Permit CITY OF TIGARD ELECTRICAL PERMIT
• ' 0 COMMUNITY DEVELOPMENT Per #: ELC2010 00403
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/04/2010
Parcel: 2S112CD08200
Jurisdiction: Tigard
Site address: 7555 SW ONNAF CT
Subdivision: Lot: 0
Project: Hammond
Project Description: (2) branch circuits for A/C and condensate pump.
Owner: FEES
HAMMOND, MIKE Quantity Description Date Amount
7555 SW ONNAF CT
TIGARD, OR 97224 2 crt Branch Circuits 08/04/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/04/2010 $7.63
Electrical
Contractor:
TYLER ELECTRIC LLC
PO BOX 807
MULINO, OR 97042
PHONE: 503 - 829 -2498
FAX: 503- 829 -5747
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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 9 2-001-0100. You ma obtain a copy of the rule • •'rect questions to OUNC by calling 503.246.6699 or 1.800.332.2344,
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Issued By: /� == – - Permittee Signature: ---g2 A /*�" J-�
OWNER INSTALLATION ONLY e
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.
CaII 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.
2010 -08 -02 15 ;37 GRF ELECTRIC 5038295747» 5035981960 P 1/2
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Ele ctrical Permit Application , ` 1 ' I ilia t►D i Ic i t � t t ►\
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City of Tigard 4, ti '- M iv ( 0 „, Permit No.. „a , --- 04C) `3
�� 9 • 13125 SW Hall Blvd., Tigard, OR 97223 11 r V 1 n Review _ ether Pe,mit: �(J - �J 3�
Phone: 503.639.4171 Fax: 503.598.1960 A G J Vai�y • lwix. B See Pa z for
inspection Line: 503.639.4175 t Ready /By:
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f .,‘-'11C1 - 'I 1,1W-tad/Method; Supplemental Information
Internet: wwtt,tigard- or.gov tI LA
� t �� 4 ` ' 1 PLAN REVIEW
TYPE OF WORK a I, NI% - ,,
Please check all that apply (submit a sets of plans w /items checked below)
❑ New construction z ddition/alteration /rep a ccment ❑ Service or feeder 400 amps or more ❑ Building aver three sta
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
Q and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Fire pump, ❑ installation of 75 KVA or
Multi family Master builder ❑ Other: - ❑ Emergency system larger separately derived system.
' .105 SiTE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A', "E", "l 2","1 - ",
t - ^ C. 100HP or mote. occupwcy.
Job no.: Job site addres ` s: '7 -51,43 0 try ,� r ,' ❑ Six or more residential units. ❑ Recreational vehicle parks.
Z `f— ❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP: � 4 6^ I' t � . _ ❑Hazerdous locations. 600 volts nominal
Suite/bldg. /apt. no.: T , Project name: �- - ❑ °11ce or feeder 600 antes or mote. _
I �" FEE SCHEDULE
Cross Street/directions to job site: nneription - I Qty. I Fee, 1 ---- Total 1
,• New residential single• or multi - family dwelling unit.
_Includes attached garage.
Subdivision:
1 Lot no. 1,000 sq. ft. or less 168.54 4
Ea. add't 500 sq. ft. or portion 33.92 i
Tax map /parcel no.: Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above '•• ft.)
Limited energy. multi- family 67.84 2
/- , - ' residential (with above sq, t )
!r ` ' ! or feeders installation, a lt e
' "" ration, and /or relocation
y Ind 200 amps or less 100.70 2
PROPERTY OWNER - 0 TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: - ' 5 D h 4 1 4. - Over 1.000 amps or volts 552.26 2
\ G Temporary services or feeders installation, alteration, and /or
City/State/ZIP: ! Z r relocation -
Phone: ( )
✓, Fax: ( ) _200 amps of less 59.36 t
125.08 2
-
, 2U1 amps to 400 amps
Owner installation: This installation is being made on property that 1 own which is not _
401 amps to 599 amps 168,54 2
intended for sale, lease, rent, or exchange, according to OR.S 447, 449. 670, and 701. Branch circuits_- new, alteration, or extension, per panel
Owner signature: _ _ Date: _ A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7,42 2
each branch circuit
Business name: B. Fee for branch circuits
- - without service or tecder fee, I 56.18 (� ! 2
Contact name; _ first branch circuit l
Address: - Each add'l branch circuit C 7.42 1 L a_ 2
• Miscellaneous service or feeder not included) —
City/State /ZIP: Each manufactured or modular 67.84 2
_ dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) -, T Recon only 67. 2
E -mail: Pump or irrigation circle 67.84 — 2
- CONTRACTOR Si gn or out li ghting -- 67.84 2
---r: ' Signal circuit(s) or limited-
Business name: 3 ECG a ' L L C
W energy panel, alteration, or
extension. Describe: Page 2 2
Address: •? a _
City /State/ZIP: /1 A , ,� Each additional inspection over allowable in any of the above
p 4 V i (.t ( ..k1 a r t" 'r 7 o 1 " Per inspection 66.25
Phone, (j1)') 0 Z ct - th I_ • Fax: ( t- 1) � # ^ 5 Investigation per hour t l hr min) 66.25
CCB Li `, c Electrical Lie.; 3 µ c 7 Suprv. Lic.: D Industrial plant per hour t 78.18
_ t ; { (� 1 _ ELECTRICAL PERMIT ___ FEES -p
Supt.'', Electrician signature, required: Subtotal; f U
• Plan review (25% of permit fee):
Print name: G L r : I t f L Y , te: p '') / 2— 4,� State surcharge (12% of permit fee): � / `
Authorized signature. 1 ��j TOTA PERMUT rt:t —.r
Thi perm application expires It a permit is not obtained i in 0
Print name: h Date: days after It has been accepted as eompler
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