Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00338
d COMMUNITY DEVELOPMENT DATE ISSUED: 6/13/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DB-00800
SITE ADDRESS: 09195 SW 70TH AVE ZONING: R-4.5
SUBDIVISION: SHADY DELL LOT : 008 JURISDICTION: TIG
PROJECT: JOHNSTONE
Project Description: Installing (1) circuit for NC.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: WISERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CAROL JOHNSTONE SUNSET HEATING & COOLING
9195 SW 70TH ST 0607 SW IDAHO ST
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: Contact #: PRI 503 -234 -0611
FAX 503 -234 -0439
FEES
Description Date Amount Reg #: ELE C117
[ELPRMT] ELC Permit 6/13/2008 $46.85 LIC 161085
[TAX] 12% State Surchar 6/13/2008 $5.62 SUP 4638S
Total $52.47 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ���+ Permittee Signature: ,2��
//
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'N: 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.
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Electrical Permit A Ilea 4 - ci...\\ I 1 . 1 ( I 1 ` , I 1 ) \ I 1
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: City of Tigard r.1;b i AT . IT
• . '4 V Date/8 : .i ” .......
Permit No.: a .,
4 • ■• . -
,. . ,: _ 1 . 3 0 12 n 5 e: S 5 W 03 1 - 1 6 31 3 1 9 13 4 l i v 7 d i ,T F ig ax ar . d, 5 0 03 R
III
t Ph :98 ,e' Plan Review
DatriBy: Other Permit: EC, dajg.• 005q5
13 Inspection Line: 503.639.4175
Daze Ready/By:
i 710 ra 1 See Page 2 for
Internet: www.tigard-or.gov &'-'\ '
II■ ' Notified/Method:
Sopplemeobl Information
.7-P4l.l.l'%"::::::';.ji''',7!"..`T...i'''")..:lFl.:11;.7.372.7:1:::;..1;7'n-r1-1,7-''.:.'!7:717,13-.1,S44".:7::',.W.'i .:"'.-. ', ' '. • ': .:i ;:.::..,,i,-4.T: , i17,1 , ;;;:nvz.p. - zci::17.',. , „-..,..!.... •
:4
4lig1-:-. : :•:,-. ' .:,,,,,i.. i.c. :.1 .. ; :... •: :. , :ii - SZW--",:aWic: s i.:k,:i...i.,.',, , i ,.;4 .. ./.. e ,„;
0 New construction Addition/alteration/replacement
- ... i . = ,;.=', , ....61ti.f.g.ris.iii.- . ..:_:'.1;: , , ;.': 1, -,, . ., '2., -g.i.".:!;-, l=: •--.
Muse check all that apply (submit' sets of plans wine= checked below):
111
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
LgL.17.7.,ITM.?.71,17:71K5.7i;".:7",,.;-':-.7q,,.7;.,--7....7T-TPT ,1 f - :.;I.,r,' • ; , .',, - •••••c exceeds 10,000 amps at 150 volts or 0 Floating buildings.
'......;.., .4.1:1,Yi,13i,44. -'::«14:xt:Z:r...-4,-,4,..li,,..-:,..VZA,Z461%:.t4an.4.4.',..:;,..",....-.....10:.-41:T.,f;4441 ,, i , ;,*: ... ' '`.. : . : . • less to gr 0 un d, or exceeds 14,000 0 c ommorc i r d. oso w
0'1- and 2-family dwelling 0 CommerciaJ/industial 0 Accessory building amps for all other installations. buidings.
0 Multi-family _ 0 Master builder . 0 Other: 0 Fire pump.
0 ingmllation of 75 KVA or
separately derived system.
° igtitietreirjaZ;V:P.VP:MTV21tfir-V1..;..,...,; t .1.%: r1 : - ..' L',-,:i.'illiS EErnezancoYfsnystemmo.tor load of ID lar "E". "I-2". "1.3",
100HP Of MOM. occupancy.
Job no.: Job site address:':: 1 C..( ( - . ; C----„,c .1) -. 7 c.-.,
0 Six or more residential units. 0 Rectal:local vehicle parics.
City/State/ZIP: Ck 1r C ( t_ [2-- 4 : 7 17 --.,' •-?.. S . 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: .-..) Project name: — it,i,..-- , v t...., , ,,t ---‘2. (....0 0 Service or fceder 600 amps or more.
----------------------.=;-- .---- :.1..:1;:-;:-'!'ll'crtl':*;'*4,2:e?,..4
Cross street/directions to job site: i .'.!:::, .f.' ?
Description Qty. see Tow •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision:
Lot no.: 1,000 sq. ft. or less , 145.15 4
Ea. addi 500 sq. fl. or portion 33.40 1
Tax map/parcel no.:
Limited energy, residential
&0Kirli,'';'1...'',''':.':.•:.2...'_;!".V...-.:.'..::.:::•'..00,elPt,rit#1,0*,;W:Ottc:.4h:4giK'3111,14er.,'. (with above sq. fl.) 75.00 2
/4 ./ (-.--- Limited energy, multi-family
residential (with above sq. ft.) 75.00
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
' • .• - -- . . - . 4.,, - - , i ..- ..., s -. . , A-,.-:‘ ,- . ,, e.: .- „,, ; . •rnmrs.
A,,T,;.1
f ..-7".:7A-,St : • ',., ',,i'.;!'',.114,0.. MIK. - 1 h..; -, -,f1.• 201 amps to 400 amps 106.85 2
1.
401 amps 10 600 amps 160.60 2
Name. i7' C. ( ".;'---1:) 4_,-.P.1---(1.,1 . .
601 amps to 1,000 arnps 240.60 2
. .
Temporary services or feeders installation, alteration, and/or
2
Ci ty/State/ZIP(1 - / - •- . :..; cnt „,. c:','; ..-:i — 7 " .f.;.. .
.... .
relocation
Phone: ( ) ..,./
Fax: ( ) 200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 201 amps 10 400 amps
1 .350 2
i ntended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75
1 2
Branch circuits - new, alteration, or extension, per panel
Owner signature:
Date:
A. Fee for branch circuits with
ia A $11.4id A:1 .:.:7 q ":;: ." 7" . .:1-: 17 , . 13 , 0100■: 4 04:11**IfitiF ..." ..F .1 ;::: abo fe fee,
eac
6.65 2
Business name: B. B. Fee for branch circuits
-
w#/?our service or feeder fee, 1,
Contact name:
46.85 C-; C.''' b .) 2
tiri . tbranch circuit
Address:
Each add'I branch circuit 6.65 i 2
Miscellaneous (service or feeder not included)
City/State/ZIP:
Each manufactured or modular
2
dwelling, service and/or feeder 90.90
Phone: ( ) Fax: : ( )
Reconnect only 66.85 2 '
E-mail:
Pump or irrigation circle 53.40 2
;:stirrRAMSi,.::" -7:-4.yligrebiNgiC, . rl.ti Sign or outline lighting 53.40 2
Signal circuit(s)
Business name: Sunset Heating & Cooling or limited-
energy panel, alteration, or
Address: 0607 SW Idaho St
extension. Describe: Page 2 2
City/State/ZIP: Portland, OR 97239
Each additional inspection overallowSble in any of the above
Per inspection 62.50
Phone: (503) 234-0611
Fax: (503) 234-0439
Investigation per hour (1 hr min) 62.50
CCB Lie.: 161085
EMMICEIM Suprv. Lic.: -, &38 s i rmazimminiamminmow ndustrial plant per hour 73.75
........
Suprv. Electrician signaturc, required: ...,,,.
Subtotal: i'/ (•-...
Plan review (25% of permit fee):
Print narne: Randy Ess
Date: (1c; 1 I - ( 1' .. I C,■.',
State surcharge (12% of permit fee): - '"5 - - (.,.
Authorized signature: t _A.,. ,a . c. - ..../- - e...,--
TOTAL PERMIT FEE: L5 7... (..( - 7
Print name Casey Wiser This permit application expires if s permit is not obtained within 100
:
Date: (. c ....... ? l 'Z t L;S•
days after it has ban accepted as complete.
•
• Number of inspections allowed per permit.
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