Permit t.
CITY OF TIGARD ELECTRICAL PERMIT
`1 �. COMMUNITY DEVELOPMENT Permit #: ELC2009 -00528
•
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2009
Parcel: 1 S 136AA09100
Jurisdiction: Tigard
Site address: 6993 SW LOCUST ST -
Subdivision: Lot: 0
Project: KAY
Project Description: I 31i AA, t4 C a }`62 A /L
Owner: FEES
KAY, RUSSELL A & CAROLENE A Quantity Description Date Amount
6993 SW LOCUST ST 1 crt Branch Circuits 10/07/2009 $56.18 •
TIGARD, OR 97223 wo /Purchase Service or
PHONE: Feeder •
1 ea 12% State Surcharge - 10/07/2009 $6.74
Electrical
Contractor:
•
SUNSET HEATING & COOLING
0607 SW IDAHO ST
PORTLAND, OR 97239
PHONE: 503 - 234 -0611
FAX: 503 - 234 -0439
Type of Use: SF •
Class of Work: ALT Type of Const: •
Occupancy Grp:
•
•
Total $62.92
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 through 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 By: tA.\>/
Y� Permittee Signature:
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.
•
-
' .
Electrical Permit A t t li, . , EIt�IED h(.71r OF'I I('Y. t •tit'. ()NIA • ' � Received
71 City of Tigard Dau.By: Puttat No.: ri_c; _ .2 S
. .� • • 131 25 SW Hall Blvd., Tigar, • • 97223 Plan Review
Phone: 503.639.4171 Fax: 503 fl 190) 6 2009 Dnte/B : ' Other Pc
. r I c: A It t� Inspection Line: 503.639.4175 Date Ready /by: funs' Id See Page 2 for
Internet: www,ti r - ov Notrfied/Method: Supplemental gad g : , , pp oral lInformation IL 0 r
�� � r rfck'F WV t �: . sN' � . y � !d F „�
'1 + -1 ( ?ri. :;";;.7#1040 ,ti r ; a' . 5 . '7aI . y c�d3 r s� a;Gl�1 Y 4: 4� '' a+ ' �f� T "' �Qi ' '�Mlllpal ,frx t , !J f t ! L - �k ks.
El New construction ® Addi to -. a tcration /replacement Pleas,: check all drat apply (submit 2 sots of plans w /items chocked bolo''):
❑ Service or feeder 400 amps or more ❑ building over three stories.
0 Demolition ❑ Other: where dt ilbt
c avaue fault curr
., ;` v} i .'o :�W.ca" ,m . ❑ Marinas and boatyards.
{ %. �'{`�• ,,....,.pit.. I , � / ^il`3�rj 1 a r �k �
Ii 4''a.•..; �; :?(', • 9 , } ?.4'"Pg .,I.,+� � , i 7 °�;`� s . L4 i1 .�b,R: '' � ' ' g00u amps :u I50 volts of ID Flowing buildings.
i, `Fehn,:;fctXa:.:;. "v''e i�G.. .,:� .1 �.� 1...Yd, ai exceeds I
F less to ground, or exceeds 14,000 El Commercial -use agricultural
'l I- and 2- Iamily dwelling ❑ Commercialindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or
,! , W ;: ,�: - ,ern • ,�• - , .+y ,`. : 46 p,,.� ,,�,,a „ 11•,:' Emergency system. larger s
3i ,� °�`'( -; ,;;;; g t. �(t xr, sr L Y Y S' Bp8ralr y derived system.
vv` �' ❑Addition of uuw motor load of "A "'G.'
Job no.: 5 I Job site address: (0IACI 3 ' (.O (,mat' 100HP ur more. occupancy.
❑
1,3 or Six more residential units, Recreational vehicle parks.
Cit /State /ZIP: -7_____al dg3 ❑ Health-care facilities. 0 Supply voltage for more drat
Hazardous locations. 600 vole tlpmival.
Suite /bldg. /apt. no.: o V/t f [] Service or fe eder 6U0 ;Naps or more.
jest name: r.^"J "( �l . t��
Cross street/directions to job site: ' ° •� . iIt ', `` , '.:`3, #0, 3 N 4!S�f aii .. t ii a
j Description ( Qty. Mn. I rmm I •
New residential single- or multi -family dwelllug unit.
Includes attached garage. _
Subdivision: Lot no.: 1,000 sq. Il. or less 145.15 4
Eu. add'l 500 sit. li or portion 33.40 1
Tax map /parcel nu.: '
jl K..'k �r!,lrPP „`.... ,,,;:.<! RgIFi'ar t , ry � ' „ Q( a F��� r [ , j�t „T � I era �( . ��� 1 y��F.V:�Yry�A■�.,}rJ�.H1Jyr7{.,Y u ;r !t f ' I v '1 ( '.1, ':Q' l[� t y'(. Limited energy. residential 723.00 2
''r%1'I�;�:I:ln1 `rit }:?.(r ttag,i!SG.;Jl.�l.`f1>•�3C mGr. �,�1.'Vf3Si^Cri.:�RS;A19.P'!ifi II�kr�l'- 'li.711;y''. •-y,±{}.I.� Sgi (with U. �.)
1 �' i 1 Y N' 1 iSS4±±± Itll above S
:.l:.ti4...c.,>_ ':, -,' t1', R ::h '],h tai n
Limited energy, multi-Family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration. and /or relocation
200 amps or less 80.30 2
! SG_,�? viii •t "t '+y1 M . y 41% �TSiI'ai 1 . j 1 i R , _ ,1 , _ ,,t�yy,' ' i ' S, $t n e r t . 2 ar m S to 400 urn 106.85 _ -_ --- 2
;.�.. ,s�i ;::1_' . ������'.� , �t�15'':F„� fit sl�li:2;,,.... f.lv,.�a4�;ur�ti�, °ra!%'�1:' � P P
Name: Russo 1 , 401 amps to 600 amps 160.60 2
p � 601 amps to 1,000 amps 240.60 2
lY
Address: ' 3 Stit) OLLL j Over 1,000 amps or volts 454.65 _ _ _ 2
City/State/ZIP: 1 ' et1 as Temporary services or feeders installation, alteration, and/or
relocation
Phone: (SZ3) / 56' 4 Fax: ( ) 200 amps or less 66.83 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 unips 100,30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps - 133.75 2
signature: Branch circuits - new. alteration, or extension, per panel
Owner si
gn _ Date: A. Fee For branch circuit; with
i�i:' ,,.n ,i'1 N�,lt �• -.�!, ; �, at :'4. ;.,�::� J. . � .T.,r. .. .�`.. tt p�. w ,fin
S[j,, ,.;1 Ih.:}_ ge lt: .t j r ' 'Y,R�.'�' t iR' 1 T �•' it "e' 0, i ( :t fit above service or teeder tee,
y�Sl:r.e(i ^a..,... a!IEAN? <ryy,..�:,, :a:h i�..; ,;u;�41!ei'�P.aia,,..it{t,,.1.r 6.65 2
each brunch circuit , _
Business name: B. Fee for branch circuits 6
56'
without service or feeder fee.
first brunch circuit Contact name: i t I 44, 2
Address: Each add'I branch circuit 6,65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 90.90 2
dwelling. service and/or feeder
Phone: ( ) J Fax: : ( ) Reconnect only 66.8 2
E - mail: Pump or irrigation circle 53.40 2
iSA
'.;:', t % : :c:�'fvl J r;;IY, ir;I:,"+;f ,'�.':^�' ' ..ch:rf ?i yr - j;l V '''? ..D;..'.::il'"`IY , :f ' ", eit7'µ, Sign ,
`a : ; i_+,• e: r";: asrAa:?' �.ti'�i4i?i:;':;"�! °�,r' �",r.�` 1 1i' Ii� a:- �: �:. :'dwn;�,vJP
:..;: >.W:''il;:e�:i .,,r;,�sa,d`I�,� >.,�:;�.>diiu., Sil,n o r outline lighting 53,40 2
1usiness name: Sunset Heating and Cooling energy panel, or limited- onor
energy Aland, alteration, or
Address: 0607 SW Idaho Street extension. Describe: Page 2 2
City/State/ZIP; Portland, OR 97239 • Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 234 -0611 Fax: (503) 234 -0439 Investigation per hour (I hr min) 62.50
CCE3 Lie.: 161085 Electrical Lie.: Cl 17 Suprv. Lie.: 4638S Industrial plant per hour • 73.75 /Altf
Suprv. Electrician signature, required: y C Subtotal: ' t4 !` Sb + 1
Print name: Randy Ess r Dat e: P lan review (25% of permit toe): ( r �
_ - State surcharge (12% of permit fee): _ ( - !
Authorized signature_ - b TOTAL PERMIT FEE: -C .-}- 62,9a.
Print !lame: Shaun! D'Am • roSia Date: 1 9 I ��� This pormitapplieption oxpirea if a permit is not ubtained within 10U
,� I days after it has beet ucceptsd US cuunptetu.
-
ERlvV v Number of inspections allowed per ponnit.
t: Uiuiadiv PcrntiuiLC•NefmilApp.doc 05/^23/06 I p V •411Wd15T(II/DS/COMIWEB ' .
Z0 /ZO 39Vd 9NI1d3H 13SNflS 6E170bEZE09 8Z :b0 600Z/90/01
■