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Permit n CITY OF TIGARD ELECTRICAL PERMIT r COMMUNITY DEVELOPMENT Permit #: ELC2011 -00451 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011 Parcel: 1 S134BD07900 Jurisdiction: Tigard Site address: 11676 SW PENN CT Project: COFFIN Subdivision: Lot: Project Description: (5) branch circuits for kitchen and living room remodel. Contractor: BFP ELECTRIC LLC Owner: COFFIN, ORAN C 28075 S BEAVERCREEK RD 11676 SW PENN CT MULINO, OR 97042 TIGARD, OR 97223 PHONE: 503 - 515 -9792 PHONE: FAX: 503 - 632 -3768 FEES Quantity Description Date Amount 5 crt Branch Circuits wo /Purchase 08/05/2011 $85.86 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/05/2011 $10.30 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rul- or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ••• Issued By: !‘ Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 08/04/2011 10:05 5036323768 BEN PAGE 01/02 Electrical Permit Auplicatio r� If — FOR (il l l(l 1. ()N1.,' City of Tigard � g Acaoived Permit NO,; I 11 _W "G�/ BateBy; i I, " 13125 SW Hall Blvd., Tigard OR 97223 Review 1 : Phone: 503.718.2439 r ax: st)3,59 0 5 2011 Datcn3y; Other Permit; j I GA F I• Inspection Line: 503.639.4175 Erste Ready/By: la See Page 2 for ' Internet: www,tigard- or,gnv CITY OF Trr a ln Notified/Method: Supplemental Information N701 1701) 3',1'.4'171 .1 " T " I41 1$ 9 YL k !' a ° ' " ,, "" " ,1 ` u l i l r !rQ' 9 ` At .. fir w, J , 7 46 , h � I a ,r .�, )1'044.N:444 • , R 9., ' t {' 4M' &1>uk' 145 n, , 111`!!. H 1 on I I, ,. �.' �, � • � �. �.. � "9•� � •n • 6 . .'.0041 rnfal a inµ .. lrlt u r' � lra �,1.�`kl & rd s .� �� r ki 6N' at r � ,1, • •. .a W - U � �l ��o-�r: ,,. 11 , ❑ New construction ► Addition /alteration/replacement v , . PIease check all that apply (submit 2 sets of plane w /items checked below); ❑ Service or feeder 400 amps or mom ❑ Building over three stories. Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. Ii1I iI;✓ II Er t' l l t l l: { i r i� I I'+ i r ar �, °! , :, o i, lit " 7 w - exceeds 10,000 amps at 150 volts or Floating .1.xo,1 a� and � f ` ; ; , d Iling 0 Commercial/industrial r w °. !G ' f p e buildin t Vi a. w less to ground, or exceeds 14,000 ❑ Commercial agricultural ❑ Accessory building amps for all other installations. buildings, ❑ Multi- family © Master builder © Uthci- I:Fnc pwup, ❑ Tnstallationof75ICVAor s. Ii; � al 1 lij j Is�; t�le bl S,y )) ll, . a ',' 'a t + ©Emergency system. larger separately derived system. P ill k g, t 7 7 i, / d ) >g .,i' a 0 a i A11,� � .,, �, q qY ',''',:g. , .,, , , 1 i r a - I , m+� k'��� , :;al la : ! ❑ Addition of new motor load Of CI "A» "E" "I -Z" "1 -3" Job no.: 22 ^0'75 Job site undress: 1/6 ,6' S tete /OCl y\ Six or ore residential occupancy, 0 Six or more residential units, ❑ Recreational vehicle parks, City/State/ZIP: a,- 7 Q / 3 ❑ Health-care facilities. ID Supply voltage for more than Cl Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: { hi ❑ Service or feeder 6UD amps or more { r, Irr i ^1 r +A l7 tl :. r r R ]w� 7,i 3 1h rat r ah. i h y!' L 1 E31n :Li° ° � �� •�' 1 l" j ' Pty. J ' '' Tong " 'ir` Cross street/directions to job site: Description � Fm Tong " New residential single- or al ulti - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 1158.54 4 Ea. addl 500 sq. it or portion 33.92 1 Tax map/parcel no,: Limited energy, residential I " ,t 1 , « W 6 8r „ y l, 4nN,�•nlVinlal:"nv vV . • ! �ryoiMrvX, hPSORidf7,'1 ( I nv .. p „ • 75.00 2 ii.r � ,; �Y p ';lgii^ .i. Ng : a a. vi with al we s . ft r. 1rwlr� I ' i Il'' tG ,i " P 1 Gh al • ' l g rr ., * u „g.^ ��1 Y' ( Q ) 4 ' . + i mM"l tnmi w r twin I r s ' 1 . i { Limited energy, mul - fami 75.00 2 r A / f7. , I'5 c 2,4„._ ... 2c ./ residential (with above sq. ft.) Services or feeders installation, alteration,andlor relocation r r f a ( _ / w _ 200 amps or less 100.70 2 :i , S 4 iiE1'. p"! R {�', - , o. l a `nt l ';/d1' B y w4 r r i' 7 tap( ' ,7dS( 7 li ' il 201 amps to 400 a ` � amps 133.56 2 i 'i t, " 1 Nl ("61i�l 11 ' ��" l�� 4J rt l '� � 111 ( IrGf rp,, x J 1 � "t G'll� 1 � ln. n�n P4�tlfeSC e rrP�.- h ^y "n�j,hnnl n , + " {'r�ntr tyl n," ��i g�S " ., "1'i nlr, p.ina, (, f %1 ' i +IL rN4..nr.. , , r.•,,1 h,L „i n,r1.. .n hnl r:r^ ,. .. m ?uJl - Name: 401 amps to 600 amps 200,34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Ci /Staff /7.TP Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or 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 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 • Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A, Fee for branch circuits with 1'1.50 r” c w1, 7i�'lt'i! 1 1 1 S i T i" ' kl' 'N 'r q. n i9 :: 1 �f+,a PA; a bove=vicout frz%Jct fizz, �r, -,ilh t,�, �,1,:,'�.; E�tki <�k'1�' a ��", 1 ��� ai 7.42 2 each branch circuit lusiness name: B. Fee for branch circuits wilhovl ' {, • service or feeder fee. first 1 56.1 R s ' b 2 Contact name: branch circuit _ Each add'l branch circuit L i 7.42 r-1 t , 2 Address; Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 67.84 2 dwelling, service and /or feeder Phone: ( ) I Fax: • ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 n „ n Pa e 1 1' ''''.4''t a l Sign or outline lighting 67.84 2 1t i'ritll Nlllyl l>' 11 i ii ai 1 li°'pr„ °, m0i ^vn ilr;r'1(�i;, Ij v,.11. .r, lit 1, �7t „) � .!. i��ildl:���l,} lf�.� � fM t: ¢ ,lp P1,�; ��, n `�,�t ■ , t tV.11v�+t� k �`'. � Bk, 1i ;tA Signalcimuit(s) energy Business name: 6 Fr , /' panel, alteration, or extension. rage *..4 2 �r Each additional inspection over allowable in any of the abov Address: v 7$ 5 6 ((( Ci - ee Z lq Additional inspection (i hr min) 66.25/ hr /J/J �/ 2 Investigation (1 hr min) 66.28/ hr City /State /ZIP: v ((�(, c/ C)/// Industrial plant (1 hr min) 76 -18/ hr Phone: (7 ) S/ S —/ 21,z -_ Fax: (5r)3) 6 3 z — 3 ?( 7 Inspections for which no fee is on nn/ hr specifically listed CA hr mm) �ta � a trF-. r CCB LiC.: c -75 Electrical Lic.: C({V Suprv. Lic,;S6.? I Atin gp� f ,`,'c.'l4,,i, b'e 1 W ,..ii, . , :w". i graiii ---�� r s '^ 3 o „ Subtotal, ` Suprv. I;lcctricid�3i atsflr., required _ _- r Plan review (25% of permit fee). Print name: 6 64 Date: b L( '(( State surcharge (12% of permit fcc): ((� 30 TOTAL PERMIT PBS: 96,f 7 1'7 Authorized signature : {� „ '- This permit application expire* if a permit is not t alncd within 180 days after it has been accepted as complete. Q,� Print name: 6 6 G(( . (/ te v e-- Date: 8 Ca ii • Number of inspections allowed per permit. 1:\ Buildin g \POl'mif4 \ELC- PermttApp.dpc 07/01/10 440.4615T(II/05 /COM/WEB