Permit CITY OF TIGARD ELECTRICAL PERMIT
III COMMUNITY DEVELOPMENT Permit #: ELC2013 -00220
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/15/2013
Parcel: 2S112BC13700
Jurisdiction: Tigard
Site.address: 14592 SW 81ST AVE
Project: Lowe Subdivision: LEISER PARK Lot: 6
Project Description: (1) branch circuit for power to hot tub
Contractor: SQUIRES ELECTRIC Owner: LOWE, BROOKE
1001 SE DIVISION STREET #1 14592 SW 81ST AVE
PORTLAND, OR 97202 TIGARD, OR 97224
PHONE: 503 - 252 -1609 PHONE: 503 - 702 -2346
FAX: 503 - 253 -5831
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 04/15/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/15/2013 $6.74
Type of Use: SF Electrical
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $62.92
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 -001 -0 90. You
^ `a may
/ 1(or obtain a copy of the rules or direct questions to OUNC by calling 503.2322.1987 or 1 800.332.2344.
Y� V
Issued B " Permittee Signature: 1µ PL C4 nod
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 503.639.4176 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.
Electrical Permit Application RECEIVE I FOR OF Fit I rSl. O.\1,1
City of Tigard Received /► 5 1 E aoJ 3 - d
City g. L} 3 `. ' Permit No.: eV as
I I 13125 SW Hall Blvd., Tigard, OR 97223
A 1 5 2013 ° e "�
r g Plan Review
Phone: 503.7181439 Fax: 503.598.1960 Date/B , Other Percent:
T1GAR11 Inspection Lire: 503.639.4175 CITY OFTIGAR Date Ready /fay: El See Paget for
Internet: www.tigard- or.gov OtIfteNMethod: Supplemental Information
BUILDIN
t � IMMI
1 � i,I 1 E OF_ WO1tI
.,; � PLAN REVIEW .
Please check alt that apply (submit sets of plans wlitems checked below):
III New construction Addition/alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other where the available fault current C) Marinas and boatyards,
.1 . 1�I'EGORY OF ON ' CONSTRUCTI exceeds I0 000 amps at 150 volts or ❑ Floating buildings.
°9 less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
ell I- and 2- family dwelli g El Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of KVA or
'. i) JOB STTE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A", "E 1.1 "l -3 ",
Job no.: Job site address: 1 4 5 9 '. '$' V� R` . , 100HP or more. occupancy.
❑
_ ❑Six or ore residential units, , Recreational vehicle parks
City /Statc/ZIP: \ �` oil �� r7 2-4 l� Health -care facilities. Cl Supply voltage for more than
1` �L "T ❑ Hananlons locations. 600 volts nominal.
Suite/bldgJapL no.: 1/4 Project name: ` R ,.. • 0 - r ❑ Service or feeder 600 snips or more,
^r n F EE SCilF.)L1r . ' . .
Cross strect/dircctions to jab Site:
Description i Qv. I ra, I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,0 00 sq• ft. or le _ 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.:
Limited energy, 75.00 2
Fif ; •1 D)p CRIPTION OF 'WORK (with above sq,ft.)
Limited energy, multi - family 75.00 2
r _ • r n. " A , residential (with above sq. ft.)
Renewable Encrg ❑ See pie 2
Services or feeders installation, alteration, and/or relocation
. ' n . PRQP TY I W I 0 TENANT 200 amps or less ^ 100.70 2
201 amps to 400 amps 133.5 2
Name: k� � P
401 amps to 600 amps 200.34 2 '
Address: , 1-t 9' „ S v j t 4t-!. - 601 amps to 1,000 amps 301.04 - 2
L Over 1,000 amps or volts 552.26 2
City/State /ZIP:
‘' 4 Q � C Z A Temporary services ur feeders installation, alteration, and /or
Phone: j ` ) =742 EOM Fax: ( ) relocation
200 amps or less 59.36 I
Owner installation: This nstallation is being made on property that I own which is not —Tii amps to 400 amps 125.08 2
intended for sale, lease, re t, or ex
xchange, according to ORS 447, 449, 670, and 701. ~
401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits - new, alteration, or estension, Depadel
!4 APPiLUC • Ni,, ❑ CONTACT PERSON A. Fcc for branch circuits iv /di
above service or feeder fee, 7.42
Business name: SQUIRE ELECTRIC, INC. each branch circuit
B. Fce for branch circuits without
Contact name: ANDREW COHEN service or feeder fee, first 1 56.18 sc,, 2
branch circuit
Address! 1001 DIVISION Each add'l branch circuit 7,42 2
• t I Miscellaneous (service or feeder not included)
Each manufactured or modular
r 1 3) 252 - t 3 - ) 253 dwelling, service and/or feeder 67.84 2
Reconnect only 67.84 2
E - mail: ANDREW(SQU RESELECTRIC.COM _ P ump o i rrigation circle 67.84 2
I CONTRACTOR Sign Or outline lighting 67.84 2
Business name: SQUIRES ELECTRIC, INC. Signal circuit(s) or limited - energy
p alteration, or extension. Pagel 2
Address: 1001 SE DIVISI N ST. #1 Each additional Inspection over allowable in any of the above _
City/State /ZIP: PORTLAND, OR 97202 Additional inspection (I hr min) 66.25 / hr
Investigation (I hr min) 66.25/ hr
Phone: (503) 252 -1609 • : (503) 253 -5831 Industrial plant (I hr nun) 78.18/ hr
CCB Lie.; Inspections for which no tee is
135085 1 Electrical Li' ® 101C Suprv. Lic.: 4882S specifically listed ('/: hr min) 90.00 / hr
r cd: k.� _ ELECTRICAL PER \TIT FEES •
' . ' _ Subtotal: 'c,, t i '
Print name: JOE SQUIRES -� Date; t Plan review (25% of permit fee):
State surcharge (12 % of permit fee): -- 6'77
Authorized signature: TOTAL PERMIT FEE: 6.,, c ,
Print name: JOE SQUIRE Date: ��� t Ibis permi application expires if a permit Is not obtained withht'rt 180
` days after it has been accepted as complete.
* Number of inspections allowed per permit.
I-\ OvildingTormits\ELC PermirApp 0409 . 440- 4615T(IvosicOM/WED
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
14592 SW 81ST AVE, TIGARD, OR, 97224
Residential - Electrical
150 Hot tub/spa/pool
04/19/2013 00:00
ELC2013-00220
PASS
Violation Summary:
Inspector Contractor