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Permit
• r q CITY OF TIGARD ELECTRICAL PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00542 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009 Parcel: 1 S133DC09900 Jurisdiction: Tigard Site address: 13145 SW SHORE DR Subdivision: Lot: 0 Project: Aryamt Project Description: 2 circuits for furnace and NC Owner: FEES KISHI, JUNKO Quantity Description Date Amount 13145 SW SHORE DR 2 crt Branch Circuits 10/13/2009 $63.60 TIGARD, OR 97223 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/13/2009 $7.63 Electrical Contractor: A -TEMP HEATING & COOLING 16000 SE EVELYN ST CLACKAMAS, OR 97015 -9519 PHONE: 503 - 650 -5014 FAX: 503 - 557 -2990 Type of Use: SF 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 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: MA. ✓ Permittee Signature: SS IA 1.) J 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. 10/09/2009 11:05 5035572990 A —TEMP HEATING PAGE 01/04 Electrical Permit Application City of Tigard RECE VE! A B Permit No.: �2 — ODS'N� , 71 . ° 13125 SW Hall Blvd., Tigard, OR 97223 plan Rcvicw Phone: 503'.639.4171 Fax: 503.598.1960 i ! - T Dala/By: Other Permit: in action Lino: 503.639.4175 0 9 2009 nee Ready/By lu fir ®9eo T ara 2 for T 1 G it It D tntemet: tvww.tigard-or.gov Notified/Method: • Information Supplemental Information e ay.,aJ *.+.c'v,o ur i • r ^. t jrZ' �ai7' t y ; " ' k l vi x r i , r ' may? �.r,l y R� ) {tK 1 °'� � r'aiq�• `.r r ' `` � h �{ `� V154 jr :, , : , "�K f''t, t,�o . ,...it .,r F't � r . 42i7u .`�4C u.P 'i zw? r�7, : ^ t� , e ll , .,, il , Il f,, vie{ , T. °t ' c � , v.. 14,10.'4'7 ti „+'...::het F` �t } a�; "WO. '� i` 1;27 I,r SL^,,,N,��4.':".r [r ,, ,„,,, S u ' r4� 1 :6V C.1, :m "�,)§... d r k i �s� ta re'_' 1 .:1 iv,4.; .t ;11.1 %0' 0 . ,.c ❑ New construction ill Addition /altcratton rep accmeni Please chock all that apply (Submit k seta of plans Whams checked below): 0 Service or fbcdcr 400 amps or mote 0 Building over three stance. ❑ ��Demolti}t In Other: where the available fault current 0 Marines and boatyards. l iq l 7r5r / ( v ' i ci { �k^ r�.. ` i�a 'i/: I'i » / m it r o c , 5 AI �w %� ° fr 1 i' 1 y'adl "a +' t t�'r cxce ds 10,000 amps of I50 volts or CI ea Floating buildin. $4 °:E.C v la ,bit• . nllt ;, . trela ,t! . • 4 7 � { lass to ground, or exceeds 14,000 0 Commercial -toe agricultural III. 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ■ , MWWtl famil ❑ Master builder El Other; ❑ Fite pump. ❑ installation of 75 KVA or r ., y •ry a rw+•!di �"' `, r ' 7e- o r {tu',v ,� ,a ,1c 0 Emcr g cnc y s y stem larger separately derived system. w b a rti r y"!, , r L. 4 µ�I+ ( i! �;;;t l n l" �a r;t r tl a; E "1 f 1 � 1” its o A v 4 ' n . a 4t 6 a± i l i + Y+10 Addition of new motor load of ❑ " A, " B 1 -x•, "I3 ", L�, t., ° w udl„ ,iM �8� .a , C F1 s w nT . ,.r' f l irr 5 xn h u yi , d ,,„ 11� r., lrt li, .tt ra- ° t ❑ I OOHP or morn. oceupancy�. Job no.: Job site address: IOW u . A ❑ Six or more residential unita, ❑ Recroadot�al vehicle perk:. • Ha'I!h care thclities. ❑ Suer* vd tar more than City/Statc/zT • . `i �. [] ❑ Hazardous locations, 600 volts 'nominal. Suite/bldg./apt. no.: Project name: r: II ❑ Service or fader 600 snipe or more 1 r t EMT �� 'I yl +,� �ryry�� .'.� ].,Y � Y Y' /u" 'r',,.,llt `"�"" � r " � ��+rT 1 -Rjrr�N „rr" vu, rGMSI�M1YV{' IYW v.Ylll(•N1 4u�4 M:M D.10 f !IT Cross street/directions to job site: Deer/ Mu New residential single- or multi - family dwellihR unit. Include% attached gate :e. Subdivision: Lot no.: 1,000 sq. ft. or less ( _ i Ea. add 1500 sq. ft. or P /mien MIME _Q Tax map /parcel no.: Limited energy, residential = II a 4 r ,�"sr ' q - 'ten n, s t �w5,�' �1 ' �e �. r .fitRF �,:tl l !'�'.� .r n big °1iIIrrLi with aboves ft, 1, ls' >f nSi'i l� °di:/f. U Pi17vt �'e r,� ,� fFtusa4 +1,...- Limited energy, multi-fa. ily M� © AP residential with nbova ,. ft. Service% or feeders Installation alteration and /or relocation 200 amps or less 100. 0 �© �r e t a s r- 1 ' 201 amps II. 133,56 a t ,� 'r w t r r se-. i.t � F , 1 3J144. �c , i I I /di , `,i:4 %; ? ky„ amps to 400 amps t1� 1'tF'if�i }' n � el in�i ;PeSr. . f ,e Sec0.r.H , , ,urn .aw..f, ` 401 amps to 1, 6013 naps NM 200.34 t 1. r V R ► ► 601 amps cn 1,000 amps _ 301.! • © Address: ` Over 1,000 amps or volts 111 552 r 6 Eil Temporary services or feeders installation, alteration, and/or City/Statel7TP: t relocation Phone: Fax: ( ) 200 amps or less 59136 _U 11.111 I 201 amps to 400 amps 125108 U Owner Installation: is installation is being made on property that I own which is not 401 amps to 599 amps ! 168 54 � intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new Iteration or extensldn er . and Owner signature: , A.Fee for branch circuits with '}}��',r�t i r,; u,. f i1 i v a r pw "tai / r•J,t above setvicc a feeder fcc, 7.42 R; � r A �^ .� f e 71 :. d`� r, L l �D ��,. 11r �� L �., tic t+ NyI l t � ; ' � E Li���r�� � 4 Si! ^. 7r�4"n' i�'u�r.,,�.rup, �' „�t�`t,. , � � ; � c �k lr. `i�+t„ b �> �?,= � . each branc circuit II Business name: M a a A r 1 • _ IIM , 1111M B. Fee for branch circuits without service or fcc cr fee, 111111Mil Contact name: , • first branch circuit Each add I branch circui 7.42 ffizigii �' it. M Miscellaneous service ;r feeder not included 131=0 I. ± I. ,' i Each manufactured or modular 67.84 a �� q dwe1lin :, service and /or feeder Phone: 505 /„l J�,) �I 'a T �' • "1 Reconnect only �� E-mail: —yt! ' Pump or irrigation circle 67.84 _ ec � '' a { I 1r.111 Q. �� as .�.` aloha' ~ ° ,. j ta h` 4 0. c4R >. SA t 9; *Mt k i:.9$ . " {earl Si or outline lighting 67.84 � rl ar lr l.''i tt @r �i+', ry +il.4.iWl� Jer 'iii , � ' e8 11 , eai � �1 Signal circuit(s) or limited- ` I I t y, A b . • • • . al . • lb energy panel, alteration, or Address: • • _ 6 .e.1 G extension. Describe: Page 2 City/State/7.IP• � `,, NA • i . ' it . • 0' Each additional ins ection over allowable in an of the above 7� Per inspection 66 � Phone: as , , rri _ Fax: r ti ' AI ...Nil 11 Investi per hour (I hr min) a 66.25 �� CCD Lie.: r1 V� Electrical Lie,: C` Sup rv. Lie.: ,DQ i4rQ t industrial plant per hour; MI 78.18 �MI ri � q � II ��,t, �'�77'�tt'''yy�tr;'.,:1>at �� [t'V ' I�'t+ 1� }, 1 , , �5�.? 'rl 4G��1p YiY;uic 1 t:u�,..t i�.. llom t k a � � Suprv. Electrician signature, requited: . Subtotal: L Plan rcvicfv (25% of permit fee): D : t r,` V — State surchnr,e (12% of permit fee): O Authorized signatur I I All '� � y`� � iOTAL PERMIT FEE: t TATS permit application a�tplres If a permit Is not obtained within 180 Ail * ` • Date: Il days after Ito been accepted no complete. * Number of inspections Ito per permit I: \uuildina \permlm \eLc rerm:Inpp.dcc I OAR lne 4.16.461Sr(1I /e-5 /COMAVBB 1 • r q CITY OF TIGARD ELECTRICAL PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00542 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009 Parcel: 1 S133DC09900 Jurisdiction: Tigard Site address: 13145 SW SHORE DR Subdivision: Lot: 0 Project: Aryamt Project Description: 2 circuits for furnace and NC Owner: FEES KISHI, JUNKO Quantity Description Date Amount 13145 SW SHORE DR 2 crt Branch Circuits 10/13/2009 $63.60 TIGARD, OR 97223 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/13/2009 $7.63 Electrical Contractor: A -TEMP HEATING & COOLING 16000 SE EVELYN ST CLACKAMAS, OR 97015 -9519 PHONE: 503 - 650 -5014 FAX: 503 - 557 -2990 Type of Use: SF 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 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: MA. ✓ Permittee Signature: SS IA 1.) J 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.