Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2013-00693
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/21/2013
Parcel: 2S110AB02201
Jurisdiction: Tigard
Site address: 14325 SW 112TH AVE
Project: First Church of Christ Subdivision: COLE'S ACRES Lot: PTS 8-9
Project Description: (1)branch circuit.
Contractor: JJ ELECTRIC SERVICE • Owner: FIRST CHURCH OF CHRIST,
PO BOX 887 SCIENTIST,TIGARD, OREGON
NORTH PLAINS,OR 97133 14325 SW 112TH AVE
TIGARD,OR 97224
PHONE: 503-447-1212
PHONE: 503-550-9161
FAX: 503-447-1030
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 11/21/2013 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/21/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 i ccordance 't. 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. ENTION: Oregon :w -•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 -0010 through OAR 952d•1-00•!. You may obtain a copy of the rules or direct questions to OUNC by calk.!..4113. 32.1987 or 1.800.332.2344.
Issu By: L // Permittee Signature:4 %" l d7/rg-4----""
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.
5on4 3 0
.1)41.1i>
Electrical Permit Application
14)..c.).1)X
Inspection Line: 503.639.4175 \-
reP" cA, ' PICR5C chSCI4 all that apply(submit 2 sets apt:ins oditemg chocked below): i
0 Demolition 0 Other: $16 0 smite or fee&400 amps ur mom 0 F.iliiillirlij OvCr three stolie 5.
where the Val lablo fault current 0 Marinas and boatyards.
0 1-and 2-lantily dwelling 21 Commercial/industrial 0 Accessory building amps for all other insiallaliom. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 1 50 KVA ilr
Job no.: Job site address: 14325 SW I le Ave.
(.:ily/State/ZIP:Tigard,OR 97224 1 0 Health-care facilities. 0 Supply witage for luorA:than
.-- I 0 Hazardous locations. 600 volts nominal, '
0 Service ift feeder 600 amps or more.
-S7u-i"te./—bTd—g./apt.no.: Project name:First Church of Christ
Cross street/directions to job site: ii
iIncludes attached garage.
Limited energy,residential
Limited energy.inulti-family 2
Reconfigure incorrect wiring and add thermostat above heater. losidential(with above si.l.il.L, _ . 7'5.00
201 amps to 400 amps 133.56
401;linos to 600 amps 200 34 2
Temporary services or feeders installation,alteration,andlior
Owner installation:This installation is being made on property that 1 own which is not ._.....--- ---
201 amps to 400 amps 125 n8 2,
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
401 amps to 599 amps
Business name: First Church of Christ each branch eircult
Contact name: 1..ouise Brown — service or feeder fee,fina I .S6.18.. 5.I 8 2
Address: Each add')branch circuit 7.42 2
Misecitaneons/service or feeder not Included)
Each manufactured or modular
Reconnect Only 6'784 '2 j
E-mail: Pump or irrigation circle 67.84 2
Business name:11 Electric Service signal cireutt(s)or limited:energy I
Address:PO Box 887 Each additional insultipa,9ve!attowahle in mu('the above
Additional inspection(1 hr mill) 66.25/hr
City/State,/ZIP:North Plains,OR 97133 -
90.00/ltr
Suprv. Electrician sip,naturc,required: 63)k.
56.IN
Ilan.review(2511.11j2Emit fee). ,
Print name: John Janowski Date: 11/18/2013 —
. i This permit application expires"iTei--ne.;;;;Al'i;Al-c;47Abli■incAl within isrievi
Print name: John Janows'. ' Dare., 11/18/2013 days atter it has been aecepted as complete.