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Permit CITY OF TIGARD ELECTRICAL PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00436 Date Issued: 08/03/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S134CA00708 Jurisdiction: Tigard Site address: 11945 SW SUMMER CREST DR Project: Desimone Subdivision: Lot: Project Description: (3) branch circuits for NC, condensate outlet and service outlet. Contractor: ERIC OLSON ELECTRIC COMPANY Owner: DESIMONE, PATRICK 10013 NE HAZEL DELL AVE PMB 432 11945 SW SUMMER CREST DR VANCOUVER, WA 98685 TIGARD, OR 97223 PHONE: 503 - 936 -8406 HONE: 360- 609 -4901 FAX: 360- 693 -2980 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 08/03/2011 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/03/2011 $8.52 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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 - 001 -0090. You may obtain a copy of the ru,- or .1 - et questions to OUNC by calling 503 717 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. Electrical Permit A � f rm � r�Olr USE ONLY Via' lea 0 i. City 0f I'lgard Received Q' A a I b �(II Date /By: 2 11 P"'"'ill'"; �c 0f!—Ov4 J G II 13125 SW Hall Blvd., Tigard, OR 9722E G 0 2 201 mat - V A .. Phone: 503.639.4171 Fax 503.598.1960 Review Date /13 Other Permit I t ww rd -o ` e,.• Boo ( 1 �� ._ . t Y -Yd ` �_ / . Supplemental Information : TIGARD 10 - Ready/By: ! ` r r Internet: www,t 0 i oU to et to . 503.639.4175 Date Rcsd /L3 N t' d/M I d , ,°'•� ' k lwy , . i d t now ,. t yy���� � �k,f�r� „43.,,,,„1:,. gtt - ', ,� . 8�111t � y, , p y 1y�1 �o .'�'ili + '1+ 's ul ift4 Nifil't 1'�1 ",_" I!f' Irg eOIRil � 3 4L 1'd h , ”" +1 51P Y� . , �! F� i : 1, , * . k,,,, 31 i.. . 4 r 1 .1 0,4,, 0 ,� . . ! t n� .:,' ;:;: ' � 8 ' r 4 , . I, e t,1..-.. -a E New construction 1 dditiotl/alteratiotl /replacement fteusa oiled; all that apply (submit a sets of pluus w /items checked below): 0 Service or feeder 400 ntnps or more a Building over three stories. 0 DelriolitlOtl, Q Other: , t , } where the available fault currant Marinas and boatyards. ..'i 3 ,.' Tess to 4�k �„ ,,,,ag lY. y ' 1, ;; P (� Flouting ' " t r�3� u i i "", , ' a' exceeds 10,000 amps 150 volts or W " ° r , W9t 4 ''round, or exceeds 14,000 ❑ Conmt e eial. buildings. b use a r iculturnl In and 2-family dwelling 0 Commercial /industrial ❑ Accessary building ,i„q >;, &u' 411 oilier insh,llutious, buildtnye. 8 ❑ MUlti- farnily d Master builder ❑ Other 0 Fire pump. ❑ installation of 75 KVA or f let gar sup; +. T M ,lira n. 1 4'i i t is a e , 1 r' T al a � � a "' / v r � a 4 TFrc �* CI hiwergenuy system, u'atelY derived system. A n , � .ci, .a.-- ii:•r`liiw~ ❑ Addition of new motor load of ❑ "A " "L' "'(.M'• "1 -3". Job no.: Job Site address: # S „ At l77er f 100b1P or more. occupancy, 1 .l . . _ * r .0 Six or more residential units. ❑ Rcereatlon,tl vehicle parka. City /State /ZIP; 1-L 0t- / 7 G I � 7 � ?3 0 1 - lealtl't -care facilities © Supply voltage for more than a 0 Hazardous locutions. OW volts nominal. Suite/bldg./apt. o.: Project name ❑ Service' or feeder 600 amps or more. v( t:.:. „,.., f #tii "y',. . p „ g -apt. t Cross Slreet/d1reotlons to job site: ri,Ht:. is i'. >" I;�itl�,. t: ,yl nfli h* t Wi!!E: 7'.50.3 4tif,:�':” "tA�1G,' 35;,,i Description I cny. I Pee. - it 'tuba I New residential single- or multi - fondly dwelling unit. __ Includes attached garage. Subdivision: I Lot no.: 1,000 iq. ft. or leas 168,54 4 ^- En. udd'I 500 sq. ft. or portion 33,92 1 Tax map /parcel no, � . residential .e , rx, r Limited energy, 2 lit; .: �'t 4., F . :::: .... . . . ..�, t.y::' ,� 3 : �, l t ' ,' 'ttv 6,, :pr,,, t" : +:tl,la; ; 67.84 ,,, .',,, C " „_ : : ,; " "ar tWetW: Er ..: , t a r_ n :qa, t; : ;, *,,. :''; (wilhubovest).11.) Limited energy, nwlti.family t t ( • 4 / " e lf ce i-"� `' , residential (with above sq. f .) 67.84 ,Qtr Services or feeders installation, alteration, and /or relocation _ '^ • (6 c r .. Al • . �.il CI A e p y 200 amps or less (3 100.70 2 .'1 " , 11Efm'.'iu"1LU°4nm��rYtw�Swi tl ,.0 Ywtitdlwc'l� ,∎ -') 4' ^” t .' 1, " : �' 1t t0 :; �!. 6� " :;i: k l :9 iil t , �, IlTMsly,,, 201 stops to 400 amp9 3.5 2 i 401 amps to 600 amps 200.34 2 Name, 110 601 amps to 1,000 amps 301.04 2 Address; III s �9 Over 1,000 amps or volts ~ 552,26 2 City/State/ZIP: p Temporary services or feeders installation, alteration, and/or 4- ( cr vie_ f 223 relocation Phone; ( �... Fax: ( ) 200 amps or les 59,36 1 201 inpS 10 400 amps 125,08 2 Owner installations This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 'tai amps to 599 snips 1 68,54 2 'Branch circuits- new, altewttioal exteusioii jier panel Owner signature: Date: A, Fee for branch circuits with A _ i fi tgt1n stn x • 1 1 3 1 . , y, ', M a. F' ; / i 4 ' above service or feeder' Pee. 7, o ,. . t, , p, ' ' , - 14 , I,aW; l ,. ref At ' . t,' G it, .. 0: L^ l c o n . !l e 1 ' t w o : , - . ,:t z 0. ,(ti each branch circuit 42 2 Business name: Erie Olson Electric, Inc. 13, Pee for branch circuits without i � . .. service or feeder fee, first 56 18 2 Contact name: Eric b ranch circuit S ii? cif - Such udd'I branch circuit , 7.42 !CF al 7 Address: 10013 NE Flazel Dell Ave PMB 432 Miscellaneous (service or feeder not included) ,_„_ Each City / State /ZIP: Vancouver, WA 98685 dwelling,tserviceeand/or modular e der 67.84 2 Phone: (360) 6094901 Fax: : (360 -) 693 -2980 Reconnect only 67.84 2 Pump or irrigation circle 67,84 2 E ericolsonelectricul gutail.cotn .,,`, ;.t45r' ts.:'.:;r•3,,. i ; V i.: m :: s r .Fa, „ i', "' ?`'f 'Sn' °1E'i:'ti:i;.. ; rT T Sign ur outline lighting 67.84 2 .n, ,: 1:J.I •p4 1:11 "G., ::.: ~ `.a4rra1L 4 iI1 , .'�,. Vii'.,.c .1, :8 i'+ �:, :'tl 1'. r_.i:::i',v°.i limited :"; i. 1. S: �r :.u..".:�- ,c,....,. a.:i1,.�'r 4 t2�::". � . � _.,k y.l..E'.,..._,.. .r..�a�r;: ,,....,„, Signal circuit(s) Orllttlitcd 6Y - Business name: Eric Olson Electric panel, alteration, or extension. Pane 2 2 tacit additional Inspection uver allowable in any of the abov Address: 10013 NE FHAzel Dell Ave PIVIJ.3 432 Additional inspection (1 hr nun) 66.25/ hr Investigation (I hr min) 66,25/ hr City/State/ZIP: Vancouver, WA 98685 Industrial plant (I hr mitt) r' 78,18/ hr - Phone: (360) 609 -4901 Fax: (360) 693-2980 - Inspections !or which no fee is 90.00 / hr q scenically listed (/, hr thin) / CCB Lie, 179408 Electrical Liu,: 37 - 10530 Suprv. Lie "```''I : 49105 '''a ttegT ;;m ,��1tt,^iYJiII4iS ' ��ri„, i i Suprv. Electrician signature, required: f� - permit fee): , 02. Plan review (25% u1 prmit ice): _ _ Print name: Eric Olson Date: C State surcharge (12% of permit fee): """"'"""—"""•, TOTAL PERMIT FEB; Authorized signature: This perrnil application expires itu permit id not obtained l thin 18 - _ _. days after it him been accepted as complete. Print name; Erie Olson Date: /S - Number or inspectionsailuwud , Ia5ultdinglrermhaLGPurmiiApp .due 10/0110'7 440- 4615'f(1 005 /COM /wE3 Z0 /t0 30dd DIel10313 NOS 086ZE6909E1 Z0 :0Z 'HOZ /ZO /80