Permit CITY OF TIGARD ELECTRICAL PERMIT
` a COMMUNITY DEVELOPMENT Permit#: ELC2013-00480
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2013
Parcel: 2S114BB08000
Jurisdiction: Tigard
Site address: 16309 SW 104TH AVE
Project: Reed Subdivision: SWANSON'S GLEN Lot: 21
Project Description: (2)branch circuits for family room and kitchen
Contractor: BOONES FERRY ELECTRIC INC Owner: REED,JOE&WENDY
PO BOX 628 16309 SW 104TH AVE
WILSONVILLE, OR 97070 • TIGARD, OR 97224
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PHONE: 503-682-4936 PHONE:
FAX: 503-682-7946
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 08/14/2013 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/14/2013 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports(Conditions)
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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. ATTE ON: Oreg.• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 through OAR 95. s I '09' You may obtain a copy of the rules or direct questions to OUNC by callin• .% .232.1987 or 1.800. 32.2344.
Issued �� - ��� ��� Permittee Signature: M' i%��'� /41—A----'
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' j ec-l_J 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.
Aug. 12. 2013 4:42PM No. 1126 P. 1
jlectrical _Permit A Iica • fig' FOR OFFICE USE ON?.)
Ill City of Tigard Ei b/ED nisY �',� Pamir No.: �' G 3-d d g0
= 13125 S W Hall Blvd,Tigard,OR 97223 Plan lieview
Phone: 503.639.4171 Fax 503.54-1 1 2 ot1,QPezmie
1)aleBr.
r? :�it i/ Inspection Lurk 501639.4175 2013�3 Date Ready/By lusts! la SoaPege 2 for _
Interact www•tigar'd-or_gov A , . Notified/Method: Supalen col_rlaformatkn
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k
❑New oonsmruction j�Addition/alteration/rep -• -.31! Please check au mat apply(submit rats of puns wfitems clothed below);
❑Demolition ❑ ❑Service er>aeder 400 amps or more ❑Building over three stones-
whe a the available fault current ❑Marinas and boatyards.
K , ; exceeds 10.000 amps at 150 volts or ❑floating bmldmgs
.,.r. '-_ '- `t ,.-mac ..• kw to gsoaad,...02„,d,14,000 ❑Commercial-use agricuinusl
LI-and 2-family dwelling 0 Cominercial/indtlstrial 0 Accessory building amps for all other installatiooa. btaldmgs.
❑Mufti-family ❑Master builder ❑Other ❑Fire Pte. ❑Installation of 751CVA or
❑❑Emergency systeta far separately derived system-
.. , :, t,__.:..,,r F- , .- % Addition of new motor load of ❑. "1-2","1-r,
Job no.: 2 ;19.13.13 Job site address:1 b-)01 5,_,0 9.4.yt : loollP or mare. may.
❑Six m more residential units- ❑Recreational vehicle parks-
City/State/ZIP: 71,4r 0 CI lisa'thrste fealties. 0 Supply voltage for more than
❑Eazardom locations. 600 volts nominal.
Suite/bldglapt.no.: [Project name: G E-7-- 0 Service or feeder 600 amps or more
Cross strret/ditections to job site: l — an. Fee Toad`
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""— New residential single-or multi-family dwelling unit.
Includes attached garage-
Subdivision: I Lot no,: 1,000 sq.ft.or less • 11E31 4
Tax mute/parcel no.: Fa add'1800 sq.ft or portion 33.92 • —1 1
Limited$ !r a�b0� al 67.84 2
S_ .!,L.-1...- .,-._.- --s.- ..--._- _ ..-, '_._ . _ _. - . ...c,,..,.� Un ued narrt mule-family 67.84 2
l.t` h4 jn �dr�1)1 rDVrI d. kr Giles tesidential(with above sq. .)
7 y Services or feeders instaltatlonyaltcration,and/or reloeatiou
200 amps or less 100.70 2
�' :, { .::-.1-,:•:, 201 amps m 400 amps 13336 2
200.34 2.
Name: K �r 1 C] °l (AD e.. tiY "601 amps to 1.000 carps 301.04 2
ddress: - Over 1.000 amps or volts 55226 2
Temporary services or feeders installation,alteration,and/or
City/StateiZIP: relocation
Fax:( ) 200 amps or less 5936 1
Phone:( ) 201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amt's 168 Sal 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701-
Bmneh circuits—new alteration,or extension,err panel
Owner signature:- Date: A Fee for branch circuits with
r,, l.. :, above re brooch circuit feeder fee,
---_ -- _ L. .._:.�' aeeb branch eitcat 7.42 2
Business name: B.Fee for branch circuits we itho,a --
• _ �Or 1 56.18 2
Contact name: branch c;naat
Each add'1 branch circuit ) 7,42 2
Address: Miscellaneous(service or feeder not included)
Bad manufactured or modular 67
City/State/ZIP: dwelling,service and/or leader ,84 2
Phone:( ) I Fax•:(. )
Reconnect only 67.84 2
Pump or irrigation aide 67.84 2
E-mail Sign or outline lighting 67.84 2
` Y a s.. Sigrml cumn s)or lim+ted•enmgy
Business name:Booties Ferry Electric
panel,a1 ation,or eAension. Page 2 2
Each additional inspection over allowabk in any of the above
Address P.O.Box Additional inspection(1 br min) 66.25/tar .
Investigation(1 hr min) 6625/hr
City/State/Z1P:Wilsonville OR 97070 industrial plant(1 hr SAW 78-18/1Ir
Phone:(503)6824936 Fax:(503)682-7946 Inspections fbr which no fee is
90.0W br
s, - listed l4hrmin
CCB Lic,: 88482 Ehxvical Lie.: 3-223C ._... .-. ,' ..:. ,. _
Ste 6' ' C-6
Cuprv.Elecnician signature.,required Plan review(25%of penult fee): .--.
1� 6//2,/ State surcharge(12%of permit fee): 7,
:tint name: '�a'h r`!QrY'dT I � Date: `J i
TOTAL P E R MIT F E E 7/..a)
Authorized signs, Aim ,• 44'♦: 1 - This permit application expires if o permit is nor obtained within 160
days after it bas been omrpted as complete.
Print name: lI i r— b -1 _ Date: 9 • Palm • Numbs eFinspecaoos allowed per pencil.
1:mo dng1P i 'FLC-r-.- duo 10/01/09 448.461ST(11/05/COWNEB