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Permit n CITY OF TIGARD ELECTRICAL PERMIT 111111 ° COMMUNITY DEVELOPMENT Permit $t: ELC2010 -00591 Date Issued: 10/22/2010 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S 133DA07600 Jurisdiction: Tigard Site address: 12612 SW SNOWBRUSH CT Subdivision: Lot: 0 Project: Kruger Project Description: (8) branch circuits for kitchen remodel Owner: FEES KRUGER, DENNIS & WENDY Quantity Description Date Amount 12612 SW SNOW BRUSH CT TIGARD, OR 97223 8 crt Branch Circuits 10/22/2010 $108.12 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/22/2010 $12.97 Electrical Contractor: COHO ELECTRIC INC PO BOX 40 WILSONVILLE, OR 97070 PHONE: 503 - 582 -9774 FAX: 503 - 582 -9840 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $121.09 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 2.6 1 -01 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. 4 4 Issued By: — Permittee Signature: � , G 7 (9/ 7 0j 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 503.639.4176 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 A p p l i c a t i o n i 'O i s 01 l I t 1 1 1. 011_1 City of Tigard ra /0 ZZ i , — P tN ° 6 i / - a-5 13125 S W Hall Blvd., Tigard, OR , r •.. `� m / 0 _ Phone: 503.639 Fax: 503. `7,t ••1 Da[ O:t� p°r' /0 " O .-3 G .010 �• �� 0 ,. _ ,a Inspection Line: 503.639.4175 \. � - Date Ready/By. hail ® see Page 2 for Intranet waw.tigard.or.gov %C;\ a0 Notified/method: 1((� Supplementalieformsdon :1`;'' . �, ', ^, ... } \ `'2''''' . .:'''''., , ... - '''::‘,. , ' ,. ': '' } , }}.: y f ti . \\. 4 ' v �} �, �. �,\ 4y } e � \ i � a ": n .0 ['New construction tli Addition/alteteti • , a Rl� !T` 2 'S a Please °beckon dau apply (submit a sets apt= wine= checked below): 0 Demolition 0 Other: v '4 ❑ service or feeder 400 amps or more ❑ Building over t stories. i where the available fault Cotten[ ❑ Marinas and • , } � y ;,';':,:',":',-- \ \ +t a v 5 maws 10,000 amps at 150 volts err Q Floating buildings. lees to ginned, or exceeds 14,000 Q Cotnmerpai -are agricultural ►! 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building amps for an other ioste>larinns. budding. ❑ Multi- family ❑ Master builder ❑ Other: El Fire pump. ❑ Installation of 75 KVA ore p, ystem. , .,". . .\ .�.> ., + ., 1, < ,ti,, :;'..r, > .. \ . ,\,ti p. } .,, -.,., ,� : , .�..,. c 'r � . , _ . .. ,` c . �Addibon load oF 0 [m'BersePorateh' s . Job no.: \ S to oZ it) Job site address: \ al lot Q S r1ow.,.) ere t.a six or mot e. c oy. � L ❑Six ix ere more residential wits. ❑ Recreational ec[eationa] ve)>;cle ,pads. City /State/ZIP - 1 - 1 OR ` -- �t Lt t..,r ❑ H�L -cane Crcinties. ❑ Supply voltage ter more Wen 0 Hazardous locations. 600 volts nominal Suite/bldg./apt no.: Project name: • y ." - O Service or foeder 600 amps or ,more Cross street/directions to job site: . . T ,` z` Q t r o d . ' a. T New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. R. or less 168.54 4 Tax map/parcel 11°'" L a cd 500 y. e s or on 33. ■ • >\, . s }1 , \ h h ...: ,. ,/. ,, i'?.r 4 ,,, --, ... '..,,,,"-..,-• E ` ti: Limited CBef$ residential /11(1 ; , Limited energy, multi -fatly 67.84 2 4 o • �� ��,w1u - 1 J residential with above sq. ft) Ch . J Services or fettle rs installation, alteration and/or relocation 200 amps or less 100.70 2 �� x, n,- .. �.,, � ,r...�...1:' '.... \`' . � ''.:--r . ,\�.. .., ;: 201'LO400 11111E301 — Name: . 401 tamps to 600 amps 20034 111111 II 601 amps to 1,000. amps 301.04 Address: ab 0 , r - ' i r _ C.+• Over 1,000 amps or volts MI 55226 2 City/State/Z1P: .- ' Q Q ci'l Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) 11.40- b ,S 1 `S Pax: ( ) 200 amps or less I 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps t° 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 am?! to 599 amps 168.54 ' 2 Owner signature s ee c fOr branch sew, alteration, eaten n, pe panel c i B or sic per \ `v: . , . - / \ � .. , , .. ? + ,��>;±�, ' . 4 r above service or feeder fee .a .... <. . ,w :.,. . ,.. ; \ .. y.... c , s .... E,., 7.42 2 Business nettle: each branch caatit , . B. Fee for branch airouits Contact name: Service or feeder fee, fast branch circuit l 56.18 b. l 2 Address: Each add'l branch Circuit '1 7.42 5k..1% t. cri1 2 Nriseellaneois (service or feeder not included City/State/ZIP: Each manufactured modular odular i Phone: ( ) Fax : ( ) dwclli+ _ service and/or feeder �� - Ell Reconnect only 67.84 E -mail: Pump or irrigation circle 67.84 :: - :, 1- .... ..,, kr .......... ... ,,,, , ,,. . .: -.. ; .:. , .:. , Sign or outline lighting 67.84 Business name: Signal circuits) or limioed- • wit tr energy panel, alteration, or Address: I ` extension. Describe: Page 2 City/State/ZIP: L31 "' c>f1V t 11e, r C). C A 1 1Vl Is Each additional inspection over allowable in any of the above Per inspection 6625 Phone- (rte.,) Q. c — y Fax. ( ) • Sa c=1 Investigation per how (1 br min) - 6625 11111111111111 lecliical Lie -: 3r 5 Suprv. Lie.: 5 . $ Industrial plant per hour 111111 7818 MN- , Adler / / y „ ; '' , . �, ti, \ ,, ., . -- .:. ` 'ti ` ' • ' Suprv. Electrician signature, required: /� \ `� Subtota I©? , to P Print name: p • K b , . r '• Ql ` Date._ a „ 1 Plan review (25% of permit foe): /2 . 9 State sutrharsc (12% of permit &e)• _ - `e ' Authorized signature: .\ ` ,' !A TOTAL PERMIT FEE: - t Thin permit application expires if a permit a Dot obtained within 180 .Print name: X1 • 4 Date: to._ al dips after it has been accepted P$ C012042. 1 / / Nataber of inspections allowed per permit 9 r: IEuiiddn8 \traats\Pl.GPamitAppdoc 10/01)04 446A615T(l[ros/COM/WEB /? / r 0 / Ir ;4