Permit v
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00311
'.' Date Issued: 06/24/2010
:TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111CC04500
Jurisdiction: Tigard
Site address: 15975 SW CENTURY OAK CIR
Subdivision: SUMMERFIELD NO. 1 Lot: 68
Project: Lynch
Project Description: Feeder installation with (3) branch circuits.
Owner: FEES
LYNCH, RONALD L Quantity Description Date Amount
15975 SW CENTURY OAK CIR
TIGARD, OR 97224 1 ea Services or Feeders - 200 06/24/2010 $100.70
amps or less
PHONE: 3 crt Branch Circuits w /Purchase 06/24/2010 $22.26
Service or Feeder
1 ea 12% State Surcharge - 06/24/2010 $14.76
Contractor: Electrical
REDS ELECTRIC CO INC
6336 SE 107TH AVE
PORTLAND, OR 97266
PHONE: 503 - 233 -6467
FAX: 503 - 233 -1281
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $137.72
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 OAR 952- 001 -0100. You may obtain - - • •y of e rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B r: " Permittee Signature: Ai. _ - 1 �1 �:..
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.
Cali 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.
Jun. 24. 2010 6:40AM r Rya' t No. 1837 P. 2
Electrical Permit Appl r• i ; I (1 i: i)f1 Ic 1: 1 Sh: ()Ni.,
City of Tigard IIp� D d i • 11 '
II : 13125 SW Halt Blvd., Tigard, OF t99Z2 4 201 Plan Review Other Permit • U r l � 1I`
Phone: 503.639.4171 Fax: 503. S98.1960 Aate/B . .. V L . ■ ■ _
1 H ., k) Inspection Line: 503.639.41 Ty r: F f t CJ` :iU Date Ready/By; lit See Page for
Internet: www.tigard- or.ggvt ;., . )lk. \ �; _ ` t` Notified/Method: t Supplemental Information
a r+l' +r y + , . t r .,.r • r. Y �'� +i r w/ ,.R r ° R x.;y�F f �,'
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:.. 'TQ)I L 4 ,. .... '.s\ ° 3' i�:i�;
❑ New construction ;1+ ddition/alterataon/replacement Please check ull that apply (submit a acts of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
ci Demolition ❑ Other: where the available (huh current 0 Marinas and boatyards.
'r c ,w + ' Ql Y G YN ?�� , >tIeilei ie i Y ,4✓s �kw,, } a a i : i, ,, exceeds 10,000 amps al 150 volts w ❑ Floating buildings.
4 . - . less to round or exceeds 14,000
' � • - g ❑ Cotnmeroinl•use agricultural
and 2- family dwelling El Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
C] Multi family ❑ Master builder 0 Other ❑ Fire pump. ❑ Installation of75 KVA or
� Lmergency systan. larger separately derived system.
Jo,$Sfl 1WEOR*TIO$ ANb Wl Ub1�j ❑ Addition anew motor load of ❑' A , °E "1.2 ", 1.3
1001. cu
P or more. occupancy.
Job n0. :6 22 5g Job site address: � j 9 5E c Ti . f „G 0 Six or ore residential units. ❑Recreational vehicle packs.
City /State /ZIP: C� 1 — • n cc K Cc NC le ❑Health more
facilities. 0 Supply voltage for more than
❑ Hazardous locations, 600 volts nominal.
Suite/bldg. /apt. no. . Project name: /t ❑ 8emce or feeder 600 amps or more
CtvD• at/ eet/1;,,....Buns to jvb site: - -- tin.. ., Yea Tend •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: — 1 Lot no.: 1,000 sqq ft, or less I 168.54 - 4
Ea add' 1500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
. i `r:.::, :' ?' `a ,4:: ( men v esq t 67,84 2
y ' ::
Lim u -family 67.84 2
D t/ _ - • j tesidexilial (with above sq. tt)
- Services or feeders installation and/or relocation
200 amps or less / 100.70 / (l0, V 2
t r + r , ?n $ ' q ur ' 201 imps to 400 amps 133.56 2
� L P1�0)�h`�'�lf' +0�1'NE�.3 .-., ...._. . ... ;:7'ANAI�fi',.,,, C .;, .
401 amps 10 600 amps 200.34 2
Name' - . 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts I 552.26 1
Temporary services or feeders installation, alteration, and /or
City/State/ZIP: relocation _
Phone: ( ) I Fax: ( ) 200 amps or Icss - 59.36 1
201 amps to 400 amps 125.08 t 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rcnt, or exchange, according to ORS 447, 449, 670, and 701 -
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
li'. t ti .,, is above service or feeder fcc,
ti • ' .. p 4► 1'L 1lCA1!i >� I r t 1
l c,. ., ON a ° $301!ir Bch branch c 7.42 l .7 y Z 2
Business name: B, Fee for branch circuits without
Ax S � - � r \GD service or feeder fee, first 56.18 2
branch circui
Contact name: `(• 1� ` l e c� �- _
Each add'/ btnnch circuit 7.42 / 2
Address: (03 3 6 ) 1 Miscellaneous (service or feeder not included)
•
City /state /ZIP: A-1 �� OR- "� ��� Each manufactured or r 67.84 2 fR 6 Each
dwelling, Mar service and/or r feeder
Phone: 03) 3 � °'Z - Reconnect only 67,84 2
'fie " Fax: / _ Pump or irrigation circle 67.84 2
E mail ' tb1'to \e k'e. e d J� e 1 8 C- , : ,..,o•:x S Igt10[0 gh 8
- � r � �- � utline li t i 67,84 2
n
- 1
i . -' . �.,a( .. ,Z t9r.O. c�i00.,•r r .....,, ; ,r.,,. �. +4_ gnat tO
1- „„ . ,. .• ..,. „ ,.,;' Si ci[cui s orlimited -encr gy
Business name: ` I 1 G - - ( , el alteration or extension. P .e 2 2
� _ Each additional Inapcctioe over allowable in arZof the above
Address: (0 37562 1,:. \ M ' Ak c Additional inspection (I hr min) 66.25/ hr
� � G�Z tC� //__ Industrial City/State/ZIP: \ � � l�' e t ndtlatrial plant lant (I hr hr min) 78n) 78.1818 h�
/
yie: ( ' j) 3_. ( Fax: ( *)3) a.3 - l 1 Inspections for which no fee is 90.00 / hr
specifically fisted (h hrmin) .�� Lic.: Lt (-I L ..t 3 ectrlcal Lie.: f - 1 f prv. Lic.: 5 , (' ; r * , o i ;' } ` - .� F ++ ! +n++'+ -.'hRE i x r�
G � � Subtotal: / ZZ, 9 /,-, Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: -1 ∎ \ . c C t Date: 6 _ z ? __ / Q _ State surcharge (12% of permit fee): c,/
TOTAL PERMIT FEE: f � 9_
Authorized signature: Thi permit application expires if a permit is not obtained.svil ion 180
days after it has been accepted .. owe. - .
Print name: Date: • Number of inspections allowed per permit.
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