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Permit CITY OF TIGARD ELECTRICAL PERMIT 11 1 a COMMUNITY DEVELOPMENT Permit #: ELC2012 -00510 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/29/2012 Parcel: 1 S125DD09800 Jurisdiction: Tigard Site address: 9610 SW VENTURA CT Project: Reed Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 106 Project Description: (1) 200 amps or less - panel replacement Contractor: OMNI ELECTRIC INC Owner: REED, ERIN C 16670 SW WRIGHT ST 9610 SW VENTURA CT BEAVERTON, OR 97007 TIGARD, OR 97223 PHONE: 503 - 747 -0805 PHONE: FAX: 503 - 649 -2709 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 08/29/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 08/29/2012 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 5 - 001 -00 0. You may btain a copy of the rules or direct questions to OUNC by calling 50033. k 21 4 232.19877 or 1.800.332.2344. w Issued By: Permittee Signature: 1 P� ek 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. Aug.27.2012 09:05 PM PAGE. 2/ 2 Electrical Permit Apalication RECEI i City of Tigard AUG 2 9 2012 Dam 8 �i- .- s r .— 13125 SW Hall Blvd., Tigard, Oft 97223 Permit N�� �/ o 1 ocs76 a Phone: 503.718,2439 Fax: 503.598.1960 Peen Review Uat T t e I n R t7 Inspection Lint': 503.639.4175 ' rye /� TI GAR � � 11 bate R Other Permit: Permit: mPermit: Cl CITY Of 1 IGAR e Ready /Hy: tore Internet: www,tigartl- or.gov etantk cn J •tified/Melhod: Ti J el See Page 3 for .5t' t7 �I j�� PPkmentalInformation TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition/altcration/re lacement Picas." check a t aut apply PPiY (submit 2 eel of Mans w /itcn,n cheated below): CI Demolition ❑ Other: Survive or feeder 400 amps or n ❑ Building over three armies. wham the availabte fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at ISO volts or ❑ Floating buildings. ® 1- and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building lass to ground, or exceeds 14,000 ❑ commcrcial•uae agricultural rY g amps for all other installations. buildings. ❑ Multi - family 0 Master builder ❑Odder; 0 Fir pump. ❑ lnabllation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. Luger soperataly derived system. ❑ Addition of new motur load of ❑ "A ", "E", "1 -2 ". "1 -3 ", Job no,: Job site address: 9610 SW Ventura Ct ' °OHPor more. occupancy. City /Stato/Z1 P; Tigard, OR 97223 ❑ Six or more re residential unite. ID aii Rvere' nal vehicle parka, ❑ Henith-caro facilities. 0 Supply voltage for more than ❑ Haxnrdou.t locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Erin Reed ❑ Service or Seeder 600 amps or more, Cross street/directions to job site; FEE SCHEDULE Dnncn ao,, Q{ alr TOGd l • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. n. or lc g 168.54 4 Ea. Tax map /parcel no.: a add'I 500 sq. ft. or portion 33.92 - 1 DESCRIPTION OF WORK 1•imited energy, residential (with above ft. 75,00 2 s4. ) tanned energy, multi - family residential (with above sq. ft.) 75.00 2 Panel Replacement Services or feeders Instalhulun and/or role 200 temp}, or less 1 100.70 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 tamps 200.34 2 Address: 601 amps to 1,000 amps 301.01 2 Over 1,000 amps or volts 552.26 2 City /State/21P; Temporary services or feeders Installation, alteration, and/or — — relocation Phone: ( ) Fax: ( ) 200 limps or Inns .... 59,36 1 Owner installation: This installation is being made on property that I own which is not 201 umpa to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 40i amps to 599 amps 1G1{. 2 Owner signature: Branch circuits - new, alteration, or extension per ousel .__. — . _ Date: A. Fee for watch circuits with . _ - ❑ APPLICANT • _ I ❑ CONTACT PERSON above service or fixdcr lbe, 7.42 2 each branch circuit $usinms name :' B. Fee for branch circuits without service or feeder fee, first Contact Hama: hunch circuit 56 2 Each tald't branch circuit Address: 7.42 2 Mlsccll ineous (.service or feeder not included • City /State/ZIP: Each manufactured or modular 67.64 2 dwell' .. service and/or feeder Phone: ( ) Fax: : ( ) Rocotnleet only 07.84 2 E -mail: Pump or irrigation cinele 67.84 2 CONTRACTOR Sign or oWlinc lighting 67 2 Business name: Omni Electric Inc - I Sign circitii(s)or limited-energy ten 2 altcratii or extension. Address: 16670 SW Wright St Each additional inspection over allowable In any of the above _ Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: eaverton, OR 97007 Investigation (I hr trod) 66,25/ hr Phone: (503) 747-0805 Industr pltml (1 ht' min) 78.18 / hr Fax; (_503)649 -2709 Inspections for which no fee is CCB Lic.: 176615 Eltxtrical Lie,: C297 specifically listed (i4 hr min) 90.00/ hr Sntprv. Lic.: 42 705 ELECTRICAL PERMIT FEES Suprv. f lectrician signature, required; M Subtotal. 1.00.70 Plan review (25% of permit fee): Print name: John M. Kelso Date: 8/29/12 Stete atecharge (!2% of permit fee): - 12.08 — Authorized signature: "w�7 TOTAL PERMIT ME: l 12.78 This • petorh application expires If a permit b rot obtained a4thia 180 _ Print name: John M. Kelso Date: 8/29/12 days after it has been accepted as complete. • Number of inapectioas allowed per permit. La tulldlnaWermimlr7 4.:- rcrmi,App,dee 07Po1/1 n 440-46151(1 11031e:UM/Wetl CITY OF TIGARD ELECTRICAL PERMIT 11 1 a COMMUNITY DEVELOPMENT Permit #: ELC2012 -00510 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/29/2012 Parcel: 1 S125DD09800 Jurisdiction: Tigard Site address: 9610 SW VENTURA CT Project: Reed Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 106 Project Description: (1) 200 amps or less - panel replacement Contractor: OMNI ELECTRIC INC Owner: REED, ERIN C 16670 SW WRIGHT ST 9610 SW VENTURA CT BEAVERTON, OR 97007 TIGARD, OR 97223 PHONE: 503 - 747 -0805 PHONE: FAX: 503 - 649 -2709 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 08/29/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 08/29/2012 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 5 - 001 -00 0. You may btain a copy of the rules or direct questions to OUNC by calling 50033. k 21 4 232.19877 or 1.800.332.2344. w Issued By: Permittee Signature: 1 P� ek 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.