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Permit CITY OF TIGARD ELECTRICAL PERMIT .11 o • COMMUNITY DEVELOPMENT Permit #: ELC2010 -00585 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010 Parcel: 2S112CB01700 Jurisdiction: Tigard Site address: 8032 SW ASHFORD ST Subdivision: ASHFORD OAKS NO. 2 Lot: 31 Project: Espenship Project Description: Reconnect gas furnace. Owner: FEES ESPENSHIP, BRENT & KRISTA J Quantity Description Date Amount 8032 SW ASHFORD ST TIGARD, OR 97224 1 crt Branch Circuits 10/21/2010 $56.18 wo /Purchase Service or PHONE: 503 - 968 -5896 Feeder 1 ea 12% State Surcharge - 10/21/2010 $6.74 Electrical Contractor: BEN'S HEATING & AIR CONDITIONING LLC PO BOX 80607 PORTLAND, OR 97280 PHONE: 503 - 233 -1779 FAX: 503 - 651 -3345 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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. ATT tegon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 -0010 through OAR 2 -0 00. ou may obtain a copy of the rules or direct questions to OUNC by callin 6699 or 1.800.332.2344. I ued By: P ermittee Sib .ture: i ��rt Vt• 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. ELECT • _ Date: jr 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. Electrical Permit Application ht)I+, 01.1:14:-E i.,SE ONLY City of Tigard WC i' i + n 13125 SW Hall Blvd., Tigard, OR 972 SEC E 'D at& B : O / Per No.: �1ac0 /o 5g 1 20 10 Pion Review Phone: 503.639,4171 Fax: 503.598,1960 Other Permit: I�at �: r t k; A r,1 t Inspection Linc: 503.639.4175 OCT 2 Date Ready/By: runs. M Sec Page 2 for Internet: www,tigurd- or.gov (�±�'� oF T1r,AR Nol ified/Method; -v — Supplemental Information TYPE OF WORK— ING D ' . • ' PLAN REVIEW -. ❑ New construction Addition/alterali amen# Please check all that apply (submit 1 Pete of plans w /items checked below) CI Service or feeder 400 amps or 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. 1: l• and 2 family dwelling ❑Commercial /industrial ❑ Accessory building leas to ground, or exceeds 14,000 ❑ buildings. Commercial-use agricultural y g amps fbr all other installations. buildings. 1 Multi - family ID Master builder ❑ Other: ❑ Fire pump. 0 ]natallatiun of 7S t: VA of JOB SITE INFORMATION AND LOCATION ❑ Ertergeney system. • larger separately derived syaem. (( ❑ Addition of new motor lend or CI "A", "17", "1.2 ", "1.3 . ', Job no.: Job site address: qt z3, £ 4 6j„A_ 1001-1P or mere, occupancy. �a !l11�s LLLLL 11111 ❑ Six or more residential units. 0 Recreational vehicle patios. City /State /ZIP: r1 a f ly�j 7aa t 0 Irealth -care facilities. 0 voltage for morn than I4 •• a ❑Hazardous locations, 600 volts nominal. Suitc /bldg. /apt, no,: Project name: , CI Service o feeder 600 amps o m ore, — Cross street directions to job site: FEE SCHEDULE Description 1 Qty. I I'StJ Tow t" • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. 11, or less 168.54 4 Ea, add'I 500 sq. ft, or ponion 33.92 1 Tax map /parcel no.: Limited energy, residential • LSCRI OF WORK . • • ' (with above eq. ft.) `�qq ,��..II / Limited energy, multi•family 67.84 C� fee- A'ML 6`� 7 1VtCC residential with above sq. tt.) Services or feeders Installation, alteration, and/or relocation • 200 amps or less 100.70 2 ig PROPERTY OWNER 1 Q TENANT — 201 amps to 400 amps • 133 56 2 Nalne; P spe !_) r J k i � 401 amps to 1500 mps 200.34 2 601 amps to 1.000 amps 301.04 2 t 7 3 Address: (,J AI ` (J '4 Over 1,000 amps or volts 552.26 3 City/State/ZIP: f • a "� Temporary services or feeders Installation, alteration, end /o relocation Phone; (203) 4 b b .. A Fax: ( ) 200 amps or less 59.36 1 Owner installation: 'This installation is being made on property that I own which is not 201 amps to 400 amps 125,08 2 intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 amps t 599 amps 168.54 Branch circuits — new, alteration. Or extension, per p anel Owner signature:. ...., Date: A. Fee for branch circuits with - "" tif APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, _ each branch circuit 7 42 2 Business name: B. Fee for branch circuits without n service or feeder fee, first / ^ Contact name: C:.I r 56 18 `lp •!� 2 branch circuit tinchadd'I branch circuit _ 7.42 j 2 Address: Miscellaneous (service or feeder not included) City /State /21P: Each manufactured or modular _ dwellinty, service and/or feeder 67.84 Phone a .... 3 ) 2 13 .. 198 p Fax ; ( ) Reconnect only 67.84 2 E-mail: — Y Pump or irrigation circle 67.84 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited - energy Business name i lk S r l eA i 0 v., 1 panel, alteration, or extension. Page 2 2 Each additional inspection over allowable In any of the above__ Address: p 0 (3fc 096 d 1 r Additional inspection (1 hr min) 66.25/ hr City /State /ZIP; Po r'1"r „A ©er (7 7 ago Invt:sligalton(1 66.25/hr l'hone: Fax: / 33 4 th Inspection plant (1 min) 78.18/ hr x: ) Inspections for which no fee is 9000 / hr //p 1 specifically listed CA hr min) CC14 isle.: 7 Electrical I,ie If / Ele hi Su p rv. Lic.: #9 i� LE ECTRICAI.' FEES � - _ Suprv. Electrician signature, required: �/� Subtotal: !) 6 . (_`6 ""-� Plan review (25% of pcmlit fee): .-e,- .Print name: Ch B Ur r t,,,) Date; r0/ tDI 0 State surcharge (12 %ofpermit foe); • to .?r Authorized signature: Al TOTAL PERMIT Fa: 70A • 9A -- This permit application aspires if a permit is not obtained within 180 Print Hanle; .4 I - if f -' r Date: d j days Boer it has been accepted as complete. • Number of inspections allowed per permit. I' dimldmagermitr \F.t.C- rrrmilApp.doc 10/01#09 440.46IiT(11/03!(;OM/WEa T0021 )3 IVPDNI -SN38 StCCTS9CO5 %Frd 80 :60 OTOZ /TZ /OT