Permit 1111 CITY OF TIGARD ELECTRICAL PERMIT
t , COMMUNITY DEVELOPMENT Permit#: ELC2015 00328
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/05/2015
Parcel: 2S111 DB04200
Jurisdiction: Tigard
Site address: 9105 SW SUMMERFIELD CT
Project: ASTRUP Subdivision: SUMMERFIELD NO.8 Lot: 428
Project Description: Replacing existing panel.
Contractor: CARTON ELECTRIC INC Owner: ASTRUP, BERT R&JOYCE F
PO BOX 860 9105 SW SUMMERFIELD COURT
AMITY, OR 97101 TIGARD, OR 97224
PHONE: 503-435-1600 PHONE:
FAX: 503-835-0539
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/05/2015 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 05/05/2015 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 t. les adopted by the Oregon Utility Notification Center. Thos= rules are at--i6Rh in OAR
952-001-0010 through OAR 952-001-0090. You may ob.'• .copy rlr=.�direct questions to OUNC by calling 503.232,1987 or 1r S 3 .
Issued By: _ _ 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 Application,
City of Tigard taco"' a 5 s `5 617-- 1 P"n N,' F7 t S=m3g 13115 SW Ha11 Blvd.Tigard.OR 6 ,� 15 ! Pisa Review pAra Paeut 1 a Phone: 503.718.2439 Fate: 5031960 nv $ Q L[i.tasv other
lie See hp 2 for
Inspection Litre: 303.639 4173 M D t Data Rady'8y ! Lear.r.
r 1•,;A k 1 tipltired Method-Internet_ waw.tiiltrd.or.8c+* P¢ a
TP o wegV 11‘\‘'C 0 i 1I
PLAN �7EW
[ No.; cuffsuuiun tTiitiome[t V- * rnent r Plum dwelt all that 4101!"itltmut a we,of pion
wra mt dictated bow
t
0 Sows a feeder 400 amps erroom ❑Bailout uar dove storms
0 Demolition ❑Other
wham des available moo torrent O Molls and boatyards
exceeds 11.006 amps m 134 volts or 0 Flaminc tooMates-
CA7'ECOAY OF CONSTRUCTION km to grota&or tweeds Moon 0 commarral-are a.icuamat
4 building fnt all otbar mstattariau hmithe►
�!-and 3-f'smit}•duelling ❑Comttsl:rriaUsritlilstriai ❑• ?' 8 7i°� []'ixamhrrinn ur;Srt tcv�or
❑?Master bilker ❑Othet ❑"►ire punep
! 0 Multi-family (]Tgtrr�sAC+'gseeea aryau scion or 156
d KvA system
r " SiITE @(F•oRMAnos v0 LoCAT1oN a Addwnea af.ay.moser lnrrd ur 0-A'."E-.--i-2-. i_3•
__-__ 100IP a mom. occur+ )
Job no: Job site address' /gJ f j fej . j/t4,� ❑Six or mete teodenttai isms 0 RecreatxrTal%chicle trams-
s �s�- , 01 p-cm faeibnat ❑+uPp;'..asps tit more Man
Cit).State'11P: / A/O 9TA ❑Hamann toeatmos Rrto:era:,n rnraal
i 1 (]Sets-me or bodes t�1 amps a roar
5uilr'hlde alert.no: 1 Project aortae: C(, e2, j FEE SCHEDULE
r
Cross Yrestrdinxtions to job site: �` .‘ C�� r- t Ike. or 1.•
1 New mialleseat tllawit-or aaTt4-tlwils dui eft trait
Ischia Mstal ed . • _ la
!
Subdivision: Lot no.:
1,000,q 1 or its 168$a !
1 Ea 011.151!94 R.et N. —
{
Tax�mapr'parcelno.. ..
DESCRIPTION of WORK [alerted enerRv.auks-faetih rs 0() ' 2 3
v reKt lrrtial ru Ott above t! t
6� ro //9e . I'>'� , its hie Entry ®'a "1,s '. . _ ..
; Sera ices or feeder.insiailation.alterstifaar t Or reisestiou t
T€ .4.. r t0 amps or i ton 70 hp 7(7 `
P1tOPER[Y OWNER 201 amps to 413 amps 133.36 '-
Name: r1
401 ants to 600 amps ! 200 M t
��!_ �Y"R��7 301 al !
® 601 a p p s to 1 ti00 amps t ;
Address: f�zoo•-- �! r.�.�1.Ga1L�1.�rt f�i7�L � Over i.041)asps w wits 5+x.36
City StatoiLIP.� , ,.1, . 97.424/ Temporary etr4leesorfeeders iaaltdiellom ideerintlam sadiar
Fax:i 1 reiocetkra
Fhcarlc ( ! 2(U amp a toes 5 36.4 1
I
" t'�
Owner'ostentation: 1 his instal n is being made on property-that 1 own which is not 201 a to 400 i 1M 0S
intended for sate.sears,rent,or exchange.at cording to(IRS 44 4rt4.6711.and 7r}i. 441 m o s to 599 aems 1 16&34 2
t tuner signature._ _. Lie: eras>k -ae.tNeer1tiatt or uuteade!.per Panel Fie fietirmailt maks with
0 APPL1 A`11 ❑ C'ONi ACT PERSON ahlwe.crvie.or feeder far. 7 42 I 2
rich Natant
alretat
Business name: ! B Fee for Wed times trireme ^
• Contact nine: service or feeder tea:first y,t a
hrsruih circuit 1:
add'l bunch circuit 7 42 2
r
Address:I--
M { feeder sot ix!lt
Or,'State-71P:
r Each m ttue3 or modular
. t Fax: ( , dectita6,ay-m x andJor Rieder
,7 1
rPiune:( ) ..e -1
Reconnect unl 6'.84 t
i __ . - -
E-mail Pimp or trrisattnr ,n it a-b4
CONTRACTOR Stan or oudtme 411tie►S 67
■ $ipsi cttcair{st or httaeod.encrgv See I {
Business name: ,� �- Plrmnt.altersixot.Of ONICOSSOtt . age
I Address: 'pO Bo X B 60 j Each addltleaal inspecdao_ over anoweble is env of.the above
Q 4 n : Additional trop5ciier e i tit mint 1 6625'h• !
t c 1r.:State ZIP: Aerie I ! i bwestipatavn(1 M mint — t 1 _1
!,' ; ! trttttntiia)pktmt(T hr meal 4 i 715 tls/hr ;
7Js�±t�� F9K:( ! I
Phone:{ t 0 di Fax: --- ! --- 1 j Inspections for%omit:u ire rs i 1 00 uui. I
c'C'tt t it: 1:1cetrical l.ic : d Suprv.Lie.: pct:•freally listed ct hr mint
15'97�� 34 �� _ ELECTRICAL PERMIT FEES
Supry.Electrician signature.required: a Q 0� - Subtotal: I sad` �
n_ �``: � t� Atat review 125"o of permit teat: 1 _.
Prins name: &r# E1 E 7't Slate surcharge(12's4,or permit fix): oi
Authorized signature. _ _._ !+i.Z
Tfia permit appKcease aphis it a peewit is oat obtain n Ohio t>tr
CAA) CAi n _}_fie. y, /�— ( days.Mr it Y►trees/avpted as eumvletr.
Print H rm.
• Number■1 mrpteeuan3 aiMwed Per ern
1 Su::dns 41/4::,^1,1.1.:" fermi.s s Ke a roe M.am 4.1!'It.i+ :o.,-.W 414 r i"1S to14tu7'a
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9105 SW SUMMERFIELD CT, TIGARD, OR,
97224
Record Type: Record ID:
Residential - Electrical ELC2015-00328
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor