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Permit
, , '''' rt CITY OF TIGARD ELECTRICAL PERMIT • ' " - COMMUNITY DEVELOPMENT Permit #: ELC2013-00077 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/30/2013 Parcel: 2S112BC04300 • Jurisdiction: Tigard Site address: 8360 SW MURDOCK ST Project: Carleton Subdivision: HAMBACH PARK Lot: 27 Project Description: (2) branch circuits to install outlets & lights for ktichen remodel Contractor: HUGHES ELECTRICAL CONTRACTORS INC Owner: CARLETON, MARK E 10490 NW JACKSON QUARRY RD JOLIN - CARLETON, MICHELLE HILLSBORO, OR 97124 8360 SW MURDOCK ST TIGARD, OR 97224 PHONE: 503 - 647 -2221 PHONE: FAX: 503 - 647 -7754 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 01/30/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/30/2013 $7.63 ' Type of Use: SF Electrical Class of Work: ALT 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 5 ?- 001 -00 0. You may obtain a copy yo of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: f1Yl .l -/.(./1 Permittee Signature: O/J /`t / PPL/c 4. - I (U 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: 01/30/2013 10:47 #337 P.002/003 Electrical Permit Application RECEIVED FOR OFFICE USE ONLY City of Tigard JAN 3 0 2013 Da idea 30 / 3 sr Permit a0/3- 0007 lil 13125 SW Hall Blvd., Tigard, OR 97223 p� • Review s Phone: 503.7182439 Fax: 503.598.014N QF TIGARD Dat : : Other Permit: T c t R Inspection Line: 503.639.4175 Date Ready /By: la See Page 2 for Internet: www.tigard-or.go„ BUILDING DIVISION Date Supplemental Information Z£ •. ,. .n. ,. , .-„ _„ r A a r. _ .. _tom, � ..� �.�. �� - _ ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit sets ofplans wiitema checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑ Marinas and boatyards. • - `tL - . RY OF " > - : .r:.,;, _ - _ exceeds 10000 amps at 150 v oha or ❑ Floating buil dings. ;:, `: _' . = Yomi ' ` .- - . • 3 less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or _ ❑Emergency system larger separately derived system. - . ' _ n = .. " - _ . , _ - - ":+f_,(4 i YI(OR,M &Ti12N :; OCI�' .911 . Addition .,_. " ❑ Addrtio of new motor load of 1:1 "A ", "E", "1 -2 ^, "1 -3 ", Job no.: 13 f�d$b Job site address: g360 JW M u r 6 C� ' e ) ❑ S 100HP or more. ' or more residential units. ❑ u vehicle parks. City /StatefZIP: 71 f OP g - 1 ray ❑ Health -care facilities. Remode ❑Supply voltage for more than ❑ Hazardous bcatlocations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: k l cher� ❑ Ser vice or feeder 600 amps or more. .. -,. - • :I?1 SOIi ED_ULE `v' ;,.-.; _- Cross street/directions to job site: ne I city ty. I Pew I T otal I • New residential single- or multi- family 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 I Tax map /parcel no.: Limited energy, residential 75.00 2 " ' DFS_ C.4titii14. Oli V allit - _ (with above sq. ft.) -� ,, g p fa � I Limited energy, multi-family 2 in5M If Ou +Ifk 1, LIAb� RP C q-thef, Rematt residential (with above sq. ft.) Services or feeders installation and/or relocation 200 amps or less 100.70 2 — •t:1 .. t1 FRQPERtY OWNER _ 'TENANT 201 amps to 400 amps 13156 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 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 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with above service or feeder fee ,. r - APPia<C? NT' • .... ,� .. , ' ;L '(1N T Cf'-P.kRSQN; _ ; - 7.42 2 _ . . . _ . - each branch circuit Business name: B. Fee for branch circuits without C'_ `a service or feeder fee, first 1. 56.18 J[D I S L3 2 Contact name: branch circuit Each add'I branch circuit 'j 7.42 ' 1 )4k 2 Address: Miscellaneous (service or feeder not induded) Each manufactured or modular City/State/ZIP: dwelling, service and/or 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 . -" ' . •;, CON'l: f A* -•::-'; _ ' , _ Signal circuit(s) or limited -energy Business name: / Con 4-�AL panel, alteration or extension. Page 2 2 H " c -5 Ele L! r G �+� - r 5 Each additional inspection over allowable any of the above Address: 104410 `,"/ J acK5OR t Industrial p O Varry P Additional inspection (1 hr min) 66.25/hr City/State/ZIP: ? i 115 ba ro OR C Its Investiga a t hr min) 6625/ hr lant (1 hr min) 78.18 / hr Phone: (5a '3 ) ( 0 4 1 _ 6 1 0 1 4:7 ) . t Fax: ( 503) ( 'T - "1 i 544 Inspections for which no fee is 90.00/ hr _ ifically listed ('A br min) Electri Lic.: rv. Lic.: r> < - � 3 � - �8f � 5 3 re = - - -. - . `:ieI;�c� �>u� i�i�s`::; ; CCB Lic.: Subtotal: (p3 r (04 Suprv. Electrician signature, required: Plan review (25% of pemit fee): i � Print name: l i t. q`t I/ I 7—r-4,40 Date: i/2_ y /� 3 State surcharge (12% of permit fee): '1 , ( TOTAL PERMIT FEE: i I aa Authorized signature: 1 This permit application expires If a permit is not obtained within 180 Print name: Date: • days after it has been accepted as complete. Number of inspections allowed per permit I:I auiWmglPermitslELC- PenniApp.doc 07/01/10 440.4615T111/05/COM/WEa From: 01/30/2013 10:47 #337 P.001/003 ELECTRICAL CONTRACTORS 10490 NW Jackson Quarry Rd Hillsboro, OR 97124 Phone (503) 647 -2221 Fax (503) 647 -7754 hec@h ugheselectrical. 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: 01/30/13 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. Please email me a copy of the permit ASAP. Thanks, Steve Jasnoch stevej©hugheselectrical.com