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Permit • CITY OF TIGARD ELECTRICAL PERMIT a COMMUNITY DEVELOPMENT Permit#: ELC2013-00555 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2013 Parcel: 1 S 135CD04900 Jurisdiction: Tigard Site address: 9775 SW LONDON CT Project: WHEELHOUSE Subdivision: LONDON SQUARE NO 1 Lot: 2 Project Description: (2)branch circuits Contractor: GRF ELECTRIC Owner: WHEELHOUSE REVOCABLE LIVING TRUS 15460 S PARADISE LN 9775 SW LONDON CT MULINO,OR 97042 TIGARD,OR 97223 PHONE: 503-829-4146 PHONE: FAX: 503-829-5747 FEES Quantity Description Date Amount 2 crt Branch Circuits wo/Purchase 09/19/2013 $63.60 Specifics: Service or Feeder 1 ea 12%State Surcharge- 09/19/2013 $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 OAR 952-001-0090. You may obta r :co•y of the rules or direct questions to OUNC by calling 503 232.1987 or 1 800.332.2344. Issued By: — _ _/OW° 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. Sep. 17.2013 09:45 GAF ELECTRIC 5038295747 PAGE. 1/ 2 Electrical Permit ApplicaREnc I� _holy of i ic:is l:Si 0\1.A City of Tigard - - J Received Data/13 : i �j C • 11125 SW Hall iilvd.,Tigard,OR 97223 Plan Review �f/_ �� Phone: 503 639.4171 Fax. 503 59831E10 1 S 2013 Date.011 .i:1(:;\k t i Inspection Line: 503.639.4175 Date Ready/13y: 6 RI Sec Page 2 for • - Internet: www tigard-or,gov rT� Nutitied/Method: Supplemental Information TYPE • I s hi .IIGARD PLAN REVIEW 1 •�_ i Iii . _ ❑New construction dditi0n /'-7l i t•• :Ot *1. -' Please check all that apply(submit 3 sets of plans whtoms checked below): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Mai hies 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 NI-and 2-family dwelling ❑Commercial/industrial [i 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 CI 5mcrgency system larger septuatety dcnved trystcm ❑Addition of new uwtur load of ❑"A""E"'•1.2"•"1-3", Job no.: Job site address. 7 7 5 L.a N I00YtPor more. occupancy. 0✓1 ❑Six or more restdcnual unit ❑Recreational vehicle pucks City/State/ZIP: Ti Cr)1-2.3 e-v to r t ❑Health-care facilities. El Supply voltage for more than' a ❑Hazardous locations. 600 volts nominal Suitc/bldg./apt,no.: ki 1 Project name: V V e_e / in U fa a G o Sawa or feeder 600 amps or more. — FEE SCHEDULE Cross street/directions to job site: tkxnatiea I Qty. I Pee. I cwt New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft or less 168.54 4 "' Ea.add'I 500 sq ft.or portion 13.92 1 Tax map/parcel no: Limited energy,residential _ DESCRIPTION OF WORK (with above sq.ft.) 67.84 2 Limited energy,multi-family 2 Ids. ."^ w / r residential(with above sq.ft.) 67 84 Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 ki-PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 133.56 2 N 1 / e- - 401 amps to 600 amps 200.34 2 Name: 67 ( (A L to i A- V./H e. � / g A.�` _601 amps to 1,0000 amps 3o1 04 2 Address: q 1 7 - SLA..) i-Q . p., C,v, i Over 1,000 amps or volts 552.26 1 2 City/State/Lll': r` a L Z 3 Temporary services or feeders installation,alteration,and/or r"1._ relocation _ Phone:( j) (,z _ Fax:( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation:This installation is eing made on property that I own which is not 401 amps to 599 168 54 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. amps Branch circuits—new,alteration,or extension,per panel Owner signature: Date: T_ A Fee for branch circuits with ❑ APPLICANT ^—I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: Et Fee for branch circuits without " service or feeder ftx,first 1 56 18 ��,1/r 2 Contact name: branch circuit X Address: Each ddd'I branch circuit I 7 42 -, 4 4 2 r.Miscellaneous(service or feeder not Included) City/State/ZIP; Each manufactured or modular 67,84 dwelling,service and/or feeder 2 Phone:( ) Fax::( ) Reconnect only ,. 67 84 2 E-mail. -- Pump or irrigation circle 67 84 2 —•— Sign or outline lighting 1 67 84 2 CONTRACTOR Signal circutt(s)or limrted.cnergy Business name: /� r -I t'L,1_�i� panel,alteration,or extension. Page 2 2 1� 1 r Each additional inspection over allowable in any of the above Address: to�.b t% yj`k Y`. e 1...k, . Additional inspgcdon(1 hr min) 66 25/hr City/Stair/"LIP. �^ l !r Investigation(I hr nun) 66.25/hr i•`Lk i".l O t 0 A• Cam.©`f- Induslnal plant(1 hr min) 78 111/hr Phone:(a ^9 �t�� Far(� A2_41_-. -��� Minna for which no fee is 90.00/hr _i�j�T- f/ pecifically listed(h hr mm) CCB Lic,: 1 (�I S 1 Electrical Lic.: 3-tf.g 4 L Suprv,Lic` )1.0 S"h-5 ELECTRICAL PERMIT FEES Subtotal: AMINI Suprv.Electrician signature,required: A Plan review(25%of permit fee): r - Print name: Date: State surcharge 12%of permit fee): (03 V Authorized signature: TOTAL PPJ(M]'f FE L. w This permit application expires If permit is not obtain'w hin ISO Print name: chyle after it has been accepted as complete. i Date: ' Number of inspections allowed per permit Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 9775 SW LONDON CT, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final 2013-11-13 00:00:00 ELC2013-00555 PASS - No C of O Violation Summary: Inspector Contractor