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Permit • CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2013-00570 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2013 Parcel: 1 S136CA02003 Jurisdiction: Tigard Site address: 10950 SW 78TH AVE Project: TURNER Subdivision: FAIRVALE Lot: 9 Project Description: (1)panel and(2)branch circuits for panel upgrade. Contractor: COLUMBIA NW HEATING Owner: TURNER,JOHN A AND PO BOX 622 BALLARD-TURNER,WENDY J SCAPPOOSE,OR 97056 10950 SW 78TH TIGARD,OR 97223 PHONE: 503-543-3624 PHONE: FAX: (503)543-6285 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 09/25/2013 $100.70 Specifics: amps or less 2 crt Branch Circuits w/Purchase 09/25/2013 $14.84 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 09/25/2013 $13.86 Electrical Type of Const: Occupancy Grp: Total $129.40 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 obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. c .^ Issued ByT �6--`-� 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. Electrical Permit Ae li l,tol;(Hi:,ci:. 1.,„ Ovl City of Tigard WifieRrEl ' in 13125 SW hall Blvd,Tig>aq Phone: 503.718.2439 Fax 543. •„• : Othar Pt r[nit: f " i(; ]c D inspoction Line 503.639-4175 ' 2013 bate Rcsdy/By: NM El SacFege 2 for Internet www,tigerd-or.gov�{�' NOtifiO retbod: Supplemental mfbonrstton . TIA Ai. ;l, ploesc dmcck Ni that aTRi1Y(autmtit2 Beta of P1am w/itn+t;checked 6clow ❑Ne1v conshucton nedit O Service or feeder 400 amps or more ❑Building over three;rules. ❑Demolition ❑Other: where the available fault cunent ❑Marinas and boatyards, ` Ctiit O cols1 i ta exceeds mow:mpg lso voles O Forting bnidmgr. Ida to ground.or exceeds 1000 Q Calmer cintase agricultural ® 1-and 2-family dwelling ❑commercial/industrial ❑Accessory btnlding a.aps for all other installation& wilding& ❑Multi-family ❑Master builder ❑Other: (]Fire ptemp. ❑Installation of 150 KVA or -- f separately derived system. JOB•Srlt INFORtMATION.Arai,IACA17ON, , " ❑B+ ' p addition ofmw molar load of 0`A'.�•.-1-2-,°1-3 ��� 10oP1,or more. occupancy.no.: Job site address:r 9 � (� `� five ❑gm or more rcaidcmaial amen. ©Recreational vehicle parks. �, t id, - ,f a G/t ©Health-care facilities- ❑Supply voltage for more than QZ3azordooslocations. 600 volts nominal. Suite/bldg"/apt no.. Project mine: Dilifi 7 ,trri igir Q Scrvies or feeder 600 empa or mote. Cross street/directions to job site r ne nevertsum 1 (1b. I Fen I meal I • New residential single-or mull-randty dwelling unit- Include;attached garage. _ _ Subdivision: Lot no.: 1.000 sq.It,or lose 168.54 4 — — Ea.add'I 500 sq.0,or portion 33.92 1 Tax map/parcel no.: Limited cnagy,residential 73.00 2 . , ., bliStiti i101Q•QF 14'17�RK ' •. •. .• . • (with;boyssg,ft) T.i csid mall,multi family 75.00 2 �^ ,ut;dctn;a1 ith abeam eq.0,) Kehl rrible Fa"!: •. "[3.Spa'1 !?e.2:: . Services or feeders installation,alteration,andlor relocation El iittor>tllrryr ii*NER. . '. © TENANT 200 or tams . 1 100-70 J O()•10 2 N& �� 2A11 maps 10400 amps 133.56 2 15J n 401 amps ho 600 amps 20034 2 Address: 141 • * • , 601 amps to 1,000 amps 301"04 2 �� ;J ' Over 1,000 amps or volts 552.26 2 City/State/ZIP. //State/ZIP. ` / i relocation services or feeders installation.alteration,and/or Phone:(503)543-36,- Fax (503)543-6385 r lo`ation 200 amps or Ion 5936r 1 r Owner insulation:This installation is being made on property that I own which is not `201 amps 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 Ousie r signature: Date: Branch dreatta—new,alteratioty or extension,per panel ' ig APPUCAN't . : . .0titofA.ct PERSON A Fewest branchcacuilsWith alxnrc scrims or&eder fee, �) 7-42 1.4.8q 2 Business name:Contractor each branch circuit Vt . B.Fee ear branch circuits wnlrour Contact name: service or feeder fee.Gist 56.18 2 — branch circuit Address: Each add'I brooch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.94 2 ?hone:( ) Fax::( ) �� r duvet �lee and/err feeder 67.84 2 •E-mail: Pomp or irrigation eagle 67.84 2 C4NT 11f,"1 OR. Sign or omline lighting 67.84 2 Business name:Columbia NW Heating Signal circuits)or timitai-eacr9y See _pal,alteratiotr,or cxtrasioa- Page 2 2 Address:PO Box 622 Loch additional:Inver allowable in may of the above City/Stme/ZIP:Scappoose,Oltt,971156 Additiowl irapeci en(1 hr non) 66.25/hr — laveatigstinn(1 hr mina) 66.25/hr Phone:(503)543-3624 Fax:(503)543-6385 Lsdmfriai plant(1 hr mm) 78.18/hr CCB Lic-: 61947 I Elce4ital Lie.: C-261 44 I Supra.Lie-: 1813-S Inspections for which no in is 90.00/hr all loosed('fi ter min ill 110 111 >fLE title la.:r.ISit>ulr reES • : • Supra-Electrician signature.7Equimd: W Subtotal:FI Jam' Print name: Bernard Japs Date: _, Plan review(25%of permit fee): r _ State sttrehargc(12%of permit fee): .�f0 Authorized signs . ;It r TOTAL PERMIT FEE: 7 a7.yQ o� Print name: a`6 Ii Date y /3 This permit application after expires s been accepted es ompicte• within 180 * Number of is pections allowed per permit. T:tt74i m6Ing\PcmiWiEtcJe.mitApp..Br `tmloc Rav mum 13 4e0-161570 7t115/COR11WE8 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 10950 SW 78TH AVE, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final 2014-01-08 (null) ELC2013-00570 PASS - No C of O Violation Summary: Inspector Contractor