Permit CITY OF TIGARD ELECTRICAL PERMIT
0 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00408
T [ O.A R. b 13 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2010
Parcel: 2S111CB01748
Jurisdiction: Tigard
Site address: 10335 SW HOODVIEW DR
Subdivision: HOOD VIEW NO. 2 Lot: 44
Project: Wong
Project Description: (2) branch circuits.
Owner: FEES
WONG, M MOOYUN Quantity Description Date Amount
10335 SW HOODVIEW DR 2 crt Branch Circuits 08/05/2010 $63.60
TIGARD, OR 97224
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/05/2010 $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 952- 001 -0100. You may o• -' - ,••••• : - • - ct questions to OUNC by calling 503.24 699 or 1.800.332.2344. •
Issued By: , _. - —.. °� , _ _ _ - 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.
2010 -08 -04 11:48 GRF ELECTRIC 5038295747 » 5035981960 P1 /2
Electrical Permit Application - , 1 t 1, t ll i 11 1 •1 'l U 1v 1 -,
. ,. �� Received r � ` 0 ea Permit No.. � (Q (/ �8
C ity of Tigard = ' t]ate/9 o
i • 13125 S Hall Blvd., T OR 9, € +� ,R,EE,,len Review Other Permit: Phone: 503.639.4171 Fax; 503.598.1960 ' a C^�� ()`t7atetey:
• e i , �.r Date Ready /0y. Ju E See Page Z for
„ l �` �� Inspection Line: 5 03.639A175 P ``�
• �� 0T� Notified/Metho& Q Suppkmenud information
.,r - :; Internet: Line: Bard -or, ,41 � —
- —
TYPE OF WORK •,v�,e,, Please cheek all that PLAN REVIEW
apply (submit 1 sets of plans w /items checked below):
El New construction ddition /alteration /r acement ❑ Service or feeder 400 amps m more ❑ Building over three stories.
❑ 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 apiculture'
�'1- and 2- family dwelling ❑ Commercial /industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi- family — ❑ Master builder ❑ Other ❑ hire pump. D Installation of 75 KVA or
❑ Emergency system. larger separately denved system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of n ew motor load of ❑ - A - , " F", "l - 2", " 1 -3
100HP or more occupancy.
Job no.: I Job site address: a a d • o Ir' • ❑ Six or more residential units. ❑ Recrrational vehicle parks.
C iry /Suute/2iP: 1
❑ Health care facilities. ❑ Supply voltage for more than
1 • • Z, U Kacardous locations. 600 volts nominal.
Y Pro name: ) 0 Service or Feeder 600 amps or more.
Suite/bldg./apt. no.: Project r1 _ _ FEE SCHEDULE
Cross Street/directions to job site: _ esenatise 1 cry. I Fee. 1 total •
• New residential single- or multi- family dwelling unit.
Includes attacb_ed garage.
Lot no.:
1,000 sq. It, or teas 168.54 4
.
Subdivision: Ea. add') 500 sq. ft. or portion =NM IIII
Tax map /parcel no.: Limited energy, residential 67 84
DESCRIPTION OF WORK (with above sg. 8.)
Z y
• Limited energy. multifamily 67.84
_ r residential (with above s.. fl.)
Services or feeders installation, alteration and/or relocatio
200 amps or less - 2
I ROPERTY OWNER ❑ TENANT 201 amps to 400 amps r- 133.56 2
401 amps to 600 amps 200.34 2
Name: Ail a_r- A Ott if 601 amps to 1,000 amps 301.04 2
Address: ' Q 3-35 W - j y � i4 6 19 !r• Liver 1 amps or volts IIIM 552.26
�
t Temporary services or feeders installation, alteration, and /or
City/State /ZIP: Ci l Z 2. t-1- _ _ relocation
Phone: (i ) 1 p� Fax: ( ) 200 amps or less MI 59.36 0
{ oz! 0 ! t 201 amps to 400 amps 125.08 El
Owner installation: This installation is be mad on property that I own which is not 401 amps to 599 amps 168.54
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration or extension, , er • anal
Owner signature: Date: — A. Fee for branch circuits with
a ❑ APPLICANT 1 0 CONTACT PERSON above service or feeder fee,
7.42 II
each branch circuit
Business name: B. Fee for branch circuits
••• without service or feeder fee,
Contact name: _first branch circuit
Address: Each add'l branch circuit j 7.42 1
- Miscellaneous (service or feeder not included)
City /State/ZiP: Each manufactured or modular - 67.84 2
dwe service and/or feeder
Phone: ( ) Fax: : ( ) _Reconnect only 67.84
E -mail: Pump ur irrigation circle 67.84
CON-TRACTOR S ign or outline lighting 67.84
Signal circuit(s) or limited -
Business name: 7 C', C,. a' ' (-.• G energy panel, alteration, or
'1 extension. Describe; Page 2
Address: 3 L> )c Wi2 I _ -
City /Stale /ZIP: _( `7 b Each additional ins, son over allowable in an of the above
M , . Per inspection ME 66.25
- Phone: (', ,) 3 . c - Fax: ( T) • j ^ 5 investi per hour (1 hr min) 66.25
E lectrical Lic.: • up . : G Industrial plant per hour 78.18
CCB Lic.: �4 `j U C 3 t{ N Sry . Lie.: J S ELECTRICAL PERMIT FEES �
Suprv. Electrician signature. required: ry Subtotal: « 7/.1
, ' `` Plan review (25% of permit fee):
Print name: 6 � r - t , r e e State surcharge (12% of permit fee): ,
Authorized signature: • _ TOTAL PERMIT FEE. j ,
This permit application expires if a permit is nut obtained thin 18
Print name: Ci (1 • 1 j • !/+ r Date: _ " r days after it has been accepted as complete.