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Permit a CITY OF TIGA ELECTRICAL PERMIT o COMMUNITY DEVELO Permit #: ELC2010 -00518 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/22/2010 Parcel: 1 S133AD15800 Jurisdiction: Tigard Site address: 11241 SW SUMMER LAKE DR Subdivision: SUMMER LAKE Lot: 39 Project: Vhay Project Description: (6) branch circuits for kitchen remodel. Owner: FEES VHAY, JOHN S & ANN E Quantity Description Date Amount 11241 SW SUMMER LAKE DR TIGARD, OR 97223 6 crt Branch Circuits 09/22/2010 $93.28 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 09/22/2010 $11.19 Electrical Contractor: RK ELECTRIC INC 24495 NW OAK DR HILLSBORO, OR 97124 PHONE: 503 - 640 -1344 FAX: 503- 356 -0513 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $104.47 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 OA' • 2- 001 -0100. You may • • •. , co• of the rules or direct questions to OUNC by calling 503.246.6699 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. Sep 17 2010 3:29PM HP LASERJET FAX p.1 I trica P r it A ll (` V4(e ` V t ion � \� 1 (trritl r ti1: II On 1 0 City of Tigard �Q i,. l '!D M gi z „itN °.; t-c • Id 13125 SW Hall Blvd., Tigard, OR 97223 S (1 I Phone: 503.639.4171 Fax 503.398,1960 �F1 \� �i Other Permit; , , :., i :1 , Inxpection Lino: 503,639.4175 G\ Go \� "• ' er_ • Su Pale 2 mr Internet; www.tigard- or.gov Q \� �pplmoonael information ,. �.os 4 a rc �,•. :;�;.: n, . . , , c _.: ; - . . . ,w mn :- La° ......« � � .a 8/ t3. - 0 New eanstroction IZI Addition/alteradon/replacement Please ahcols all that apply (submit a sets of plot w 'tem, chocked below): 0 Demolition 0 Other; 0 service of *odor 400 amps DT more El Building over throe stories, � Demolition a-z� +cam , rsn rr• , r-�►- . ' . .) , + t5t { whero tb !mailable fault o urrp„t Me rle botzYarde. ab as tad —� ,: ,. ..•_ o ' much 10,000 gasps at l50 volts or ['Floating bw7dln6l, Q 1 -end 2- fllmily dwelling 0 Commercial/indueuial 0 Accessory � lass to ground, or exceeds 14,000 0 Cottunetmal -sea agricultural ompa Dar all otter installations 0 Multi- family D 0 Other: Master builder D Fire :mop. p Installation of 75 KVA or y . • ` ''.-.. - ' "'r 4 =1• n , a — 0 Emergenoy system. le1ger aeparetel) derived system. • ",qe ,'„ bL_ ,`1'.•r?.�E« .. , .,P., z.a ::'.: ,.m.;..i, :t, 8/=+- r+..t 2 r � ,j'ir ." � ' � �mc�c.a u xt ❑ Additlan ed!ilex =Wired of ID "q", "B", "1 -2", "1.9", Job no.: 2619 Job site address: 11241 SW Summer take Drive 10014P or mare. occupancy. 1' Six or more tesidmdd unite. 0 Recreations] vehicle penis. City/state/ZTP: Tigard, OR 97223 D Meatthsme tomes. 0 Supply voltage no more than Q Hazardous locutions. 600 volts aomin,t. Suite/bldg. /apt, no.: Project name: John & Anne Vhay 0 Service W feeder 600 amps or mote. r h L c <r Cross street/directions to job site: r .!:.x...--_,..::. -'. _ �.' • ::� �*` Deception C grr 2:7= `» • New residential rlogie- or multi- family dwelling ant. Includes attached garage. Subdivision: Lot no.: 1,000 sq. R or leas 168.34 4 Tex map/parcel no.: Ea ,dd'1500:q. R or portion 33.92 i z �• t« Limited energy, residential v t' 7-‘..e, � r" '.. E' „`._ mow ;;, 3 : a (with above sit. (k) 67.84 2 r ..:° Limited energy. muldeflunily Kitchen Remodel residential (with above sq. ft) 6784 2 Semites Or feeders Installelfe alteration, and/or relocation — F ®11.7-7.777{!•.'..1,7;06:77.4 - 7.,> mops or less 100.70 2 i .- ..,... ,,�._ a' , t8/ .I. at . :,'rt e :'.' .: + 201 smpa10400 mpg 133,56 2 Nerve: 401 amps to 600 antgi 200,34 2 601 ampe to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 532.26 2 City/State/ZIP; Temporary service, or feeders iestallation, alteration, and/or relocation Phone: ( ) Fax: ( ) , 201 amps or lean 39,36 1 Owner installation: This installation is being made en property that I own which is n01 201 amps *400 trmps 123.08 2 intended for sale, lease, rant, or Pecchange, according to ORS 447, 449, 670, and 701. 1 am ps ro s99 gim 16134 s Branch circuits -new, alteration, or extension. ter canal Owner signature: . Date: A. Pte for brands circuits with h� .,'.,., - -- , o ,,, .. � ,6.. o .,.077 s ),'•'m yQYy r. . 1..,: �1 �� =�as c '' " - 2)':?.i: ,. ®� each circuit 7.42 2 Business name: RK Electric, Inc. B, Fee far ereeeh otrourts without 1 aerviee Or feeder see, first 56,18 $ 56 . 18 2 Contact name: Zath Milton Mulch 0irouit Each edd'I breach circuit 5 7.42 Isr.to 2 Address: • Miscellaneous (service or feeder opt included) City/State/Z1P: 1 manufactured or modular 67,84 2 dwelling. service and/or feeder Phone: ( 503 ) 840.1344 I Fax: : ( 603 ) 368.0618 Reconnect only 67.84 2 E.ma11t , , Pump or irrigation circle 67.84 2 t4,_ „' ,." �� ° 7 r �`. i��s ,: Sign or outline limn 67.84 2 s-•.e .;..w Signal ©rouio(s) or limited- earcgy Business name: RK Electric, Inc. panel, alteration, or extension- Page z , 2 Each additional inevection over anowa$e is etaW of the above Address: 24.498 NW Oak Dr. Additional fo eotim(1 hr min) 66.25/hr City /St'ete/Z1P: H 111 1. o, OR 97124 investigation (] in °,t°) 66.23/ hr India-Mal pleat (i hr min) 76,18/ hr Phone: ( 503) 640.1344 I Fax: ( 503) 356, 0513 inspections for which no see is 90,00/ hr • IR listed Si hr min CO3 Lie.: "'� d � 9 4275 � Electrical Lie.: • -375C Suprv. Lio 4724 - S •�t�� L s •��`�'� _.- r:�s.:,:.. 4�-.: clr 611pRV. Electrician a Subtotal: 113.26 signature, required: jif f 4 . Plan review (25% of permit fee): Print name: Ron L. Kurtz Date: 17/10 State surcharge (12% of permit foe): 311.19 Authorized signature: TOTAL PERMIT PEE: $104.47 ■ A k This permit appacadon tapires hr a permit is not obtained within 180 • Print llama; Ron L. Kurtz J Date: 9/17/10 days air t has been accepted es complete. o Number of Inspections allowed per permit. alkisw ing4 we. inmo.poeedtpyµd 1 010143 440.4615TO 1/05(C0Ml veh