Loading...
Permit CITY OF TIGARD ELECTRICAL PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00291 Date Issued: 06/16/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S133DD05400 Jurisdiction: Tigard Site address: 11568 SW LAKEVIEW TER Subdivision: Lot: 0 Project: Criss Project Description: Install /alter (2) branch circuits for a/c and GFCI. Owner: FEES CRISS, KENT E/TERESA L Quantity Description Date Amount 11568 SW LAKEVIEW TERRACE TIGARD, OR 97223 2 crt Branch Circuits 06/16/2009 $53.50 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 06/16/2009 $6 42 Electrical Contractor: HILLSBORO ELECTRIC LLC 21185 NW EVERGREEN PKWY #110 HILLSBORO, OR 97124 PHONE: 503 - 439 -9666 FAX: 503 601 - 3680 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 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 throu. h OAR 952 - 001 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling. 503.246.6699 or 1.800.332.2344. Issued Bys (II 411 '� , & l 1 . • _ Permittee Signature: SC . L. - 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 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' , 06- 12 -'09 14:11 FROM- Hillsboro Electric 503 - 601 -3680 T -654 P002 /002 F -109 .„,o' '� Electrical Permit Application x � ° t EcElvE, � J r t ` i,!, I,Ct t , „ , I „i „...., 1" 0;;,14,,, ,,, �: �, ,; ; � ,, r City of Tigard " 13125 SW Hall Blvd., Tigard, OR 97223 JUN 1 2 2009 _ 4 wit No.; — 1`1 `; `� 0' Phone: 503.639.4171 Fax: 503.598.1960 Datelly, Other permit I N . , f i` Inspection Line: 501639.4175 -. — Internet www.t CITE' OF -TIGAR r Date R e thy: see 1'atte z for tgard -or.gov � • cif , - �. 1 iii' ' r =: Sppplempgtal lnformpgan 'E OF 15 • . ' PLAN REVIEW ❑ New construction L Addition /altcrationfrcplaeement please check all that apply (submit 1 seta of plans w /items checked below): d Demolition ❑ Other: Service or feeder 400 a or more 0 Building over three storie where die available fault current [] Marinas and boatyards_ CATEGORY OF CONSTRUCTION exceeds 1 0,000 amps at 150 volts or Ell 1 - and 2-family dwelling OFloating buildings. ua Y g [] Commercial/i ❑ Accessory building amps �°n� o exceeds ons. commercial -rise agricultural B ice for all other installations. I buildings. t4 0 Multi - family ❑ Master builder Ratio ❑ other. Ferro Pip. ❑ installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ['Emergency system. larger separately derived system. 0 Addition of new Job no.: � Job site address: / f!'.l , 10011P or more motor load of O occupancy. ^B• " t "l -3» ill / ' ❑ Six or more residential units. ❑ opal vehicit parks. City/State/ZIP: / t R� / -1 l 3 q.Heal,h , (�ilitie,, 0 Supply voltage for more than Suite/bldg./apt. no.: `" . — O Hazardous locations. 600 volts nominal. Project name: 4/ % CI Sarvioo or feeder 600 amps or more. _or Cross street/directions to job site: • FEE SCHEDULE • -- _ trQertaau. Otr. Fats These • New residential sink- or mufti- family dwelling unit. Subdivision: Includes attached garage. _ — Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no _ Ba. add'I 500 sq. ft. or portion 33.40 a DESCRIPTION OF WORK • Limited Energy, residential with above ... it. 75.00 �� ;r J Limited energy, multi- family residential with above sq. g 75.00 2 Services or feeders installation alteration and%or relocation ❑ pROPFRTY OWNER 200 amps or less 80.30 Ilill TENANT 201 maps to 400 amps 1.11 106.85 Ell Name: _ 401 amps to 600 amps 160.60 • Address: 601 smite to 1,000 amps 240.60 � 2 Over 1,000 amps or volts 454.65 • City/State/ZIP: y^ . 2 lm ra ry servton or feeders Installation, alteration, and/or Phone: ( ) relocation Fax: ( ) 200 amps or less 66.85 Owner lnata.11atlon; This installation is being made on property that I own which is not 201 amps to 400 amps 1 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps ME ME 133 75 Ell �© Owner signature: bate: Branch circuits- nma' alteration tension r • - A. Fee for branch circuits with _ "• 0 AppucANT (J CON'IpCT ` PEONY above service or feeder fec, Business name: branch circuit 6.65 B. Fee for branch cat uits Contact name: without service or feeder (tom, III .- first branch circuit 46.86 �5 Address: Each WI brined circuit 6 IBMAUEN City/Statc/ZIp: Miscellaneous (service or feeder not Included) l?aclt manufactured or modular Phone: ( ) Fttx:: ( ) dwelling, service and/or ier 90.90 2 E-mail: Reconnect 66.85 © Perm, or irrigation circle 53. 53.40 40 CQNTRACTg1Z Sign or outline lighting Business name: HILLS : e R . E - Signal circuit(s) or limited energy panel, alteration, or Address: 21185 NW EVERGREEN PKWY #110 exbenston. Describe' Page 2 City /State/ZIP: HILLSBORO OR 97124 Each additional los. Hon over allowable io a of the above Phone: (5 0 3) 439-9666 Fax: ( S 0 3 ) Per inspection 62.50 �- 6 01 - 3 6 8 0 Investigation per hour (1 br min) NI 62.50 III - CCB Lie.: 134481 Electrical Lie.: 34_499 ..Suprv. L ie.: I ndustri al plant per hour _ 4 9 41 S � c��� ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: subtotal: Ibl' Print name: JOEY V I TACCO Date: Plan review (25% o£ permit key- Authorized signature: - State surcharge (12% of permit Erse): • Print name: TOTAL PERMIT FEE: IL. Date: �11 This permit application exptrea if a permit is not obtained within 180 II days after it has been accepted as complete. IlaufidingtNa . p ,itApp.doo p5ft9/Od " Number of inspections allowed per permit. 440-46 0TO I/OS/COM/WEB