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Permit a CITY OF TIGARD ELECTRICAL PERMIT 11111 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00713 T [ G ARE) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012 Parcel: 2S109AB04400 Jurisdiction: Tigard Site address: 14362 SW 134TH DR Project: Mallory Subdivision: THREE MOUNTAINS ESTATES Lot: 37 Project Description: (2) branch circuits for hot tub connection and instjallation W.P. receptacle Contractor: HUGHES ELECTRICAL CONTRACTORS INC Owner: MALLORY, MATTHEW D & MARIE M 10490 NW JACKSON QUARRY RD 14362 SW 134TH DR HILLSBORO, OR 97124 TIGARD, OR 97224 PHONE: 503 - 647 -2221 PHONE: FAX: 503 - 647 -7754 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 12/17/2012 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/17/2012 $7.63 Type of Use: SF Electrical Class of Work: OTR 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 95 -001-00)). You may o•tain a copy of the rules or direct questions to OUNC by calling 501232.1987 or 1.800.332.2344. Issued By: A! g = ( ' Permittee Signature: e^'u 4 / P6 / e 4- T70 0 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. From: 12/14/2012 13:47 #296 P.002/003 Electrical Permit APPlica"RECEIVED FOR OFFICE USE ONLY City of Tigard 1 =r! I- r7 la l'i Permit No.le.- (42/.. Ot - 7t3 ill --- " 13125 SW Hall Blvd., Tigard, OR 97) 7 2012 Other Permit: Plan Review I Phone: 503.7182439 Fax: 503.598= ris : : Inspection Line: 503.639.4175 Date Ready/By: Mil VI See Page 2 for TIG ARP Internet: www.tigard-or.gov crryorrIGARD Notified/Method: # Supplemental Information LXPAMIIIIMIMi E Ntn.4 construction Z Addition/alteration/replacement Please check all that apply (submit 1 sets of plam w/items checked below): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Dcmoliti011 [1] Other: where the available fault current 0 Marinas and boatyards. .,_________ ............_ CATEGORY OF CONSTRUCTION - exceeds 10.000 amps at ISO volts or 0 Floating buildings. I.. - — less to wound. or exceeds 14.000 0 Commercial-use agricultural EX] I - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for an other installations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or , 0 .. , ,,,,,,t, 0 EmergencY sYstern- larger separately derived tem. sys 1431,44.egaitta j. :, i :::, 0 Addition of thew motor load of 0 100HP or mom. occupancy. Job nO.: 12A599 Job site address: 14362 SW 134 DR 0 Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: TIGARD OREGON 97224 0 Heakh-c.are facilities. 0 Suppty voltage for more than 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt no.: I Project name: HOT TUB CONNECT 0 Service or feeder 600 amps or more Cross street/directions to job site: Dd.. Qty. Fee. Tetal • New residential single- or multi-findiy dwelling unit. Includes attached garage. . Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map/parcel no.: Limited energy, residential 75.00 2 4§;1•'V: . :' .. ':GTitiSt 1 = kAttikVeliiAkinarifiR (with above s q . ft Limited energy, multi-family 75.00 2 CONNECT HOT TUB AND INSTALL W.P. RECEPTACLE residential (with above sq. ft.) Services or feeders installation and/or relocation 200 amps or less 100.70 2 qj* 201 amps to 400 snips 133.56 2 '' ''''' . ‘-. - - - '''''' . "4. 401 amps 10 600 amps 200.34 2 4 ' -' ''' ''4 ' ' s '''' ' - ' . '''''''' ' ' Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP! relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteratioii, or extension, per panel _ Owner signature: Date: A. Fee for branch circuits with ' ' ' above service or feeder fee, 4.i.tit.. . i 742 2 Business name: B. Fee tbr branch circuits without service or keder fee, first I 56.18 56.18 2 Contact name: branch circuit Each add'I branch circuit 1 7.42 7.42 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City/State/ZIP: dwelling, service ancVor feeder 67.84 2 Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 , Pump or irrigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 4Matrial.Mi1itiliaii*11.4?-;' si circuit(s) or limited-enmity Business name: HUGHES ELECTRICAL CONTRACTORS panel, alteration, or extension. _ Page 2 2 Each additional inspection over allowable in any of the above Address: 10490 NW JACKSON QUARRY RD Additional inspection (1 hr min) 66.25/ hr Investigation (I hr min) 66.25/ hr City/State/ZIP: HILLSBORO OREGON 97124 Industrial plant (I lu min) 78.18/hr Phone: (503) 647-2221 Fax: (503) 647-7754 Inspections for which no fee is 90.00/ hr apecificall listed ('A hr min) CCB Lic.: 49850 Electrical Lie.* - X/ . v. Lic.: 51 1 5 _5 Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee)! 63.60 Print name: DAVID TRAPP Date: 12/14/12 State surcharge (12% of permit fee): 7.63 TOTAL PERMIT FEE: 71.23 Authorized signature: Ibis permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: • Number of inspections allowed per pemiit. 1:lBuilding \PermitskELC-PertanAyp.doe 07/01/10 440-461 ST(1 1 /05:(X/M/WEB • From: 12/14/2012 13:46 #296 P.001/003 11eS ELECTRICAL CONTRACTORS 10490 NW Jackson Quarry Rd Hillsboro, OR 97124 Phone (503) 647 -2221 Fax (503) 647 -7754 hec©hugheselectrical.com F A X C O V E R S H E E T TO: CITY OF TIGARD - PERMITS ATTN: PERMITS FAX: (503) 598 -1960 PHONE: (503) 718 -2439 FROM: STEVE JASNOCH DATE: 12/14/12 RE: ELECTRICAL PERMIT APPLICATION No. of Pages including cover: 3 Message: Attached is an electrical permit application for the referenced work, along with the credit authorization form. Please let me know if you have any questions. ALSO, PLEASE LET ME KNOW WHEN THE PERMIT HAS BEEN PROCESSED. I WOULD LIKE TO SCHEDULE AN INSPECTION FOR MONDAY TOWARDS IT. Thanks, Steve Jasnoch stevej @hug heselectrica l.com Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 14362 SW 134TH DR, TIGARD, OR, 97224 Residential - Electrical 199 Electrical final 04/18/2013 00:00 ELC2012-00713 PASS - No C of O Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 14362 SW 134TH DR, TIGARD, OR, 97224 Residential - Electrical 199 Electrical final 04/18/2013 00:00 ELC2012-00713 PASS - No C of O Violation Summary: Inspector Contractor