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Permit 4 * CITY OF TIGARD ELECTRICAL PERMIT Ar.v' ,. COMMUNITY DEVELOPMENT Permit #: ELC2010 -00123 [ G AR L? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/17/2010 T Parcel: 2S114BB04100 Jurisdiction: Tigard Site address: 16535 SW GREENLAND DR Subdivision: PICKS LANDING NO. 1 Lot: 55 Project: Kelleher Project Description: (3) branch circuits for new furnace, heat pump and outlets. Owner: FEES KELLEHER, JAMES & KIMBERLY Quantity Description Date Amount 16535 SW GREENLAND DR TIGARD, OR 97224 3 crt Branch Circuits 03/17/2010 $71.02 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 03/17/2010 $8.52 Electrical Contractor: JARMER ELECTRIC INC 5105 SW 45TH AVE #200 PORTLAND, OR 97221 PHONE: 503 - 246 -5381 FAX: 503- 244 -8037 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 Required Items and Reports (Conditions) This permit is issue t 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 ordance with ap roved 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. A NTION: Oregon law r • . - - yo. to follow the rules adopted by the Oregon Utility - • Center. Those rules are set forth in OAR 952 -00 010 through OAR 952 -00 81 r 0. • may obtain a copy of the rules or direct question • OUNC by . • -• • 3.246.6699 or 1.800.332.2,80. Iss ed By: __ 1����' 2 . _. d /__, Permi • • '• r :ture• — ". Z. "° / ' P 1e—It____ _. 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 INSTALL TION ONLY SIGNATURE OF SUPR. EL Date: 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. Electrical Permit AprHica r I .�. � R`'''4, . P ` m `' 7n ¢Yl 4F��' 7,, •;aria C o res , us l.l�VED �'�� �'r���. f � I ()I.t()I � I( l l (h \'I' , - �'��� 1 "" `" City of Tigard Received 3 ' f 7 /b Permit No.: eke E 13125 SW Hall Blvd., Tigard, OR 97 • ` , 0 0—CO 4,2 3 ,, Phone: 503.639.4171 Pax: 503,5981 t * ". t 1 7 L t, i L P l �e cview Other Permit: i i Inspection Line; 503.639,4175 Ano Ready/By: ® Sec Page 2 for r lrttcrncr, www.tigard•or.gov CITY OF TIGARD Notified/Method; IEM Supplemental Information TYPELi �iDIViSI - . PLAN REVIEW ❑ New construction Addition /alteration/replacement Please check all that apply (submit 3 acts of plane w /items checked below): 13 Service or feeder 400 amps or morn ❑ a uitdina over three stories, CI Demolition © Other: where Marinas mid boatyards, the available Mutt current tyar • • • • eATtot ty (11R cO e ,( TtiNT =CC 10,000 amps at 150 volts or ❑ Ratting buildings. lam 1 - and 2-family dwelling ❑ Commercial/industrial to ground. or exceeds 14,000 Q Commercial -use agricultural ❑ Accessory building amp for all other installations. buildings, ❑ Multi- family ❑ Master builder ❑ Other: D Fire pump. 0 installation of 75 KVA or 13 Emergency sy stem, larger separately derived system. • .10. SIT INFORMATION: ANii tsocierltor I J ❑ Addition of new rooter load a ❑ °A° "E "1.2" "1 -3", Job no.: / odl A Job site address: ((p 5 35 660 6( r 11s A/ 100AP or more. occupancy. ❑ O Six or more residential unite. Recreational vehicle patio, City /State/ZIP: r( " Ci ( --;. )-1 0 Health -care Facilities. ❑ Supply voltage for more than , 0 Hazardous locations. 600 volts nominal. Suite/bldg, /apt no.: ! Project name: L.r service or feeder 600 amDs or mom, Cross street/directions to job site: r7 i_4tra, ,Ike. I Tout I • — New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: I Lot no." 1,000 sq. ft. or less 168.54 4 Tax map/parcel no,. Ea. add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential 67.84 2 . DESCRIYBION'OF *ORR • (with above sq- ft-) I I � l / G � Limited energy, multi - family 67,84 2 �V J l > residential (with above sq. n.) � � / 1 Services er feeders instatlation and/or relocation ( 200 amps or less 100.70 2 • CI PROP'ERTY'.ISVVAR • I . ❑ TEMANT. ' . 201 amps to 400 turps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address; 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP- Tempnrary services or feeders Installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 1 59.36 l Owner Insffiilation: This installation is being made on property that I own which is not 201 snips to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447. 449. 670, and 701. 401 amps to 599 antpa 168.54 2 Branch circuits- new, alteration, or extension, er panel Owner signature: Date: A Pee for branch circuits with d AF')?'bI AIVT' ' f •C I CONTACT PERSON above service or feeder fcc. 7.42 2 easiness name: each branch circuit B. Fen for branch circuits Contact name: • without service or feeder fee. / 56.18 ,j� is/ 2 first branch circuit Address: Each add9 branch circuit , A 7.42 /11, gi 2 C /StatdZiP. Miscellaneous (service or feeder not included) ' Each manufactured or modular 67.84 2 Phone: ( ) I Fax: : ( ) dwelling, service and/or feeder Reconnect only 67.84 2 E -mail: Pump or irrigation circle _ 2 • CONVEACI'OR • Sign or outline lighting 67.84 2 1 1 B usiness name: � � � L C - i - � L 1 N . energy p reens) or l i m i t e d - or crtergy panel, alteration, or I Address: L o 4.+h i DOD _ tension, Describe: Page 2 2 City/State/ZIP: ' 'Ott L.A NO 0 qqo . I Each additional Inspection over allowable in n of the above Pcr Phone:6 3) 0.1,1.67 -. S ( Fax: (x0_N P,t I Investigation 66,25 °'�'`� �d3i Irivestigallon per hour (I In min) 66.25 CCB Lic.: ( Electrical Lie,: • I-I4{ Su . Lic.:40445 industrial pi hour 78,18 •. WG dieted, 'PERMIT FLE$ I. sum. Electrician signature, required: c „.e. -.� ' t..,.• -•--, -. Subtotal; ), 0 v of rinit (/o fee Plan review 2 5 ° pc ) Print name : .(-v Ar -(' 5 L. Date: 3 _ `(o old Authorized signature: / / , �� State surcharge (12% of permit fcc): �f S - k_ . „.. ti- i9 / /.= TOTAL PERMIT FEE: 1. q ,5 Print name; ' Date: Ms permit application expires if a permit is not obtained drilhln r � , l days after it has been accepted as complete. hgndrd • Number of inspections allowed per permit •ytUbrmits1El.C•PennitApp.dee raoiin9 4«o-tn I ST(11/n5/COMNIEB