Permit ' CITY OF TIGARD ELECTRICAL PERMIT
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a -.. COMMUNITY DEVELOPMENT Permit #: ELC2013 00029
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/16/2013
Parcel: 2S104BD01900
Jurisdiction: Tigard
Site address: 13770 SW FERN ST
Project: Lamb Subdivision: HANDY ACRES Lot: PTS 27 .
Project Description: (1) 200 amps or less and (1) branch circuit to replace main electrical panel and provide circuit for heater in sun
room
Contractor: JRA INC Owner: LAMB, CHARLES B AND ZADA M
11860 SW GREENBURG RD 13770 SW FERN STREET
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 639 -4627 PHONE: 503 524 -8748
FAX: 503 - 639 -4673
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 01/16/2013 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 01/16/2013 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 01/16/2013 $12.97
Electrical
Type of Const:
Occupancy Grp:
1 _
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 0 R 2 -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: J Permittee Signature: 04.1 PpPtfL
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.
01- 14 -'13 13:51 FROM- Frahler Electric 5036394673 T -142 P0001 /0002 F -447
Electrical Permit A lic ati CEIVED FOR OFFICE: USE ONLY
III City of Tigard c : ( / GIME Per mit No., C 7 do/ 3' (t)O t'
- - t 13125 SW 1-lall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.7182439 Fax: 503.5981j/601 1 4 2013 Datem : Other -tit:
T1GAab Inspection Line: 503.639.4175 Date Ready /By l3 See Pape 2for
Internet www.tigard•or.gov CITY OF TIGARD Notified/Method: Supplemental information
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit E at of plans w/amns checked below):
❑ Service or feeder 400 amps or more III Building over three stories.
❑ Demolition ❑ Other: whet) the available fault current ❑ Marinas and boatyards.
Q �.��` XON': " '� ex ceeds 10,000 amps at 150 volts or Floating buildings.
• ir` >
i`, . 7r 1,.�1 � 0 ,t? t "'''''''''''''''''''''''''':•''''''''''' '',i. :. ?. Ps ❑ ng g
' " - " ' •'''''''' ` '" less to ground, or exceeds 14,000 Cl Commercial-use agricultural • ® 1- and 2 - family dwelling ❑ Commercial/industrial ❑ Accessory building amps lbr all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ['Fire pump. ❑ Installation of 75 KVA or
..;: : s+ :. -; ?. ❑Emer system. Isrger separately derived system.
;J SITE IN FORMATION • ` •• AP7Di L TlON ' - - --
,,,.....r .,. �.... .:. ... ..... ,.,..: �� ...,..... .,.....:.,. ' ?.' ., ❑Additioaofrmwmotorloadof 1
Job no.: 70149 Job site address: 13770 SW FERN STREET 100111 or mom. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle pans.
City /State/ZIP: TIGARD, OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
4 Hasardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: LAMB RESIDENCE ❑ Service or feeder 600 amps or mom.
Cross street/directions to job `' .'.3. i a ,,1 t` " "`'; ' i :'1$1 S0OSE tILE . n::: • :. . ;11..: " ; : :
j site: Deaen I Orr. I Fee,. I Tom ,_' .I.. : •
-
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33,92 1
Tax map /parcel no.:
Limited energy, residential
; y F, ,.. (with alcove s . n. 75.00
Limited energy, multi - family 75.00 2
REPLACE MAIN ELECTRICAL PANEL AND PROVIDE CIRCUIT FOR residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
HEATER IN SUN ROOM. 200 amps or less 1 100.70 100.70 2
. :J• :A. ail
8 I'Itp1!RI Yi:;O�YNER; ' ; []'; T. " t`; '; 201 amps to 400 amps . 133.56 _ 2
Name:
401 amps to 600 amps 200.34 2
601 amps to 1000 amps 301.04 2
Address: Over 1,000 amps or volts 552,26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to $99 amps 168.54 2
Branch circuits — new. alteration or extension er panci
Owner signature: Date: A. Fee for branch
;1 :1,VkI C : : %; `: - Ei ..00: : = 4..if <-. a erch ve bran cerv e i h ce ci ° rc r u f i cede t r fee' 7.42
•
Business name:
• B. Fee for branch circuits withow
service or feeder fee, first
56.18 2
Contact name: branch circuit
Each addl branch circuit 7.42 2
Address: Miscellancou9 OCrViCt or feeder not included
City /State/ZIP: 67.84 2
dwelling, service and/or feeder
Phone: ( ) I Fax: ( ) Reconnect only 67.84 2
Pump or irrigation circle E - mail: 67.84 z
:. ,.... , , 67.84 2
,1 ;' A CT ; •
Business name: .IRA dbn Y: RAILER ELECTRIC COMPANY el aerate orextension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 11860 SW GREENBURG ROAD Additional inspection (1 hr min) I J 66.25/ hr
OR 97223 Investigation (I hr min) 66,25 /hr
Industrial plant (1 hr min) 78.18 / hr
Phone: (503) 639 -4627 Pax: (503) 639 -4673 Inspections for which no fee is 90.00 / hr
CCB Lie.: 197172 I Electrical Lie.: C861 I Suprv, Lie.: 5110S specifically listed �h hr min)
^zXl.)ECC`RYCAI<:. IEIt 1 fUS. ; . :1-
'.
Suprv. Electrician signature, required: � Pla review (25% of p fee): al: 108.12
Print name: ADAM ETHERINQTON r Date: 01/14/13 State surcharge (12 %ofpermit fee): 12.97
TOTAL PERMIT FEE: 121.09
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: I Date: • Number of inspections allowed per permit.
r:\ BuildingiPcrmit &t5LC.PerautApp.doc 07!01/10 440.46t5T(11/3i/COMIWEn