Permit CITY OF TIGARD ELECTRICAL PERMIT
'- COMMUNITY DEVELOPMENT Permit #: ELC2009-00186
Date Issued: 04/28/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S134ACO2605
• Jurisdiction: Tigard
Site address: 11365 SW COTTONWOOD LN
Subdivision: Lot: 0
Project: Burns
Project Description: Install electric furnace and heat pump (within setbacks allowed by zone).
Owner: FEES
BURNS, ROBERT B & PATRICIA ANN Quantity Description Date Amount
11365 SW COTTONWOOD LN
TIGARD, OR 97223 4 crt Branch Circuits 04/28/2009 $66.80
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/28/2009 $8.02
Contractor: Electrical
CANBY ELECTRIC INC
790 S IVY ST
•
CANBY, OR 97013
PHONE: 503 - 266 -7878
FAX: 503 - 266 -5543
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Total $74.82
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 0 R 952- 001 -0100. You may Qbtain / � a op of the rules or direct questions to OUNC by callin. .13.246.6699 or 1.800. 32.2344.
Issued By: �tk \ J 0 f\ .2 �� Permittee Signature: NC)() �
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.
2_7_
Electrical Permit ApplicatiR FIVED • , • :,(iit.oFF.,..v.I ..sE ONLY ' - - . . ' •
,..... City of Tigard . "R .
Tigard, OR 972236 2 4 2.009 Date/B . 2 1 0q . Ptmllu i No _ . .030
t
'., .• ; '' •:' 13125 SW Hall rilvd., .Plao Review '
. - •. : •, 2 .. Phone' 503.639.4171 Fax: 503,598.1960 . Date/By: Ono, i mil
Inspection I .ine :303.639.4175 •
.' TIGA.14.6 I
. D a re Joe, I el set:vane 2 for
• .: - • • Intemet. www,4.arci-or.gcre Nordied/Merhod. , o _ q I Supplemental Information •
- • • -"" •
,..
. ,
.. . ..
. .. PLAN REVIEW ' ..• . .::. . ..
• .. •
, ...• TYPE OF ..,.... • ' •' •:: '''' ."
w, _ fl . N1 ,u,L.4 ii()I 4 FG T?A1 • I D ,.. ,
__
.. .
. . ..
.
• 0 INIewicoastrucTi7, AdtiiValteration/replacement : Please check ali lintraiVIY (Sntinnt 2 itch orplans wittemA chec4C1 MOW): . . .
• .
E1Service Or feeder 400 ;imps al aloe 0 Funding ,) three stories.
.Dernotition Other: .
where the available iiiiilt ow rent (7 Marinas anti boatyards,
.•
CATEGORY OF CONO*V0F.ION::;.,. .•: ;.;::•••;•;4: .;:i!*/':',,:;..;::.:,.: exceeds 10,000 aittpx at 150 Yobs et, 0 1-honint., buildings,.
. . ...
" - 1c55 (0 grbuii4,0, exceeds 14,000 o (..,,,ilinei'ei41-ten agricultutal
P... 1; and 1-family d we I 1 mg 0 cointnerciaiiindustrial 0 Accessory bonding wisps for &) other ITINLallalitntS. b1Iliditip, ' .
. . • Multi-family 0 Master builder LI Other: • • Cli pump 0 installation of 75 KVA or , • : .
-- larger LO
JOB SIT ATION separately derived oysietn :
. . . E INFORMATION AINIi'.C":'''.'''''':":.!"..' '''1: :. - .' ''. '
• _ ,„ ,_ , .„ . . . . . , '' . El Addition of ow, Int■10t WO ■.■1
. . 00jupim>
... Job no Joh site. address: )13_4,5 5 ir tyrt , ( L T or more rean
ii . 0 s HP- ---. , xiinol n', 0 . , .
in ker.reuitiroil vehicle park5
. i
. .
City/State/ZI P • L, 1- ' 7)1. Oie. 972,Z, 0 ii,„„),...„t_ f.iii„. 0 Supply ktlilligt for' more than
---. ..
• ' . — CI Hazardous !minim (0) ,olv. nomimil.
• Suiseibldglapt. no.: 1 Project name: feili IA-i- 0 service or feeder 600 amps or more
'' — ,.. . _..., FEE $CHEDULE
Cros s Street/directions to job sit e .
Descri i us. ...,
jgry:",,T • Fey. I 'rota!
_ - -
. • New residential single- Or multi-Mindy dwelling unit. '
• Includes attached garage.
. . . .,
- ....
145,15 , ' 4.
,SubdiviSiOn: Lot no.: 1,000 sq. fi.. or leSS
- .
...,- Es. addl 500 sq. It or portion 3340 • . 1 .
lax rrnap/parcel tio.. .„ ,. .
Limiird •
enery. residc
.,.., r. . . „ .. . 75.00 , . 2
, . DESCRIPTION OF ..WORK • • •
.., -.,.......-... ,. . (with ales sq. li )
_ . .. . .. . . . ..
- Limited energy, III Ul I i family
, residential (with above so 111 75.00 • . ' ,7
Services
. . -: '''_,.<=_114,<--6,■±1. (4.----- 4----
. . _. .
or feeders installation. altera ion, and/or relocatio
200 amps Or less 80,30 2
:'D PRO ERTY WNER.. , ' : • • •: : 7 : . .. • ‘ 201 amps to 40 106 8° 0 amps ,-
• : 2
. • Name: • ,,,s_ 401 amps to b00 amps 160.00 2
,, 60) amps to 1,000 amps 240.60 • 2 . .
Address: et 5 '
r/C_)2-..-. _....., ov.- 1,000 amps or volts
, • _....
.. • City/State/ZIP: Temporary services or look' rs nstalli lion. alteration, and/or
.,_ ..
...... relocation . . . •
. . .._ ,....
Pl:tone:,(CA ) 5 71. __ or _) Fax: ( ) 200 amps less
....., 66.85 i
.
.1,1 ‘s .....
. . . Owner irmIallation: his installation i8 being made on property that - I own which is not 201 amps to 400 tit , 100.30 . 2 . .
intended for sale. lease, rent, or exchange, according to ORS 447, 449. 670: and 701. 401 amps to 599 amp$ 133.75
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: Ilranch circuits - new, alteration, or extension, per panel
.:. , Owner. signature: Date:
• A Fee for branch cirCuitS mil, r ---7---- . '
... ' -.,-
' . 0 APPLICANT • ': a Co tXet t : .. : : : ... • ahewe service or lbodes foe.
.. . . , ..... ,.. ... .. ., ... • .. Is
- ....... . - . each branch cireuil
....,,
Business name- 13. Fee for branch CirCLIRS
. . Witi/011( service cg (bettor fee. -- )
46.8 9 2
Address ,,
5 4 35.
Contact name: fifsf brands Circa) ii
- • .--
. .. Each addl bronch circuit '"- _67r 2
:
.... . „ .. miseenamous (service . 9r (rel riot included) . .
..„-
Cit./Statc/ZIP' Eeeil manufactured or modular 90.90 . 2
- ,---.•- - ...—,.. ..„ — dwelling. service and/or t;ecdcr _
. . • Phone: ( I — 7 ... Fax: : ( ) Reconnect only ..., 66 85 , 2
: 2 . .
E-mail: Pump or in igation . etrc le . ... . '..e 3.40
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CONTRACTOR outline Sign or litthtinv, 53,40
, ' ' . • - . , . _
• " Signal circuit(a) or limiled
Business name. C 4 F L (,,--\._. f 7 energy panel, atter:num. oi
.
extension. Describe Pub,: 2
Address: -- 1 . 9 0 c 7 0,4, -....i—k, _ .._ ......— . .
City/Statc/Z l P. 1 4.._.L r . ,• "I 6 i —2 F.aeh additional inspection to or :■Ilowahle in any of the above
- Per inspection
. „ ..___..
Phone: tcy2) -21 ( _ 7 i „, 5,, lax: ( S c - 2.,_(, 6 - J•5 1-4 7S .., " Investigalion peliti.ir, I britau! ' I . ... ,..:1
•
[ 73.7.5
llectriett! I Ac : ., _AI 2 es_ Suorv, Lie.: - 2 . _ i -2, - 3 5 , Industrial plum per how
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if.LECTRICAL PLRMIT FEES
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Suprv. EleCts iCian :it L.:11■1Itirv. requip,.,!: \ ...
._ ...... ......... . ...... ...... ... .... .._.. PI, revit.e, i'' ,.. ,,t perrml It.cl'
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