Permit CITY OF TIGARD ELECTRICAL PERMIT
' 2 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00668
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011
Parcel: 1 S 134CA00529
Jurisdiction: Tigard
Site address: 11635 SW MANZANITA ST
Project: FISHER Subdivision: PANORAMA NO.2 Lot: 38
Project Description: (5) branch circuits for kitchen remodel.
Contractor: PRECISION NW ELECTRICAL Owner: FISHER, RED
12020 SE ANNA CT 11635 SW MANZANITA ST
DAMASCUS, OR 97009 TIGARD, OR 97223
PHONE: 503 - 413 - 9870 PHONE:
FAX: 503 - 594 -2873
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 11/30/2011 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/30/2011 $10.30
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 -0090. You may obtain a copy of the ru ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ..
t
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.
11/29/2011 02:00 FAX 5035942873 PRECISION NW E1002 /002
RECEIVED
Electrical Permit Application FOR OFFICE u511 ONLY
Ci of Tigard Nov 2 9 2011 Received pennii No.:
°�7 :3r Receive' / I /l / - lJt CAOX
II W n B l v d . , Tigard, OR 97223 plan Review
Phone: 503, 718.2439 Fax: o�tggy(
so3.5 TIGARD RatefUy: Other I'. tit:
T1 t., A IUD Inspection Line: 503.639,4175 IVIS » bate Ready /By: See Page 2 for
I nternet: www.tigurd- ur.gov BUILDING Notified/Method; � Supplemental Information
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" " / ,14/1. Iili,. .44t444` ' .: �5 (c: r, 1 t • n,i ti,e 1 sets p ' i1 +s he t ,. u .
;.,� ci.Y iii �';'i�a, ; .a . c t. •l "�':' a .,ui ,n rt.4s 11„ &. ILn�:rr t�liti..:., m.. nGitr, • D New construction R i Addition /alteration /replacement Plrtse cheek a n that apply (submit 1 secs of plans w /items over three checked below);
i
Q El Service or feeder 400 amps or more ❑ Building over three stories.
0 Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
i a r i ' I" exceeds 10,0011 amps at 150 volts en ❑Floating buildings.
• p• ".�F ; t u .� : "' r.14 72707114440711n. !+ lu• p•
iW6I :a • nt, "ii ", ''':'%i•;i;, Oiiip' t , . r ! Hil i ,+ "L. 1�.l.i xt..; or 14,000 ❑ Commcrciai.use
• •��,� ., less ground, 0 agricultural
1511- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building amps for other installations. buildings.
A or
❑ Multi family Q Master builder iii Other: Fire pimp. eet d ved system.
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1 , .,� r 6 1 `�F •, I.tyf r ` ..We •'i7 :M � . ^ ' , .1 ,,, r�� - �„
loom' or more. occupancy.
Job no.: i Job site address: i i L@3 5 Sii..1 Met$J t o 1.t 1 #4 A S ❑ Six or more residential units, 0 Recreational vehicle parks.
❑ Health -care fualitics. 1:1 Supply voltage for more than
4 i s i ? O t
City /State/ZIP: - C � t (•�J �
S / �ry - ( ❑ Hamrdnrrz locations.
600 volts nominal.
• V
Suite/bldg./apt. no.. Project name: / CI Service or feeder 600 Amps Or more. q �, �}� U
I � s ,rear "'k, Iii' rs i iii /' r r n ±e it It J�,ii3FA k ",G`�t+'llv It i ' , ,i 4 I r `y j,O
Cross street/directions to job site: nescriptiun Qiv. Fee. 'fats! •
New residential single- or multi-family dwelling unit.
includes attached garage.
Subdivision: Lot no 1,000 sq. tt. or less 160.54
.. Ea. add'l 500 sq. II. or portion 33.92 El
Tax map /parcel no,: Limited energy, residential 75
' . r i c ': a 6 231 lul�w1 ^ ; � ,Niat +'r i' : ' ! " M . v: d ' abO •. It.)
� . �' ..Y G Y, t 9 MrUr rfl 4 !� iimA,1. M,,•n i( tlM,r.. fir. Y fli " it D
r a ',•tt( 1,,,. , ar. • , ,, Luniled ener , multi - ,;,mile
' 75
�i e residential (with above s . R.)
�P� Se rvices or feeders installation, alteration, and /or relocation
200 amps or less IM 100.
, 1 �� 1 ., . r ( i , 4+ amps to 400 amps 1 33.56 • ' _ ,�I ' •4 ,, N C t' r 0 'u r t 1 ;1 ' ,t➢ 1)llif. " n i..Mi,)` p � 2. 201 amp s p
' i sere; -li i,, td th a .' ! ..:..:1 , 4, iii i n Ir;•,.. 200.34 2
dOl amps l0 600 amps
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Fax: 200 amps or less IA 59.36 �
Phone: ( ) ( ) •
201 amps to 400 amps 125.08
Owner installation: phis installation is being made on properly that I own which is not 401 amps to 599 amps 168 El
intended for sale, lease, rent, or exchange, according to OILS 447, 449, 670, and 701. Branch circuits - new, alteration or extension, i er panel
Owner signature: -
Date: A. Fee for branch Circuits with
---R a.., '� /i ;'}.p,,!� rv. (;T +ni ';I, '
• c aboveservice 42 2
. ,• �,A4'11I�;�.1r�,"4�t�;�' seas'' /" n,tj�e�( ,7�' 1;,,�4'�in .rH4 +i�;9r�a e' " each branch circuit ,
Business name: B . Fee for branch circuits without
-" ,• service or feeder fee. first 56.18 at At
Contact name:
branch Circuit 7.42 +7 2
Each add'1 branch circuit 1
Address; Miscellaneous (service or feeder no included)
EaCb manufactured or modular 67.84
City /State /ZIP; dwelling, service and/or feeder
Phone; ( ) Fax: ; ( ) Reconnect only 67.84
Pump or irrigation circle = 6 7.84 iii
E-mail: , .,,,. Sign Or outline lighting . 67.$4 8 fa: (• -r � � . ;vas . ;' ,tl 7rV�, `wj, + 1 ' "' !;,/ ,1 � i 1< "! a Signal circuits) o energy
• tc�yt.t • ���r I . .� �� h ,; I,,, w• +n ; n , J, ,... run.,, etts: panel, alteration, or extension.
Easiness n c 2
Off -(Gs St F �) L` t L+� L•.v • WA' �. Each additional inseection over allowable in an of the above
Address: r Additional inspection (1 hr rem) 66.25/ hr
1 7 U'7 --U S t:, i - eQ(vtfs. C.. "' 66.25/ hr Investigation (1 hr min) Mil
City /State /7.1P: , � _N 91 0 e Cl industrial plant (1 In' nin) - 78.18/ hr
phone: (S 02 41 3 ei Q. 7 U pax; ( Sul) Semi' -"Lee "3 inspections for which no fee is Ell 90.OU/ hi
r C s • cifical tilted %: hr min)
C;CB Lie.: ((Q '3 E Lie.: "1 Suprv. Lit:,: 603 7 ,:i 7(:,!(�'`, '4`; .,:, .l �;vl��
■ 'i
Subtotal: •
Suprv. Electrician signature, required: Plan review (25% of permit tee):
Print name: (.0 . r Date: I t ) 1 , State surcharge (12% of permit fee): IAA ��1(.t -� t�"� IOTA!. PERMIT FEE.:
Authorized signature' This permit application expire% if a permit is not o tallied within
7 - , days after it has been accepted a om c
Print namc:mi U X' Date: 11 y • Number of inspections allowed per permit. i / ( p
I.l nuilding \PermilslbLC- Permil App.doe U7/01 /10 , 440- 4515T(t1 /05 /COM/WER