Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: ELC2010 -00688
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/15/2010
Parcel: 2S110DA07600
Jurisdiction: Tigard
Site address: 10555 SW LADY MARION DR
Project: CARRUTH Subdivision: ERICKSON HEIGHTS Lot: 37
Project Description: (2) branch circuits for outdoor lighting and spa.
Contractor: ENDERS ELECTRIC Owner: CARRUTH, JAMES H & KAYLA B
PO BOX 1661 10555 SW LADY MARION DR
BEAVERTON, OR 97075 TIGARD, OR 97224
PHONE: 503 - 626 -4813 PHONE:
FAX: 503 - 646 -3871
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 12/15/2010 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/15/2010 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 doted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -D01 -0010 throu. BAR 952- 001 -0090. You may ob copy e rules or direct questions to OUNC by calling 50 .1987 or 1.800.332.2344.
Issued Bye / _ �� t 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.
CaII 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.
Dec 15 10 03:18p END TRIC 503 -84G -3871 p.3
n Permit A I Eton FOR OFFICE USE Electrical p 5 2010 olio ONLY
t �, R ece ived
City Ti and DEC U Pennit
13125 SW Hall lvd., Ti and O X23 Date/13 : t� (� ��Gf}G ( .a' . . .011, l: g 1 " ``CARD Plan Review Other Permit: ir
. Phone: 503.639.4171 Fat> � 5 1966 ! O pt Date /B
•I' I C7 A R l) Inspection Line: 503.639 ®ING pIV a IS tv Date Ready /By: 10 See Page 2 for
Internet: www.tigard - or. Notified /Method: Supplemental Information
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�� ��.6k�ree.._ ✓,�: r r' "i � �"£ 'u�d:£`�i . ..tFtb �'� � f�,] 3ld.i..,.S,«.v4oa. ?�� #`;��,,,�,�7Ay���r
❑ New construction ®Additionlalteration /replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
I:., t ` : . ," irti a 'q` "; °� � „.o, exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
`"' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
•. ; ,r ( 4', :,.7 Emergency system. larger separately derived system.
�,. i,�,�„ ; ��� �° *,, " b , � , ' ( t ,., �;, 6 „ •,� „ : „ � h - ' � � Addition of new motor load o1'
Job no.: Job site address: 1 ` SW Lady Marrion Drive
1001-1P or more. occupancy.
y
El Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR /' 0555 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite /bldg. /apt. no.: I Project name: Carruth ❑ Service or feeder 600 amps or more
Cross street/directions to job site: n °a Qtv. Fee, Total
New residential single- or multi - family dwelling unit.
includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'! 500 sq. ft. or portion 33.92 1
_ Limited energy, residential
' { - ' r M a;C1 s I . r .., a ' mo , at .
Mr i P a a l , 67.84 2
M u ] '. i' %� ) 1141 (with above s q. R.)
Branch circuits for outdoor lighting Spa wiring Li e s i d energy, (with above sq . ft 67.84 2
g p g resideatial (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
a., . . r . e :lillI ,P dar ri , . . , tit° Y 0. aT 201 amps to 400 amps 133.56 2
Name: Kayla Carruth 401 amps to 600 amps 200.34 2
' 601 amps to 1,000 amps 301.04 2
Address: 1055 SW Lady Marrion Drive Over 1,000 amps or volts 552.26 2
City /StatelZlP: Tigard OR Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)320.6228 i 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 to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, er panel
Owner signature: Date: A, Fee for branch circuits with
r, a t 4V z .Y 0 ; b above service or feeder fee
�. p er '" 7 7.42 2
each branch circuit
Business name: Enders Electric B. Fee for branch circuits
without service or feeder fee, 1 56.18
Contact name: Allen G Robertson first branch circuit 56.18 2
Address: PO Box 1661 Each add'I branch circuit 1 7.42 7.42 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Beaverton OR 97075 Each manufactured or modular 67.84 2
Phone: (503) 626.4813 I Fax: : (503) 646.3871 Re co in t only and/or feeder
Reconnca onl 67.84 2
E -mail: Pump or irrigation circle 67.84 2
"- f 5 . ' .a '� r E q;pna e �� rd rl - E Si n or outline lighting . x s.a,airr;ra�s����?�5,.: ��...� �.� . �?, � ..,.. Ot .e..1' >r,Y .....,k, g g g 67.84 2
Signal circuit(s) or limited -
Business name: Enders Electric
energy panel, alteration, or
Address: PO Box 1661 extension. Describe: Page 2 2
City/State./ZIP: Beaverton OR 97075 Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (503) 626.4813 Fax: (503) 646.3871 Investigation per hour (1 hr min) 66.25
CCB Lic.: 26728 Electrical Lic.: 34 -265C Suprv. Lic.: 4685S industrial plant per hour 78.18
a"E e M tG ' t t ,a a
Suprv. Electrician signature, required: �`'
ea , ` Subtotal: 63.60
Print name: Allen G Robertson Date: 12/15/10 Plan review (25% of permit fee).
State surcharge (12% of penult fee): 7.63
Authorized signature: TOTAL PERMIT FEE: $71.23
Print name: Date: permit application expires if a permit is not obtained within 180
ate' days after it has been accepted as complete.
` Number of inspections allowed per permit.
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