Permit CITY OF TIGARD ELECTRICAL PERMIT
511
# COMMUNITY DEVELOPMENT Permit#: ELC2014-00332
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/18/2014
Parcel: 2S110AA92831
Jurisdiction: Tigard
Site address: 10789 SW CANTERBURY LN 103
Project: Fannie Mae Subdivision::ONDO SUPPLEMENTAL PLAT NO.6:I Lot: 28-3
Project Description: Reconnect only.
Contractor: Owner: FANNIE MAE C/O REEKIE PROPERTIES LLC
9830 SW MCKENZIE ST
TIGARD, OR 97223
PHONE:
PHONE: 503-746-9763
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 06/18/2014 $67.84
Specifics:
1 ea 12%State Surcharge- 06/18/2014 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 OA 52-001-0090. You may obtain a copy of the r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. t
Issued By: Permittee Signature: ��_ i/., ;i . . _
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.
RECEIVED
Electrical Permit Application
II City of Tigard JUN 17 2014 Reedved o L� • rf- Permit No.: am O t i —Gb 33 Date/BX
• 1312.5 SW Hall Blvd,Tigard,OR 97223 Plan Review
1 ' Ph 503.718.249.639.0175 1.1 l t'9F TIGARD mate Ready/By: thhor Pernik: , id Bee lsage 2 far '
t lGAltlt /.-o
R I,JII'{DIVISION Hodtt.�Melbo : Supplemental Id tnatkn
Tntemet warty ngwdirrgov
- tea.:.= � Y :�4i.•�'fiM7R�_, , ..,..r,s.j.- ::�'�' _ .. b14 ' �1,10,....4., •, �) ..,
❑New construction 0 Addition/alteration/replacemem
Please check all that apply(au�aei.c of plans Whams clerked below):
0 Service or feeder 400 amps or more El Ballding met three stories.
Q Demolition ®Other:reconnect wham the available fault currant 0 Marinas and boatyards.
(� tylstivr� - '•S. exceeds 10.000 r exc c 150 mks 0 or 0 Commg buildings.
a.
� ' " t �`R'43� , ` "' F "�" Iw to ground.or exceeds 14,000 ❑Commercial-use agriculmrnl
® I-and 2-family dwelling ❑Commerciarndustrial E]Accessory building amps fot alt otherinstaiwdona, bendingn,
E]Multi-family Q Master builder ❑Other. 0Eire pump ❑Installation of 159 1 VA or
xatp ��.r��iv [IErcrgeray suntan). largeraepaneeiy derived system.
01i VI ar j�I/Q 'Y()ikl A4n'sr1 L9CATAOlab Q Addition of now motor load of 0`A",'-B^,"1-z-,-I-3".
Job no.: Job site address:10769 SW Canterbury Ln loor>P or more r a occupancy T , 0 Stx or more mldennal units. 0 Recrestionel vohkk parks.
City/State/MP:Tigard,OR 97224 0 Health-care facilities. 0 Supply voltage for more than
I O Hazardous locations, 60(1 volts nominal.
Suite/bldg./apt.no 103 I Project name: []Service or feeder 600 amp,or morn.
JJJ M f r:! �i t i l%s l t,:• _ -) :,
Cross streetkiirections to job site: Demtwo. QV. , x0121 •
New residential single-or multi-family dwelling unit.
indudee attached garage. _
Subdivision:Canterbury Heights Condominiums `Lot no.: 1.000 •.ft.or less 168.54 Emu
Fa add'I 500 sq.R.or portion 33.92
Tax map/parcel no �"1 - 75.00
Limited energy,multi-famlly 1111 75.00 II
electrical reconnect inspection residential(with above a.,ft.
- - Renewable E.-. v ri See P..e e 2
Services or enders installation alters•..,and/or relocation
Via' at** 43 ,• 200 amps or less 100.70 _ 2
Name:Faunae Mae CIO Reside Properties LLC 401 amps to 600 amps d
401 amps to 600 amps IIIII 200.34 El
Address:9830 SW McKenzie St 601 amps to 1.000 amps ■ 301.04
City/State/ZIP:Tigard,OR 97223 Ova 1000°'er car"°Iu S,alto
Temporary services or feeders Instailation,alteration,and/or
Phone:(503)639-1600 Fax:(503)213-2013 relocation
200 amps or less 5936 1
Owner installation: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. lath amps to 599 amps 168.54 2
Owner signature:, Date: .ranch circuits-new alteration or extension • •anal _
t 0 F[ its ,' ,-, A.Fec for branch circuits wit
.; I: �: ':!*Ps "'Yt '-,i$,J^t. above service or feeder fee
Business name:Reside Properties LLC each branch circuit 742 2
.-- _ - . . B.Fee for branch ciraults Contact name:Sue service or feeder fee,Iirtt
16.18 2
branch circuit
Address:9830 SW McKenzie St Each add'l branch circuit 7.42 2
City/State/ZIP:Tigard,OR 97223 MIscenaneoua service or feeder not inclurledL
Each ma nfaclured or modular III 67 84 2
Phone:(503)7464763 1 Fax::(503)213-6083 dwcllin:.service and/or feeder
67.84 2
E-mail:sue.wereekleproperties.com 67.84 2
..... n.,?.. e -_..Mi, :4:::: 41,iV# z,`'4 i.., :` ,.ti";t Sign or outline lighting MI 67.84 MIN 2
Business name: Ignalcircuit(s)orlimit-•-energy -
._ --__ - - _ panel,altetado$orextension. Paget 2
Address: Each additional inspection over allowable In anj of the above
City/5tatelZlP: - Addltional Inspection(Ihrmin) 66.25/hr
- Investigation(I hr min) 66.25/hr
Phone:( ) Fax:( ) Industrial plant(1 hr en) 78.18/hr
inspections for which no fee is 90.001 hr
CCB Lie.: Electrical Lis: Suprv.Lie.: a. elfin]) Ilsted 'A hr min
Suprv.Electrician signature,required: Subtotal: 67.84
Print name: Date: Plan review(25%of permit fec):
•
4 1 Sraec surcharge(1296 of permit fee): 8.14
Authorized signature: 1OTALPERMITFEE: 75.98
Print name:_( ' �� �? Thai permit application expires If a permit In not ol�tatricd within 130
` Date: days after It has beed accepted an enlpleta.
• Number of inspectttms allowed per permit.
1ABoo,l l,,aiPenrtuWLC_P anti pp LR_BRadoc Rev 05/11/20 13 4404101111/OS/COM/WEB