Qjr CO1151 - KI TIOi'i 44444.3x 10,000 n..,pp 41 ISO vphp or ❑ Moraine 6v4ldinac I- And 2 - [amts dwelling less to grOUnd- or exceeds 14,000 A Comantrrtrst -use agrtaltumtl y g ❑ C ommercial /industrial ❑ •csaory building amps for all Outer installations buildings © Multi - family ❑ Master builder Other: S'j'o rL 4 G F ❑ Pins pump. O Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION I3 Emergency system. larger reparately dtnvad syattm ❑ Addition of new motor load of ❑ "A" 'P" "1 -7^ "1 -3" 10014P o r inOrC, ottalmnCy. Job no.; Job site address: . 0 Recreational vehicle parks r. J o fl Six or more residential snits City /Stale/ZIP: ti � ` p liealUt•CUe facildra. C15upply volmgo for morn then T t r r 4 /1.0_ ir ❑ Hvardwslocations 600 soils nominal Suite/bldg. /apt, no,: Project name: ©service ar [ mop 'order 000 am or more c��klN Tlf,r l W NEE SCHEDULE _ Crust. street/directions to job site; . 3_6___a_---_ ,..,_ / nM.U`S ECP0-. nearriptloa V Q Pa y _ Tnta - New residential single- or multi - family dwelling unit. Inrtodox attarhrd ea root. Subdivision, Lot no, ; 1,000 sq ft or lest? 168.54 4 - °' Ea, add'] 500 sq. It or portion 33 92 1 TAN map /parcel no.: r-amlt«I energy, reetdanriar 75.00 2 DESCRIPTION OF WORK — (with above sq. ft.) _ - „ - �y Limited energy, multi-Comity 75 00 2 . S fl'� /2 / 6 hT r i 53 /4 T /1 it 6 M. rtsldcnual (with above sq. it) Services or feeders instaltationotteraCIon nndfor relocation _ 4 L ,Q t 4 200 amps or less 100.70 2 0 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 13156 2 401 amps to 61X1 a mps 2017.34 Name: _-.__- _ " _ . .. ,,,,_ _ ___ 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 --.- 2 City/State/ZIP: Temporary Services or feeders installation, alteration, and /or relocation Phone; ( ) Fax; ( ) 200 amps or less 5916 I Owner installation: This installation is being made on property that I own which is not _ 201 amps to 400 amps 125,08 Z intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168,54 2 Bra nch circuits - new, alteration, or extension, per panel Owner. signature; .- •,-, -. . . Date: A. Pee for branch circuits with 0 APPLICANT 0 CONTACT PERSON above acrvrcc or feeder fee, 7 4.2 2 -- each branch circuit Business stain: S. Fee for launch circuits without —'- -- - -- service or feeder fee, first Contact name' branch circuit ' 56.18 4 Z -- Each add'I branch circuit !� 7,42 / y 2 Address: Mtscelaneous tservice or feeder t of Included) City /Blase /ZIP: Each manufactured or modul 67,84 2 dwelling, service and/or feodot Phone; ( ) Fax; ; ( ) _R ecolmcct only 67 84 2 E-mail: Pump or irrigation circle 67 2 Sian or outline lightin5 67.84 2 CONTRACTOR _ _ Signal rrrrurt(u) or I,rnifrd rnergy 6,,,inCb lig� t � 6 - e � � - panel, alteration, or extension. Page 2 2� Each additional inspection over allowable in any of the abov Addr es�t'S`'� , e . sQ J Additional inspection(1 hr mill) — 66.25/ hr I' Investigation (I hrmin) 66.25/ hr City/Stine/ZIP' a Q,t a ate C 7 Y Industdalplant(1 hrmin) 78.18 /hr Phonc: 60 - , - 1 jr ROC _ a ) .6,9 4 73 2_ Inspections for which no foe 13 90 001 hr r spcclflcally list (Ys lit mtn) CCB Li c gr.i. f 'j_ _., Electrical Lie.- z e s t q e, Suprv. Lie.:'] � e . —$ ELECTRICAL PERMIT FEES Sutrv. Electrician Signature, required.' A ,,, . s.1 Subtotal: '� �. ar+ -� lien revi (2) 1t. or permit fcc); Print num i ot a: I_/ State urchargo (12 °1 of permit fee): tGia -e L I � .i� -e 11 �I�.2• TJ TOTAL PLRMiT FGC _d _ lure: This permit epplicgryino eapinn if a PCrmit iv not Obtafnvtflrtthln 180 days after it naa heen accepted as complete_ PTint Monte: I Date • Number of inspections allowed per permit. lAlle ldingtfunais 5ELC•PCmllNpif doe 07101 /10 445 -0C1tip lro5/COM/LWE9 09/28/2011 02:40 5036326732 MICHAELRAFFAEL PAGE 01/03 ccs #: 58422 MRC CONSTRUCTION, INC. ELECTRICAL CONTRACTOR 01)0)' P.O. BOX 1673 W y ' OREGON CITY, OR 97045 \if `'' OFFICE: 503 -632 -6720 / CELL: 503 -781 -9857 / FAX: 503- 632 -6732 e -mail: mikesnrc@bctonline.com DATE: _V1.1 T PHONE #: 50- — („zg r L, zt TO: C ei `T7 f, L Fax #: l0 3 - 5 9 E - / 9 e C> r FROM: p4 RE: f'-e , / /O.R 10 5 Lam, ~L esd Z , COMMENTS: p , c.� -PP a-? f4- 1-- 11 4 D goOtI —00002\ a 1O !� � f \)) ■)A0 )2_,t)a.;AezqA --��- • COIF J Etc A/4- �- l cA •