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Permit CITY OF T I GARD ELECTRICAL PERMIT PERMIT #: ELC2001 -00509 c I DEVELOPMENT Tigard, ) 639 -4171 DATE ISSUED: 10/12/01 PARCEL: 2S 110DA -04300 SITE ADDRESS: 10810 SW KABLE ST SUBDIVISION: ERICKSON HEIGHTS ZONING: R -3.5 BLOCK: LOT : 004 JURISDICTION: TIG Project Description: Install 1 branch circuit to hot tub. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: • Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC: Owner: Contractor: MARY GUERTEN GARNER ELECTRIC 21785 SW TUALATIN VLY HWY #C ALOHA, OR 9 70 06 -1 24 9 Phone: Phone: Reg #: 60-6444{ SUP 3707S ELE 34 -305C FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 10/12/01 $46.85 2720010000( Elect'I Final 5PCT CTR 10/12/01 $3.75 2720010000( Total $50.60 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to Permit Signature: Issued By: 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'N: —ems_. 01/1P LIA �7,/•----• DATE: LICENSE NO: -3 2O 73 Call 639 -4175 by 7:00pm for an inspection the next business day FROM : GARNER ELECTRIC FAX : Oct. 12 2001 12:55PM P1 Electrical Permit App ication , • ti City Dale rccci vcd: l o /yv Permit n o.: D I' ' °''�'' of Tigard RECEIVED ,J -, -0e. 6. ^� � . Y g Project /appl. no.: Expire date. : city vfTigard Address: 13125 SW1lallBlvd, Tigard, OR 722 Phone: (503) 639 -417 OCT 1 Date 2 2 QQi By tv Rcceil no. Fax: (503) 598 -1960 Case file no.: ` � ^ t� Land use approval: C ©i MIM4ITY DEVELQFMENI I - �...:. TYPE OF PERMIT • ›A 1 & 2 family dwelling or accessory U Commercial /industrial 0 Multi - family ❑ Tenant improvement U New construction U Addition/alteration/replacement 0 Other: 0 Partial • JOB SITE INFORMATION • Job address: to s._t_ , _ S\ Bldg, no.: Suite no -: Tax map /tax lot/account no.: Lot: Block: Subdivision: ,k7.0110\ a. Lc), Project name: Description and locMibn of work on premises: Q . 'Q %_C Estimated date of completion/inspection: CONTRACTOR APPLICATION - FEE SCIIEDU E Job no: Fee Max 13usiness name: c .RFt" �,���5 , 11.— @C C Peccriptlon Qty- (ea.) Total no. insp New rrsidential - single or multi per Address: �.\ AU U . W C e ( dwelling Unit. City: 0‘.\ J State:0 _J ZIP: 4 ( r 13 e'( Servicelncluded: . Phone: a4.7. kt.. SZ Pax•O4� .!A I E -mail: 1000 sq. ft. or less 4 CC: 0.: '� . b' Elec- bus. lie, no: , 0 C Each additional 500 sq, ft, or portion thereof 136, � � Limitedenergy,residential 2 C[L y !!w ' . \ 6 Litnited crteryy. non- residential 2 LA "" AL `0 . \ ZI _ Each manufactured home or modular dwelling Signati a of supery '- ing-electrician (required) Date Service and/or feeder 2 Sup. elect. name (print): , Service* or feeders— installation, Csa t. Cy��r�� License no3'Zr�'�, alteration or relocation: 200 amps or less 2 Name (print): �c i / `-( �� 201 aps 400 amps 2 • /// -r 401 amps 10 6 ps to 600 amps 2 ` lviailing address: 601 amps to 1000 amps 2 City: I State: I ZIP: Over 1000 amps or volts 2 Phone:, Fax: I E -mail: Reconnect only 1 Owner installation: The installation is being made on property I own ,-----t Temporary services - which is not intended for sale, lease, rent, or exchange according to installation, a lteretion , orrclocation: ORS 447, 455, 479, 670, 701. 200 amps or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 ' Branch circuits - new, alteration, , or extension per panel: Name:— A. Fee for branch circuits with purchase of Address: service or fender fee. each branch circuit 2 City: I State: • i ZIP: B. Fee for branch circuits without purchase Phone: Fax: E-mail: of service or feeder fee, first branch circuit_ li �;-(, tt. '� 2 Each additional branch circuit: • PLAN REVIEW (Please check all that apply) Misc. Serricc or teeder Included); ❑ Service over 225 amps - commercial ❑ Health-care facility Each pump or irrigation circle 2 Cl Service over 320 amps - rating of 1 &2 Q Hazardous location Each sign or outline lighting 2 family dwellings CI Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel, O System over600 vol is nominal more residential units in one structure alteration, or extension' 2 O Building over three stories ❑ Feeders, 400 amps or more •Description: O Occupant load over 99 persons CI Manufactured structures or kV park Each additional inspection over the allowable in any of the above: O Egress/lightingplan O Other. Per inspection r J Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other Permit fee $ i - `. Not a kt jurisdictions aecepr credit Cards, please colt jurisdiction for more infpgtion Notice: This permit application a 0 V rm Visa O MastcrCani expires if a permit is not obtained Plan review (at _ %) $ Credit card number: / / within 180 days after it has been State surcharge (8%) .... $ '3 - S Expjres accepted as complete. TOTAL $4 - a Name of cardholder as shown on credit card $ Cardlle�?cef signature Amount � a �^ dApdGFS GKblCOM)