Permit CITY OF TIGARD ELECTRICAL PERMIT
1 1- CO MMUNITY DEVELOPMENT Permit #: ELC2013 -00402
Date Issued: 07/17/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S125DC07500
Jurisdiction: Tigard
Site address: 7041 SW ASH CREEK CT
Project: Mendez Subdivision: ASH CREEK ESTATES Lot: 8
Project Description: (2) branch circuits for NC and service plug.
Contractor: BOB'S ELECTRIC Owner: MENDES, RYAN
2700 NE BURTON ROAD STE A BUSEY, MARAH
VANCOUVER, WA 98662 MENDES, JEFF & PATRICIA
7041 SW ASH CREEK CT
TIGARD, OR 97223
PHONE: 360 -254 -7200 PHONE:
FAX: 360 - 254 -8219
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 07/17/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/17/2013 $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 0: - • ;— •01 -00• '. 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: Permittee Signature: pN �/ / �� e 77
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 603.639.4176 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.
FROM ( MOM >JUL 15 2013 3:41 /ST. 3: 40 /No. 8302825668 P 2
Electrical Permit Application I O It O (I- l ( I t , ,I (1\1 \ •
III City of Tigard � Received ,1 , Permit No.
• 13125 SW Hall Blvd., Tigard, OR 9 plan Review C
s Phone: 503.718.2439 Fax: 503.598.1960 Dar :: Other Permit: �-C.� • t 3 - 00'38 •
TI ARE) Inspection Line: 503.639.4175 Date Ready /By: ® See Page 2 for
- Internet: www.tigard or-gov JUL. 15 2013 Notified /Method: Supplemental Information
"" -....- "...,: r 1 . •-.- -; , e.--..,---- c '' • _ m - ^-r. - °—°'_ -_ i - -.- . t ' 11..: ' ' -�. ^°. •- -' .3,
❑ New construction ®Additi011/fitt Please check all that apply (submit 2 sets of plans w /items checked below):
+isrw jQl�! ❑ Service or feeder 400 amps or more ❑ Building over thrcc stories.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
" ^ x "" to $Y ` `"" " "" T;a - "-- exceeds 10,000 amps at 150 volts or Floating buildings. = 4 ; t lo t a e r l ; s . . P 6
= 6
""" """" _= - " — less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
- _.-. _._ '''' w:..._ -- ❑ Emergency system- larger separately derived system.
_-_ ,,..,. T'' fr . E_i i t 1 E 1. f L... k1: e'' a d i i ,._
.'.''•�' • `"` .. �-a .,:` .:�. _ ❑ Addition of new motor load of ❑ • °E• ` •• 1.3
Job no.: 13 -780 I Job site address: 7041 SW Ash Creek Ct. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations - 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Description I Qty. Fee. '
t Tina/ 1 .
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'/ 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: - ' Limited energy, residential '
75.00 2
-. :5,= _ � ------ - = -•a_ w ° .:1 o ''a' " ..."" •Sans" (with above sq. ft)
_ - - - Limited energy, multi - family 75.00 2
A/C connections & service plug - 2 branch circuits residential (with above sq. fl.)
Services or feeders installation,,alteration, and/or relocation
200 amps or less 100.70 2
-,-__ . _ -t. y .._._.�... " _ 4 ' . 1 . _ a.w 4.v...::A�w - ..` =fig -, °,= ;: 201 amps to 400 amps 133.56 2
Name: Ryan Mendez -_� _ 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 7041 SW Ash Creek Ct. Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard, OR 9 7223 Temporary services or feeders installation, alteration, and/or
tY g relocation
Phone: (503)927 - 4756 I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not
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
Owncr signature: Date: A. Fee for blanch cilcuils t
-- G,,, .:_ •-- ; •;;, -:- •7,. r'� 7.-:.---..- service or feeder fee,
_ each branch circuit 7A2 2
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 1 7.42 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84
2
ty dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
,..-°°.' 7- �^ tl --.mo �.
-moray_ ..-;.; -'` a .3 e� ,e :. — - "'""- `..�_�'•.....- Signal circuit(s) or limited -energy
Business name: Bob's Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2700 NE Burton Rd., Ste. A Additional inspection (I hr min) 66 -25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Vancouver, WA 98662 Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 254 - 7200 / Fax: (360) 2 - 8219 Inspections for which no fee is 90.00 / hr
specifically listed C/: hr min)
CCB Lic.: 53136 Lk l 1 1) Electrical Lie.: 37 -431C Su Lic.: 43225 " sx --
Subtotal: 63.60
Suprv. Electrician signature, required: ..."-•----Z___ Plan review (25% of permit fee):
Print name: Kevin Broselle Date: 7/12/13 State surcharge (I of permit fee): 7.63 /
TOTAL PERMIT FEE: 71.23 t/
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
I:• nuilding \Permits.ELC- PennaApp.doe 07/01/10 440-461 ST(I1.'05 /COMM'EB