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Permit �� CITY OF TIGARD ELECTRICAL PERMIT 1 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00061 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/26/2011 Parcel: 2S111 0C14600 Jurisdiction: Tigard Site address: 9105 SW DURHAM RD Project: HINTON Subdivision: STUDIO ESTATES Lot: 4 Project Description: (1) feeder and (1) branch circuit. Contractor: VANGUARD ELECTRIC INC. Owner: HINTON, REBECCA ANNE 3800 MORRIS ST 9105 SW DURHAM RD NEWBERG, OR 97132 PORTLAND, OR 97224 PHONE: 503 - 537 -5006 PHONE: FAX: 503 - 537 -5019 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 01/26/2011 $100.70 Specifics: amps or less 1 crt Branch Circuits w /Purchase 01/26/2011 $7.42 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 01/26/2011 $12.97 Electrical 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 Os r You may obtain a copy of the r irect questions to OUNC by calling 51 232.1987 or 1.800.332.2344. • Issued By. 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. 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. Jan 26 11 01:37p Vanguard Electric 5035375019 p.1 Electrical Permit Application FOR OF ICE USE ONLY City Tigard h E C E / E LI l l' 41 13 $I [ - Received 13125 SW Hall Blvd., Tigard, OR 97223 DatelBv: , /LJ / ' ` Permit No.: �•� / _ Plan Review " • d Phone: 503.639,4171 Fax: 503.598.]96,1N 2 6 2011 DatejBv: Other Permit: T I G A R D Inspection Line: 503.639.4175 Date Ready /By: r.gov 7 Notified/Method. I Supplemental See Page 1 for Internet: Www.tigard o (: {� OF iC,3D Supplemental Information TYPE OF MIMING DIVISION PLAN REVIEW ❑ New construction Nt, Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition Q Other: 13 Service or feeder 400 amps or more ❑ Building over three stories. where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. ] - and 2 - fhmily dwelling Commercial/industrial Less to ground, or exceeds 14,000 ❑ Commercial -use agricultural g ❑ ❑ Accessory building amps for all other installations, ❑ Multi - family ❑ Master builder © Other: ❑Firepump badan . ❑ Installation of 75 K V A or JOB SITE INFORMATION AND LOCATION ['Emergency syste larger separately derived system, ['Addition of new motor load of ❑`A °E",`•1_2'•,° _y' Job no.: I Job site address: 9/0 5 w DO-k01°\ FOOHPormore. 1 occupancy. 0 Six or more residential units, ❑ Recreational vehicle parks. City /State /ZIP: E'D ❑ Health -care facilities. ❑ Supply voltage for more than � ❑ Hazardous locations. 600 volts nominal. Suite/bldgJapt. no.: Project name: 0 Service or feeder''600 amps or more. FEE SCHEDULE Cross streetidirections to job site: oordpoon i 1 Qty. I Fa. I Toth New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. tt. or less 145.15 I 4 Tax map /pare 1 no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential TION OF :0R: (with above sq. ft;) 75.00 2 L200 imited ps energyless , mlti- fancily 0. Kt? O 1! Q r f L D ll S DESCRIP p �j rQ Cc f r G t! 1 t S residential (wi above sq. R.) 75.00 80.30 2 S CO fib aryl Cal ft 4- l n I fQ �� �V �t r Services or feeders installation, alteration, and/or relocation TD �U f frP ... am or —1- 2 /pU e.-70 0 OPERTY OWNER ❑ TENANT 201 amps to 400 aims 1068c 2 Name: 401 amps to 600 ainps 160.60 2 Address: 601 amps to 1,000amps 240.60 ' 2 Over 1,000 amps or volts 454.65 2 City/StatelZIP Temporary services or feeders installation, alteration, and /or relocation Phone: ( Fax: ( ) 200 amps or less 66.85 1 . 1 Owner install lion: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended fors e, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 2 • Owner signat e: Date: Branch circuits— new, alteration, or extension, per panel A. Fee for branch circuits with APPLICANT ❑ CONTACT PERSO\ above service &feeder fee, Business name each branch circuit I I 6.65) ( 2 '� r /�,•- ,7 gu�r leG f r 7�� - nC. . B. Fee for branch circuits �� ` /� �- �/ without service or feeder fee, Contact name: /`s ' v Z //pi g first branch circtiit 46.85 2 Address: C3 800 /1v 0 ` riS Nt=s/..t - Each add'/ branch circuit 6.65 2 City /State /ZIP: � . e f . p / Q 9' 7/3 Z- Each m aae f us (ser modular ice or feeder not included) ! r` b ✓ C/ :1 Ea manufactured�o I Phone: ( t� dwelling, service and/or feeder 90.90 2 •-0 3 ) 5-3 7 - ( ,6, Fax: :8 ) 53 7 - u' / / ' Reconnect only i 66.85 2 E-mail: Pump or irrigation circle 53.40 _ 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: r El F.- 1nG Signal circuits) or limited - energy panel, alteration, or Address: ff JL 0 r.r;5 Nj t extension. Describe: Page 2 City/State/ZIP: 1, w e e r - J) e 97� ' Each additional inspection over allowable in any of the above / [JIL -- y ^ � Per inspection ! 62.50 Phone: (6 J - 1/ � ) 3 7.- L7 - //o�ff/ Fax: Fax: r� ) 5'37 ��/ UfJ� (`703 Investigation per hour (I hr rain) 62.50 CCBLie.: 1 Electrical Lie.: 36 -10LiG Suprv. Lie.: %lies Industrial plant per hour 7175 is ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: S ubtotal: Q � • % � J Z t D ale: Plan review (25% of permit fee): 1' � 6 Print name: A� �� /M 2 , s State sui ch Authorized signature: I arge (8% of perm it fee ): a ^� d �fi I TOTAL PERMIT FEE: f F80 I ' 09 Print name. `/ f ? ^� D L�' p D a t e: �,• �, l / This permit application expires it a permit is not rained within t 1 Y /! days after it has been accepted as complete. • Number of inspections allowed per permit r:mocriagmerntroF..C- ereastro.da 0523 /06 44O 4LSr(1 Lr051COs era