Permit -w
. `q CITY OF TIGARD ELECTRICAL PERMIT
=`' 7. 2 .. <` COMMUNITY DEVELOPMENT Permit #: ELC2009 -00383
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/29/2009
7 i� g Parcel: 2S109DA06300
Jurisdiction: Tigard
Site address: 15032 SW GREENFIELD DR
Subdivision: Lot: 0
Project: Owen
Project Description: Add /alter (2) branch circuits for a/c and receptacle.
Owner: FEES
OWEN, DAVID & Quantity Description Date Amount
OWEN, ALLISON, 15032 SW GREENFIELD DR 2 crt Branch Circuits 07/29/2009 $53.50
TIGARD, OR 97224 wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 07/29/2009 $6.42
Electrical
Contractor:
BOONES FERRY ELECTRIC INC
PO BOX 628
WILSONVILLE, OR 97070
PHONE: 503 - 682 -4936
FAX: 503- 682 -7946
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59.92
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 i ccordance th 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. TENTION: Orego I- • equ es you to follow the rules adopted by the Oregon Utility Notify :n Center Those rules,_ are set forth in OAR
952 -0 1 -0010 through OAR 9 -001 -0 I I I You may obtain a copy of the rules or direct questions to OUN -by calli fir r .t►,.699 or 1.800.332..344.
i i
Iss d By: 0 Permittee S • ature: ��_;ii1' i �1���
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' .o 5 � + ,rte p �� Date: for
I
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.
1 ' lecirtca� xerm Application N • 1664 P. 1
PP �j f t FOR OFFICE USE ONLY
City of Tigard 1 ! �,�-. i t a
I "I
13125 SW Hall Blvd., Tigard, OR 972 3 y C J: 4�j �,��
Phone: 503.639A171 Fax: 503.598.1960 Plan Review
�t
JUL L 2 8 L U 0 9 Dates Other Permit:
Inspection
T:i c. R l) Line: 503,639.4175 Data Rcad runs:
Internet; www. and -or- ov S Sae Page z for
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� I , ,�.. a yr (submit an ..ear,.. i .. /ite ;�t,s checked b 'M
o New construction ❑ Additton/alte . 1 Ilk . - - t I r r Please ahesl all that apply (submit sets of plans wlkam cheelrod below):
Q Demolition Other:
Service or feoder 400 amps or more ❑ Building over three stories.
h a aS „ "?: : "v tS x y`," c " +h d % "s' sqw :; ^ - rM: - ^x s rc; where the available fault currant ❑ Marinas and boa
`, . S l 1 " � t , 'a'; .. G.. �5 e j P . r r+ w y + g ;e1.7 , 'r boatyards.
r .. Z't::k: ham.. -:. p /. ,`, ;t*. <.. ^ :12 .-_., 'r , c , . "a :.
. Tk ,S.:Z i �i...w c :�;: e,, ground, o axreeds 000 or ❑ co rn met buildings.
al' ns agricultwal
❑ 1 - and 2- family dwelling ❑ Commercial/industrial 0 Accessory building craps for all other installations. buildings.
❑ Multi- family
Master [� Fire p A or
...:. x 'w, », .. .r;. -•. • •'s.. ; ,.. .. ;..;:. , : "x , i .. � Y .y ^' w' "; . F . r "• ^>,3?R� Emergency builder ter' P ❑ Insta ll li o f 7 5 KVA
•.. �' >k�>� s' a..,.. � +�.... d ,.5,.t. ay 3�'� :,a. �K "'� � ❑ ewcysystom. larger
._.1«knee o l''P r . , �.``ip•_ ;; t ; 1.... t Ca: a 2 1 g parrtelyderivedrystem.
Irv, i ' •,t';uf r / ,.;;s:x3�5 .�.:�.za�t:.,s.,h_` -'i ,.,d„S „c� 1 r .2
�`°':�:�;- -w•+•_ `''� �%.,i-,,,.•,.iw„_- _t�.M,.,' ❑ Addition of new motor load of ❑ " ° ,.1 -2". °1,3..
Job no - : j e) i} - 9 lob site address: ) 5 03 z >1,..) { � 1D011P or more. occupancy.
•
-
o f e Irl ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: '7' ' a,,,.._ , 0 '1 ❑•Health•eare facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: 1 , C ID Service or feeder 600 amps or more
% :�:e:, y :,_t.,c,- ; ��.� : ra ^rr:;!.- m�. ""';,rl'S wq,i< �,."",
Cross street/directions to job site: .
Dmcription 9lr.F'V. }�;� / .,.1 ! {'a'h`r li• S Y •tG .Ni ryrw v. _u :..
.- :•- ..z.,,.: ta;4aa .......,;,,.sr „_�s'r..^ c, .ev' ^.«.rl�, »i.;a:i^-= `sr": �' <; {�yw < �
Qry. _. F Total •
New residential single or multi- family dwelling unit.
Includes attached garage.
Subdivision: c--, Lot no.: 1,000 sq. ft. or less _ 145.15 4
Tax map/parcel no.: I ®� ,j: Ea ilea add'I
energy sq. It- or portion 33.40 1
^.-zt a <5: '''' 4 •' : =� .m.F a- iµ .-,: ;.; -a<w, '.�aa'.�-w." . _ - Limited ever residential
��� > ✓... ^• 'l.¢�:�..`5.. .: '»7 , «�;�. . * 2..o-`F- "'� .r ra.��:1''^i:u ?w;� _ �'r
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. r. a. rr, S�.,.. �. .v..f..xr;.u:- .....:,,t... C-:r'o�.:,u�,. " ?. s �- cs,,.r'rl•*�.a�cr,,:. � u .:•1^r.Z;r�: ,.,,, «, r .. I,vi q. ) 2
er . �r'.: > .. ,r .:• ( th above s ft.
L
ited energy, mult - fam
... -di,` J {4 e 1 residential (with above sq. R ) 75.00 2
Services or feeders installation, alteration, and/or relocation
., ,,,„ -ei ,, 'rc' ,r,.. •Tr ,Ft ., 07,74 w5r . - in z :, ,;:r.�. 100 am�fs or less
n ..,..lra?• ryl.. "f E tP'F: «: ..t .:.� .:I, �rr:;c;* > 1 :;% -
2
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3r b . °- r...»"..,. ; 1, .:1::" h�, wr: �. � 1. �: : „,M..,. .....,..:: :.t ` � :.:2; :`r ** i;.`'>
..�.a_.. aced. a � c' �=. rsa: �tn:: � ��va"' �2�;; nn; ��; �: rv� �,.... -.�2:��'t.E- au6 ^ .,�...,� < ?.aT.sg * �.�4, " > >;1'i7+'c`se�. 2
.... � . .;:~ �: t; �:>:; s' �rH .;�:e..�x.,_..;;a^%�?::..,,.- .,��sz(: 0 amps to 400 amps 1 2 -
Name q L & O (,CE 401 amps to 600 amps 160.60 2
^ � - ` rf sC ' n • 601 amps to 1,000 amps 240.60 1
( 563 2
(dress: (D !�-� /`
Over 1,000 amps or volts 454.65 ' 12
City / State/ZIP: / (p/)- /2_1 � 170--- Q 7 ?Ali' Temporary services or feeders installatio alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 11111 100.30 r 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 am 1 s 133.75 2
Owner signature; Date: Branch circuits - new alteration or extension r er lane(
r;„�� {-; �.,, _ >� -- :�%r -. +.: - ... -- A. Fee for branch circuits with
t '.f 'r• :.,4 P )f tii:' F; ,.. ,- .m, ' i u st7 �': i� -rI � . . , '� z '• +z,+;r
z: , q r; ; «y 1 F. p1' � l' �ii't,�:W'+. q:ti - ;��: • {q g; ��y G�.tt Y" �'t�
:;:d.: :n:$;,, i : ;Y' - ..�.w^..... ,e - ,F, g'd- k.:.5Z27 °:;' §:: aa'g'ga;42 �iJri'4F' �"4:. .'z„w ;. . " � +_; 'e g�, „. .~ .., above service or feeder fee
` each branch circuit 6.65 2
Business name:
- B. Fee for branch circuits
Contact name: without service or feeder fee, 46,85 2
first branch circuit
Address: Each'addl branch circuit / 1 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: ( ) F ax; : ( ) _
Reconnect only 66.85 2
E Pump or irrigation circle 53.40 2
,� , w,! _
��" {%�+rti x-�" 4'' i�; l; ��rc, ..�y "'.c«;�.sai,{G.:v' ^ "3'm,%h; •n.,8;,m,�. - .- � `r�•aM - ";: ;�w ,
. - -. ", x• i.,.,.,,,. ,�-,.,..,......1.,, :... Eft _,... r i S3 4Q 2
._u, „,... •_.,..,r3...r:" ��s'I,:,::.N.�,.,�.�.,.w ... _ ;� , .. .. ,,, .:.:„,v <, -�; • � =�i;, : n' ' "' Sign or outline
M... .. �.��n. ^+• _rm :_ t«',�,h. 5..,. r��l" �::�` >�a,,..:i^,�.e..�.w5i'� *� lighting
Business name: Boones Ferry Electric Signal circuit(s) or limited
energy panel, alteration, or
Address: P.O. Box 678 extension. Describe: Page 2 • 2
City / State/ZIP: Wilsonville OR 97070 Each additional inspection over allowable in an of the above
Per inspection 62.50
Phone: (503) 6821936 Fax: (503) 682 -7946
Investigation .er hour (1 hr min) IIM 62.50
CCB Lic.: 88482 j Electrical Lic.: 3 -223C Suprv. Lic._ 3 / 701 Industrial plant per hour 73,75 _
Ail-1" � i ", ;i'- a iW,e . r"ir� ,-. w y 4Y- Ell r 'yr ^rvii;;..�ti
Suprv. Electrician signature., required: - >- rk•= ^<:.r.k�..ea +.- 4 •a,_:- . ° "1i<s. �.
Subtotal: s' ? 5
•
u1t rlarrte; . Date: Plan review (25% of permit fee):
�, � State surcharge (12o /a ofpermit fee): o , F
V Authorized sigma .' 41� .. • TOTAL PERMIT FEE: ' • `7 . `J
Print Warne: t ,/ V This permit application expires if a permit is not obtained within 180
e J� r �,„� b ate: p • days after dims bey acs pt l as complete.
• Number of inspections allowed per permit,
I: Bu1 05/23/06 440-0615TO 1/05/COM/W55