Permit IU CITY ®I= TI�9AR® ELECTRICAL
a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00273
Date Issued: 06/08/2010
rT i CARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S135CD01008
Jurisdiction: Tigard
Site address: 9944 SW SCOTT CT
Subdivision: SCOTT Lot: 6
Project: Coleman
Project Description: (3) branch circuits for fire damage repair.
Owner: FEES
COLEMAN, TIMOTHY J & Quantity Description Date Amount
KLASSY- COLEMAN, TINA &, ABERE, KENNETH
J 3 crt Branch Circuits 06/08/2010 $71.02
JR /JILL A, 805 SW BROADWAY 8TH FLOOR
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/08/2010 $8.52
Electrical
Contractor:
ROSS ELECTRIC INC
2870 SE 75TH AVE #203
HILLSBORO, OR 97123
PHONE: 503 - 642 -2800
FAX: 503- 642 -5815
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $79.54
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 '• -ccordance . 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. • TENTION: Oregon :w . • ou to follow the rules adopted by the Oregon Utility No tion—Center. Those rules are set forth in OAR
952 -r r 1 -0010 through OAR 952 -r :1 -0100 You may obtain a copy of the rules or direct questions to 0 - • • .rye.•,:,.. :6.6699 or 1.800.332.2344. -
Is ued By: III. � /' ,.I_ _ ' Permi .. 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
AiMwm
SIGNATURE OF SUPR. ELEC' 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.
66/07/2610 10:19 5036425815 ROSS ELECTRIC INC PAGE 03/04
Electrical Permit ApplicatioEECEIVED #,,t
City of Tigard JUN 08 ?010 Received
p' g p petmtt No.: �AeC,�o %o— � 73
q ] 3125 5W Hall Blvd„ Tigard, OR 97223
a Phone: 503.639.4171 Fax: 503.59 Plan y:
ir Inspection Line: 503.639.4175 OF TIGARD Dom: Other Permit:
T[ U n tz n p Date Ready/By
*• Internet www tlgard or goy BUILDING DIVISION Nnngedimerbad '' ' 1 s66 Prigs for .. ; � A x--• -F �n„�,.. �J i �4 . �'d°' kM^a }-° t �� t r 1 . 74 �� �dt •X .0 I ea Information
uP tal on
•
❑ New construction I: AAddition/alteration/replacement Please check all that apply (submit a sets of pleas w!items checked below):
Cl Service or feeder 400 amps or more 0 gailding over three stories
0 Demolition 0 Other:
r ' ^',� F'ytip' -Y-.r+� 1 a yM il'' ,, s r _ where the available fault current ❑ Marinas and boatyards.
pc,•,1.s..�? ..i ,;;Tt . r. `,k .n` „.tu z+F_ �.,"� sr`_: 3 :t.4,t a .' ,f � ..,s ,, , exceeds 10,000 amps at 150 mks or Floating buildings.
111 1 and 2- family dwelling 0 Commercial /industrial 0 Accessory building leap to ground, or ins silo 14,000 [] Com ings. •use sgrt�ustural
amps far all other installations. buildings.
1 Multi-family [] Master builder 0 Other: [] Fire pump.
'2 "•w? ti"» ev rcr 77 x 7 ❑lrgersean separately derived
'' I « . b . c' I r ,'. ,,x4,s, t 7 ; y n . 4 ° i i °:,, A( , y:7 i i 1 1 1 t r i t � . .. C7 Emergency system. larger separately derived syatei
�. ✓ 5 ..w , nk «. ., ❑ Addition of new motor 0 '•A••'•I; ^, ^1•3"7I -3 ".
lob no Job site address: �' 5.,... 44– tOOHPormorv. occupancy.
'sm ' ::-!' ❑ Six ar more residential units. 0 Recreational vehicle p
� parks. ❑ Health -cars facilities.
r, $ L ' ! 0 Sll voi voltage al. more than
❑ liaxardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: O C i /44lt.—.) D service or feeder 600 am . a or more.
Cross street/directions to job site: � J
• New residential single. or multi- family dwelling unit.
Includes attached garage.
Subdivision; Lot no.: 1,000 sq. ft. or less 1111 168.54 11.11 4
Tax map /parcel no 00 sq. ft. or ports
Ea, 5 1 I
Limited ens
t^`•,•r h of t; M � 4. r° q wry l ' '- sli --'''''--77:7-77.7=4,•'''T.-•,--' lh. , e3l' i- '.. •;• 'rJ
67.84 rte, residential
..- �n.n. ,. .�:, ,.,,...... N.: ^t..:zf...Y.�,i.N,.Ar - , ,.. �:r.. Kr .,,. : rFi; A . .. . . ) . , n '...,,,.',:•.'`.1' .., .Willi above " •. R. 2
j _ (� 0 Limited energy, multi - family li
/'1 S 7 i `/ b Pi 3 ' C \.1\1; re residential with above :. it. 67 11111 2
Services or feeders installation aiteratio and/or relocation
M �+,, ° {{ � — �,� � �1 200 amps or less MI 100.70 2
t:m!IC.�i �°utit+ inY f i i ":" Zhu ii.4: ti�'E'� �� b7f � ! , r F� '''a ( 201 amps to 400
_.,,,,. �, =w.. t..r- . -::,. N >,.,s.,:v..Y. .,. �,. amps 1E1 133.56 1=1111 2
Name: 401 • •8 to 600 amps 1111 200.34 2
Address: 601 am. - to I,000 amps 301,04 MI 2
— _ • Over 1,000 am • s or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less Mill S9.36 IMO
Owner Installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 ilmon
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 am ,s 1.1.11d
Owner signature; Date:
A. Fee for branch circuits with
b �'"a c:. a .5 1, . c ..,.. ti £ t .,e'. }
`o .,..iw� i:..� .. •e: �;. ,;-Tn , c � .«� :n... • {"�:mtxd(s • ,••;,37:.� nn . i .,.; t ., ., �,`�, :.n V. .� i ..., .a. :....t above service er tbedor fe, II
Business name: each branch circuit
B. Fee for branch circuits
Contact name: without service or feeder lbe, 56.18 if. first branch circuit
Address: Each add'I branch circuit PINIMMEIFEMIEN
City/State/Z1P: Miacellaneoua service or feeder not ncluded
Each manufactured or modular
Phone: ( ) Fax::( )
dwellin service and/or feeder 67.84 �
E-mail l onnect only
IIM 67 °, �, j Pump or irrigation circle 67 �
,..,:,,, :_ . ,•.. , .. j, ,-,', 1:,.;*:' Sign or Outline lighting � Ellilla
Business name: Ross Electric, Inc Signal circuit(s) or limited -
energy panel, alteration, or
Address: 2870 SE 75 Ave, # 203 extension. Describe:
City/State /ZIP: Hillsboro, Or 97123 Each additional ins • ection over allowable in an of the above
Phone: (503) 642 -2800 Per in .ection 66 25
Fax: (503) 642 -5815 I.
Investigation per hour (1 hr min) MEM CCB Lic.: 157891 Electrical Lie.: 34-436C Suprv. Lic.: 4232S Industrial plant • . hour �M3�
/ r
Suprv. electrician signature, required: � , . 4.;.;i:'...:.'...:.
. „ '
Subtotal: Ei
Print name: Stephen Ross Date; 2/8/2010 Plan review 25% of •ennit fee :
--
Authorized signature: State surcharge (12 %ofpermit fare):
TOTAL PERMIT FEE: • .S' ,
Print name: Ante This permit application expires if a permit Is not obtained within Iso
days atter it bas been accepted as complete.
1: 10u116ing \PelmltsViLC- PermitApp.6ot 1 0/01/09
* Number of inspections allowed per permit.
440.46 t 7r(11/05/COMMrea