Permit CITY OF TIGARD ELECTRICAL PERMIT
• • COMMUNITY DEVELOPMENT Permit #: ELC2011 -00074
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/01/2011
G
Parcel: 2S104CB03500
Jurisdiction: Tigard
Site address: 13188 SW ASCENSION DR
Project: Haima Subdivision: HILLSHIRE WOODS Lot: 81
Project Description: Garage remodel.
Contractor: PRECISION NW ELECTRICAL Owner: HAIMA, CHAD & NATALIE
12020 SE ANNA CT 13188 SW ASCENSION DR
DAMASCUS, OR 97009 TIGARD, OR 97224
PHONE: 503 -413 -9870 PHONE:
FAX: 503 - 594 -2873
FEES
Q uantity Description Date Amount
1 ea Services or Feeders - 200 02/01/2011 $100.70
Specifics: amps or less
5 crt Branch Circuits w /Purchase 02/01/2011 $37.10
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/01/2011 $16.54
Electrical
Type of Const:
Occupancy Grp:
Total $154.34
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 • 2- 001 -0090. You may obtain a _.• • of • - - • direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B _ _ Permittee Signature:
D
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.
01/30/2011 23:31 FAX 5035942873 PRECISION NW a002/002
Electrical Permit A licatio ,
CEIVED F„,, 0, , ,, l'Sl': ()NIA
e/ny
City of Tigard Received . , ti
'--
Drit: „,.../ f Permit No • - " - ./..C .. .,k it.-cz.Z Li
" 13125 SW I lail Blvd Tigard ' OR 97223 Plan Review / / ir _
i l l 1
• Il 11 • Phone: 501.718.2439 Fax: 503.598.1960 L , A Dateasy. • Other Pennit:
A C A I P Inspection Line; 503.639.4175 Date Readyilly: Turis: 0 Sec Page 2 for
". l
Internet: www.tigard-or,gov CITY OF lICIARD, Notified/m.,,,od: L 7-2-z ? supplemental Information
i ,j,', rrIfillir5n7., 1 ,,, . „..;..;; IA :,,, gr,;.;!7;:•.,•:. ..:.:,:,,., : ..,.: . .:::
tn 4.6ve,cfaz,‘,, Alt. ;..a. 511 6.S. ,(,.. ;' .:'.: ,, .3411 r 6. '- '..7,7t1:,:. ,,.... ,,Ir . :•::,'''':. '. '. : . ,,.,, ::;.,. ,-:;, .,
El New construction gi Addition/alteration/replacement Please check all that apply (submit 2 serfs Of plans w/items checked below):
pserviee or feeder 400 amps or more 0 Building over three stories.
0 Demo] ition El Other: where the available fault current 121 Marinas and boatyards.
.4, IMar VE!' '..; 1 w
.
„', ,,i IvH t x,ak 10,000 amps at 150 volts or 0 Floating buildings
.: ''''' ' ' .' " ' - .. t . ' It , ,j hfiRkM j ' , . h ■'). ', .... Iris to ground, or exceeds 14,000 Deommercial-use agricultural
E 1- and 2-14mi ly dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. biiiiilings.
0 Multi-family D Master builder 0 Other In Fire pump. 0 Installation of 75 KVA or
1 ,.. ,,, ,, , , ,. , . C11 system. larger separately derived system
. ' ' '40:4 • ' ^ ,h'sUtsigEM,' i . b ,5r,:. ,,,, f,';',;!;,,,±.y , f ;41t.' CI Addition of new motor load of
100HP OT MOTO occupancy.
Job no.; Job site address: I 31 88 sw Asc.,. • i o ILI 1-.3 six or more residential units. 0 Recreations) vehicle packs.
City/State/ZIP: 1 (C3 - 7 '?--)-- 1:1Hcalth-care facilities.
0 Hazardous locations. D Supply voltage fur more than
600 volts norrunal.
Suite/bldg./apt. no.: Project name: LIService or feeder 600 amps or more
E t :+7;;:, ?to .1; 0 ,
Cross streeUdirections to job site: Description . ' E1 Fee. ‘;ilnt I . -
New residential single- or multi-family dwelling molt.
Includes attached garage. . .
Subdivision: IAA r10.: 1,000 sq. tt. or leSS 168.54 4
Ea. addl 500 sti 11. or portion 33 92 I
Tax map/parcel no.: Limited energy, residential •
,,. r, nr ,...., . . ir • iiiut,miliwiawrt inrepirrim , c teimitin . t ,■.. i■ . ',,vi .l 75 2
:•, '.:'.. : : ' " '.•: , !''...! . :' . /....' .'.) :' *7. ':: UM '
(with above sq. ft.) 00
Limited energy, multi-family
75.00 2
?OA4...1 C \ l'IMI..e., - G-f..1„,Vq.,%, , ‘ 4 d e..1 residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or lass 1 100 70 2.
' ''::! . . ' '' tairgitlr : ': '15 201 amps to 400 amps 133.56 2
401 amps to 600 amps 20034 2
Name: ,Ajoj I 1; 4... t o r n 0,_ 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
. Temporary services or feeders installation, alteration, and/or
City/State/ZIP: reineat1011 __.
Phone: ( ) I Fax; ( ) 200 amps or less 59.36 1
- 201 amps to 400 amps 125,08 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps 168 54 2
intended for sale, lease, rent., or exchange, according to ORS 417, 449, 670, and 701. -
Branch circuits - new, alteration, or extension, per panel •
Owner signature; - A. Fe c for branch circuits with
: ..- 0 i 1 . - • ' " ' ' • ''::'';! H:'''W,1" .,'::: - ' ., ON' IT , 1 1 -1T 4 , I ,m!!!:.!,'■ above service or' feeder fcc, -
. • , _______ , 9100,. : ,. .::''!..::;11•P:t.1;,,;- . 'j'' .!: " .::‘,::,.:'!' '' each branch cimuit 742 g-7, 1 0 2
. ,
Business name: B. Fee for blanch circuits with
service or feeder fee, cast
2
branch circuit
56.18
b
Contact name; ....
. Each add') branch circuit 7.42 2
.-
Address; Miscellaneous (service or feeder not included)
lath manufactured or modular
67 R4 2
City/State/ZIP: dwelling, service and/or feeder
Phone: ( ) Fax: ; ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 7
r-mail: Sign or outline lighting 67.54 2
'in ;g!!O10 7 S' l • . . ( ) l i mi t e d . . . -
u g
,....., ,..4 , ,,,,,,-...4% , . . S ci rcu i t(s) s or -enetgy
_ • • - ..e" t k r panel. alteration, or extension F'szLZ , 2
Business name; P uj cs,ELLS: A) .. t' i co,‘ ._ Each additional inspection over allowable in any of the ahoy
Address; rae)(10 Nt- Ax\ot, Q - A l i
Additiima inspecton (1 hr min)
66 25/11f
Investigniun (1 hr min) 66.25/ hr
CIty/State/ZIP: DCorsak % t • • ''' ..
. . Industrial plant (1 hr min)
78.18/ hr .
Phone: 1313 ) 4 ... 13 —
95 /0 Fax: (S61 ) SO! 9 _-).s-13 i for winch no fee is 90.00/ hr
specilicall . listed (ii hr min
— '
CCB lie )(33 1 fi. Electrical Lie.: C, 97 Suprv. Lie,: 503(0<, IIIA,IiIk(tt !,:"'• ' , 7 ' '6'7, t:TrrT Y:'" , .. I t',.;'''
- - Subtotal:
-- • _
Suprv. Pleetrician signature, required: fyyjil. Plan review (25% of pennit fcc); .
.
ca )c,r3ct..I CA. aPrint name: i 1 C yyt _ r-.._ _ I I D tc: 1 .-.b 1— 1 1 State SurCharge (12% of permit lee):
i Alm
TOTAL PERMIT FEE: I - _ ..iit
Atithori4ed signature
.
- -40 Thi perm App ii cH ti o ,, as pires If a permit is not obtained within 1S0
days after It has been accepted as ennipiete,
• Print name: 1 / •
tVeLl i 1r\ , ' , -
.. I Date; 1_3 k — / 1 . Nuinbc, of inspeetinns allowed per permit.
1:\riuildi*reimits\ pi C.PermitApp dm. 117/01/10 4.411.461 5T111/05/CONVw kw