Permit CITY OF TIGARD ELECTRICAL PERMIT
II I - COMMUNITY DEVELOPMENT Permit /1: ELC2010 -00052
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 1 S 136CA03600
Jurisdiction: Tigard
Site address: 11290 SW 79TH AVE
Subdivision: FRIENDLY ACRES Lot: 12
Project: Knight
Project Description: (2) branch circuits for heat pump and air handler
Owner: FEES
KNIGHT, ROBERT W Quantity Description Date Amount
11290 SW 79TH
TIGARD, OR 97223 2 crt Branch Circuits 02/03/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 02/03/2010 $7.63
Electrical
Contractor: •
GENIE ELECTRIC CONSTRUCTION INC
8701 SE 156TH AVE
PORTLAND, OR 97236
PHONE: 503 - 762 -9296
FAX: 503 - 762 -9188
Type of Use: SF
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 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permiftee Signature: Al / e--4 0 h./
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 603.639.4175 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.
,, n. ELECTRICAL PERMIT
CITY OF TIGARD
....,i, '': - : 0 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00052
r : Date Issued: 02/03/2010
TEGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S136CA03600
Jurisdiction: Tigard
Site address: 11290 SW 79TH AVE
Subdivision: FRIENDLY ACRES Lot: 12
Project: Knight
Project Description: (2) branch circuits for heat pump and air handler. 2/10/10, adding service panel to scope of work.
2/11/10 ADDING (2) branch circuits to scope of work.
Owner: FEES
KNIGHT, ROBERT W Quantity Description Date Amount
11290 SW 79TH
TIGARD, OR 97223 1 ea Services or Feeders - 200 02/12/2010 $100.70
amps or less
PHONE: 4 crt Branch Circuits w /Purchase 02/10/2010 $29.68
Service or Feeder
1 ea 12% State Surcharge - 02/10/2010 $15.65
Contractor: Electrical
GENIE ELECTRIC CONSTRUCTION INC
8701 SE 156TH AVE
HAPPY VALLEY, OR 97086
PHONE: 503 - 762 -9296
FAX: 503 - 762 -9188
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $146.03
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 throu h OAR 952-001-0100. You may obtain oobbta a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
n
Issued By: ! . tJVJC 6 l / -� Perm ittee Signature:
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
_ �`1" 1
SIGNATURE OF SUPR. ELEC' P 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.
CITY OFT A RD LLi4...ez,k 1061, 7 ELECTRICAL PERMIT
1,
COMMUNITY DEVELOPMENT Permit #: ELC2010-00052
T I G r\ R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 1S136CA03600
Jurisdiction: Tigard
Site address: 11290 SW 79TH AVE
Subdivision: FRIENDLY ACRES Lot: 12
Project: Knight
Project Description: (2) branch circuits for heat pump and air handler. 2/10/10, adding service panel to scope of work.
Owner: FEES
KNIGHT, ROBERT W Quantity Description Date Amount
11290 SW 79TH
TIGARD, OR 97223 2 crt Branch Circuits 02/03/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 02/03/2010 $7.63
Electrical
Contractor. 6 da 12% State Surcharge - 02/10/2010 $8.23
GENIE ELECTRIC CONSTRUCTION INC Electrical (manual)
8701 SE 156TH AVE 52 da Electrical Permit Fee 02/10/2010 $51.94
HAPPY VALLEY, OR 97086
PHONE: 503 - 762 -9296
FAX: 503 - 762 -9188
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $129.40
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. ATTENTIO • regon law requires you to follow the ivies adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -00 rough OAR 2 -001 0. may obtain a copy of the rules or direct questions to OUNC by calli . ' . • 6699 or 1.800.332.2344.
Issued Permittee Signa • = •� ' 4 fk f
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 503.839.4176 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.
Feb 08 10 03:32p LeRoy White 503- 762 -9188 p.2
• Electrical Permit Applicatio FOR OFFICE USE ONLY
City of Tigard D 1] 0 9 26 0 Received
a /D PersnitNo.: Y,..., e.:' 2049 la CVO d4
r Plan 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 F T1 AD Date la : Other Permit
Inspection Line: 503.639.4175 Cirri 0 N
Internet: w�tw.tigard -0r.gov Date Ready/By: ruris ® See Page 2 for
TIGl�I:I3 gu1LDI GDI Notified/Method: : Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction I:Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commereial -use agricultural
i g„Land 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fun pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A", "E", "1- 2 ", "I -3 ",
n /�^ . 10011P or mom. occupancy. no.: `Job site address: �� (U 5 w e t c ❑ Six or more residential units. ❑ Recreational vehicle parks.
� ❑ Haalah -care facilities.
ID Supply voltage for more than
City/State/ZIP: �.^ ? ❑ Hazardous locations. Supply
volts nominal.
Suite/bldg. /apt. no.: Project name: ['Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Oocdption I Qtv. I Bee. I roes 1 •
— New residential single -or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or kss 168.54 4
Ea add') 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OF WORK With above sq. B.) 67.84 12(
/ ,L � i Limited energy, multifamily
67.84
C f j"t} of �`- Az 5 4/ jr
C- �rr/ti. -e / residential (with above sq. R) /u
( � f` Services or feeders installation, alteration, and/or tomb)
/y ,( r.,,, ��`'.{ •''ep 200 amps or less j I 1 00.70 CaC Co 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
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
Phone: ( ) Fax: ( ) 200 amps or less 59.36 l l
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 1 2
intended for sale, lease. rem, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 I 2
Branch circuits — new, alteration, or extension, e��
Owner signature: Date: A. Fee for branch circuits with ( r
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee. 42 t °Z
each branch circuit 2- 7
L `
Business name: B. Fee •for branch circuits Q/
without service or feeder fee. 56.18
r
Contact Herne: first branch circuit
Address: Each add'I branch circuit 7.42 !
Miscellaneous Iservice or feeder not included)
City / State/ZIP: Each manufactured or modular 67.64 2
dwelling, service and;or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
C.-FP: f Signal circuit(s) or limited -
Business name: Cq -e' FY (-•C_ C.-FP: G C a /�s c. a1 energy panel, alteration. or
Address: 8 7 / S L l S ce (-".-r. extension. Destxibe: Page 2 2
City/State /ZIP: f.-/-ix /1/ (,..4i, /1 0 A d '7 6 (Pk Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (fb5) nt 2_4 4 (Fax: (5-03 ) 7 0 L -2 t g a Investigation per hour (1 hr min) 66.25
CCB Lic.: 7 6 3 ? Electrical Lie.: 3 N love Suprv. Lic.: (45 G 5 Industrial plant per hour 78.18 •.7
ELECTRICAL PERMIT FEES / - �
Suprv. Electrician signature, required: "-�� C,�c2- Subtotal: �'
Print name: /----e C f .> Date: r O Plan review (25% of permit fee): • ( f /.
,L� State surcharge ()29'0 of permit fee):
Authorized signature: • - [/v — TOTAL PERMIT FEE:
// 0 This permit application expires if a permit is not obtained within 1 80
Print name: 1--e �� (, f� t Date: data after it has been accepted as complete.
• Number of inspections allowed per permit.
lABuildine .PermitskELC- Perrni:App.dec 10.5OI.Y9 4 I/OS /COMAVFB
Fah G1 10 10:05a LeRoy White 503- 762 -9188 p.1
Electrical Permit ApplicationRECEIVED FOR OFFICE USE ONLY
III City of Tigard Received : 02/3 /0 _Jr.. •e.•tnit No.: C /0 -Q 00502,,
• 13125 SW Hall Blvd., Tigard, OR 97223 F 0 2 2010 Plan Review
Phone: 503.639.4171 Fax: 503.598.196 2010 Dace B}. Other Permit:
T I G A R D Ins Line: 503.639 Date Ready /By: ]mi /^� 13 See Page 2 fur
Internet: www.tigard or CITY OF TIGAR Notified/Method: '�/(3 Supplemental Information
TYPE OF PLAN REVIEW
❑ New construction dition!alteration/replacement Please check all [liar apply tsubnut 2 sets of plans 'di/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the ayartable fault cum.•nt ❑ Marinas and boatyards.
CATEGORY OF CONSTRICTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
K ' less to ground, cc exceeds 14,000 ❑ Commercial -use agricultural
and 2- family dwelling ❑ Commercialiindustrial ❑ Accessory building amps for all other installations. buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 15 Kb' A or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derive system.
❑ .Addition of new motor lard or ❑ "A ", "E ", "1 -2" ": z"
Job no.: 5207 I Job site address: f / 2._t' p 5 - '7 ! IOOHP or mote. occupancy.
❑ Six or more residential nlial units. ❑ Recreational vehicle parks.
City /State /ZIP: (7'(6 -e ❑ Health -cue facilities. ❑Supply voltage for morn t t•0 than alr
`` r ❑ l larardos locations. 6 volts nominal.
Suite/bldg. /apL no.: Project name: r j f f ." - ti ,.( c t � te r ,. ❑ Service or feeder 600 amps or more.
job site: FEE SCHEDULE
Cross street/directions to
J Dcacnprion I pr.. I pm I Total ) •
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. IL or portion 33.92 1
Tax map/parcel no.:
Limited energy. residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
( /L Limited energy, multi- family
if O < Lt.;' cue *-n t // /�� residential (with above sq. ft.) 67.84 2
(-1'o ^1-f- /1 Services or feeders installation. , and /or relncatin
r{ " ' , e � / t / 2 `� �� 200 amps or less !00.70 ���j
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2 I
amps 401 amps P
s to 600 s 200.34 2
Name: " <Ar/ lrlff / !� 0Q/
j 601 amps to 1,000 amps 301.04 2
Address: 9-.t,/ g Over 1,000 amps or volts 1 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 i
Owner installation: This installation is being made on property that l 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 I I L'
❑ APPLICANT I 0 CONTACT PERSON above service or feeder fee, i - 7.42 9 �� 2
each branch circuit
Business name: B. Fee for branch circuits • / 8
e,
n•ithour service or feeder fe
Contact name: f 56.18 5
first branch circuit
Address: Each add`I branch circuit 7.42 _ 2
Miscellaneous (service or feeder not Included)
City /State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Genie Electric Construction, Inc Signal circuit's) or limited -
1
energy panel. alteration. or
Address: 8701 SE 156th Avenue extension. Describe: Paget 2
City /Stale/ZIP: Happy Valley, OR 97086 Each additional inspection over allowable in any of the above
( 503) 76 2 -9296 p ale: (5 3) 762 -9188 Perinspectiun 66.25
Phone: p ' Investigation per hour 0 hr rain) 66.25
CCB L 56619 1 /31 I Electrical Lic.: 4=' RF C: I Suprv. Lie.: CL53 - Industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 2 ) 0 i 1 IJ Subtotal:
Print name: / I D ate: Plan review (25% of permit fee):
LeRoy White 2/2/LO10 Statesurcharge(12 %ofpermit ) -- •
Authorized signature: "..`r _ TOTAL PERMIT FEE: / v
(/ This permit application expires if a L �
Print name: x `ti Date: I pl p accepted is not plet eed w a
LeRoy White — — 2/2/2010 _ lass after it Iran been accep as complete.
• Number of inspections allowed per permit.
L: lauitding LC- Permii App.doc 10/51/09 440.4615TI I I/05/COM/WriB
P ts 6-- ricvx BA p E l MU i T
02/09/201.0 TUE 14:1.2 FAX 5036242938 Willamette Electric 10002/002
Electrical Permit Application
Cit of Ti and eccived
y g ,V (e/B Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 an Review
Phone; 503.639.4171 Fax: 503.598.1960 FEB O 9 ry Date/13 : Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: t See Page 2 for
Internet; www,tigard-or.gov CIS. Notified/Method: tr" Supplementallnfarmation
i
rh 4, sf
ry'e_ C niiiF'3: ~SS.e~l: :lt•,::1' .i tl. /fI tfp3 1)h ~ L Y
New construction - Addttion/alterati0n/replaCeme /Q Please check all that apply (submit 2 sets of plans w/items checked below):
Y 0 Service or feeder 400 amps or more [3 Building over three stories.
El Demolition ❑ Other: where the available fault current O Marinas and boatyards.
. exceeds 10,000 amps at 150 volts
x . ;3 .rz T or ❑ Floating buildings.
,
~ - - less to ground, or exceeds 14,000 0 Commercial-use agricultural
❑ 1- and 2-family dwelling ter' Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: O Fire pump. O Installation of 75 K VA or W&MOGM O Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ •`A" "E^ ° L2^ ^ 1.3^
Job no.: 1 t~ Job site address: 100HP or more. occupancy.
[3Six or more residential units. 0 Recreational vehicle parks.
19 ❑ Health-care facilities. ❑ Supply voltage for more than
City/State/ZIP: ~?-f r { /1 .4 ,
O Hazardous locations. 600 volts nominal.
('SUICbldg./apt. n0.: Project name:
INC O Service or feeder 600 amps or more,
r=. s
Cross street/directions to job site: 'u~/~J r
Dcscri lion Fce. Total
New residential single- or multi-family dwelling unit.
Includes attached garage,
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea, add'[ 500 sq. It. or portion 33.40 1
Tax map/parcel no.;
Limited energy, residential
with above s q. R. 75.00 2
< Limited energy, multi-family
residential with above sq. 11. 75.00 2
Services or feeders installation alteration and/or relocation
~r 200 amps or less 80.30 2
r'~.Q,jlt.< t( I~'pL°z4~ 5x G, ~ rrS 4`s i .L1 ~L~;,i~~ay~4' (Gt s,
y:K 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160,60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 net Signature: Date: Branch circuits - new, alteration or extension per panel
; A. Fee for branch circuits with
r, a APPLiAlVT t a s above service or feeder fee,
c . , ONAGIi PEI(.501~
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee,
~ 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous service or feeder not included
City/State/ZIP: Each manufactured or modular 90.90 2
Phone: dwellin , service and/or feeder
( ) Fax:: ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
Business name: Willamette Electric, Inc. Signal energy circuit(s) or limited-
energy alteration, or
Address: PO Box 230547 extension. Describe: Page 2 2
City/State/ZIP: Tigard, Oregon 97281 Each additional iris ection over allowable in an of the above
Per inspection 62.50
Phone: (503) 624-3631 Fax: (503) 624-2938 Investigation per hour (I hr min) 62.50
CCB Lic.: 75059 Electrical Lie.: 34-283C Suprv. Lie.: 4226-S Industrial plant per hour 73.75
`w•f i v+'•tiJ~ +4.1, l?ilaFi4:.1'i[j~`t'. a7`.`,'L~i. Y -W
Suprv. Electrician signature, required: Subtotal.
Print name: David Fife Date; Plan review (25% of permit fee):
2i y
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: F~
Print name: Date: This permit application expires if a permit is not obtained within t80
days after it has been accepted as complete,
` Number of inspections allowed per permit.
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