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Permit CITY OF TIGARD ELECTRICAL PERMIT Ip ' 2 ' . COMMUNITY DEVELOPMENT Permit #: ELC2009 00613 ;TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/13/2009 Parcel: 2S112CD07300 Jurisdiction: Tigard Site address: 15838 SW 76TH AVE Subdivision: PP1994 -100 Lot: 1 Project: Smith Project Description: Add /alter (8) branch circuits for kitchen remodel. Owner: FEES SMITH, ROBERT W & JUDITH C TRUST Quantity Description Date Amount 15838 SW 76TH AVE TIGARD, OR 97224 8 crt Branch Circuits 11/13/2009 $108.12 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 11/13/2009 $12.97 Electrical Contractor: REDS ELECTRIC CO INC 3605 SE 21ST AVE PORTLAND, OR 97202 PHONE: 503 - 233 -6467 FAX: 503 - 233 -1281 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $121.09 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 l a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344, Issued By: `� �� t A 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' AVO Date: LICENSE NO. Jet 1V 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. ANov. 12. 2009 8:44AM Reds Electr No. 1046 P. 2 Electrical Permit Applicatio ECEVE � 1 FOR OFFICE USE ONLY City Tigard of Ti Rived NO V 1 20 Rev 4 Permit No.: E1�.2 •01 _ ° 13125 SW Hall Blvd., Tigard, OR 97223 09 Plan Review ew v� t +�+�o 2 l el!: • Phone' 503.639 4171 Fax: 503.598 1960 Date/ y: �- Other Permit: 1'IGARn Inspection Line: 503.639.4175 OF DatcRcad tmie: 0 Sec Page 2 for Internet; www.tl ardor. ov -� / or ifiediMethnd: g g CITY 1 lC� Supplemental Ln[ormatfon -.. . - -- i YRI OF,' WO .. Pl A N :RE ❑ Ncw construction 5"; .• Please check all that apply (submit 1 sets of plans ...Alms checked below) El Service Ur heeler 400 maps or more 0 Ouildmg OvCr three stories III Demolition ❑ Other: where the available fault current ❑ Marinas and bo;tryards s a t 150 volt; o: CATEGORY. OF ( exceeds ❑ floating buildings. l - ` ' • 10.000 emirs 1csa to ground, or exceeds 14,000 ❑ Commercial -use agricullor;ll and 2- family dwelling 111 Commercial /industrial ❑ Accessory building amp for all other installations buildings. Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installatina 01'75 KVA or ❑Emergency system. larger separately derived system J S1TE INFORI►XA lIO '•,Ai1'D i.0(.....op?.i . ❑ Addition of new motor load of ❑ `'A ":' '1 -2" 1 3' Job no.: pf Job site address: ; 10 _ r J 1 / l00l UP ur more. 11\}. occupancy. �� �( f / —� 0 or more reside uis] units ❑ Recreational vehicle parks. City/State/ZIP: ❑ 41ea11h -care facilities- ❑ Supply voltage for more than ❑Hazardous location 600 volts nominal. Suite/bldg. /apt. no.: Project name; . - A r D Scrvtcc or fccdcr 6 00 amps or more. — .:.FEE , SCHEDULE , - Cross street /directions to job site: nrvrripno,, I cny. l Fin. I Total ! • -- New residential single- or multi-family Dwelling unit. Includes attached garage. Subdivision: Lot no.: 1.000 sq. ft. or less 1 145.15 I 4 Tax map /parcel n0.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy,, residential I'•'WORK (with above s . ft,) 75 M Lt 7 ;,; , DESCRIPTION O AKIIPMIENnia Limited energy, multi- family residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and /or relocation 200 amps or Tess 80.30 2 ._ 0' 1ROrERIY'OWNER t [] I;LAAINI x . 201 amps to 400 amps 106.85 i 2 Name; 401 amps to 600 amps 160.60 2 ~ — 601 amps In 1,000 amps 1 240.60 2 Address: Over 1,000 amps or volts I 454.65 2 CltyIStatC /ZIP; Temporary services or feeders installation, alteration. and /or .. relocation Phone; ( ) Fax: ( ) 200 amps or less 66.85 1 1 1 Owner installation: This installation is being made on property that I own which is not 201 snaps to 400 amps 100. 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration. or extension, per panel Owner signature :_ Date: A. Fee for branch circuits with 0y; APP XCA.NI• .; pi []' CbNT jPERl�lr ' r ° above service or feeder tee, , _ , 5 . .. - : 6.65 2 Business name: each branch circuit , B. Fee for branch circuits 16-4 5p. - 3 (p without service or feeder fee, • Contact name: first branch circuit /f - 2 Address: Each add'I branch circuit 46 . - 2 jj• t q4 - Miscellaneous (service or fccdcr not included) City /Suite /ZIP: Each manufactured or modular 90.90 dwelling, service and /or fccdcr Phone: ( ) Fax:: ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 'CONLRAC�TOlk : - Signoroutlinelighting 53.40 2 Burin — Signal circuit(s) or limited - energy paucl. alteration, or Addrc RED'S ELECTRIC CO. INC. extension. I)escrihe: Page 2 2 6336 SE 107TH.AVE City/5 PORTLAND, OR 97266 Each additional Inspection over allowable in any of the above 503-2334467 FAX 503-233-1281 ^ Per inspccrion 1 62.50 Phone CCB# 4443 ELECRICAL LIC 26 -152C SUPRV LIC 5010S Investigation per hour (I lit milt) 62.50 C013 .. industrial plant per hour 73.75 •. ELECTRICAL:P_ER FEES Suprv. Electrician signature, required: y- Gaa.� Subtotal. Print panne: U Date: plan review (25% of permit fee) 109 • l2 c State surcharge (12%ofperinit fee): 1 I Authorized signature: TOTAL PERMIT FEE: _ O - This permit application expires if a permit is not obtaiued within 180 Print name: Date; dpys after it has been accepted as complete. • Number of inspections allowed per permit. 1 2 I • 09 19nu ildintVermile\ELC_rnrmitAnp.dnc Ot/23/a6 440 n615T(I I/05 /COMnVED Illa(V- jr( U v CITY OF TIGARD ELECTRICAL PERMIT s COMMUNITY DEVELOPMENT Permit#: ELC2009-00613 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/13/2009 Parcel: 2S112CD07300 Jurisdiction: Tigard Site address: 15838 SW 76TH AVE Subdivision: PP1994-100 Lot: 1 Project: Smith Project Description: Add/alter (8) branch circuits for kitchen remodel. Owner: FEES SMITH, ROBERT W & JUDITH C TRUST Quantity Description Date Amount 15838 SW 76TH AVE TIGARD, OR 97224 8 crt Branch Circuits 11/13/2009 $108.12 wo/Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 11/13/2009 $12.97 Electrical Contractor: REDS ELECTRIC CO INC 3605 SE 21 ST AVE PORTLAND, OR 97202 PHONE: 503-233-6467 FAX: 503-233-1281 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $121.09 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..n You_may oobtain~aocop/►y of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By:~ U ~1 0 A.A X 11 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' 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. AN: v. 11 1. 2C0 9 8,44AM 4 ri5 El~i :trl 1046 F', 2 L:lectri<cal Permit A licatioU h FOR OFFICE USE ON LV C f City of Tigard G Y x°~Ci°°d 13125 SW Hall Blvd., Tigard, OR 97223 12 2009 Date/ll - Plan Review Phone 503.639.4171 Fax: 5035981960 Data/E3 ; UtbCrPcrmit:PLm ]nspection Line g 03.63 4175 Dace RcsdyBy, ]a e: ®Scc Pagc 2 for A ]ntemet; vnvw.tl 3rd-of. OV CITY I t OF TIGARD otif ed/Mo[hod. Supplemental lnformatton xYP_U OF'WO XLAN:ItEvIEW' Please check all that apply (submit b sets of plans w/items c6eckcd below): ❑ New construction ddition/alteration/replacement El Service or fender 400 amps nr more Q .13nilding over three stories. r-1 Demolition ❑ Other: where the available fault current ❑ Mari„as and boatyards CA vvhe TEGORY- OF 1~QNSTItj1C'rlgN cxcccds 1U000 amps at 150 or ❑ Planting buildings. El Commercial/industrial ❑ ACCeSSOry bllll(hn less to ground, or exceeds 14,000 El Commercial-use ,tgriculium) I- and 2-farnily dwelling g amps fbr all othcr installations buildings. `tD Multi-family Masrerbuilder ❑Other; ❑Firepunip- ❑histallstinnof75KVAor JOB' SITE.INFORh1 #"I'TON'4,1VD) ACTION ❑ Emergency system. larger separately derived sys[em ❑Addi[ioaofnewmotorloadof ❑"A".`F', `I-2't.3'. Job no.; Job site address: IVnlu' or more. oecupaney. - r -L ❑ Six or more residcmial units. ~r ❑ Recreational vehicle parts. City/State/zl1': ❑ Heahh-care facilities. ❑ Stq,t,ly voltage for more than ❑ Hazardous locaiiong. 600 volts nomiaal. Suite/bldg./apt. no-: Project name; . - ❑ Service or feeder 600 amps or more- Cross strcct/direciions to job site, FEE 3CHEPULf. nrsrr1,11mt o utc- Tatar y7 - New residential single- or multi-family dwelling unit- Includes attached garage- Subaivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no.; Ea. MCI 500 sqa ft, or ponioil 33.40 1 ],united enemy, residential 75.00 2 DLSGRIPT70N OI ~'IURK with above s . ft.) Limited energy, mull-family 75.00 2 -0 VIA residential with ahove s q. ft. Services or feeders installation. alteratlou, and/or relocation 200 amps or lm,s 80,30 2 © Flt UPER 1 Y- OWNER'<' , „i. I LNR11?~ 1 201 amps to 400 amps 106.85 2 Name; 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: _ Over 1,000 amps or volts 454.65 2 City/stale/ZIP: T•empurary services or feeders installation, alteration, and/or relocation Phone; ( ) Fax: ( ) 200 amps or less (iG,85 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 300.:50 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration. or extension per panel A. Fee for brunch circuits wr[h d?9PlER~ J(CANTx CbNTAOjPER56`N ' above service or feeder fee, 6.65 2 each branch circuit Business name: B. FCC far branch circuits 1 _56 -1(a- I Without service or feeder fee, 2 Contact name; First branch circuit 1 I Address: Each add'] branch circuit 2 l Q~ Miscellaneous (service or fccdcr not included City/State(7.I1': Each manufactured or modular 90.90 7 " - dwelling, service and/or fccdcr Phone: ( ) bah: = ( ) Reconnect only 66.85 2 F-mail: Pump or irrigation circle 53.40 2 i. ONTRi4'( TOI2 l • Sistn or outline lighting 53.40 2 r . , , Busini Signal circuit(s) or Iialacd- _ energy pant], alteration, or Addre RED'S ELECTRIC CO. INC. axtcnsuon. Describe- Page 2 2 6336 SE 107TH.AVE Cit ,/S PORTLAND, OR 97266 Each additional inspection over allowable in any of the above. 503-733-6467 FAX 503-233-1281 Pcr inspcctlon 62.50 Phone CCB# 4443 ELECRICAL LIC 26-152C SUPRV LIC 5010S Investigation per hour 0 hr min) 62.50 rC(-13 Industrial plant per hour 73-75 ELECTRICAL=PERMIT, FEES' Suprv. Electrician signature, required: Subtotal. Print name: Date: Plan review (25%ofperntit fee): O c State surcharge (12%ofpertnii fee): 1,-?.T-7 Authorized Signature: TOTAL PERMIT FEE: 1 V This permit rtPptitariorr expires if a permit is not obtained within 180 Print nartle: Dart: days after it has been accepted 29 complete, • Number of inspections allowed per pcnnir. ~ ~ ~ , Qq I \Ruil din lTrrnni Ii\ELC-Ycrmit Anp.doc 06/23/tIG 440-4615T(I !105/COhfN•'L3 V_ Ya3v U Y-