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Permit CITY OF TIGARD ELECTRICAL PERMIT �F'!'` COMMUNITY DEVELOPMENT Permit #: ELC2011 -00705 Date Issued: 12/16/2011 TIGA.R.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S102BCO3900 Jurisdiction: Tigard Site address: 12820 SW WATKINS AVE Project: PALM Subdivision: Lot: Project Description: Bathroom remodel. Contractor: COHO ELECTRIC INC Owner: PALM, JULIE PO BOX 40 12820 SW WATKINS AVE WILSONVILLE, OR 97070 TIGARD, OR 97223 PHONE: 503 - 888 -6623 HONE: 503 - 582 -9774 FAX: 503 - 582 -9840 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 12/16/2011 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/16/2011 $9.41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 rules or direct • uestions to OUNC by calling 503.232 • :7 or 1.800.332.2344. Issued By: --- ittee Signature: ! j /i / � ; �. 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. Ltectrical "Permit Application FC)R r71- ' F!(1- t fit; (l\f.l City of Tigard IVED ReCki' ` v ed )- / ° 13125 SW Ball Blvd., Tigard, O D ! i1I Term t No.: ? - ■ `� ��� IS ' Phone: 503.639.4171 Fax: 503,598.1960 Dates w PCrilut. 1111 i i; ;,..1, D inspecion Line. 503.639.4175 D No Internet: - a! /� !I� -�7t 7 met www.rig,ard-or.gov E C 1 2011 nli athd o s� x r oa em end aformation i 4S ;.: r 1 .,,.,... ,'„ bb 1 ,'. \. :.3 y ., . :! 7 •'C \. .... \ ,a( \ \ i\ \\ 4 \ - ) t ' k ' ', \ \ � 1 \ . \! \ \ \'\ a \} \\ Q �Y \� \ \ ►: E New construction Ad i 1lt "liar #14�;. Ili', s4�111,�! „ Pkase cheak allthat "' ' aPPly (submit � se ra of pla \ s w /items cUecked b e . ): ❑ DC1r10lition © Ocher ❑ service or tbeder 400 amps or more 0 Building over three stories. `r ' oe l) , n e y u watt. We available fault mama ❑ Marinas end i .. „ ; \ :, : . ', , 4 .'„ } ; =needs 00 amps at 130 volts or 1' loatins buildings '' at w\ .,. a a 1 .. ...,k 10,0 �' 1- and 2 18n11Iy dwelling L] COrriznerclaUindtistriai 0 ACCesso building 1 488 to ground. or exceeds 14,000 p Commercial -use agricultural ill Multi - family ❑ Master builder S other mstallanons. amps fbr all h \ S \ i �� �) � � u ' � u a \ tr .,ku r _ \ ,n � ❑ Other: El Fire pump, u ,., n l ! b't , / .. \ r h * r 1 z \ .,, + t ergOncy xi Installation of 75 criv or , ,,).. \ e: t\e :.. 1 i . A °S \ ' a \\ \ w, v astip ❑Em larger�pm` 2" deri3eC systeul. Job no.: ( - t Job Site address: U1$O r „ l ' " 1o o x or more motor load of q p» �t.2 « - „ `�+,) - occu Z E ❑Six or more rC Si dBntidl amid, ❑ ltecreatioa al vehicle patios. • (D a 9," — © }Iwo.. facilities. 0 Supply voltage for more than SuiteJbldg "rapt no.: Project name: f,,,,‘ ❑� locations. 600 volts nominal. ❑ Service or feeder 600 amps or more. Cross sireet/dlrectiozis to job site: r = \ ' > 4 a 4 ° , , h : 4 Nil a R(ti ti '§''''''' L4 [ 4. 111 New residendal single- or multi- family dwelling unit. Includes attached arage, Subdivision: 0 Lot no.: 1,000 sq" ft or less Tax maplparccl no "_ n E. ft j energy, sq. ft• or ltio 33.92 Limited e ` .•! ` ; :,,�!V, ( n ;.,;;N t;':', : . ,. S A,,. c. :. ss "4 : ts, : „ a \ \ '�,: K ., r , ^.; 11Crg -lt. iderltt8l w+ c ) � , .::..,e„ e ..,. i•,:., £ , . r t wall above .. ft. 67.$4 w ...... Limited energy, multi- family • • ,� residential with above • .. ft. 67.$4 2 C? Services or feeders installation alteration, and/or relocation 200 amps or loss r \ 100.70 iEs . ,,; :, ,'. ,, +n ,,.;. ; 201 nines to 400 2t11ps 133.56 401 amps to 600 ; • .s r W Nye �a1 y.,,..‘ � 200.34 Address: ,,,.,,,,, 601 amps to 1,000 amps 341.04 Over 1,000 amps or volts 552.26 City /State/ZIP: Temporary services or feeders installation, alteration, and/or Phone: ( ) relocation 200 amps or less IIII 59.36 MUNN Owner installation: This installation is being made on property that I own which is not Z01 am. s to 400 amps IN 168.54 2 125.08 intended for sale, lease, rent, or exchange, according to O ILS 447, 449, 670, and 70L 401 amps to 599 amps Owner signature: , $� w : Date: nc ircnits -- ne alteration, or extension r : , : \ , ,\ ) ti y \4 A Fee for branch l Pe panel : 'r.; `..HV (E� 5 ..> r` , \ y ? ,': h � � \+i z h $1 `i )' '.' ,"� :1> y s( ', : :t' t'8t1C11 C1fe with h <. .. r ) , ..,, r ., au ,., ,. :.'�. �a ' \ \ c ^ above service or feeder fly, Business name: tech branch circuit 7.42 2 B. Fee for branch circuits Contact name: without service or feeder fee, lxxst branch circuit 56 . 1 111111 Address: Each add'! branch circuit 7 City/State/ZIP: Miscellaneous service or feeder not included tech manufactured Or modular � 11 Phone; ( ) dwelling service rvice and/or feeder Reconnect only 67.84 --- 2 •, Pump Or irrigation circle 67.84 2 . Y ' , � ..,, :ti . ".,. ) J`\.. i A;, :.); „M a ,, :,n :.� eh ` ti �, i) ' µ9 :; Sign Or outlinelightimg Business Warne: 67 "84 2 Signal ctroxlit(s) or limited. Address + energy panel, alteration, or .1>/ 4 , / extension. Describe: Page 2 City /State/ZIP: r - , z.(1vr 1 14 © Q` Each additional ins • ection over allowable in an of the above Phone: c„, ) �a� �� Fa x: Per inspection INN 66.25 Milli CCB l ic.: ^� 4 ( ) S ga\ ��'t4 V FnvestigAtion Per hour (1 br min) UM 6625 ,01 Electrical Lie.: - Stlprv. Lie.: 5 skis Indusutai plant cr hour IIIIIIEMIIIIIMIIIME Supra. Electrician si_ a '/ y•u : I CI "� n \ 'E; ,,�\a, n : ) Pr1111 name. P- - � S ubt[ l'� � • �' E � • Dare � �A � t Pion review 25% of permit fee): Authorized signature: l��i► ��, State surcharge (12 /e of Permit fcc): ° t .41 Print name: 1 v TOTAL FERMTf FEE: <, , ?:I UVtMgIMIIIIIIIIII Date: '1 _ ,,, ` ,� 4 Ws permit nDp�ltcatioA a =p;ra it a permit la act obtained within 180 1 6 days after it has been accepted as complete, t :lBuildlfiglYe jts�SLGPermiiApp.doo 1LV01 J09 '' Number of iuspectioos allowed per permit. 4 40-4615T(1 1 /05/CQM/ Wwn