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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00389 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/15/2011 Parcel: 2S103DC00825 Jurisdiction: Tigard Site address: 11294 SW VIEWMOUNT CT Project: HERKNER Subdivision: Lot: Project Description: (2) branch circuits. Contractor: A TEMP HEATING & COOLING INC Owner: HERKNER, GREGORY A & MONIKA 16000 SE EVELYN ST 11294 SW VIEWMOUNT CT CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223 PHONE: 503 - 650 -5014 PHONE: FAX: 503 - 557 -2990 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 07/15/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 07/15/2011 $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 - 001 -0090. You may obtain a co. of the rules or direct questions to OUNC by calling 503.232.1987 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. 07/13/2011 11:27 5035572990 A TEMP HEATING PAGE 01 RECEIVED Elec Perm t A i Iic atil t l:OR •0i 1 si.: ()NI,Y JUL 13 2011 Received City of Tigard Desists) -: 7 II GC t�( xs� gr . ° 1 3125 SW 1 iall Blvd., Tigard. (72 972 Pim, Review Air A Qom Permit: ' Phone! 503.713.24.39 Fax: 90 ; I rQF l iGtii�i� I)ate�Liv: inspection i Mc: 503.639,4 JILDINGDIV Data Read Pct7 nit Nn.: /By: .runs: 1� See Page 2 for T1(. %:�K►) p Intem i Noriliedas4Fl:had SupplementalTnfnrmialon cl: ww1v,I:i -nc - TYPE OF WORK �. - PLAN REVIEW Please cheek :III that ripply (?uUntit 2 :Vs nr plates w /items checked l,cln,vl: ❑ New construction EitAdditionitilierationircplaceinent ❑ Scrv;c` or {ceder •inn amp; nr n,orc [] Building uvgr SS1rcC ntnrreN © it cnlalilinn ❑ Other: ,vhcre the avniloblc bath cIIrrtml ❑ Marinas and boatyards, CATEGORY OF C? , ' ,. L1CTit)1\ c,1cuuels MVO nmpa n1 150 v4111s nr ❑ 1:1c,111np bwil(lin less to aT.,„„ i, or cxcccds 14.000 C Cp mmereial- P C agricultural N. I- and 2- iiiimily dwelling ❑ Commercial/industrial ❑ Accessory building ,tarps tornll shcr installations buildinl+s ❑ Multi family © Master builder Q Other: C] Mrc pulnp. ❑ htatallntlon r,r 1 K VA or . - - ©P;mer system. howl' separately derived system, JOB SiTE iNFORMAT.ION AND LOCATION ❑ Addition ldnew motor load ut' - IADHP nr mare, necup:,Cy. Job no.: .lob site address:1 "� � � _ _ CI tits or more resident units. ID Recreatinmtl vehicle parks. In blc hh -u rc fnciliri n ❑ Suppli' wimp for more Ihnn City/State/7.1P: '' \ 0 _ 9 - 1_13- 7 ). — ❑ 1117.m-dm: loentlnns. 600 volts lenminnl no.: Suite /bldg. /apt. Project ect Mune: Gf t/ ❑ Scteicc; nr I'eedcr 6((t amps or mare. I FEE SCHEDULE ('1'055 I.rie1fdircct.ions to job site : . Des cripti o n I : Qh , . l nee" i Tntnl m � - ......- New restdettCiA! single- or multi-family dwelling Utuf. Includes attached garage. Suhdlvision: Lot no,: 1,000 sq. It, or less 10.54 4 -- Ea, add'1 500 sq. il. or portion 33.92 r " T ax map /parcel n0.: Limited energy. residential 75.I)II 2 W DESCRIPTION OF WORK (Nail above .4q. tl.) `.,- s'} ^f^ ^ e Limited energy, multi- family 75.00 2 b' b{ ::(, t ( � 1 , ' J Qt V 1 L.Q, msidcntial (with above sq, tt.t wT O Services or feeders instalintion, alteration. and /or reloca amps or 200 100.70 2 W PROPERTY OWNER „ ❑ TENANT 201 amps to e100 amp; 133.36 � 401 amps to 600 mops _ 200.34 Marne zh; ∎4- 54 6. ' , . AA - C C, amps to 1 RIl (l amps 1oI .fun Address: Over 1.000 tulips or vNts 552.26 2 temporary services or feeders installation, alteration, and /or City/Statc /Z,IP; " - ^ 1 relocation , -- „ •_ _ 200 gimps or less 59.36 1 Phone: ( } 11 Fax ( ) — — • 201 amps to 400 amps 12S,013 2 Owner installation: This installation is being made on property that T own which is not intended for salt, lease, rent.. or exchange, according to ORS 447, 449. 670. and 701. 401 amps t:q 599 amps 10E1.54 2 Branch c.ircnita - new, alteration, or extension, per panel Owner signature: _ __ Date: A. Fcc for branch circuit,; with • above. cervicc nr Feeder fat, �.^ APPLICANT I ❑ CON7 AC'T PERSON each branch circuit 7.47 - 2 13usincss name; A-TEMP liEATING MD B. Foe for branch circuits w]11rnrrr ,• IO.tA� _ service nr feeder fee. Firs' / Contact name; 160005 St. branch c.iresit 5(, • I R ,10.. — • Ti1ch add'I hrmnch circuit: - 1 I 7A2 7 4 2 Address: 503. 65,50134 Miscellaneous Sserv'ice or feede not included) ,.....,. _. _......- Bach manu'r,1,:turcd or modular M.R4 City/Slate/7.1P: .1P: rlwcllinp service and /or (ceder _ - Rcrnnncct only 67 .g4, 2 Ph one : - Mr] ) � — 1(e_07_, 5?T � ).-9 L Q I•'ump or irris±ntinn circle 67 .R4 ? E, -mail: _ Rion or outline lighting 117.64 2 CONTRACTOR ..._.., -_._ 5ipnal circuigs) or limitod•cncrcY Business name: 1�r7 HEATING lr panel. alteration. Cr e,'desilm. P age 2 2 __,_" ,, 16000-SE-Evelye-St .....• -.. " -. 1, ch additional inspection over allowable in . :,112X . or tllc n11ov __ I Address: c1ac1camH$ OR 97015 • AdlliIinnal inspection (1 hr min) ,_ 1 1-6,2'I hr 650 5014 - __ C "iCity/State/71r: X03 Industrial plant (I hr min) L 7 tion (I hr mint 60251 : (Sr ? ........_._. —L — _ � ^ ........._!, I n sp ctii oI ._..._ 1 -_.__.._.. -- ..._.___._ 6.16 /hr • 1 1 lire: l I 1'tlx: ( p ns for whkch no 1CC r.; uQ 01.1i I� liat�d (' hr hr pi. C C'T3 i.ie.: a "r FEleetriertl I..ie.; • 5 I..ic. x ' 1 0 5 C RICAI :PERMIT FEE'S A Subtotal: Suprv: Electrician signature, required: — ._ . .. ............_.._ n _ , .._. _ G 3 � D Plan review (25 %o of permit lee ?: Print t1 a.t11E1 1k1. ` tl�):.liti: iJ i 1 Stoic sittvhal'gC 412% c, l'pern, %t ice): _ ToTAI. PI :RMl.T FEE: Authorized stgm'titlre_ 411I r I A, 1 ' " This perntit application crpirca if n permit i3 not obtained within 150 " " s "" / — " tunx after it Irma Neon aeecptcrl pc cn .0Irw Prins name: '^ ■ e EA D tie• .,., t t { ^ NUmhcr nl"ipSpcclions alloyed OCT Pcrmil. w A. (�� our --.. + - r h,n„ iii ;n,irn,,Ii0.:i.1'- i'cra,il d m . 57111;1!) 1 -i .5.1 S'rtI I /r¢If•q Ad /WI-:li