Permit CITY OF TIGARD ELECTRICAL PERMIT
• °. COMMUNITY DEVELOPMENT Permit #: ELC2009 -00216
T I G ARL] 13125 SW Hall Blvd., Tigard OR 97223 503 639.4171 Date Issued: 05/13/2009
Parcel: 1 S125DD06400
Jurisdiction: Tigard
Site address: 6 605 SW VENTURA DR
Subdivision: Lot: 0
Project: McGowan
Project Description: Install (1) circuit for a /c.
Owner: FEES
INGALLS, BRIAN J & Quantity Description Date Amount
MCGOWAN, THOMAS J, 6605 SW VENTURA DR 1 crt Branch Circuits 05/13/2009 $46.85
PORTLAND, OR 97223 wo /Purchase Service or
PHONE:
Feeder
1 ea 12% State Surcharge - 05/13/2009 $5.62
Contractor: Electncal
GARNER ELECTRIC
2920 SE BROOKWOOD AVE A
HILLSBORO, OR 97123
PHONE: 503 - 591 -1320
FAX. 503 - 642 -7925
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $52.47
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 AR 952- 0014100 You may obt 'n a copy of the rules or direct questions to OUNC by calling 503 246 6699 or 1 800.332 2344
Issued By: Q Y- Permittee Signature: QC 14 On
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'N 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.
•
r
,, +'lcctrical Permit Application , FOR oh,i lc; l USE ,ONLY
City of Tigard t -, rpl v ` o • Penr r ,t Ne .. E,t�,,q - o o a��
1 3 1 . . 5 SW Hall 1 3 1 'l rgdrd, OR 97223 =P a ev,ew
..:.,..,.. II
■ Phone. 503.639.4171 Fax 503.598 1900 MAY 1 y 1)au/b Other l'rnrut
i t.; l i Inspection Line: 503,639,4175 1 200 t ' Date Ready/BY: - .. El see Page 2 for
tl'tl ;��
Itnentet' www,tigard- ur.gov 4 N,nili d'Method I I C 1 Suppiemeotal Information
li ; :y 6} Ili. r,a;rl t t, { '%i :t 'r rv i R tk � �l § :, 14,+ r ]�.I r �I�p, 1153t n
+ .. ... ill l• ' ,i +�Il' p l + i , f. i , '�1.+" r n 3 , � � -.�. . t U' a � jaiy��' E. i „ Y. i J, , 1 f1�� p • tlli � j � ill �,� a �' � m in.,� � 9 4w �1: 1 if , � �•.- >it •) ,
E] N ew construction : t • ddiHon /alteratrnn /repliccmt;nt "' ' I 1 Please check all that apply (submit 1 acts of plans w /itbvit checked below),
❑ Service or feeder 400 amps or mum ❑ Building over three storks
❑ Demolition ❑ Other where the available lauit current ❑ Matins and boatya,d,
i 'n u t fr r ', v "t . � ,, +'�; .s+" -°'- , ;�f"i i,t air trvaw P ;0= 1 A ttiM
yl' 11 ;,. ; + t i �l • rl, ; ,1 Ni l e e �s a 3f , k till exceeds 10,000 amps at ISO volts or 0 1 hmUng buildings
f` lr " ha k a iti MP' ' 1 el , less to ground, or axceed;: 14,000 ❑ Commercial -use agricultural
g I- and 2- famil dwelling ❑ Commercial /industrial 0 Accessory building amps for all other installation, buildings
❑ Multi -family ❑ Master builder ❑ Other' ❑ Fireptuap. ❑ itmetutioa of 75 KVA or
I t' ti S, • MV° 1 �'i �+y - 707 ; ' Al -,r+ Q t� i a :c , s la t tt , I + ; ❑ Iuusr•gemy system larger sepmatdy derived system
,','.1141.q.41.1, ': iN M. "+ 4 :k t 4 ,' I " t � rl .,,1t. . '• ir,1 r : i af .� 1 � P , io I r�; , :� : f ❑ Addition of new motor load of ❑ „ ., .. .. s ,.
O IOOHP or more occupancy.
Job no.: Job site address: I i/ ;, 0 S's UT more residential units. ❑ necroutionul vehicle parka.
` City /StateZZf : �//� C] Health -care facilities ❑ Supply vnitagt fur more than
' , ! / V! .- ❑Hazardous locations. 600 volt, nominal.
Surtc/bld /a t. no. Project name: B P ] - ._ .. . ❑ service or leader 600 600 amps or more.
Cross SlrCet/direellUn5 1b site. r t o " i , �`�- -" tl--lt -' � u P � ';1
bcmcrif,ttan Qty Fm
New residential single- or multi - family dwelling unit.
Includes attached garage..
Subdivision: Lot no.: 1,000 sq. R. or less 145.15 —
ft Ea. add'] 500 sq. ft. or portion 33.40 0
Tax map /parcel no.' Limited energy, residential - -w ... —
tr l r , IS;II t a
is i 1 ' 1 h 41;a, (! d �g K. ;1� 1 III{( I,t �U� 4 W,� ; " uu (with ,l oves ft. 75.00 ril
,d aiiii( • t5ilt 1, ,i't , ); i , st' t , r „ t,,-,, 140 ,.,t. l.��ll �ir�1,�o(il, 4 01I Y.,_)_
„• :. Limited energy, multi- family ■
�/ y 75.00
- / �-�-[C[-l. l ,.. �r irG residential with above gq p
Services nr feeders Installation, alteration, and/or relocatio
v r�,., a, y w, � c11tA If1' 200 amps or loss $0.30 2
), p,, y �lI ' . 1' P' T ' I • i M„It� ,t Ya�L a, it 11 r hil G ,..- .......�
:,,tutu, .,a t ri$'.. ;' lA5�in1+ ;,, �p1 t }r �l ���t” I y AI,' ii ' a
J ` .''' '. : , I ,. 201 amp t o 400 amps 106.85 z .,.,
Name: i 7 L 6 1 War) 401 amps to 600 amps 160 GO 2
/ r V l emu! GOl amps [a 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454 65 2
City/State/ZIP: Temporary services or feeders inataliation, alteration, and/or
relocatioq
Phone: (� — „_
-, __ ____-_,.e. )) . -. 3b - O 'I R Fax: ( ) 200 amps or less 66.85 1
Owner Installation; This installation is being made on property that I own which is not 201 amps to 400 amps 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
Owner signature. _ + Date: ranch clr h- new, alteration, or extension, per panel
K diun u 'un er
rt: �;'- v 'J �jti t l" . �q' i y rt P r ri�{ I� ""`•, y ; SIM a Rr41' 4 A CL' Or branch ClICU1t5 with
1 vnw67(l • {' ,,.w ,., 11,7 , I.�+ , - .�I 1 11 A� n l +� liti ; ;,VER ai, , :Y t above scivice or feeder fee, (, (15
t � each branch circuit 2
Business name: B, Fee for branch circuits I
a
Contact name: without service or feeder fee, 46.85 { 2
first st branch circuit _
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder nut include
City/State /ZIP_ Each ntanufactuted or modular
90.90 2
"' — - -- dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) ° '
Recrntnectrmly _ ^, . _66,65 2
E -mail: - - [Pump or irrigation circle 53,40 2
a C 1 ;k; t` + ii�u t$?tl' dl.r,i ` , ' � ��S l � + ii ° >It ` i � 1 l ,i
tt ' t t ,, s I
, 6 a , mei , i ii % t "� 1 1 , i ,, 4 m V VI M12 sign outline lighting
: gn or outne ghting 53 _. -. 2
;a I, 14 . +a, i.r 40
Business name. GAR �( E T1Q! Signal circuits) rn limited-
cncrgy pane], alteration, or
Address: 24:12.0 .s � r 2c2 i r L.1.. '� extension. Describe: Page 2 2
City/State/ZIP: L.G�1 GG II GG�a� Lll VVV Each additional inspection over allowable Ai' r R q7 X23 wle in any of the above
.� . �_.
Phone: ( ) � Pax: � Per inspection 62.50
p
I � a — (� 4 Z 7 �� Investigation per hour (1 la min) 62.50
CCil : Lic. Electrical Lic.: . ' . Lic.: Industrial plant per hour 73 75 it
_...._ .,. iZlt . .._ aL 3 7D " 7
Suprv. Electrician Signature, < 1r '' i 1i'" 1ilus! J' ` if T t M' u bto :r,3 ; ai 1 i ,1 i,, ";'
;. • Subtotal: `il
(25%
' % " ��" Plan review 25 o emit fee
Print naive: �Y a :. r •.._ ( -... )'
6h L{[.+`� Stale surcharge (12% of permit fee). 5, I
Authoriced signature: ^ "`
— -- — _ _ TOTAL PERMIT PBE d e
i i T � Thls permit applieation expires if a permit l` eel obtaioe. within 180
_
Print name: Date. r j da after It has brae accepted as complete.
• Numb. of , allowed per permit. B Lk
It l3uddmalPeimtis\ELC- romitAou 05/23/06 daura,c tvnlna,rnun,.rnn
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