Permit n CITY OF TIGARD ELECTRICAL PERMIT
` :" COMMUNITY DEVELOPMENT Permit #: ELC2010 -00080
:TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 02/17/2010
,.,..y; Parcel: 2S104AA11100
Jurisdiction: Tigard
Site address: 12305 SW 128TH AVE
Subdivision: BELLWOOD NO. 3 Lot: 130
Project: Long
Project Description: (12) branch circuits for kitchen and bath remodel.
Owner: FEES
LONG, THOMAS AND CYNTHIA Quantity Description Date Amount
12305 SW 128TH COURT
TIGARD, OR 97223 12 crt Branch Circuits 02/17/2010 $137.80
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 02/17/2010 $16.54
Electrical
Contractor:
BOONES FERRY ELECTRIC INC
PO BOX 628
WILSONVILLE, OR 97070
PHONE: 503 - 682 -4936
FAX: 503 - 682 -7946
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $154.34
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. ATTENTI N: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 hrough • :R 95 -..1 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
I '
Issued B : _ , .. 1 _ . 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' � — 4 J / Date:
r •
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
Feb. 16. 2010 2.33PM 1 \1 'ED No.3148 P
Elec>cr>tca>t rermit A R . C� , Et
' '' '.� ' . 4 %�'� • FOR E l 9 S I N L I ' t ±m )w �
t
r City of Tigard C 01� Roceivea
l r " " 13125 SW Ha11 Blvd., Tigard, OR 97223 1 6 DatdBy: a / !a LO ! Permit No.: aOfo ��G�
-- / n Phone: 503.639.4171 Fax: 503.598.1960 plan Review
�' �� . 5981960 � oFTIGARD I)aldBY: Other Permit:
:,T�llr 3'f ri I ns pection Lin 503.639.4175 ion DateReady/By Jeri::
*'` "" i tatty Internet: www.tigard- or.gov t �� h rDI /1 1 HI See Pena 2 for
A DI
Nottfied/Method
A Supptemental
-.a r Y`�y tr�w � 'z' Zfa >`+" '. + x`. .. x , •'_ ✓:ra u a1 s �} raF ✓ 5 , ti. ,, �C" "-
i
;,,:x F. . ____, r : 'S.. ° i. ��-�_ , "a..: s?:',h! a :_.. ;: i ? r,. .��.' ..!..7:z--.. y-t- -� P.. v ti r, .,......_:-_gni
o . 1 a %.... ;below)
['New construction j } Addition/alteration/r laceme Plea check all th at apply (submit n ets of
X�• � � plans w / items checked b
['Service or feeder 400 amps or more ❑Building Over three stories.
E] Demolition 11 Other:
rz �w� a. tS r c _ where the available fault cu ❑ Mar inas and boa ards.
. 110:1 I� x G ty
Yr+'Y,tier ;'". ; ';'''' :,, s ,. h , .l .L? 41 .k i 3 e > exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
1 - and 2-family dwelling 111 Commercial/industrial III Accessory building less to ground, or exceeds 14,000 ❑ commercial -use agricultural
-
4 g amps for all other installations. buildings.
❑ Multifamily Q Master builder ❑ Other: ❑ Fire pump. I
r F'- ir x-- _° m� y -- —z , .. nstallau or
on of 75 Kvp
i " w x t b , ✓ g . ,, • . (fK n E i ..,Frz ti x t ❑ Emergency system. g separate)) derived system.
. q F- .i87:+.fi7''t AF- r S:7" . -4=.: 2 . ,�o. p._ r 1 1. , 7,,.. . 1 ^`" ,.. - ,u t . t f ,r r Ee y new motor lead larger 4C
• 2~�=s., .2.ty:� - El Addition w of ❑'•q ^ E 1 _ 2 .,.. 1 �.,
Job no.: / 6 / 8 /0 Job site address: 12 3 0 5 S w /Z +- IooHP or mote. occupancy.
I] Six of more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: f y G + 4 ❑ Health -care facilities. El supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Project name: Lp
J ,, e, ❑ Service or feeder 600 amps or more.
Suitc/bldg. /apt no.: Pro
Cross street/directions ` •-a `r `'J k7 §T- �w;: ' -+ '7 ing ;r
ns to job site:
Dorsi• r r • . yf <�1 > s V >a ` ^'
Goa •
Qty. Fee l Toul i
New residential single- or multi - family dwelling unit. •
Includes attached garage.
Subdivision: 1 Lot no.: . 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: ! Ea. add'I 500 sq ft. or portion -
33.40
•
ik77 �-� _-,; rte.. -4_ cr .: 1. Limited energy, residential
, ',;,.. •' :5 :7:1' i .F . t'' il 4lt : i N.:l� ',i. : :,A i1-a y w w r Cy. Wallabove9 ft 75 II L, � L energy, multi - family 75.00 2
F-++ 4 G 1'l•c.� t)"' r -O 71 YC r•I p ti e, L residential (with above sq. R.)
Services or feeders installation alteration, and/or relocation
200 amps or less 80.30
ti? fi yo- }a " .rife , "
A ,
+ 7''- .5 . f rw r , , .. .,; r 2
n
"'� amps
.,.,�.. � �; u,o ' ., a t. f �' l� �,�`l at.. _�+.- .,.iS =s 201 amps to 400 am 106.85
Name: 401 amps to 600 amps Mil 160.60 1E1
601 amps to 1,000 amps 240.60 2
dress:
Over 1,000 amps or volts 1 454.65 2
1 City/State/ZIP: 1 Temporary services or feeders installation, alteration, and/or
•
- relocation ,
Phone: ( ) Fax ( ) 200 amps or less 66.85 I I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps _ 100,30 i 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133,75 2
Owner signature: Date: $ranch circuits - new alteration, or extension, I er panel
„ ; t � � - f ,. + 1 _ _ A. Fee for branch circuits with
�. y » � -.% :7 ,i.t.a :l i ' w�:t� : �s . f;i3'..�'1' ;;s., g... 3M ' - .. "F g 1., - � ..1, 'i. ;� ;y`-'�
act,• r = a- � �.i�: -;�: y=' ,.a�°�ac t..0,•,� :�...�; � :? ,.. y »�- . service or feeder fee,
Business name:
"` each branch circuit 6.65 2
B. Fee for branch circuits CC 1
I Contact name: without service or feeder fee, 7� h
first branch circuit 4(31.3 2.b 2
Address: Each add'l branch circuit 1 1 14 - 241-7 - r 2 .
Miscellaneous service or feeder not included ' • G
City /State/Z1P: Each manufactured or modular
Phone dwelling., service and/or feeder_ 90.90 2
( ) Fax: )
Reconnect only 66.85 2
E - mail:
,�� 7w�, �: !_� Pump or irrigation circle 53.40
:') Xfi;;rr rer - n<8','s'• .. `t':.,.7+)�.F f -;d",' s:•- ,. r: v.��_ .s - ..� ._.
{ :,K r ,.. .; i` •,41.'nJ.x:.,W�� Ar v - r .......,, Si or outlineli lighting .7, aG%N" lG �. ." �. :Ef�w��._:r._.rrwti..�Jse-..;m:� r�'Frwr �.: a:: ah '�_.x,Y%i�4- �i:,� "e�:v�z Sim �► B 53.40
Signal circuit(s) or limited-
Business name: Boones Ferry Electric
energy panel, alteration, or
Address: P.O. Box 628 N extension. Describe: page 2 I 2
City/State/ZIP: Wilsonville OR 97070 Each additional ius' coon over allowable in an of the above
Per inspection 62.50 MEM
_ ?hone! (503) 682-4936 Fax: (503) 682-7946 investigation per hour (1 hr min) 62.50 El
CCB Lic.: 88482 Electrical Lic.: 3 C Suprv Lic.: 411( e Industrial plant per hour _ _ 73 NMI 1
Suprv. Electrician signature, required: l =�asw '• `= . `% = ` ,, , ,,-.. - .`"=-�':_ - -. 9�
• ' Su btotal: 9
int name: 5-4_ or3 (4, Date: 2 / 6 '0 Plan review (25% of Permit fee): t � it
State surcharge (12% of permit fee): 1,
Authorized signature! I TOTAL PERMIT FEE: -
J {� 4.1-1
This permit application expires if a permit is not obtained within 180 . � t
Print name: Date: days after it bas hero accepted as complete i ���
Number of inspections allowed per permit.
140 46157(I1I05 /COPIJWgB
I:t Building \Permits\HLC- PerraaAppdoc 05/23/06