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Permit CITY OF TIGARD ELECTRICAL PERMIT • ' - COMMUNITY DEVELOPMENT Permit #: ELC2011 00575 Date Issued: 10/18/2011 .TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel: 2S1106CO2300 Jurisdiction: Tigard Site address: 11988 SW ASPEN RIDGE DR Project: Boitano Subdivision: ASPEN RIDGE Lot: 35 Project Description: (2) branch circuits for furnace replacement and heat pump install. Contractor: A TEMP HEATING & COOLING INC Owner: BOITANO, TIMOTHY & CAROLYN 16000 SE EVELYN ST 11988 SW ASPEN RIDGE DR CLACKAMAS, OR 97015 -9519 TIGARD, OR 97224 PHONE 503 - 650 -5014 PHONE FAX: 503 - 557 -2990 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 10/18/2011 $63 60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 10/18/2011 $7 63 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 accords re 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 ATTEN • Orego law equires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-001' through OAR 95 I1-089P,‘ You may copy of the rules or direct questions to OUNC by calling 50 32 1987 or 1 800 32 2344 Issued By. . ' /� Permittee Signature: CJ's 0,',0 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. Electrical Permit Application Past, OFFICE Ic l USE t)NL I J , City f Tigard Re ceived / Ani..% _P -Di' Nu.: �. Le ,s{ ' //- OD 57.- I •J Dale/1 3 r Q r a 13 12 5 SW Hall Blvd., Tigard, OR 9723 � � Pla Reviaw II Phone: 503 718.2439 Fax' 503.598, 6' ) C' M orbei Pcnml, ^ ,�xte; t3y Inspection Line, 503.639,4175 h et ` �`',, ' `� i, `girt. Ready/13y loos B1 Sep Nose 2 rur T I GA 17. t1 M Supplemental , Method. Information Interact www tigaid Ur,pov J. , _ TYPE OF WORK Cr} , ' REVIEW - ` ' .> Please check all plat apply (submit a seas of plans w /items checked belay ) 0 New construction RAddition/altera [ ion/r'eplac l> t ` LI Serv,a_e of tccder 400 snips m mole ❑ Fuild■ng ove, three stones ❑ Demolition ❑ Other: t��� v, here the a, ailable fault c tin ent ❑ rvlannas and bouryards c.cecds 10,000 erupt at 150 volt, or CI !'loafing buildings. CATEGORY OF CONSTRl1C '110N leas to giawid, or exceeds 1 -1,000 ❑ Cuincurnal -usu a5ricultuial ff I - and 2- family dwelling ❑ C0111itterclal /iridustria! ❑ Accessory buildinu arnpt. rur .,n othm' mat, lhstious buildings El Multi- family © Master builder El Other: ❑ Eire pump. ❑ lnstuliation of 7.5 KVA Jr . ,, _ _ ❑ Enaergeucg ss rew laiger seprrptrly derived 5v51ern JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ©"A "E' I.7 I • -1 Job no.: K24 UUHP or mote occupancy. - 111 Jo site address �� � S Ye °,�,y �7 U . I J ❑ 51, ur more tasidentld! urn. ❑ occup vehicle Uarls, 1 ❑ I"ical(h -,are laCillrics l supply .oltage for mote than ('its /State /ZIP: (/ b "1 2,2„ ❑ Hazardous lot,niuus 00 volts IllalllMA Suite/1)1dg /apt no,: • Project name: ; D T ado ❑ Service or Ieeder 000 amps or limn: : I FEE SCHEDULE Cross street/directions to Job sire: Dencnptou I Qty I tie Tatar J- ° New resideiltlat single- ur Multi- family dwelling unit. Includes atiacticd garage... 1,000 ski, 0 or less 160 54 4 Subdivision: Lot n0.: Ea ndd'1500sq, K or portion 33 92 1 Tax map /parcel no.: Limned energy, res,denual _ 75 00 2 DESCRIPTION OF WORK (with above sq. 0) — Limited energy, multi - family 75 00 2 1-- � C r U C �r (,, -11. F .10 1 f p -' . • 8. / residential (with above a It ) (f11 i Services or feeders installation, alteration, ar'sd(or relocation F C aC ( e' , r 'S A - 5 L p ,) ({ , (154-0,1 .1 „L_ 200 amps or less Mill 100 70 z PROPERTY OV4NELi h u TENANT 201 amps to 400 uanpC 133 56 2 401 amps to 600 amps 200 34 2 Name: 11 m 0_14,v 01ka OD _ 6 01 a t�rps to 1,000 m tips - 301,04 2 ' t I Ov er 1,000 m' rips or volts 552 26 2 Address' I (� $ i , t / • ' r) t Temporary services or !ceders installation, alteration, and /or I City /State /71P: ` '' '' Ho t i t') • M relocation ,• �1 200 amps or less 59,36 1 Phone: ( ) Pax: ( ) .- - 201 amps to 400 amps 125 08 2 Owner installation: This installation is being made on property that 1 own which is not ..... 40 amps to 599 amps T 168 54 2 intended Fur sale, testae, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel Owner signature: _ Date: _ _ A Pee for branch circuits stirh > CONTACT” PERSON above service or feeder fee, 7 42 2 $ APPLICANT © each branch circuit . _ C9 Fee for branch circ,uils w BuSitress name: 1+J se lcz or feeder foe, fist 56 10 I t y(� 2 b lench circuit 1 b t b Contact naunc: I 7A2 9-, n / 2 Each add'I branch ciruutl Address' `' M iscellaneous (service or feeder not in —93466 _ °" Each manul cturcd tit modular r 67 8.1 2 City /State /'ZIP. dwell sem and/or f _ __, ( � '? , L O Reconnect only 67 b4 2 Phone: ) Pax : ( D — L ` r,7 84 ..�., 2 ( Vamp or in igrion chute h7.B4 2 S ign o r outline lighting E .� , CONTRACTOR Signal ctrcwt(s) or lnmled•encrgy - - - panel, alteration,, or extension rage - ' - 2 Business namr; Each additional inspection over allowable in any of the a bove "�T=i� LPC:t It "d t.11 .A �'vylly LNG, INC Additional inspection (I hi min) on 25/ ht ._.N Address: Vt l ' i F .1 'ttl ,i: C i6 25/ ii - 7 lnvestigannn ( hi mill City' /Slate /ZIP. I..ldCLatiitls_ (._.P. 97015 _ lndusUtal hr min) - 7R / h — _ � p T — � ) Inspections for which no fee is 90 00/ hr ` T Phone. ( ) (,� ;ptxnu all S listed (y. hi man CCI: Lic,: q I s pQ L lcctrival Lie.: C Supr'u I it:.. 2i M ELECTRICAL PER141PI FEES w _ Subtotal' Suprv, Electrician signature. r quired, s P(anrr evte(25% of permit fee): -- e . • Date: State sulcharae (12% UI' permit I'ee). , -, ^ Print name; � l� co, .+ YY11 A + 4 t1 t % TOTAL PERM! l FEE, , .3 Authorized Signature' 41 tv This per,alr apphcadon arpr i f a permit is no obtained within 180 � �� , drys after it has been - accepted tin compita•, i Print Bat 11.� : pi 04e. l Y N A-4 � w Date: 10/ k / (/O 1 , ' Nuuibr,i of iuspcenons _Awed per pernnl LL„ = ,tm.Jh i SS1'f 11 E0 39 d BNI1d3H dW31 d 066ZL55EO5 5E :9T TTOZ /1'T /0T