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Permit
irL CITY OF TIGARD ELECTRICAL PERMIT 1 "11 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00203 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/07/2009 Parcel: 2S103CD01700 Jurisdiction: Tigard Site address: 13775 SW FAIRVIEW CT Subdivision: Lot: 0 Project: Ludes /Lyons Project Description: Install (3) branch circuits for furnace, heat pump, and GFCI. Owner: FEES LUDES, GREG J & Quantity Description Date Amount LYONS, JENNIFER, 13775 SW FAIRVIEW CT TIGARD, OR 97223 3 crt Branch Circuits 05/07/2009 $60.15 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 05/07/2009 $7.22 Contractor: Electrical HILLSBORO ELECTRIC LLC 21185 NW EVERGREEN PKWY #110 HILLSBORO, OR 97124 PHONE: 503 - 439 -9666 FAX: 503 -601 -3680 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $67.37 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 th o6 ug IOAR 952- 001;Q100. 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: �� U Permittee Signature: '1 ` `-max itn5011 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. le, �\ s - 05- 04 -'09 12:23 FROM- Hillsboro Electric 502-601-3680 T -525 P002/002 F-596 Electrical Permit Application rtrltiti'iit l 1,1 t,,\r1 ' - City of Tigard �� a r Received t7wttJ ' r q _ Permit N �C;ZQxq • 602 ,� 1312 SW Hurl b - lvd -, Tigard, OR � I r 1 � ,, Phone: 503.639.4171 Fax; 503. 8.19 C EV A Plan Rey e,v DatdB : Other Permit: I I I ,\ KO spection Linc: 503.639.4175 MAY 4 4 2009 , te B y: a e See Page 2 for . Internet: www.tigard -or.gov Notified/Method: NM • TYPE OF OF TKiAHU — Supplemental Iaforarafio� 0 N ew c onstruction Add m/alt i 'r t ------ �i9 PLAN REVIEW ll--•li Lik t o IP/iap rtt� ,)! Picase check ail that apply (submit 2 sets of plena W /items checked below); 1_l Demolition Other: eP: 0 Service or feeder 400 amps or more 0 Building over three stories, • where the available fault ourreat ❑ Marinas and boatyards. CATEGORY of CONSTRUCTION exew^cds 10,00o amps lit 150 volts or p Floating buildings. 1- and 2- family dwelling 0 Commercial/fndustriai 0 Acvcssory building 1 c's amps for all Le r all other installations. buildings. , m e xceeds 14,000 ❑ Cou El L use age cul tural Multi family 0 Master builder Other: ❑ Fire puny, ❑ installation t o � ion of 75 KVA or • JOB ,SITE WFORMATION AND .ILOCATfON 0 Emergency system. larger separately derived system. 0 Addition of new motor load of 17 "A", "IT, "1.2•• "1 -3 ", lob no.: yob site address: 1 V 100 HP or more o �„� u , cy. City/S = IP ' V c - [1 Six or more residential units. ❑ Recreational vehicle parks. ty •Tl�� / . II 7:1,3 ❑Health -care facilities. D supply voltasc for more than Suite/bldg. /apt, no.: P roject name: S ❑ Hffi r l fee dtx der m. doe volts nominal. (� _ ❑ Service ce o t> b00 amps or more. • Cross str�eet/directions to job site: FJd E SCHEDULE , • New residential single- or multi-family dwelling nit Includes attached garage. Subdivision: Lot no.: 1,000 sq. ti or less 1111 145.15 III Tax map/parcel no.: Ea ttdd'l 500 sq. ft. or portion 33.40 NMI" • DESCRIP I70N OF WORK Limited energy, residential (with above sq. R.) 75.00 III 11111 n Limited energy, multi - family AI / • VI:t"li residential with above ... a. 75.00 2 Services or feeders installation alteration, and/or relocation h1ftOPER I Y OWNS It !! 200 amps or less 80.30 2 I C) TzNANT zot amps to 400 amps 106.85 � Name: 401 amps to 600 160.60 =En Address: — - --I 601 amps to 1,000 amps 240.60 Ell Over 1,000 amps or volts 454.65 2 City/State/Z1P: Temporary services or feeders Installation, alteration, and/or Phone: ( ) - relocation Pax: ( ) 1 200 amps or less 66.85 MIME' Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1.11 100.30 © intended for salt, lease, rent, or exchange, according to ORS 447, 449, 674, and 701. 401 amps to 599 amps MIM © Owner signature: Date: Branch cirCUlls —new alteration or extension, r panel A I'PL I (:AIV 1. k Fix for branch circuits with . ., _ �] IC -414 above service or feeder fee, Business name: each branch circuit 6.65 2 B. Fee for branch circuits Contact name: —" ea — " without service or fir tbe, first branch circuit 46.85 i 2 Address; • 6.65 (� Each edd'1 branch circuit • lill City/State/ZIP: ____`- Miscellaneous (service or feeder not lacludo!d _ Each manufactured or modular Phone: ( ) [Fax: ( ) - dwelling, service and/or feeder 90.90 2 E-mail: L — Reconnect only 66.85 2 Pump or irrigation ads 53.40 OMEN 'GONTIIACI'Olt •• . Sign or outline lighting 53 - 40 2 Business name: HzLI;SBpR • L • . ~� Signal circuits) or limited - I'J'O energy panel, alteration, or Address: — 21185 NW EVERGREEN PKWY #110 extension• Describe: Page 2 2 City/State/ZIP: HILLSBORO, OR 971 2 4 - Each additional inspection over allowable in an of the above Phon ( c , 4 3 — 9 6 6 6 lax: ( 5 0 3) 6 0 1— 3 8 Per inspection 62.50 Investigation per hour p min) ) 62.50 • h - CC$ Lie.: 13 4 4 81 E L 34-499C V e1 / C ' SUPS'. tic. e) 9 41 5 Industrial plant per hour 73.75 �I. luprv. ectrielan signature, required: / ' 1 -jr ... - Subtotal: • �� Print name: JOEY V Z TACCO / Date: Plan review (2S% of permit fix); — - — Authorized signature: State surcharge (12% of permit fee): • MIN TOTAL PERMIT PEE: (irl - J Print name: Date: Fla , This permit application expires if a permit is not obtained within ISO days after it ham been accepted es complete, ic per • Number of inspections allowed , , , nadinaw.nni,...C- .pami,App.doo 0/23(06 p permit. CO ^ 37 f 4404l,,STII I MCirna.nu.co W /