Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2013-00619
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2013
Parcel: 1 S 136AB01703
Jurisdiction: Tigard
Site address: 10170 SW 72ND AVE
Project: Ziebart Subdivision: METZGER ACRE TRACTS Lot: 3
Project Description: (3)branch circuits for kitchen remodel
Contractor: CANBY ELECTRIC INC Owner: ZIEBART
790 S IVY ST 10170 SW 72ND AVE
CANBY, OR 97013 TIGARD,OR 97223
PHONE: 503-266-7878 PHONE:
FAX: 503-266-5543
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 10/16/2013 $71.02
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/16/2013 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
Required Items and Reports(Conditions)
This permit is ' -- • -•'-ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done '• accordance with =••roved 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. • TENTION: Oregon la re• you to follow the rules adopted by the Oregon Utility enter. Those rules are set forth in OAR
952-s•1-0010 through OAR 952-001 .190. You --obtain a copy of the rules or direct questions to OU -by- I' .232.1987 or 1.800.332.2 4.
i
I• ued By: - l - _ Permittee Si
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.
•
. • . • r Ilur lt.,, .... .
liectricalfernlit ApplicatliffrA v ti.J v • FOR OFFICE...USE-ONLY.-' . .
.
, Recrivcd. ,
' 1 City (it-Tigard i Daie,B, toff 5 Cafre, 1,:., ., ,.,. EzzA0/5-e040/0
. 1!. .1312s SW Han iiivd_Tigurtl,(.)1( '')NT 1 5 2013 Plan Itsv.e... ......____. . ...--.
"d1.,.."'-',•. ____..
' ?hone. 303.718.7.4.'19 rlit:i' 50:''.1''')8 19(.0 Dtity .,
.', ' —. .....
•1,,c,A F,I., ..ItiSection Lac' 503,63,)I I 75 DT Restly(8y: :71-.'■4.171-0).1' C-1.1,,r
- llt6rOlq: WwwtiPrthot•YO'' CllTY OF MARD Notifled/Method Supplemental Information•
• '. --TV-P-MilaiNGEVISION _,___.,..._.... ....____. _-...... —__. .. ,
. . . .
. ,....,..
PLAN ia.‘.11.W
_ ......._-----. . Plean chca all that ana17.7.:;;;-:l.'2....7.77. i■I;i:;77Cielli,-,:.11ccked be-lo.w' ). '6 • ..
n New construction —.44-Additionitiliondion/reolacement
- 0 tier...,or fr:vie.•uu an;I...o:..,,,.. ;:.: ihrcc stories
.
0 Demolition E(Alter, where the 3VallilHe hill!,■,:l,i,,, El'‘I.,r,VIS am:,,,,favorrts.
-
exceed,10.w amp,.;!! i';.,.,011,.; 7 i.,,,u,1
. CATEGORY OF CONSTRUCTION' . '
• lea.to ground,or c,roed, '1.0('. li' ..m,"tTe.;-'"'lgriCUltM71 .''
-I-and 2-famils dwelling 0 Counnercial'iiidustrial 0 Accessory building .ni),for all 911,e,.in;:nIIII,nr, owlffingh.
.
• Multi-family I-1 Ma-nor builder 0 Other: p r$re:rump. ;'I ,,,qapor,,,,,,,,f75 KVA or•
- —,.__ ,... . 017,mergcocy 5),It m 1j,.,Seri htcly derived system.
.
12 Addilic.of sow mom !.;:t6 ts1'
. . JOB SITE INFORMA'r TON AND LOCATION
. . .
...
- • ,,c,,,orilic■•
Job no::, ; Joh site>1(1(11'eV, I Oi 7 0 5i.,,,,„/
_..... _. 7 1P e9 )7A. -:_, 0 s,Ni,HOr,M 8„O M ns CS
idFn11'.11 V,Uhlele parkt•
City/State/ZIP. - 0 Heath-care Iolitie, :11' t l ‘04or more ha.n
-
1 El 1 Inardoes Incston.; ,..00voltNuesorial
.
Suitc/bldg./apt.no: vroict•I ,iiii,,.' 2,.0, .._____1 7--
, D S.ysslit or recctcl e,'.19;rm..0;:;:,.!!..
....____.... ..... .. __.!_!.. ...... --.. i:EE sci-ii.1)0,.17. .
. . . .
• cross str eet/direction to.joh sift. Iin. Fc.r.. , Total '. I • '.
.— .----
- '' .
' 'TN ew regidential sill& or mol it.falitil■ dwelling unit. .
' .
1 Includes lnaciicd ca riwr. .
- ._......—. .
Subdiyision: 1 Lot no.: 1,(1nsq It ot e6.,:• • 1,.:A:01
. 4.
,..__., . _____ _..._ I ELI.ald'I 500 sy R Of 110fVeIrr 17,(I2 ! . . I'
. .
. Tax map/parcel no.: , •
-.... " I '
1 unued crerg%.o2sid,..noit; . 75 01) 2
DESCRIPTION'tir WORK , (with above sq); i •
. .._
-
. - L.-1;4,1d energy.111010 fam,I. ..
• ...,.1q1
i residential(with 01!.c.,c..;,.1 11 .
. -1-
• . --44-41-------1 L_Renewatgc EnFrg,. _ .-_ . .... ....7..,scc,PAge 2 '
•
Services or feeders iusi7liation.Ole,anon,.a inEor reification
• . .. ,
..••.:,'•:...''...,•.'•::::•:12.4420PERTY OWNER _l • 0 TENAIsIT ----- 1 200 amps or les.; ...._ 100,70 1
. ,...--H 201 amps to 4(10 amos .2 '.
Name -- •
• __I 1 401 dOpS to 600 tip ......_. ... ?to 34 J 2
_......- . ... - ..... - ._
Address: 601 Amps to 1.000 Limp:, 301■1■1 ! . 2
• ,
_ -- .,
Over I.000 Bmps ut volts 5 .52 76 r 2
i City/State/ZIP: .._____ __ . . , •
Temporary services cu.Icedrrs installation.alteration,and/or
— , —.
Phone!( •) i FUN:( ) relocation . - • -
• 200 amps or less i 59 11, 1 ., I
•• Owner instillation: this insliillatic,ri i5 hein!,,made on property that I own which is 001 201 ampc TO.IN:tops ' 12;IF - • 2
•. intended for sale. 16a.se,rent.or esch!Ine. tc•.‘sc.,!-diti,4 to ORS 447.449,670.and 701. ' • - i
40 I amps to 509 wills:lls . 1 x.1 . 2
.
Owner signature ,.. _ Datc __
I. -
., ,„__ _ , Rranch circuits • or ultriltion.or extension,per panel
• .'•.;•., •., :.• ..•:',..:12 APPLICANT i 0 CONTACT PERSON , A I.te,ff hrInch cii..:.:.1.,I,;b
.. .,---....- dIDC■v■':scrviLL! +! ■L'.;',Ior I'L•■• ' 7 42 i •2 ,' •
•
Business name:
' • . • . - • lr f , _ouch tilen■:1)Lln.'ult
' 1. II C .1 ,.....______.... •••- , B 1:e‘..
O . ,
. .
. .
... I .v:.__,./.,!x :Sji,1 1...8.7L42
Contact name t4 1 ,iervice or t•cedc, 1.,..... l‘rxt
—. . --- -• '-I 1 branch clicoit
AddreSS: . C ---
57.--:1-24 ' - .S--------. .. .._ ____ ,r-F-.8h add•I l'(t1be-h CI:r0,1—.
,
• .2- ' 7,.d- I Pi.r4f
.. . - r mis,:eth,„eous(service or reedy!' out i.nclude-o.1 • . •
'City/State/ZIP _Cdeivi
,q----.• . °I 0 R,._ )-7 e i-.
, ...._,..... ,_.... .
, Eitel,manufacturcd or moth.10. ' ' 1
_
.... ..--••, ---- • 2
._. HlwcIling,selyice.and/NJ:oetle! ..__ ..
Phone (SZ.5)z6, 6 _ u .2 i r'''''' '(53) Z. .,'((, /3
• ..__L.. ' . Reconnect bid,. : 61 SI ' I 2 •
- • i -
,..
E-mail!btu c. c k. il (&:b_ ..1„ i <4..ry■..-- _
-cvlp FT • _.,.
LPUMp Of irlie,alion CIICIC ........,
i (1 Si4 2"
.,.
(ON'fRA("TOW j 1;7sn or ourlificlightm...'.----- t'17 54 7 2
.- ---- '- ..--
Signal eircollis)
Business name: (1-44, .C.‘e F./. 1 (-- i .6 .:.......____ _.-..„__, i P371.iilterao9n..ol oions.uk .
....••-•-=-!.'
Address: / e.:-0 c
E I,-...i 3 I-- i ,r--Eeh additional insim.tioo o‘er:11u1slihte in in' of the above
------- Additionid wpccilo,!,• '0,,,:-, • h!,.2:Vhr
Ciry/State/Z1P: rt b.. ...k.. ...... ..._3_ _ .„(igaLi,„,,.,
i •
.......,,,..,.:-..hr
Phone:(503/ L(i,(,, - t l'•i ,...
' )71:C11 'L./ I.'"6:7::3 I Zt .• S5‘(3. ,todustriol i!ii-vii!; 1., ..,I ,
. •,!: ..;.ii!
CCB Lic.:tc,,,.:7 i 1,,,,...!..,,, ..,:s, 3_I/Lc__ , tiuory, 1„i(.... 2/z.. \ , ..1,!...,,i,, h,, ,,,,!.:,.,. •,• !, •,..1,,: I::-
...,.. ....
IS up ....... . .....7.... ..._..-J HI( ■I i'l R1111' FEES —
• ....
1 3uPrv• Electri,••!i 7• I'.:1:t11%; :,,,i..:•' 1 I ;,
2..1„.1,i1,..k....-..!':. /..,-.. („:::/..." / , ..... . 1: .1,m,.,1
,.
I Print(1/1111C. I \ . i ... ./ , DatC: ---. ••., .. . • •sI!,111 tI.,:,
' iCk r.1.1c_ I‘ ./._).. L/ ti_J..(''.1___. ..._. .--..—_. ...--. -A,Ait:•.,:i. . t. • ..-,oi;tee,
.
_ ...
Authorized :. ::itire:
' -',1 •i•: ! lit a 5 Li
- - - • "." "----"
l'hk pmrtil n(101.•.0,1,'s I,' - ' -.•,'.■1,1 i• II Ii within 180
Print name: 1);11c!. : ,i,,,,,1., :.".,• •• ;,,,,:..•,-,,,,,h.w.
1•,51.16iniwerrn,i,\Ft -,...-"..!,,,,-- , ,.;,:H• !'•,,,,,,,,i 9.i,,
Td t4dS2:TO 2TOE Si 1-00 2bSS99E2IOS : 'ON 3N0Hd 3N1 31N13 -12 AEINU3 : WOad
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
10170 SW 72ND AVE, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
2013-11-07 (null)
ELC2013-00619
PASS - No C of O
Violation Summary:
Inspector Contractor