Loading...
Permit '. CITY OF TIGARD ELECTRICAL PERMIT ` • = COMMUNITY DEVELOPMENT Permit #: ELC2010 00653 IIGARD : 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/17/2010 Parcel: 2S 102B B00809 Jurisdiction: Tigard Site address: 10210 SW BROOKSIDE PL Project: Greenwell Subdivision: BROOKSIDE PARK Lot: 3 Project Description: (1) 200 amp service and (20) branch circuits for fire damage repair Contractor: CROWN VOLTAGE Owner: FROHNERT, FRITZ E LIVING TRUST 12607 NE 199TH ST BY FRITZ E FROHNERT E TR BATTLE GROUND, WA 98604 10210 SW BROOKSIDE PL TIGARD, OR 97223 PHONE: 360- 666 -0995 PHONE: FAX: 360- 666 -4673 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 11/17/2010 $100.70 Specifics: amps or less 20 crt Branch Circuits w /Purchase 11/17/2010 $148.40 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 11/17/2010 $29.89 Electrical Type of Const: Occupancy Grp: Total $278.99 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 95 ell-009e. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 4),e'.* 1 Per mittee Signature: 4AV f // AL i e �� �/ 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 the next available inspection date. 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. CITY OF TIGARD ELECTRICAL PERMIT JT : <:i`. COMMUNITY DEVELOPMENT Permit #: ELC2010 -00653 13 125 SW Hall Blvd., Tigard OR 97223 50 3.718.2439 Date Issued: 11/17/2010 TIGARD Parcel: 2S102BB00809 Jurisdiction: Tigard Site address: 10210 SW BROOKSIDE PL Project: Greenwell Subdivision: BROOKSIDE PARK Lot: 3 Project Description: (1) 200 amp service and (20) branch circuits for fire damage repair. 12/1/10, reprint to add an additional feeder. Contractor: CROWN VOLTAGE Owner: FROHNERT, FRITZ E LIVING TRUST 12607 NE 199TH ST BY FRITZ E FROHNERT E TR BATTLE GROUND, WA 98604 10210 SW BROOKSIDE PL TIGARD, OR 97223 PHONE: 360 - 666 -0995 PHONE: FAX: 360- 666 -4673 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 11/17/2010 $100.70 Specifics: amps or less 20 crt Branch Circuits w /Purchase 11/17/2010 $148.40 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 11/17/2010 $29.89 Electrical Type of Const: 1 ea Services or Feeders - 200 12/01/2010 $100.70 Occupancy Grp: amps or less 0 ea 12% State Surcharge - 12/01/2010 $12.09 Electrical Total $391.78 Required Items and Reports (Conditions) is permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. At work will •e done in accordance with'approv plans. This permit wilt expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon I \ regi • you to follow the rules adopted by the Oregon Utility Notifica'••.Center. Those rules are set,. forth in OAR 952- 001 -0010 t rough OAR 9 - 001 - % u may obtain a copy of the rules or direct questions to OUNC • - 987 or 1.800.332.23)4. Issued By: r / ` 1r � ' • n Permittee • . /"�/'.�i e i li (��` 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: yi CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' ■ i� • e Date: , LICENSE NO. Call 51 .639.4175 by 7:00 a.m. for the next available inspection date. 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. . RECEIVE jugstriggEtrmit App1icatioi I r lit r ri `u if 1: 1 �t A. ill, City of Tigard NOV 1 7 7010 Receive e y a l V I O f / Permit N n te /D —00653 I N 13125 S W Hall Blvd., 'Tigard, OR 972 P1an Review -T aZ0to-4O Phone: 503.639.4171 Fare 5OEjprIPCIFTIGARD Date/Ely: Other Pemti t��/at) / .,�„,,,,., Inspection Line: 503.639.417 GILDING DIVISION D... Ready lAy; t�r' Sec Page 2 for Internet' www.tigard•or.gov Notified/Malhod: '11 Suppleme y d' ",; ` ; d' , t • , ' , �i, " ;'": , 'rdY(, , , i . H b '.G '" 4 �1� r .e �' E o n `i , kt '. _._ t24ii odu kill , i t T,t r , sert ; ' ., - ' A A4 12 New construction gt Addition /alteration/replacement Please chunk all that apply (submit g x t► of plena wlilema checked below): Q Service or feeder 40a amps or more 13 utldIng over three stories, ❑ Demolition ❑ Other: current the available F1ull cunt ID Marinas and boatyards, • ° ,,,,p,..!. 4 t ' 1 , , c ; : r. ii in ' a A i cV�yl� t a 1 i ii : 4 '' ,C r r f i i i . eneeda 10,000 amps at 150 volts of ❑ Floating buildings. y ,(.,, ^ ' � • ,t r l..ur" wxa Molv4,1 . eliViii iiokairt ithi �t i _ 1 °, , .. E l k ' less to ground, w wrxteds 14,000 I,7 Commercial - use ttgrip.rltural '+ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other 1050 building]. • ❑ Multi fpmll ❑ Master builder ❑ Other © 1, Elme Emergency system 0 larger sepa*wely system. KVA or g ; , ��L7y`q� ���jin U���ppapp to M r •I e Al •• 4 '' ` r ` . w � rt'? ❑ Additi CI "A", "E ", "1.2", "1.3", t)1: y 1 � ' v �Q � ��':M' 'eBMYgmf liYr9]{ ' 17 � - t in i I on erne* motor load of 10014P or more. occupancy. Job no.. Job site address Z1 V 5W i a -/`.. Vii.' r'f ■ Sin °r Moro residantiai unlit, ❑ Recreational vehicle mks. ❑ Hetph -care %ciinics, ❑ Supply veltags for more than ,a A tli } 1:1 hiPaardoue location. 600 volts nominal. Sulle/bldg. /bpt. no.: Project name: ❑ Service or feeder 600 am or more Cross street/directions to job site: pre •tloa • ". Tetil 0 New residential single- or malts - family dwelling unit. includes attached earn: • , Subdivision: Lot no.: 1.000 sq. ft. or less II 145.15 4 Ea. add'I 500 sq. ft, r1t ..rtion 33.40 IMO Tax map /parcel no Limited energy, residential ■ 75.00 © i'. y iii. ` 42. ."1'.., -' New a "'', ,, '' l'''''''1' i r ' i<% 4 'i'• Witb pi�OVE 4a' fl•) • r � nr7,,, Limited energy, muhi-ffimily 75.00 � O * , .. J � ' V { T .0 4.t.) residential with above t.. ft. Services or feeders Installation alteration an or relocation • (f 6 / t - X 20D amps or (FM Q 80.30 [!ie t a 11 it ' , >t r d r !"i , r,, aluiM,1i k t MI 106 11,, +�-r�iAY �` "- I'�4 � t,�� a� � af� r) - � '�c' lr 1 ' ,,i�;• � 201 amps Wa ggEll Name: 401 amps to 600 am •t NM 160.60 Q r a 601 amps to 1,000 amps MI 240.60 © Address: Over 1,000 amps or volts 454,65 2 Temporary my services or feeders Installation, alteration, and /or City/State /ZIP: Phone: ( ) Fax: ( ) 200 amps or less I 66.85 Owner installation; This Installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 intended for Aale, lease, rent, or exchange, according to ORS 447, 449, 670. and 708. 401 amps to 599 amps 133.75 Dale Branch Circuits - new alteration or extension .er ,aoel Owner signature. u � A. Fee fbr branch circuits with 2 y , 71101 +.! ,1 .'. dir : 4 i (. i t��,;3 ". ', i: 1i�14't 1 ", , 4a dl d Tlpt�t' __,I al 0Y Wf »„ d t,'l A . •ik shove service or feeder fee, t i i W , , gatbk.+t+.S°neaa0.u,n r - each branch circuit Business name: CROWN VOLTAGE, INC. B. Fee for branch circuits wrrhour service or feeder fee, 46.85 ill! Contact name: STACY first branch circuit Address: Each add'I branch circuit 6.65 2 MtaeeIlaneous (service or feeder not Included) Each manufactured or modular 90.90 2 dwelling. service and/or feeder Reconnect ant 66.85 2 Pumper irrigation circle II 53.40 2 n :. a sI' Sign or outline lighting 53.40 - 2 energy rat panel, a l e r t i o n , d- Business name: CROWN VOLTAGE, INC. _ enerBY panel, alteration, or Address: 12617 NE 199 STREET extension. Describe'. Pegs 2 City /State /ZIP: BATTLE GROUND, WA 98604 Each additional inspection over allowable in an of the above Per ins. Lion 62.50 ' hone: (360) 666 - 0995 Fax: (360) 666 -4673 Invosti : ; ion per hour (I hr min) 62.50 ( CCB Lic.: 153934 Electrical Lic.: 37 -984 Suprv. Lie.: 4116S Industrial plant .er hour i' o, t ,, 1 " ',b: g a r lMta a 1 l .' t ii Subtotal :' • � t t J• Print name: MARGARET HOWES , Q Plan review 25 %of permlt fee}; ��n ,+, :r 1._ State surcharge (12% of permit fee); Ws���ti Authorized signature: .„ TOTAL PERMIT FEB; _ A6,,,,,•"/ The permit application expires if ■ permit is not Obtained within 1110 Print name: DANIEL TUCKER Dube: 11 U da after lr h as peen accepted at complete. ry vim' • T ` EL9fr 999 -09E 31J I 39d110A NP1DN0 Wd2 T t 0 T 0002 UeC 92 - P - e osze, AM 40 ,q # ,,,,,` Electrical Permit Application! ' 1.f11ets.� I. I 1 :): r S�,11 ,. Cit of Tigard 1t/ os rti r; Psrinh No IN- 13125 SW Hall blvd,, Tigard, O 9 Plan Rcvicw Phone: 503.639.4171 Fax: 503,598,1960 1 q Datc/Dy: ()filar Parmic l,,• t l,_,. Inspection Line'. 501.639 4175 DEC 1 (.O'U bate needy trey: Jun 1 el ;Res Pace 2 for Internet www,lipard -or. gOV Nntiflad/MHh d, Supplemental lnr.ratntton . -r t, a : . /.': t'Ik �41, r'g, .a !i,' �:>~HOu , =f.1 ata1�!( n3A!'•"':u` .r , !+ 2 ti ,, r.. ,: ,.,. .,.g *•��.� „., tat: o. , t . a - ...,. _._ ❑ New construction AdditionJa ef' g tji• g 5 Mau check all that apply (PAM a sits of plane w /,temacMc below). 0 Service Cr' tiled& 400 amps of no ❑ 5olldtna over throe node.. ❑ Demolition ■Other: where the available Foul; ettnent ❑ Marine and bouyerdf. o . r a r R ' ' f ' f r . ix1',. #4 '1�; � exceeds 10,000 sops at I$0 volts a ❑ Floating buiidinps, ate ,ei - i{k, ° ,tier l }' . + ° n , Iesy to ground, or t:roe.ds 14,000 ©Commercial•uae egicultursl 1- and 2- family dwelling ❑ Commercialtindustrial ❑ Aeeessory building amps ibr all whet i nstallations. buildings CI Multi -fpmil ❑ Master builder 0 Other: 1 1 Flit puma. ❑ ttatalintiplt of 75 KVA of &. Emcrgcovy system IsrKer >Mrpd@taiy danve4 system JOB :11� • l d „ ! s . a, A ' 4 I d'd q `,; , . In Addition of new motor load of Cl "A” "E" "1-2", '14", . +� 100Hp er mdrc. occupancy, Job no,; Job site address .., a ` `Lr a ,- • gin or TON residentisl unite ❑ p rohlctewits. Cit /State /LIP; . 0 ❑ Ha ardo ura ra ❑Supply voltage for morn due � �Q t ❑ Hazardous locations, 600 volts nominal. Suite /bldg. /apt. no.: j Project name: ❑ Sonic" or reeds* btu am or m 7li ?� x 'i74 ' aM.' 1 = .. ,ti' its r 13Y p v'.: �.' !k EN Crust/ street/directions to job site, t � 1•11111 New residential single. or multi dweiting unit. Includes *troth ed :aea•e. Lot no.: 1,000 sq, ft. or less 141 1-a, add'I 500 sq it, of portion 33,40 Tax map /parcel no,: Limited energy, residential 7500 III rt 3 I w e it% e ..,:,i44.:,.,, . i , with abov@ . 6. • Limited energy, multi - family 75 2 residential with above 6q, ft,) Services or feeders Installation mites n'... retoeation 200 amps or Ices AA '0 P!OPERT'Y 0WI k " `•. L-.'TE, W',. 6' " e.,' 201 am to 400 amps 106.85 401 amps to 600 amps r 160.60 �© Name: ,df�Yt ILY/I l 601 amps to 1.000 amps' 240.60 u Address: Over 1,000 ern. a or volts III 454.65 © Temporary services or feeders installation, alteradon, and /or City /State /ZIP; relocation Phone: ( ) F ax; ( ) 200 amps or less In 66.85 MIMI 201 amps to 400 amps 100,30 Owner Installation: This installation is being made on property that I own which is not 401 amps to 599 amps il 133 75 S to ORS 447, 449, 670, and 701, „ �,g„ , fl e, actor in Branttl circuits — cave, alteratlla, or extension, Qer petrel Owner signature; intended for sale, lease, rent, or exc an If _ Date: A. For: for branch circuits with - ' ,:ra "• .. G� < � �- " 1: �, .. „If+ ; .•••: '�X4.. � , • b; .,�i , i ys , d li�+- �` . ��t� s ' � ` • ��;y .:�',. • above service or feeder fee. 1 ' 6.65 2 , CO. .., �re , i � each branch circuit Business name: CROWN VOLTAGE, INC, 13. Pere for branch circuits - w/rhoui service or feeder lee, 46,85 �� Contact name: STACY • first branch circuit Each add'' branch circuit MEIIII3111 © Address: - Miaeeltaneoua service or feeder not Included City/Brett /ZIP: Each manufactured of modular II 90,90 111 , dweilin:. service and/or feeder Fix:: ( I Reconnect only MI 66.85 0.11111131 Phone: t ) E -mall; Pump or irrigation circle 53.40 MEI C0r rRAgcoR Sign or outline lighting 5340 Ea Signal circuited) or limited- Business name: CROWN VOLTAGE, INC. energy panel, alteration, or Address: 12607 NE 199 STREET — — extension. Describe: Page 2 City/State/ ZIP: BATTLE GROUND, WA 98604 Each additional ins. anon over allowable in an of the above Per inspection NI 62.50 1111 Phone: (360) 666-0995 Fax: (360) 666 -4673 Investigation r hour (1 hr rain) 1.11 62,50 r CCB Lic.: 153934 Electrical Lic.: 37 -984 Industrial plant hour in 73.75 �� , ,P tl l',�i�,t�m f'1� -+5 T 'uprv, Electrician signature, required: 1 /�;� ►I /L`y Subtotal 4) l Plan review (25% of Emil (e): 1 Print name; MARGARET HQWES go State surcharge (12 %of permit fee): / 2 , 0 -e— This permit application esplrea N • Wok Is not obtained within Authorized signature: / TOTAL PERMIT FRE AL. —or Print name; DANIEL TUCKER _ I)ate;' r 0 days Oa. le Are Men @copied lb e.apteta — Z ' d EL91 - 999 -09E OW I 39I=1110A NP1021a WIT i E : 2 OOOZ qa3 O I