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Permit , CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00299 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/03/2011 Parcel: 2S104CD00700 Jurisdiction: Tigard Site address: 13591 SW HILLSHIRE DR Project: YODER Subdivision: HILLSHIRE ESTATES Lot: 7 Project Description: (2) branch circuits Contractor: ONION'S CANBY ELECTRIC INC Owner: YODER, STEPHEN M & PENNI J 790 S IVY ST 13591 SW HILLSHIRE DR CANBY, OR 97013 TIGARD, OR 97223 PHONE: 503 - 266 -7878 PHONE: FAX: 503 - 266 -5543 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 06/03/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 06/03/2011 $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 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-01,,,' ► 9 +. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19877 1.800.332.2344. Issued By: V /�/ �L Permittee Signature: QN // /0L e`¢T0" /.1 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. FROM : CANBY ELECTRIC INC n P ONE NO. : 50326655 Jun. 02 2011 09:17AM P2 Llectrical Yel• d�. , ... ) 71icatiol>I , ... Received y 13125 SW :tali C e ,2_0/7-6 0 ,g9.• City a (Il >Dtt _.�.- - --- -- t tli i3lvd., t it;ard, OK 97223 f IN 2 2.011 Plan Review rxher Per irlyr-� �����+���rrr 4 Phone: 5t/lr>a9 41'w1 hAx: 503.508.1960 Date/i3y: ����/ �Q _. . - -� I Fl: i l;lt laspectioo 1.,a,:. 34)161).44 C 11�`, 'rD DateReady /11y; i /j /� � ket Pa ge1for Internet: ��w h.ttga: ot.gav C I` OFTi�� Notified/Method; // 1C�J Supple:DohaIsformat • TYPE OFW v, . 'PLAN 'REVIEW ; ; _'., a '` ❑ New cons' ruction - -- 7ttlti1LO11 /AI1CratiOn /repIaCement Please check at that apply (YUlrntit 2 sets of plans w /times checked below): ^ 0 service or feeder 400 1111111110f more Cl Building over three stories, ❑ Demolition ❑ Other: where the available fast current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceed% 10,000 amps at 150 volts or ❑ Floating buildings. - ---- -� less to ground, or exceeds 14,000 (] Commermal• use agrteultuas and 2- family awaiting ❑ (:ommcrcial/industrial ❑ Accessory building amps for all other installation v. buildings. Dill VI r Multifamily ❑ Master builder El Other: ❑Firo pump. 0 Installation ot 30W sm.: INFORMATION AND LOCATION 0 Emergency system Wier separately derived system, _ ❑ Addition of new motor !sad of © "A". "E" "14 ", "1.3 ", Job no.: Job site address; � r e rus o ccupancy. l3 l l ..,. f �� CI six ix o or r moorn esnlenlrul u0rts. 0 Recrenlianal vehicle parks. City/ /LIP; E ,„ o 0 Q Health-eare, facilities. ❑ Supply voltage for more than ? 6� D j [a IOCAtiOnA El Service ar feed 600 amps or more, 604 volts nOmiaal. 1 Suitr/bEdg, /upt. no.: J [ roject name: 5 Y�G .� 176,— P , :l nl tit , v' X113LE ' „' l :.kI; ..`1. ,'. Cross streeddirections to site: Dacdptba 1 on, I F 1 Jaru.. I New residential single or multi family dwelling'uoit, • ' Includes attached garage. _ • • Subdivision: Lot.no.: 1,000 sq. ft. or less 168.54 j • • : . 44 . : • TeX map/parcel no.; - Ea. add'l 500 sq. ft. or portion 33.92. ' • ' 1 ' • Limited energy, residential 67.84 .2 . • . DESCRIPTION OF WOitit ' (with above so. a.) Limited energy, multi- family ' (., •q' k..., residential (with above sa. R.) 67.84 . 2 • Services or feeders installation alteration, and/or relocation : 200 amps or less 100.7i) 2 : ❑ PROPERTY OWNER ❑ TENANT . • : 201 amps to 400 amps 133,56 • : ' 2 Name: ,x ._ t/-- 40l amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 . • 2. • Address: Temporary ecru ces or feeders installation, aiteratlon,.an 2 City /State/ZIP d/on. - _ .. relocation Phone; (x,(70/ �1) Pte' ( ) 200. ampsorles� ..,...,.,..,,,..:,,........_ ..,._,� ._ . - 3 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 . . • •nterided for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 599 amps 16834 . '' Owner ' signature: B Branch circuits - new, alteration or extension • , er . anti • '. ' _ _ _ - A,'Fee for branch ci rcuits wi t h ❑ APPLICANT -- _ —• r « , , , ❑ CONTACT_ P E R SON above service or fe eder fee, each branch circuit 7'42 Business name; B. Fee for branch circuits [ • •M,.^ first branch circuit u� � without service or feeder fee }� Contact name: ] D'. Address: Each add'I branch circuit 1 7.42 7, Mlicellaneous feeder not included). . City/State /Zll': Each manufactured or modular • . Phon ( ) Fax: ( ) - dwelling, service and/or feeder • • _.__..,,.,, -_ , ......._._ Reconnect only 67.84 ' . ' • 2 ' • • E-mail: Pura, or irrigation circle 67.84 . ' . 2 • _.. ,., .. ._,.. -- I 1VTRACTOR Sign or outline lighting 6T.84 : 2 . • Business name; - Signal circuit(s) or limited- . _,,p _ OA t 0. _ .4 a 4 r C- . . 1 energy panel, alteration, or • • Address' v S extension. Describe; Page 2 2 City/State /ZIP: _i L„,.., a 4 �'- )3 Each additional ins ection over allowable In an of the above:, .; ' ne: ) ( _ p er; ( t Per inspection 66.25 • Y s 3 � SS >' lnvestl per hour (I hr min) 66. 25 P • 0 *. : CCR, i.tc,: 07 � ,, / 2. f Icctrical Lic.: S _ // ( Suprv, Lie.: 742, I •lent • • hour 78.18 u rv' Electrician I w Di LV 1 7 J` "Iii i' "E C"TRICr 'sPSRM1T: x rt •: Wµr; ,,:,•.; S g , . �, a signature, required: 10 ' `" "' • • _ , Subtotal: �`3 :�ti f Plan review (25% o f it fee); ['tint dame: f Date: 3 tail I surcharge (12% of permit fee): • Authorized signature: �� Print tiaine: Date: This P _ TOTAL PERMIT FEE: 7 i . 1 84 v This p ermit application expires if a pe rmit is not *milled within - ._.._, L • , w _ W days after it has been accepted as complete. - . . ' Number of inspections allowed per pwrnit. - , t: auilding'Permib'ELC•PermitAppdoe ;ON 1/09 440.4615T(I1 /05 /COAVWEL