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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2013-00483 T II GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/19/2013 Parcel: 2S 111 AA05000 Jurisdiction: Tigard Site address: 8680 SW INEZ ST Project: Handy Subdivision: GREENSWARD PARK Lot: 24 Project Description: Replace(1)200 amp panel Contractor: MISTER SPARKY OF BEAVERTON Owner: HANDY, KENNETH M ERIN JOY 1365 SE 10TH ST PO BOX 23802 WARRENTON, OR 97146 TIGARD,OR 97281 PHONE: 503-643-3500 PHONE: FAX: 503-861-2157 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/19/2013 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 08/19/2013 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 a 1 00.1. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 '.198 or 1.;10.332.2344. Issued By: P Permittee Signature: ,,/L.jsqm 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. Electrical Permit Application R 'CEII/ED i: ,1 412 c F I I(,t i sE ON I \ 'I I i s City of Tigard p 'I; 9 Date/B Received /9 ti ?'- Permit No.g—al_ ,i3 _el p y/3; �' r` 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ',1 Phone: 503.718.2439 Fax: 503.X98.196 Date/B : Other Permit: }It ,!ki6 p 'ITY OF Date Ready/By: Page I l' i'i'' Inspection Line: 503.639.4175 Juris: ® See Pa e 2 for I `I I Internet: www.tigard-or.gov BUILDING DIVISIO Notified/Method: 77 Supplemental Information ; TYPE OF WORK PLAN REVIEW 1 • . Please check all that apply(submit 2 sets of plans w/items checked below) ❑New construction .Addition/alteration/replacement ❑Demolition ❑Service or feeder 400 amps or more ❑Building over three stories. ❑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 ❑Commercial-use agricultural 18-1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A "E","1-2 "1-3", Job no.: Job site address: 1 5--(.. 100HP or more. occupancy O ��✓ e-�/ ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than Z S� 7 2-Z ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: / Project name: ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee I Total I •New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Tax map/parcel no.: Ea.add'l 500 sq.ft.or portion 33.92 l Limited energy,residential 75.00 2 . DESCRIPTION OF WORK (with above sq.ft.) a A (J Limited energy,multi-family 75.00 2 td C.-e-- 2-115C) fill A�C residential(with above sq.ft.) 1 Services or feeders installation,alteration,and/or relocation 200 amps or less r 100.70 tut,76 2 ❑ PROPERTY OWNER' , ❑ TENANT 201 amps to 400 amps 133.56 2 Name: � 401 amps to 600 amps 200.34 2 ��e.4 P= ,,‘,1 601 amps to 1,000 amps 301.04 2 vddress: ef..0 e r Over 1,000 amps or volts 552.26 2 City/State/ZIP: �_ �'s'1 Temporary services or feeders installation,alteration,and/or TLgQ,�'� relocation Phone:( ) / 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 I own which is not 401 amps to 599 amps 168.54 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits—new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with -❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.4') each branch circuit Business name: B Fee for branch circuits without service or feeder fee,first 56.18 2 Contact name: branch circuit Each add'l branch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling,service and/or feeder - Phone:( ) Fax: :( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail:, Sign or outline lighting 67.84 2 CONTRACTOR. Signal circuit(s)or limited-energy Business name: 0 ,-t n(anrM ` /)� -1 Qom` panel,alteration,or extension. _ Page 2 2 t`F Lt / 0�u M Each additional inspection over allowable in any of the above Address: tans (tiC (eld . ( Additional inspection(1 hr min) 66.25/hr City/State/ZIP:[�et e t r i 7 i ke 6 Investigation(1 hr min) 66.25/hr C/" Industrial plant(1 hr min) 78.18/hr Phone:(S©9) s C(3_3 Fax:(CJ 3 ) i6(.-_267 Inspections for which no fee is 90.00/hr specifically listed(IA hr min) CCB Lic.:306( _ Electrical Lic. E Suprv.Lic.:/q/6 S ELECTRICAL-PERMIT.-FEES' • - \uprv.Electrician signature,required: A `77 Subtotal: l�� f0 k "? '�Clr` . Plan review(25%of permit fee): Print name 1 l,J1� ?16 r a I� Date: State surcharge(12%of permit fee): /a Der - Authorized signa r : v TOTAL PERMIT FEE: // , -71 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:1 Buildin e\Permits\ELC-PermitApo.doc 07/01/10 440-4615Th 1.I0SICOMf%Vt B