Permit r
, CITY OF TIGARD ELECTRICAL PERMIT
Ilk
COMMUNITY DEVELOPMENT COMMUNITY ELC2009-00313
Date Issued: 06/24/2009
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639.4171 Parcel: 2S103DB02500
Jurisdiction: Tigard
Site address: 13490 SW GENESIS LP
Subdivision: Lot: 0
Project: Lowry
Project Description: Hot tub circuit
Owner: FEES
LOWRY, DAVID B . Quantity Description Date Amount
13490 SW GENESIS LP
TIGARD, OR 97223 1 crt Branch Circuits 06/24/2009 $46 85
wo /Purchase Service or
PHONE Feeder
1 ea 12% State Surcharge - 06/24/2009 $5 62
Electrical
Contractor:
RK ELECTRIC INC
24495 NW OAK DR
HILLSBORO, OR 97124
PHONE 503 - 640 -1344
FAX 503 - 356 -0513
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $52 47
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 952 100 You may obtain a copy of the rules or direct questions to OUNC by calling 503 246 6699 or 1 800 3322344
Issued By: Permittee Signature:_ �i! i_ —e- - -�
Y� r,
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.
- - kin 22 2008 8 :43RM HP LASERJET 3330 p.1
Electrical Permit Application . , . FOR O R Ol UI I lISl, ON: t
• City of Tigard JUN 2 2 2009 Q e` Permit No.: Ge, c z,, q.-o
li ' v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review v
Phone: 503.639.4171 Fax: 503.598.1 Dace/B Other Permit
,i1 ''t,1 KE, inspection Line: 503.639.4175 OF TIGARD D ate Ready /By: Toms H See Page 2 for
Internet: tivww.tigard -or.gov BUILDING DIVISION Notified/Method: Supplemental Information
i'''.. � gg - _ II€� �a 6�1t yy # � € [ S [ S���Iii ttg� � � ' t a . x. �-. -. :. €ii•�a..^^����� �a< t
,. rs� ���I t
p 1 ) . 1 - i i• € 7 1 I 6i t IMPF .i 4�1. t ar'.� i : €x w •airt144. vii: i i, M'� l
� � t `�sN}_�4' ins - � �! r � {S'1 t i, '€�d S , r,'.`.'h'a °:
❑ New c onsttuetion m Addition/alteration / replaeemeni Please check all that apply (subrmt2 sets of plans w/itcros checked below).
❑ Service or feeder 400 snips or more ❑ Building over three stories.
❑ Demolition 0 Other:
where the available fault current ❑ Marinas and boatyards.
l !' 1407a' i' g • n p Er a t ,1, s f." exceeds 10.000 amps at 150 Volts or ID Floating buildings
1 prs '4711)1° 6,e' Is - 4-49 11a' ' . ;.:.. t 5 k l . 113111
- less to gmnnoi, nr exceeds 14,000 ❑ Cammereial -use agnculmral
El 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
r a a1 or . t :t 1 ❑ Emergency system. 1 Vgt 1 °.rs Cft i, _ , 41!O.Y U c`t 3k ,
s t1; d,gFli€ 3 fateer st. ,`. ❑ A ddit io n o new motor load of ❑ "aA�" " er separately
"12'Y derived system.
1 Y
Job no.: 1651 Job site address: 13490 SW Genesis Loop 100HP or snore occupancy.
R
❑ Six or more residential units. ❑ ixreatianal vehicle parks.
City /State/ZIP: Tigard, OR 97223 ❑ Health -care facilities 0 SuliPl voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: I Project name: Carol & Kelly Lowry ❑ Service or feeder 600 amps ormo iY re ` a x
'�.. E 1 4 , :.:.I' ' q "ri$ - s Ilt.,eiIliJ4
Cross street/directions to job site: Description Qty. Fee Tidal
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision. I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea add'I 500 sq. ft or portion 33.40 1
� awrrrsr nlren one tmigngaat a7 [ 1 Limned energy, residential 75.00 2
'ryR'1 I r �I �: e t " re? 4 i 1 , � , t` 1 �' l' l (with above sq. ft.)
Fh' oli i 1 -I Balk ' °�' 'l ' .iu rim stefl€tat r Wr �i 6,1.+44. tt , XL. t a -,
Hot tub circuit Limited energy, multi-family 75.00 2
residential (with above sq. ft.)
Services or feeders Installation , and/or relocation
200 amps or less 80.30 2
a - 1 lei up
e
!
1 + p� t , 3 ' l " r ➢t �i I ' "4 201 amps 106.85 2
' amps to 400 am
aoy eii loss. a ∎ids 1a ^1 . ... 1 1 it 0 it a eu +r �� 3 P P
Name: Carol & Kelly Lowry 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 13490 SW Genesis Loop Over 1,000 amps or volts 454.65 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503 ) 896.4149 Fax: ( ) 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 133.75 2
Owner signature Date: Branch circuits - new or extension, per panel
A. Fee for branch circuits with
a: , tie f t rc ;na T r r
€ S wa, : ' ., , r, ,lA 1 . I a: _ :. l 1, r a I2 Ti f Ill above service or feeder fee, 6 65 2
Business name: ach branch circuit
RK Electric, Inc. I nC B. Fee for branch circuits
w:thaut service or feeder fee,
Contact name: Zach Milton first branch circuit 1 46 85 46.85 2
Address: Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 90.90 2
Phone: (503 ) 640.1344 I (503 ) 356.0513 Reconnect
dwelling, t on ye and/or feeder
Fax: ' 0513 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
iu n u n - axr €++� ,
r t 1 rTidl'r+blt „og ii I'M s r 'g x +_-_ Agi l l 1 s m� a�: v si or outline lighting
i� I, '. , Il�rp llJp lv„.d,� �s 'uir�al�tir3e � t .� ,�i��r- rtil�� {�' >i i li 53.40 2
R Electric Inc. Signal circuit(s) or limited -
Business name: r energy panel, alteration, or
Address: 24495 NW Oak Dr. extension, Describe: Page 2 2
City /State /ZIP: Hillsboro, OR 97124 Each additional inspection over allowable In any of the above
Per inspection 62.50
Phone: { 503 } 640-1344 Fax: ( 503) 356 -0513 Investigation per hour (1 hr min) 62.50
CCB Lie.: 9427 Electrical Lic.:34_375 Suprv. Lic.: 4724 -S Industrial plant per hour �{ 73 75
.14,:i., i € 1 �1 i'V I n �e t s Y rv1u 31t r n� r
I-0 0 7 7 (1 I - • ._, t Prvir ;, ioArt. it to
Suprv. Electric I ti trre, required, �( / C 1 � t 1 _ Subtotal: $46.85
Print name: Ron L. Kurtz � /22/09 1
Plan review (25 %of permit fee): $0.00
�( / �J State surcharge (12% of permit fee): $5.62
Authorized signature ( d ! 1 spp r TOTAL PERMIT FEE: $52.47
l This p ermit application expires if a permit is not obtained wi thin 180
Print name: Ron L. Kurtz Z j Date: 6/22/09 days after it has been accepted as complete-
" Number of inspections allowed per permit.
I \Buildirg\ ?milts \E.LC- PermitApp doc 05/23 /06 410.461 Tr(i l /05 /COM/WEB