Permit CITY OF TIGARD ELECTRICAL PERMIT
111 ' COMMUNITY DEVELOPMENT Permit#: ELC2013-00461
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2013
Parcel: 1S 125CA12300
Jurisdiction: Tigard
Site address: 7415 SW CEDARCREST ST
Project: Johnson Subdivision: 2008-030 PARTITION PLAT Lot: 1
Project Description: (1)branch circuit.
Contractor: ROTH HEATING&COOLING Owner: JOHNSON,MICHAEL WAYNE
PO BOX 1265 7415 SW CEDARCREST ST
CANBY,OR 97013 TIGARD,OR 97223
PHONE: 503-266-1249 PHONE: 310-651-8760
FAX: 503-266-3478
FEES
' Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 08/06/2013 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/06/2013 $6.74
Type of Use: SF Electrical
Class of Work: ALT
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 952-001-0090. You may obtai - •• • _rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ _ _ _—_ Permittee 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
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.
Jul 24 2013 11 : 04AM ROTH HEATING 5032632513 p. 1
Electrical Permit Applicatio E IV ,' tOIt(AAA, l: t!tir(,;\t,,
City of Tigard AUG 1 2013 ReceiBed . I I `
I. 13125 SW Hall B1vd.,Tigard,OR 9'223 Plan Review
• ' YOFTIGARD Other Permit: 3_uo
�� Phone: 503.718.2439 Fax: 503,598. 1,� DatelB ; �
Inspection crue: www: 503.6r.gov 5 BUILDNG DIVISION Not&R& etho S See Supplemental for
Tl:.,,,.,.,i 67V ilV
Internet: waw.tigard-or.gov � Notifxd.'Method: Supplemental laformatfon IMII
�, z::t It#i l!3r- T .i ... `itl t s�V,t 5•-'.v i.-,1 f s.. f` T rt's t "_r` ,irvk rt 1•r[ . _. f r ,E:'i i-t.Tt, Sara csr 4. `4e fa is
:.i....;.1„...a.._.t L -;y.:�.*.t 1,..._ </3 ..,`e.:t.st,;.mac__. „Y,'�c.?...,.-.4u.y-. %,.- t.....,..3' -; �., ? t,..�. 4 i,,k..'' ,..t+-. .-1- a t..1.: t" . ,,,,, . ., �.:
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Demolition ❑Other. ❑Service or feeder 400 amps or more ❑Building over.three stories
where the available fault current ❑Marinas and boatyards
t 4 t `": +i, .S:n ° . ii ' ° r.r,t 1..,t i!;` i M. , exceeds 10,000 amps at 150 volts or ❑Floating buildings.
r'i. t::n.�..irf 'Z .::._�. . ....:,, {.A.».l..3 ...:_ ...wi1ix... . It:it f.Kil; M,r t .n
`�'- .- less to ground,or exceeds 14,000 ❑Commercial-use agricultural
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other ittstallati000. buildings.
❑Multi-family ❑Master builder ❑Other ❑Firs pump. ❑Installation of 150 KVA or
o a i t-. .tt yr r .:, s.ix 2 t K f � Fl f,n�r ri ❑Emergency system. larger separately derived system.
..ti..t.. i.':......r. ,-a .. ...,..., _ ;:l..S ..fr i..+:lfNt..... c. . .-.: �r'i.i, s 1 i"t^ ❑Addition
of new motor load of ❑"A","E,."1-2", 1.3.,
Job no.: Job site address:7415 SW Cedar crest St IoDHP or more. °C°pa°Cy.
❑Six or more residential smite. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for mote than
❑Hazardous locations. 600 volts nominal
❑Service or feeder 600 amps or More
Suite/bldg./apt.no.: Project name Johnson/46647 n►p
1 +s{t �-. 1 Y> d skT i Zz.r --c 7.-vS" t Cf ti a.
Cross street/directions to job site: flambuaa Qty. Fee_ Taw •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1;000 sq.-it.-or less -- 168;S4 - 4
Tax map/parcel no.:- Ea.add'I 500 sq.A.or portion 33.92 1
r• t I{n s-. ,r s SS ,, t tt Limited energy,residential 75.00 2
7 t-ti.1h Sj ,! St�ty d 1f la i �t. Z , 4q i;_I,l .^rte :lft (with above rat ._,.. .. ..v"t_..,i..e4c„ �1..y.,:-.rc- ..+=......: .....- ..-1 !t:c s..., -.::::.. Limited energy,multifamily
75.00 2
1 new circuit residential(with above sq.ft.)
Renew able Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
y , aa.s�t ,.t.x ... y ; -x , r Ia r�.s � .0'r: , : , 200 amp 07 less 100.70 2
t Wit',, &r°_{.s ,t , i : a ll'.!:i, }... .. ..:ul'w s L . . lh: e_,.. ti,5 u.l ;r s: :;
Name:Michael Johnson 201 amps to400 amps 133.56 2
401 amps to 600 amps 200.34 2
Address:7415 SW Cedarcrest St 601 amps to 1,000 amps 301.04 2
City/State/Z1P:Tigard,OR 97223 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Phone:(310)651-8760 Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 estrus 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
Owner signature: Date: Branch circuits-new,alteration,or extension,per panel
S 1y:vlrf s f i tt... F z+;s i}�}' ... : 'r . s . A.Fee for branch circuits with
above service or feeder feq 7.42 2
Business name:Roth Heating and Cooling each branch circuit
B.Fee for branch circuits without
Contact name:Angela McGraw service or feeder fee,first I
56.18 56.18 2
branch circuit
Address:PO Box 1265 Each addi branch circuit 7.42 2
Miscellaneous(service or feeder not Included)
City/State/ZIP:Canby,OR 97013
Each manufactured or modular 67.84 2
Phone:(503)266-1249 Fax: :(503)266-3478 dwelling servioeatld/or feeder
Reconnect only 67.84 2
E-mail:angelam @roth-heat.com Pump or irrigation circle 67.84 2
t+: {..v AS l�. ° sI7 r y t h x •_ y -x r Ci4;S-I i tits i. .£n „.
v.5:�.. ,w -•..�:. .:r os�f..�,,.,R.:.a ,..it. ,,.�, s.�.,..��,. ,.,r.._:�;:rr_.-,L.az�c.a.,i..:..�..-, ?"�: Sign or outline lighting 67.84 2
Business name:Roth Heating and Cooling Signal circuit(s)or limited-energy See
panel,alteration,or extension. . Page 2 2
Address:PO Box 1265 Each additional inspection over allowable in any of the above
City/State/ZIP:Canby,OR 97013 Additional inspection(1 hr min) _ 66.25/hr1
Investigation(1 hr min) 66.25/hr
Phone:(503)266-1249 Fax:(503)266-3478 industrial plant(1 In min) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lie.: 14008 - = I Suprv.Lie.: 50935 C r I ■ listed t hr min
j , 2 x;_ c ry ` . ta 3.Jbtt� .:, :5uprv.Electrician signature,required:
Subtotal: 56.18
j rr Plan review(25%of permit fee): -
• ��Sitpson # •� Date: 8/1/13
State surcharge(l2%of permit fee): 6.74 .
Authorized sit 4MPrnFAJ TOTAL PERMIT FEE: 62.92 '
Eeril This permit apptiratioa expires if a permit is not obtained within 180
:t Date:
8/1/13 days after it has been accepted as complete.
• Number of inspections allowed per permit
I:\Huil \PamidtELC_Permi[App_ER_ERE.dec Rev 05/21/2013 440.46157(11/05/COM/WEB
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