Permit CITY OF TIGARD ELECTRICAL PERMIT
'` ✓s COMMUNITY DEVELOPMENT Permit #: ELC2010 00101
'TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010
. Parcel: 1S134ACO2637
Jurisdiction: Tigard
Site address: 11045 SW COTTONWOOD LN
Subdivision: ENGLEWOOD NO. 3 Lot: 194
Project: Misk
Project Description: Replace (1) 200 amp or less panel.
Owner: FEES
MISK, ANDREW Quantity Description Date Amount
11045 SW COTTONWOOD LN
TIGARD, OR 97223 1 ea Services or Feeders - 200 03/03/2010 $100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 03/03/2010 $12.08
Electrical
Contractor:
SOHLER ELECTRICAL CONSTRUCTION
41131 SW BURGARSKY RD
GASTON, OR 97119
PHONE: 503 - 985 -0131
FAX: 503 - 214 -6246
Type of Use: COM
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 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through AR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
1 Q
Issued By: l v \ _1...9,. j. QiJ 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' 'C �' n n (3 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.
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Electrical Permit Apo lica ion' '' - ,
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FOR OFFICE 11SE ()NLV
City of Tigard MAR 10 Received
Date/13y: 1.4 ) Pennit No.: ( r 7 g 0 . (2) 1
. 13125 SW Hall Blvd., Tigard, OR 97223 0 2 2
111 Plan Review
' - Phone: 503.639.4171 Fax: 50- 1 9 iSy9 6 fl: . .. ,.„ . Date/By: Other Permit:
TIC. A R D Inspection Line: 503.639.4175 '-' . .,.., ; ,. \ ;•;-• .' " Date Ready/By: IZI See Page 2 for
Lnternet: www.tigard-or.gov ;,,„: ..,.. , ..,., , ' - - Notified/Method. 1 1 Supplemental Information
-• • • .. • .: :::: •. .. ::: . : . -. : : • 1• . ..: • • . . ..„,... ...:. • ........,..,..,..,...1 . : . . :: :1 ,.• . ::::. . : . • - •••:...... ;.:: i• • ••• • • . ••• . • ' • ' ..: ' „,,„.•.„, ,....-....,„...‘•' .,,,,---,,...::.: : ••,.., ,..: ..1 : ': 1:1: '' ,
. :: ,..• r:1 ' '1, '' : ..:•.:::::::.::: ' :. ' •::.:::;••;:,:',:. i:i i i .; ;1 • • .. i.i.mr. :wvic&..]:•::; ,..:: : ::. : ' : ' r: : :••::••::-.,:.::::::::.:...:: : •,•:•••':•.:::,:::•:.:,, :...,...., .: :.:..i.': . i....:. • '' . . i: i:. . i . . .: Le.;
... , .. .... ......
p New construction E Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below)
El Service or feeder 400 amps or more 0 Building over three stories
0 Demolition 0 Other: where the available fault current 0 Mannas and boatyards.
.• •••• •-•••• • •• 11 . %
CATEGORY
... ,•''''.''' OF cs
:pis.TKI,x7rxo exc
N • ... i.:::. . :, i .: : ..-i..::.:::: : :-: : i .::. eeds 10,000 amps at 150 volts o O HO buildings
r i.
less to ground, DI CX WC liS 14,000 CI Commercial-use agricultural
El 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
ED Multi-family 0 Master builder 0 Other: 0 Fire purnp. 0 Installation of 75 KVA or
- 7 1 .77.7 . : : :• .. ... :. . .. . . , .......... . • • • . • • • ........ •• .... •••• •••••• • • . . •• . ...., :. El Emergency system. larger separately derived system.
• . -; . : ..... .: .... . . . . .. ::i : '..:::':!-:':: ':', . ' : ':' :' ::- 0 Addition of new motor load of
Job site address: I / CIL/ c 1001-11 or more. occupancy.
Job no.:
...< ( c..j NJ' ;,40. , - , ci CA/. 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZJP: : 6_ A a O 0 ,f, 9 7, . . 2 a3 0 Health-care facilities. CI Supply voltage far more than
0 Hazardous locations. 600 volts nominal.
SuitrJbldg./apt no.: Projec(narne: pi (5J( 1:3 Service or feeder 600 amps or more.
1'1: :::*::''':':':''';'......•:.. ... ... : . .i.' .. '; . . : : i.•:::i::: : :::'::: 'i..... .:•:',:';.
Cross street/directions to job site: Description I Q r' ' F : c■•• - .. Total t •
' New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 i 4
Ea. addl 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
.. , Limited energy, residential
67.84 2
1.: ;":: i . .. '''.'''' . .......... • • • -.., 0.0c*F'ilfOl'i .. :1'; '::::'::': ':.;'::.'::'...' ':: . 1 :: i :.1.1 ( with ab"e 5 '1. 1)
.... . ..... . ._ . ,. ..... ., ...... ..... .. • ... .
Limited energy, multi-family
67.84 2
X t 1 a c z., c_LLE ) residential (with above sq. R.)
Services or feeders Mstallation, alteration, and/or relocation !
200 amps or less i 100.70 ici Li .. •1 0 2
.. . . . ' • • •
1 •:;...:....:: :, , ... ::.: .. 11tOiltry . 'i'..: . .,::: . 1::::: . .:',1 . •::,: .,1,.:;•;...,:0 ; 1: 1. i : i ;, . ; . :;:::. .i: 201 amps to 400 amps 133.56 ) 2
• ••••• • . •• . • . • . . .. • •• • ..... • ......... •... ..: : .: .• : •" . •:• . , . . : . . . .• .. ,.::.,.:• :•.:••:.• ..• ..,•.:..• . - . ... .. • ... ... •. • • ........ ... -
401 amps to 600 amps 200.34 1
s 2
Name: i l. N 6.1 ('1 v ,. / 1 5 k
601 amps to 1,000 amps 301.04 --
2
Address: // b ■4 - 5 6 / L j_./.. A , 6.ac 0 d LAI , Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/Z1P: -r; , c, (o f
c 4... (1-7,-),,73 relocation
i
Phone: ( ) Fax: ( ) 200 amps or less
59.36 I
- .. - 201 amps 10 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange 401 amps to 599 amps 168.54 2
, according to ORS 447, 449, 670, and 701. -
Branch circuits - new, alteration, or ezten.sion, per panel _ 1
Owner signature: Date: A. Fee for branch circuits with
Ei :: 8 0 . .4 0 * 0 t.::.: .: :E..:..:: :::: ...::. : ............ ........E . ::;.............:;:: . ::.:.•:::,::.N.:::::: above service or feeder fee,
7.42 2
each branch circuit .
Business name: B. Fee for branch circuits without
1 service or feeder fee, first
56.18 1 2
Contact name: branch circuit
Each adel branch circuit 1 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZAP: dwelling, service andior feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
- Pump or inigation circle 67.84 2
E-mail:
Sign or outline lighting 67.84 2
- . - ......'. ': 1':.. : . ..'' . ... • 7 .1C ini '• Y . ":'-' , .- ' ::'::•'•'...:......:' i H . '•:•'''•':. • '..•'•H . ' . '.. . ' Signal circuit(s) or limited-energy
panel. alteration, or extension. Page 2 2
Business name: c 0 )4 t..e- 6- le 2 lc A L C o (,-, :.i r _1- Af C
Each additional inspection over allowable in any of the above
Address: t-ti 131 5 j4/ gu „ (,:://:,gs k•I Additional inspection (1 hr min) 66.25/ hr
Investigation (1 lir min) 66.25/ hr
City/State/ZIP: ./.. . . 1_ ,
t & ‘, ; 4 , - / G Cie ci 71 19 Industrial plant (1 hr nun) 78.18/ hr
Phone: ( 52) y ) ci8-- 0 i 3/ I Fax: ( 5) ) .2 ) Li -- 6 , '-/ C Inspections for which no fee is
spccifically listed (V. lir min) , 90.00! hr
CCB Lic.: ' 1 7 Elec i t Lic.: ' . A rtrv. i*.: 5; ::: IiTE.:::•.:;::::":
firt7' Subtotal:
Suprv. Electrician signature, frlINIFW 1111111Fig .
Han review (25% of permit fee):
Print name: I) c fr ill L 0 i g L C 5 5 Date: 3/2/ 0 State surcharge (12% of pa-mit fee):
TOTAL pERmrr
Authorized signature: ,: , ,„ LIM c2-1,t,......- This permit application expires if a permit is not obtained within 180
/ t,
days after It has been accepted as complete.
Print name: 1 1 L ri 5 itr Date: .3///t 6 • Number of inspections allowed per permit
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