Permit �►' � �� Q c� d < a_n.c(n rC
�� CITY OF TIGARD ELECTRICAL PERMIT
111 - COMMUNITY DEVELOPMENT Permit #: ELC2009 -00491
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09(22/2009
TIGARD Parcel: 1 S125DB11000
Jurisdiction: Tigard
Site address: 7485 SW ELMWOOD ST
Subdivision: Lot: 0
Project:
Project Description: Added (1) branch circuit 10/2/09.
Owner: FEES
DURR, KEVIN Quantity Description Date Amount
7485 SW E ST 1 ea Services or Feeders - 200 09/22/2009 $80.30
TIGARD, OR R 97223 97223
amps or less
PHONE: 1 ea 12% State Surcharge - 09/22/2009 $9.64
Electrical
1 crt Branch Circuits w /Purchase 10/02/2009 $6.65
Contractor: Service or Feeder
CONDUIT ELECTRIC 0 ea 12% State Surcharge - 10/02/2009 $0.79
19461 SW 89TH AVE Electrical
TUALATIN, OR 97062
PHONE: 503 - 692 -1428
FAX: 503 - 692 -3652
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $97.38
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 952- 001 -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: C6,4 InLi
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.
- ". . E.rom:CONDUIT ELECTRIC 5036923652 09/30/2009 09:21 #721 P.001/002
Electrical Permit Applicat' o: CEIV FOR OFFICE USE ONLY.
City of Tigard Received Permit No. �t 200c? \ �(�
�lQ
1317 SW Hall Blvd.. Tieattl, OR 97 ?297 j � 0 'Z009 Plan Review Other Permit.
Phone 103.639.4171 Fax: 503.598.196 (1' Date /By: I
Inspection Line: 503.6394175 C OF TIGARD Date Ready/By: inns ® See Page 2 for
TIGARD p
Internet: aww.tigard or.gov Notified /Method. I Supplemental information
TYPE gut
WING llIV1SI N PLAN REVIEW
Please check all that apply (submit y sets of plans winems checked below):
El New construction ,['Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
'.CATEGORY OF CONSTRUCTION ' exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14.000 ❑ Commercial -use agricultural
-and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps fiat all other Installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of ❑ "A ", "E" .. "' "1 - t"
/ 100HP or Inure. occupancy.
Job no.: O� 5 Job site address: - 7�I S5 5�) E I ✓Yl li d ( ❑ Six or more residennal units. ❑ Recreational vehicle parks.
City /State /ZIP: --e^ ❑ Health -care facilities ❑ Supply voltage for more that
� ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: �1.A. -v- l ❑ Service or feeder 600 amps or more.
' FEE SCHEDULE
Cross street /directions to job site: Description I Q4'. I Fee, I 1 Dial I '• I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no,:
1,000 sq. ft. or less 145.15 I 4
Ea. add'I 500 sq. ft. or portion I 33.40 1
Tax map /parcel no.: Limited energy, residential
2
DESCRIPTION 'OF WORK above sq. ft) 75.00
(willt _
Limited energy, multi- family
A c .` A \ C - C) Pe )11/1 'l �-- residential (with above sq ft ) 75.00 2
�\I i /� Services or feeders installation, alteration, and /or relocation
el. C p 2 O ' OV'lCl t 200 amps or less 80.30 2
;❑ PROPERTY OWNER " ;'''.:'' ' `.. .': TENANT . ' 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name:
601 amps to 1.000 amps 240.60
Address: Over 1,000 amps or volts 454.65 I 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( )
200 amps or less 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
I intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. 401 amps to 599 amps it 133.75 2
Branch circuits new. alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
❑ APPLICANT ' .:.,..:,'0 CONTACT PERSON ::: ; 6.65 2
each branch circuit
Business name: B. Fee for branch circuits I
I without service or feeder fee, 46 85 2
Contact name: first branch circuit
Address: Each add'1 branch circuit l 6 65 I t 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular I 90.90 2
dwelling. service and /or feeder •
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40. 2 • .. ' ' ' CONTRACTOR • - Sign or outline lighting 53.40 , 2 I
Sienal circuits) or limited- '
Business name: Conduit Electric energy panel, alteration, or
Address: 19461 SW 89 Ave extension. Describe: I Page 2 2
City /State /ZIP: 'Tualatin, OR 97062 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 692 -1428 Fax: (503) 692 -3652 i lnvesti_ation per hour (1 he min) I 62.50 �^
CCB Lic.: 109669 Electrical Lie.: 26 -905C Suprv. Lie.: 4501S Industrial plant per hour I 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature. required: _ Subtotal: (, if
Print name: Charles Parker Date: `�y!
Plan review (25% of permit fee): l
d� 0 9 State surcharge (12% of permit fee) t 6 D
Authorized signature: a TOTAL PERMIT FEE: [• L45 ,
This permit application expires if a permit is not obtained within 180
Print name: Date: I days after it has been accepted as complete.
. Number of inspections allowed per permit. —I - L4-"T
I \Uuddma1Permtnits \ELC- Perm,App dr, 05/13/06 4x0- 4615T( t 1 /05 /CO6iM'EB
CITY OF TIGARD
'�! ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT ELECTRICAL
ELC2009 -00491
Date Issued: 09/22/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S125DB11000
Jurisdiction: Tigard
Site address: 7485 SW ELMWOOD ST
Subdivision: Lot: 0
Project:
Project Description:
Owner: FEES
DURR, KEVIN Quantity Description Date Amount
7485 SW ELMWOOD ST
TIGARD, OR 97223 1 ea Services or Feeders - 200 09/22/2009 $80.30
amps or less
PHONE: 1 ea 12% State Surcharge - 09/22/2009 $9.64
Electrical
Contractor:
CONDUIT ELECTRIC
19461 SW 89TH AVE
TUALATIN, OR 97062
PHONE: 503- 692 -1428
FAX: 503 - 692 -3652
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $89.94
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503 or 1.800.332.2344. //
Issued By: 4 ;� C: Permittee Signature: � i' �' �� `�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
From:CONDUIT ELECTRIC 5036923652 09/21/2009 12:43 #699 P.001/002
Electrical Permit Application ir n tt , ` a FOR OFFICE USE ONLi
t a R r�� ?� Aemtit No.'
7
l 2 of Tigard Z0U9 �/ 0 09 PLC Co9 —.0 0 1— /q/
. - b n C - Daie/By: eC r
1 3 1 2 5 SA' Nall Blvd., Tigard, OR 97 j E P 1 Plan R v
Phone: 503.639 4171 Fax: 503.598.1960 Date/By Other Permit
TIGARD, Inspection Line 503.639.4175 �•' y`r , r t � ® Date Ready /By: 1+ r- See Page 2 for
\' 4 p 7 t�J1110 Notified / ($
Internet: tvw\n.tigard- or.gov / Supplemental Information
e+e .r ., A
. .. TYPE 'OF — ' r • te '.'_ '--i "' ... PLAN REVIEW . '
El New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans wiliness checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
1 I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi- family ❑ Master builder ❑ Other: I ❑ Fire pump, ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOE SITE INFORMATION AND LOCATION •, ON . ❑ Addition of new motor toad of ❑ "A ", "E' "1 -r, "1 - ",
,lob no.: S — iC Job Site address: ` 1 1 A% ' W + •-� .l - L , v . " X ' ' f
❑ Six or it or or more. occupancy.
J v more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: I ( � ❑ Health -care facilities. 0 Supply voltage for more than
(l r �` \J �� ❑ Hazardous locations. 600 volts nominal.
Suite /bide. /apt. no.: 0 Project name: l r -• - ?„ Q', � ❑ Service or feeder 600 amps or more.
(J - FEE SCHEDULE
Cross street /directions to job site: , Description I Qty. I Fee. 1 Total I
• New residential single- or multi - family dwelling unit.
includes attached garage. j
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 I 4
Ea. add'l 500 sq. ft. or portion 33.40 I I
Tax map /parcel no.: Limited energy, ', residential 1 ''
. 75.00 .-
- DESCRIPTION OF WORK • ` ` - (with above sq. ft.)
Limited energy, multi - family 75,00 2
(1 C .�rk.c� residential (with above sq ft.)
Services or feeders installation, alteration, and /or reloca on
i 200 amps or less ) 80.30 1150 1 2 ,
' IPROPERTY OWNER ❑ TENANT 201 amps to 400 amps I 106.85 2
Name: .46-URA / Ei i/1 401 amps to 600 amps 160.60 ; 2
601 amps to 1.000 amps 240.60 , 2
Address: 6:-- Over 1,000 amps or volts 1 454.65 2
City/State/ZIP: Temporary services or feeders installation. alteration, and /or
relocation
Phone: ( ) I Fax: ( ) ' 1 200 amps or less 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 I 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT " "' ' : `I '` :'`: ii,E1 CONTACT PERSON . ::.....'':, •'.: above service or feeder fee,
each branch circuit 6.65 2
Business name: I B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
-
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR ' i Sign or outline lighting 53.40 ` 2
Signal panel, or limited- o
Business name: Conduit Electric or
energy panel, alteration, or
Address: 19461 SW 89 Ave extension. Describe: Page 2 2
City /State /ZIP: Tualatin, OR 97062 ' Each additional inspection over allowable in any of the above
— - Per inspection 62.50 I
Phone: (503) 692 -1428 / Fax: (503) 692 -3652 Investigation per hour n h r mine 62.50
Q CB Lie.: 109669 I Electrical Lie.: 26 - 905C ✓ Suprv. Lie.: 45015 /' Industrial plant per hour I 73 75
0' ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: I d.-120
Plan review (25% of permit fee):
Print name: Charles Parker Date: C
` I , i 1() State surcharge (12% of permit fee): 9
Authorized signature: i TOTAL PERMIT FEE: et Ct c ± _1 '/
This permit application expires if a permit is not obtained within ISO
Print name: Date: N•J5 days after it has been accepted as complete.
I Number of inspections allowed per permit
I \Buildme\Permits \ELC -Permit App doe 05/23/06 440 - 461 >T(11 /05 /COMh \'EB