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Permit (76) CITY OF TIGARD ELECTRICAL PERMIT !Ai q COMMUNITY DEVELOPMENT Permit#: ELC2017-00722 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/03/2017 Parcel: 2S102C602600 Jurisdiction: Tigard Site address: 13066 SW PACIFIC HWY Project: Walter Subdivision: None Lot: None Project Description: Reconnect only. Contractor: OWNER Owner: WALTER,ANGELA D ANGELA WALTER 2863 RIVERWALK LP 2863 RIVERWALK LP EUGENE, OR 97401 EUGENE, OR 978401 PHONE: 541-729-5431 PHONE: 541-729-5431 FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 10/03/2017 $67.84 Specifics: 1 ea 12%State Surcharge- 10/03/2017 $8.14 Type of Use: COM Electrical 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 thro 1-0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 500f3.232.1987�or,11..800.332.2344. Issued By: ,/ L'Permittee Signature: / `// /7 r 69 7?C AJ 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. EVElectrical Permit Applicati as FOR OFFICE USE ONLY City of TigardrReceived I'ernut Iiii '+ 13125 SW Hall Blvd.,Tigard,OR 97223�� 2.017eDateBy: l©/Z//'7 — /7"d0 7,0'7.2., _, Pian Review I',- Phone: 503.718.2439 Fax 503.59$41 by .(E i i 6 AHD.D. t D te,By Related Permit if • l�.itttt �t ---.__. TIGARD Inspection ttan Line: 503.fi39.41'75 tI , ION Ready Date/By: loris: 1 RI See Page 2 for s � is-"'"P.:, Internet: www.lrgard-or.gov I ( !(l f7,at, .. 9'o I .•A E . Notified/Method: ,y�3.,,,g��,_, Supplemental Information _. '' '' II;1'-* ..`c .,.,., i,*l 6�1 ``0v'��.'' .. , .. . ;G�,�"" '1 q �'.� i5 (1 s"4 a .4«� New construction ❑Addition/alteration,replacement I Please check all that apply(submit 2 sets of plans w,nuns checked): 0 Service or feeder 400 amps or more 0 Budding river three stories. ❑Demolition Eg Other:re connect mete{ where the available fault current 0 Marinas and boatyards. 17.,::..:,..,..:: '? ` i:ifi OF.Z6*$-t .t T t 1 exceeds 10,000 amps at 150 volts orI •-� -.-b ", '� 0 Floating r] I-and 2-family dwelling ❑Commercial/industrial AccessoryEl building less to ground,or exceeds 14,000 0 Commercial-use agricultural 1 amps for all other installations_ buildings. ❑Multi family ❑Master builder ®Other:re activate 0 pine pump. 0 Installation of 150 KVA or v, 1 i*n ` Ill'**' jQ £ i-pg R 1 '+J 1F.1 ❑Emergency system. larger separately derived I Job 4: Job site address.,td�AS0 SW Pacific pw ?/f/ l 10Ad0irioo of ore motor load of system. .. _ s'f y ------! / 100fIPormore. ❑'A' 'F` `"I � .:'I-3", City/State/ZIP:Tigard OR 97223 /3043c C ,,,/�iz fy� ❑six or more residential mots. occupancy. g -- ❑Health-care facilities, 0 Recreational vehicle parks. Surtt'bldg.rapt Protect name: �� 0 Supply voltagefor more than 0 Hazardous locationspl — — — 0 Service or feeder 600 amps or mor 600 volts nominal. Cross street/directions tojob site:1+retyingp # Descri neon Qty. j Lach 6m211 r" -- - New residential single-or multi-family dwelling unit. Subdivision: Lot 4: includes attached garage. 1,000 sq.ft or less 168.54 , 4 lax map/parcel 4 — Fa tdd'I 500 sq.ftor portion 33.92 1 s - I. 4a, t; " 0-08 ", K 'rU.,�,a Iij' Linutedenergy„residential 75.60 i — — 2 \re connect power at existing shop (with above sq. ft. --- -_.--- —_.. Limited energy,multi-family 75 002 residential with above sq.IL) Renewable Energy D See Page 2 f -�- ----- ------ .---..u° 2- Services or feeders installation,alteration,and/or relocation Name:Angela Walter 200 amps or less 100.70 2 Address:2863 Riverwalk Lp — 201 amps to 400 amps 133.56 2 -- — 401 amps to 600 amps 200.34 2 City/State/ZIP:Eugene OR 97401 6(11 amps to 1,000 amps 301.01 2 Phone:(541-)729-5431 Fax:(541)683-3373 i Over 1,000 amps or volts i 552.26 j 2 _ — --- q Temporary services or feeders installation,alteration,and/or ; Email: M .$. °.V et:v-"� -1 � : ( I relocation —1 Owner installation: This installation -bei, made t property that I own which is not 200 amps or less i _59 36 I 1 I intended for sale,lease r exe nge o ii ng ORS 447 449 670,'andp70 1 201 amps to 400 amps_ 125.08 12..1 Owner signature: L Date a' 401 amps to 599 amps 16854 2 I . 14 T Yµ q" ki : t o tt,,5�2N , i march eircwts-net+ alteration,or extension,per panel � � - A.Fee for branch circuits ai itM" Business name: above sen ice or feeder fee, 7.42 , each branch circuit I Contact name:Tom Walter Fig Fee for branch circuits without 1 I service or feeder fee,first 1 Address:2863 Riverwalk Ip branch circuit 56.18 2 City/State/ZIP:Eugene OR 97401 Each add'I branch circuit 7.42 _ -- L2 Miscellaneous(service or feeder not included _. . I Phone:(541)729-5432 Fax: (541)683-3373 - _ Each manufactured or modular 67.84 2 I Email:Tom�awaltercustomhomes coin dwellingtie vier and or feeder Reconnect only 67.84 2 , - k' ix 4 R r ::,n - s Pump or irrigation circle . 67.84 2 I Business name: Sign or outline lighting i 67.84 2 1 Signal circuit(s)or limited-energy ❑ See Page 2 i AAddress: panel,alteration,or extension. L ` City/State/ZIP: Each additional inspection over allowable in any of the above I ._---_ Additional inspection r — (1 hr min) i 66.25/hr j Phone:( ) Fax: _ ( ) htcestu ttion(I hr min) 90.00!hr I Email: Industrial plant(1 hr mini _ 78.18/hr — _—._.._. Inspections far which no fee is j CCB lis Electrical tie I Supry l•ic specifically listed{'!hr min) I 9(J 00/hr Suprv. 4isetrreran signature required: Subtotal: Print name: i Date: 0 Plan Review Required(25%ofpermit key State surcharge(12%of permit ice). r, �j Authorized signature: —— 1'O'I'Al PERMIT FEE:I I 7� y,-�`d -- —_ This permit application expires if a permit is not obtained within 180 Print name: Thomas A.Walter Date: 9/25/17 days after it has been accepted as complete. —_._._ ..._..._ _._-_ __-----_ —._...--------.__ ...--- ___._. - Number of inspections allowed per permit. hlBuilding\Pei mits'lit,(::_PerteitApp_}?t.R_6'RF.doc Rev 06/17/2015 440-461.5T(11(O51COt1,WF,6