Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit 4: ELC2012 -00448
T [ G A.RO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/26/2012
Parcel: 2S103DD00419
Jurisdiction: Tigard
Site address: 10795 SW FAIRHAVEN WAY
Project: Toomer Subdivision: FAIRHAVEN COURT Lot: 14
Project Description: (1) branch circuit for wire for new service, refeed Hot Tub
Contractor: STONER ELECTRIC Owner: TOOMER, JAMES R AND VIRGINIA A T
1904 SE OCHOCO 2005 REVOCABLE TRUST
MILWAUKIE, OR 97222 PO BOX 1916
PASO ROBLES, CA 93447
PHONE: 503 - 462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Quantity Description Date Amount
1 crt Branch Circuits w /Purchase 07/26/2012 $7.42
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/26/2012 $12.97
Type of Use: SF Electrical
Class of Work: ALT 1 ea Services or Feeders - 200 07/26/2012 $100.70
amps or less
Type of Const:
Occupancy Grp:
Total $121.09
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 2 -001 -0 90. You may obtain a co y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: D )s PPPvl
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.
Jul. 26. 2012 9:14AM . Stoner Electric Group No. 3486 P. 1
ppJZEERTEDElectrical Permit A licatio FOR OFFICE ('SE ONLY
City of Tigard
Date/By: 1 t.)40 I .• — Permit N eLet9etem N "' 00 4 1 44(/
11 q 13125 SW Flail Blvd., Tigard, OR 97223 JU L 2 6 2012 ph,. 'levies
Phone: 503.639.4171 Fax: 503.598.1960 Dereilly: OLBer Pennir
Inspection Line: 503.639A175 CITY OFTIGARD I It! kendYIBY tqii Co l til See Page 1 for
TIGARD NoulletWahod: Supplementat toromnation
Internet; wtvw.tigard-orgov vi. 1
.:,..nr.lp. oF:.) -;:lii.'. • ....:.:..: . -;,:s3..-w. 7 ''' • . , .::.:•XS ' S' - : - : '-4:4:03.1:: .. ...,..1 -. ., . ....
Please check all that apply (rubmii z tars of plan s wfilema checked below);
El New construction kAdditionlalteration/replacement
0 S mice or feeder 400 imps Or more 0 Building overthree stories.
ID Demolition ID Other: where the available fault current 0 Marinas and boatyards.
- • - f exceeds 10.000 amps at 150 volts or 0 Floating buildiags.
ta r7 M .-V - ': • '••••:= — 4 INP:c.. . . s.:[:1. • ..-. "!••• less to ground. or exceeds 14,000 0 Commercial-me agricultural
:: 1- and 2-family dwelling El Commercial/industrial D Accessory building invs for all other installations. buildings.
El Multi-family 9 Master builder 0 Other: °Fire pwmp. 0 Installarion 015 KVA or
.._....,, . . ,....,.., ., .,,,,,,..,_, . .. „. ..). i. ... . .. ..... .. .... , :,.,.. ::.. El Emergency system. larger mparately deri‘'ed system.
W,_. .,,,' :.• : ::' .: ■
JOB gEgaNroxo..Ario.,k9 • . N ....;.:.:: .... • .., 0 Addition of new motor load of 0 "A "E "12
100HP or more. occupancy.
Job no.: 6 94, a 1 Job site address: /0795 524) ,c12,41 0 Recreational vehicle parks.
_ GI Six Or more midential units.
0 Flealth•cato fo aid O. ra Supply voltage for more than
City/State/ZIP: -774, 4 LI te 0 Hazardous local ions. 600 volts nominal.
.
Suite/bldg./apt. ao.: 1 Project name:1 ive 0 Service or feeder 600 amps or more.
Cross street/directions to job site: &mind= 0 . ee. Total •
• New residential single- or multi-family dwelling unit.
Includes attached garage.
• 1,000 sq. . or ft less 168.54 4
Subdivision: I Lot no.:
— Ea. addi 500 soil. or portion 33.92 1
Tax map/parcel no.: Limited energy. residential 75,00 2
:'•;.S.:Htf.i3ESORKffi.tik017-8YONW.17j,l . ,. '411Ef...:.:.... . :1 __Vial above sq. ft
Limited energy, multi-family
75.00 2
4> lee .c.07 A/an) ..5 ,e,-z' "147— residential (with above sq, ft) _
Services or feeders Installation alteration, and/or relocation
200 amps or less / 100,70
El.;'. .ijkrety; ER • : ,.P.':. f- • • • :•: .::,',27 1,fitsfAN't:::, ::',41', . -:.. .... 201 amps to 400 amps • 13356 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1.000 amps 301.04 2
Address: Over 1,000 amps or volts 55226 , 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: T el
Phone: ( ) I Pax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 2
Owner Installation: This installation is boing made on property that I own which is not „26,.....584
401 amps 10 599 amps i 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits.- new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
‘.. • •• . above service or feeder fee, / 1 -Y LiC
. ... : .•11NOA 1 ast 3 '.c -I. .13 . Oli-k-7::.'....PEOsMi'' ',';:-. :: , meh branch circuit 142 7, 4., 2
B. Fee for branch circuits without
Business name:
service or feeder fee, that • 56.18 2
branch circuit
Contact name:
Each add'I branch circuit 7.42 2
Address: . miscellaneous (service or feeder not included)
Each manufactured or modular 67,84 2
City/State/ZIP: dwelling, service and/or feeder •
Phone: ( ) . I Fax: : ( ) Reconnect only 67.84
• 2
Pump or irrigation circle 67.84 2
E Sign or outline lighting 67.84 2
t e.F/; . .. .-... ' ..,:f • . - ..0Z , •CONIint• . -. lt ...:: :-..; .:. ., — Signal circuit(s) or limited-energy
panel, alteration, or extension. Page 2 2
Business name: STONER ELECTRIC, INC. Each additional inspection over allowable in any of the above
Address: 1904 SE OCHOCO Addiiional inspection (I hr min) 66.25/ hi
Investigation (I hr min) 66.25/ hr
City/State/ZIP: MILWAUKIE, OR 97222 Industrial plant (1 hr min) 78,18/ hr
Phone: ( 503) I Fax: ( 503) 659-4968
I Inspections for which no fee is
90.00/ hr
. specifically listed (% hr min) _
CCB Lie.: 44823 s I Electrical Lie.: 26-122C SuprV. Lie.: 3496S ;:•:. - . - •:•ff._ .145 dar. ...: • . .. 4.
,
Subtotal: /,/ '2
Suprv. Electrician signature, required: ma Aia---........ Plan review (25% of permit fee): -e-
Print name: MICHAEL FALCONER Date: 7/21,frz. State surcharge (12% of pennit fee): 12. 97
TOTAL PERMIT PEE: / 2/, oL
Authorized signature: This permit apilleadon expires Ile permit U not obtained within 180
days after It has been accepted as complete.
Print name: . Dote: • Number of inspections allowed perpermii. .. _01
lAbngTemilatl..C.Perroiappdoo 07/01/10 440-96157(11/05/CW4/WEB /