Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00712
T(GAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/21/2011
Parcel: 2S110DB90872
Jurisdiction: Tigard
Site address: 15430 SW 114TH CT 87
Project: YEOMANS Subdivision:MAINS AT SUMMERFIELD CONDO -PH/ Lot: 87
Project Description: (2) branch circuits for spa tub and heater.
Contractor: GARNER ELECTRIC Owner: YEOMANS, THOMAS R REV LIV TRUST
2920 SE BROOKWOOD AVE A 15430 SW 114TH CT #87
HILLSBORO, OR 97123 TIGARD, OR 97224
PHONE: 503 - 648 -4552 PHONE:
FAX: 503 - 642 -7925
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 12/21/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/21/2011 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 0 • : 952- 001 -0090. You may'obtain a coy of the rules • _direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
A
Issued
s ✓ �- -
B � � ._ _ Permittee Signature: �&s/
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.
FROM :GARNER ELECTRIC FAX NO. :5035427925 Dec. 20 2011 09:22AM P1
Electrical Permit A plication �� volt (►1' i?1c ;., USE ONLY
City of Tiger �j �� Received I�tr ...
penuil ; LL 1 /— ()0 _
13 125 SW Hall Bl vd. Ti g ard „C� , O Flan Review other Permit:
1. .. Datc/B . --
��..77 Phone: 503.7 t 8.2439 H'ax: 5 • 19 G0 c� O do �`' „, 1urie: 6� Si s Page 2 roe ins ectinn Lane: 503. )39,4175 \ U ` ,' Date itoady /By:
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1 P C ' � � d � Notified/Method: Supplemental I IaPnrmnt
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p a, +, , , r 1� I - :'.� ' •„ r d .:.:L { r .,. ,: 'll �,.,1'), ,• 1 l ease clu all that ap ply (submit Z ee ls of
, !„ n • „'r(tl ,1 ' `h,.- te 1,'I';d- , plots whtcros cl lacked lielow
❑ Now construction 0 Addition /alters tV !
• Other: acetlrenl 0 Service or feeder 400 amps or more ❑ Building over three stories,
❑ Demolition whore the available fault current CI Marinas and boatyards.
..ry ; .. ,� {y .. . ., , .,,,ri qF , �..::: ? G, . „! ry • 'i . r.:'.��i. . i' a ', 4.1: 111!' t
. ,, . ::,,r,, rl„ t , ; .., - ....r.,:::,: ,,.,, ,. .:..,,.' ;.: ;:. ,.. ;' ; ;'' exceeds f0 000 amps at 15 +) vole e' ID Floating building. r :. : :,:, , ,.• • ; I I f 1r' ; : �' 9` r�, , ; .,,,, ;c ;)I ; ,.,,, ; ;. ; r: '•' 1 ,. ; .: UIi ;�:1,'y�'� ;�'!fJ15X` �yLL 1<1' ' 1
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0 1 and 2 dwelling ■ Commercial /industrial Ill Accessory building amps for all other installations. buildings.
❑ i Master builder Other: Fire l ❑ l ar la r la tl l onuf75 ■ KV n
her: ❑ re p . un p
Multi - tamely ❑ ❑ Hmer ens system. NWT separately
'- '-'�r :.,�.r, ..':'�, r,n ,... IMi,.,._. : . -'; %�. 1 .... � .:i�: �',�':.� vr: 1. ..1 .: is �r,il:: ; ;i �: ,,I,x.:rr• 0Addition -A”,
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.,Xh, ��4 ,titi ;r rr ' `4 tl' Court ...J; ,
Jo b n 1 1 nr, Job sir address: I5430114 'Y .� l--1 SIX
1001 d1` or more, occupancy.
Job no., - 1 ()r more residential units. ❑ Recreational VCh1G10 parka.
❑ Health-care ftwi ks, ❑ Supply voltage for rr+nrc than
City /State /Z..l h: Tigard, OR - ❑ Hazardous locations. Mal volts nominal.
0 Service or feeder 600 amps or more.
Project n ame: Kurt Green Construction ' „ 1y .,; "' --
Suite /bldg, /apt- no,: �� r1 jiV °I,gl 101,1.. r:t::. ;rXll.i ?! ;ii ;`+� � �31,t 1
� New residential single o r Ili family dwelling �,Jlll a s(iiv:a;, '9' ":F „b,r . -- Tnn '
Cross street /directions to job sit I a __�'.
• _ ng unit,
includes attached garage.
r Subdivision: Lot no.: 1,000 aq, R , ur less w 168.54 4
.. - ,, m-- Ea. add' / 500 sq. ft. or portion „ 33.92 I
Tax map /parcel no qq Li energy, residential 75,00
'Fl ii (l4 'a,iIrt,'I}i S( Itl L N a r � jS r,' ir I
. .: ra! >II h d,�li r,i'l (with aboveaq,ft,) 7. 10 2
Wire sod , rr i i( „r fi. I ” "uu» Y. ,,, •1. —
� 14 YI i l �,, r u
Installs a tub and b ewer } � ,, " ., „ r , ., Limited energy, multi-family
p s eater reaiden(inl (with above sq. ft.)
. _ "-� S ervices or f eeders Installation, alteration, and /or relocation
200 amps or less 100,70 2
. "A,. �1 :,. I!i :i;.: 201 amps to 400 amps 133.SG
( �I j1� . tot ll ” .....,r,r „n,::'• ;'r .............. '
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..� le:e::' I..:'C ^ �l� , +aW, „ r.. i?y��,,,� ' ..... �:::'aa'a.!C:, "' �,.�'�:�Eiyr:`ulriru•I nr nr „�}�''' r ;.,:.. rii i�,
;: i' ;oil.( i � -°"w 401 maps to 600 amps 200,34 2
Name: ... 601 amps to 1,000 snipe 301.04 2
Address: over 1,000 amps or volts 5.52,26• 2
- ” 'Temporary services or feeders installation, alteration, and /or
City /State /ZIP: _ - relocation ,
Phone: ( - ) bras: ( ) 200 amps or less 59,36 • i
201 amps to 400 amps _ 113.08 2
Owner installation: This instal ,;ion is being made on property that i own which is not q01 amp to 59411n _ 168.54 2
intended for sale, lease, rent, or : xc:h,inge, according to ORS 447, 449, 670, and 701, liranelr circuits — new alteration or extension, per panel -
Owner signature: Date: A. Fee for branch circuits with
':: : :., " „, ,. W,., ... ..,...,, , ;:I.,:.::i IL' !: ahniCe o1' feeder lie,
... ' r r,r:,r. �i; 4 : :!�,,,, 1, I ,., ' :,, ,•. r:':!I,,,r:,r,;i „ I :. 7 2
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Business name: Garner Electri ' B. Fee for branch circuits w!! {low
service or feeder fee, first 56.111
Contact name: Melanie A. Ilolnes branch circuit
..Y., •• .. - Each add'! brunch circuit 7.42 7.42 2
Address: 2920 SE Brookwood kve., ttA Miscellaneous (service or feeder not indtide) , ,
Each manufhetured or modular (,7.84 2
City /State /ZIP: H illsboro, OR 97123 dwelling, service and /or feeder ..,
Phone: (503) 64S -4552 h'ax:: (503) 642 -7925 Reconnect only 67,84 - 2 2
•r . -- , . - Pump or irrigation circle - 67,84
E -mail: tnholmes(aAarnerelecl rlr,com Sign or outline lighting 7 4 2
c) .x 2
r. r. ; , ', a.r. c.::.; .,.:.,:' I,c:.'f' - i e r ,,.. r rr.r . 1. rMg ni:;.,:,,; an:!! ; ;: ; ^i {. "..111i: °, iro " C;1 .i. ,iii , IG,i'( ;Ii : J :. . 4 ;
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' „ I...rr +v'1lll� llwr' "iia'k1 ^ „.r ,,,rQu., «:bc ,.r� ...,.�,�,.Lr.1..:�+,,. 'h, r. _. .',
panel, alteration, or extension, I Page 2 2
Business name: Garner Laectr c Each addltlnnal InapccUan over allowable in any of the above
Address: 2920 SE Brookwood Ave, #A Additional inspection (1 hr tnin) 66,25/ hr
'—' Investigation (1 hr min) 66,25/ hr -
City /State/ZIP! Hillsboro, OR 97123 Industrial plant (I h min) 78.18 / hr
Plionc: (503) 648 -4552 Fax 13) 42 -7925 Inspections for which no fee is 90.00/ hr --
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C u i • 3707 - S ',I' '' 11(1, , 1, ''il! „l'i 1 g t;.. T `ii 4 . ;i : ,.
specifically listed /� hr min) - ,
Ct.ai Lic.: 121159 Eccu /cal Lac.; 3' , t)5 � r � 63,60
'
p 113 tlilff';,,,1 � ;.,'�.�'r b�;...�Y cF� ° .;,
, , • v- Subtotal: '
Suprv, Llcct.rician signature, reluircd : Mir ,
Plan review (25 < %c,,f permit fve):
Print name: Chuck Garner • • Date: 12/20/11 State surcharge (12% of permit fee): +
- 7 c.3
'yj �t
y , IOPAL PP.RMITT F..
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Authorized signature: '
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Tide petrol/ application expires If permit to not obtained within 180
- - - - days after it has been accepted as wimples!.
s!.
Print name: Chuck Garner Date: 12/20/11 • plumber of inspections allowed per permit,
. 4
: e a llft \Pcrmitall.C- PermI1Apn.duc 07 /1r U 440- 4615T(I1/05 /CUM /wn11