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Permit
CITY OF TIGARD ELECTRICAL PERMIT III I • COMMUNITY DEVELOPMENT Permit#: ELC2013-00056 TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503 718.2439 Date Issued: 01/23/2013 Parcel: 2S 104CA10000 Jurisdiction: Tigard Site address: 13745 SW JENNA CT Project: Taylor Subdivision: HILLSHIRE Lot: 100 Project Description: (5)branch circuits for kitchen remodel Contractor: PDX ELECTRIC LLC Owner: TAYLOR,GERALD P&BETH 7933 WHITFURROWS CT 13745 SW JENNA CT DURHAM,OR 97224 TIGARD, OR 97223 PHONE: 503-997-1989 PHONE: FAX: 503-200-1362 FEES Quantity Description Date Amount 5 crt Branch Circuits wo/Purchase 01/23/2013 $85.86 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/23/2013 $10.30 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 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 OA 9 2-001 090 You ay obtain copy of the rules or direct questions to OUNC by calling 503.2332/19887 or 1 800 332 2344 Issued By: K-'^--T Permittee Signature: rT I PLI L r7--rod, 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. 1/23/2013 8:20 AM From: PDX Electric LLC/503-200-1362 To: 15035981960 2 of 3 Electrical Permit ApplicationCEIVE City of Tigard Received I/a-3 I3 I y. Permit No.:�i��!3- ® 13125 SW Hall Blvd.,Tigard,OR 97223 JAN 2 3 2013 PA3 i Plan Review Phone: 503.718.2439 Fax: 503.598.1960 DatG73y: Other Permit:Inspection Line: 503.639.4175 ARE) Date Ready/By: ._.— lydsi rn ® Page 2 for CITY OF TIInternet: www.tigrd-orgov ;fcd/Mathod: r Supplemental Information rmation TYPE OF WcffILDINGIAN. PLAN REVIEW ❑New construction ®Addition/atteration/replacement ❑Other: Please check all that apply(submit 1 sets of plans w.items checked below): ❑Service or feeder 400 amps or more ❑Building over three stories. CATEGORY OF CONSTRUCTION where the available fault current 0 Marinas and boatyards. exceeds 10,000 amps at ISO volts or ❑Floating buildings. RI 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑Multi-family ❑Master builder ❑Other: amps for all other installations. buildings. JOS SITE INFORMATION AND LOCATION 0 Fire pump. ❑Installation of 75 KVA or ❑Emergency system. larger separately derived system. Job no.: Job address:13745 SW Jenne Ct ❑Addition of new motor load of ❑"A","E","I-2","1-3", 100HP or more. occupancy. City/State/ZIP:Tigard/OR/97223 ❑Six or more residential units. ❑Recreational vehicle parks. • ❑Health-care facilities. ❑Supply voltage for more than Suit;/bldg./apt.no.: Project name: ❑Hazardous locations. 600 volts nominal. ❑Service or feeder 600 amps or more. Cross street/directions to job site: tiZ4 soma 7LE nnerlpn°n.. ..... I Qty. I F. I Tetaa 1 New residential single-or multi-family dwelling unit. Subdivision: Lot no.: Includes attached garage. 1,000 sq.ft.or less --� 168.54 4 Tax map/parcel no.: F.a.add'l 500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) Kitchen Remodel Limited energy,multi-family --75.00 2 residential(with above sq.ft.) Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER 0 TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2y Name: __._. 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 City/State/ZIP: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Phone:( ) Fax:( ) relocation 200 amps or less 59.36 1 Owner installation:This installation is being made on residential or farm property owned by me or a member of 201 amps to 4()0 amps 125.08 2 my immediate tbmily. This property is not intended for sale,exchange or rent.(OkS 479.5411(1)and 479.500(1). 401 amps to 599 amps 168.54 2 Owner signature: _., ___ ________ _____ Date: Branch circuits-new,alteration,or extension,per panel ® APPLICANT Q CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, 7.42 2 Business name:PDX Electric each branch circuit B.Fee for branch circuits wirhouf Contact name:Marty Palmer service or feeder fee,first / 56.18 S6',a he 2 branch circuit Address:7933 SW Whitfurrows Ct Each add'I branch circuit of 7.42 E( 2 City/Slate/ZIP:Portland/OR/97224 Miscellaneous(service or feeder not includedL_ Each manufactured or modular 67.84 2 Phone:(503)639-9708 Fax:(503 )200-1362 dwelling,service and/or feeder Reconnect only 67.84 2 E-mail:info @pdxelectric.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name:PDX Electric Signal circuit(s)or limited energy panel,alteration,or extension. Page 2 2 Address:7933 SW Wttitfurrows Ct , Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr City/State/ZIP:Portland/OR/97224 Investigation(I hr min) 66.25/hr Phone:(503)639-9708 Fax:(503)200-1362 Industrial plant(I hr min) 78.18/hr Inspections for which no fee is E-mail:info©pdxelectric.com CCB lie.no.:192731 (I(1(I 5 specifically listed('/r hr min). 90.00/hr 25 ELECTRICAL PERMIT FEES Electrical tic.no.:C696 I.\\\\ City or metro "c.:11027 �1 P(� Subtotal: &c.&L Supervising electrician 1 11k1 Plan review(25% permit fee signature,required: Marty Palmer 1/ - ( pe fee): v� State surcharge(12%of permit fee): t tys 30 Print name: Date: 1-23-2013 TOTAL PERMIT FEE: 7 ... /�., Authorized This permit application expires if a permit is not obtained within 180 Signature: days after it has been accepted as complete. " Number of inspections allowed per permit. Print name: I Date: r:�,.,.e:•�,,......-... 1/23/2013 8:20 AM From: PDX Electric LLC/503-200-1362 To: 15035981960 1 of 3 PDX ELECTRIC 7933 SW Whutfurrows Ct Portland, OR 97224 (503) 639-9708 (503)200-1362 www.pdxelectric.com info @pdxelectnc.com To: City of Tigard Permits From: Marty Palmer Fax: (503) 598-1960 Date: 1/23/2013 8:09 AM Phone: Re: PDX Electric Permit Application Comments facsimile 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 13745 SW JENNA CT, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final 06/07/2013 00:00 ELC2013-00056 FAIL Island recept not gfi protected Per 210.52 nec Violation Summary: Inspector Contractor