Permit r-
n CITY OF TIGARD ELECTRICAL PERMIT
11 1 '` COMMUNITY DEVELOPMENT Permit #: ELC2009 -00241
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/26/2009
. Parcel: 2S 114AB09000
Jurisdiction: Tigard
Site address: 16300 SW 93RD AVE
Subdivision: KNEELAND ESTATES NO.2 Lot: 94
Project: Quinton
Project Description: (2) branch circuits for heat pump and receptcle.
Owner: FEES
QUINTON, STANLEY R Quantity Description Date Amount
16300 SW 93RD
TIGARD, OR 97224 2 crt Branch Circuits 05/26/2009 $53.50
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 05/26/2009 $6.42
Electrical
Contractor:
AFFORDABLE ELECTRIC WORKS LLC
545 COLLINS CREST
GLADSTONE, OR 97027
PHONE: 503 - 722 -1558
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done jn ccor ce vith approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. TTENTION: Oregon'law recieires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 01 -0010 through OAR 952 -001 - 11100. You a obtain a copy of the rules or direct questions to OUNC by calling 503.246. 9 8 .3 .2344
Is ued By: ' / .,L � Permittee Signature: X
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
� �i CONTRACTOR INSTALLATION ONLY
� SIGNATURE OF SUPR. ELEC' /y� ? ; l - Date:
G /
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Ek tr-ical Permit Application U FOR OFFICE E OiNEY
51
C City of Tigard Received r, /- ( i / OD /
g Date /Bv. .7 Ovlk 0 \ Permit No.: c._ ,2,1
r' " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Permit
TIGARD Inspection Line: 503.639.4175 Date ReadyBy Juris: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method' / 4 Supplemental Information
g . y.� �. » ...e�t t,cc ., -;Fa • � � -� e N d�, �. ti , � t; x w. ^ ,, . Ra<< ^ :�... w
" „" ' i;3: t:' ;3 _ t .F w,+�i„"F3? ., ae..,. - 'h' ^. ''`.:.:r" ,': � ; .7 ' S . ?r)§.:" -:x - ` - }7 "I ;az A* . g = a• v �;
,sue t. , , . ,, . T iWO RK • t fps � , x. '�: - =.x,. t a .'4, Ty, ; i `' <$. .:. 4y � , -, 1 - , a..t , - -., :
. y} p.. . �:.. �sS' ��.. ti0s�.: v+. F•,, ��. E1'.',s �; 1s��+ Y�c�x... t,: r2a° v ��:•' - "]:"..._; �? ...;....r�.:<�. �1�,5'','° ,, -.,�1 ',�w .'Y� ��'k:- �,d�+V ".`�'? 'f'C"�.#�'�.�v.` C:: 2. h :,LXx;:d<k`�'�i..."':�._�'.4�a� ����„r4llli�w'� � � ��n �y E_
❑ New construction Addition /alteration /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.
• :„ if„. zE:.: �Ckir: ;��.;: �,.4.. .1 ;. :rPms csbr:»:» 'ev „ "2: .tt,t .Nn ^�cA ;r°a.vn< - "a,= ,s*ry.y� ..4 ^ ^: .'. :oaf° ' .K? ..
_.eFr a - : >. exceeds 10,000 amps 150 volts or Floating buildings. ,� r - ; y i x CA TE GOR Y ® CONSTRUCTION " S% - p ❑ g s.
, g
. <o, x .� ,:. �; �� a. . ; ,. h _ =` �^ m '.` . , z- ., : r._` "" C less to ,
round, or exceeds 14,000 g ❑ Commercial-use agricultural
X1- 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
.s$ - <; n x _ ., *; - . . ,,:, , .:_... ❑ Emergency system. larger separately derived system
- ; v V _ ' J OB SPTE3[NFORMATIO AND' I ORATION 'AY `" t @T
4rs. u s .:. '.. .... eu - x, . .<., z c...�� ,, a s..,. �.E: ,,.-�. : 4 , 4s h;,�.� t a ❑ Addition of new motor load of ❑ :: <: :, I .2 „ << -3 „
Job no.: Job site address: /&30o S a.,3 A I or s, cc
9J ❑ Six o or r more e residential units ❑ Recreational eational vehicle parks,
City /State /ZIP: -77 �Cr�- t � R 9 1 � 2 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: QG{ t \ f U N...) ❑ Service or feeder 600 amps or more.
n ; s :,= s "FA r1', :FEx4SC1 RULE 'r 4 r. °' a ;;x= r`=
job site: " s ° " " "' / " "" E "" " "' I " "° e e. I l I •
``"
Cross street/directions to
J Description I Qty. � Fee. I . � Tolal
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.. Ea. add'I 500 sq. ft. or portion 33.40 I
Limited energy, residential
:; ; r k ti W< <a= ,:: , :,. n -_. o , f4.rz ',r,'�;w4, >r -m ±: r 75.00 2
,,,.:( `: a �t. a ' s`? DFSCRIP I T®N OF O , ,, c v i. , ,g si i ; ,, ;; . (with above sq. ft.)
. � a _ w ._zzt,,.v. _a,.�. - ..,a�.._ t' ".. a <,_' .arm »'4:��a; " S'at�3�ar,�:� � . r?'�R_' -..
� Limited energy, multi - family 75.00 2
3oA 2 4c ✓ /�e / Ce47.%,O Di- / residential (with above sq. ft.)
O G� Services or feeders installation, alteration, and /or relocation
iti 12 O / 200 amps or less 80.30 2
, ::,f`y ':u `:.'. , r _ :. ; c ;
' "" t ? `;t.: PROPER;.# ,OR R - O . t 'EN:a]\T
�`� -�� � � u:; ; ,.<.�- a =:�"a�,,..:� �.: t..���d� -�. - .- � » „.,.:.,:... �?���, * ��� 201 amps to 400 amps 106.85 2
/ 401 amps to 600 amps 160.60 2
Name:
S./0_41 Q wi/1Tey? 601 amps to 1,000 amps 240.60 2
Address: go 2 00 S w A ti-12._; Over 1,000 amps or volts 454.65 2
City/State /ZIP: 721 x , 1 2 ,., 9 7 7 . i.„, L/ Temporary services or feeders installation, alteration, and /or
d relocation
Phone: ( f6 6 r8,./ g Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with -
} •; - m''�� '. �� °�� � - - ` :?�i�" ._..' ex:. J � � y . g -,. y ., n -.:;.� .. ,a -»w m .�, �;� �;,;�,
nx` v
(AP L , w l ❑ CONTACT PE' above service or feeder fee,
, N : ,t; .: it';Zi4 , . a i .; ,. , , < �_ ^, . <'_ . �,S'Ov:' 6.65 2
_ J1__ //-- ,� l c ` �, ) , - Fee for branch circuits
without service or feeder fee,
Contact name: d 1,ue z first branch circuit 46.85 2
Address: SC S- co / //,L.L" Ci�s1 Each add'I branch circuit ! 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: ' &a5i , 0 9 702_7 Each manufactured or modular 90.90 2
Phone: -(5,3 ) 7 Q f ~ acre Fax: : ( ) Reconnect
dwelling, t on and /or feeder
Reconnect only 66.85 2
E -mail: • Pump or irrigation circle 53.40 2
' -* k,ty', - t w',,tr. .-::: - „,r2 - -:`:° 4..F >. :, - -x
.":,, _vet CON 100: , ass,. =r,.. e s.4 - si outline lighting 53.40 2
5
.,.;' k� ;���;��- ��-�= �:.:��ra_,,�.G�.. . �.: a�.,, �,. ��.. �.._ �.<.,. �::.rN,�.��:�,..ey,..u��...s -�� a�;`��� <'�,,: g g g
circuit(s) or limited -
Business name: ir �� /C tj y t energy panel, alteration, or
Address: S`�c - / / ''s C
tiiS -1- °` Signal circui
' extension. Describe: Page 2 2
City /State /ZIP: G &-�s r-e_ G ,... g 7
Each additional inspection over allowable in any of the above
. Phone: (5 '.2 / � Fax: � ( ) t i\ Per inspection 62.50
'I Investigation per hour (I hr min) 62.50
v CCB Lie.: /k 3 0 S' Electrical Lie.: -c C Suprv. Lie.: 51��� C Industrial plant per hour 73.75 •
` J %r`:t #TRCAI 1'RRiV11T TEES. z > `_
iTi
Suprv. Electrician signature, required: l � I I t M In Subtotal: ,f6 ,5T �
/ G ; 1 ' /' Plan review (25% of permit fee): $
Print name: � Date:
Q State surcha (12% of permit fee): (, • . L(' ,Z
Authorized signature: �o��d 9 4 �� O TOTAL PERMIT FEE: 59 9 a
vv CC " This permit application expires if a permit is not obtained within 180
Print name: XW r d.;2 f z Date: days after it has been accepted as complete.
` + Number of inspections allowed per permit.
I:\Building\Perm its\ELC- PermitApp.doc 05/23/06 440- 4615T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard I Other • { -
Page 2 - Supplemental Information Total number of commercial systems:
LIMITED ENERGY PERMIT FEES: »No licenses are required. Licenses are requir
for all other installations
�R WORK�ONI:Y � F
Fee for all residential systems $75.00
combined
Check Type of Work Involved:
I I Audio and Stereo Systems'
I I Burglar Alarm
I I Garage Door Opener''
I I Heating, Ventilation and Air Conditioning
System'
Vacuum Systems/
fl Other:
Fee for each commercial $75.00
system
(SEE OAR 918 - 309 -0000)
Check Type of Work Involved:
Audio and Stereo Systems
I Boiler Controls
Clock Systems
I Data Telecommunication Installation
I Fire Alarm Installation
HVAC
Instrumentation
n Intercom and Paging Systems
I I Landscape Irrigation Control'
I I Medical
Nurse Calls
Outdoor Landscape Lighting* .
I I Protective Signaling
I:\ Building 'Permits\ELC- PermitApp.doc 03/23/06