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Permit CITY OF TIGARD ELECTRICAL PERMIT ! COMMUNITY DEVELOPMENT Permit #: ELC2011 -00461 TfGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/16/2011 Parcel: 1 S 133CA15800 Jurisdiction: Tigard Site address: 11016 SW MALLOW TER Project: Reel Subdivision: VILLAGE AT SUMMER CREEK Lot: 81 Project Description: (1) branch circuit for NC. Contractor: PRECISION NW ELECTRICAL Owner: REEL, ERIN 12020 SE ANNA CT 11016 SW MALLOW TERRACE DAMASCUS, OR 97009 TIGARD, OR 97223 PHONE: 503 - 891 -6900 HONE: 503 - 413 -9870 FAX: 503- 594 -2873 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 08/16/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/16/2011 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtai - •• of the rules .�,;,�___..uestions to OUNC by calling 503.232.1987 or 1.800.332.2344. i Issued By: —mow-- _ C ..F�.r Permittee Signature: ' 'G _ �_ r_ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 08/14/2011 20:52 FAX 5035942873 PRECISION NW a 002 /002 Electrical Permit Application i L FOR OF FICE USE ONLY 1111 City of Tigard Received 9 2Q11 �nte/B : y " ` J . 1 /2D = p 13125 5 50 Ha11 , Fax: 5 Tiga OR 9 8.19 60 AU G , 5 1 flea Review 16 l Phonc: 503,718,2439 03,59$.19 Dnte/By: ate Read /B an' e: ® See cinul� inspection Lin 503 D �q (� y y rt Page 2for Internet: www,tigard- or.gov �� i J F ��� tar ` Notified /Method; Supplemental Information i ... . � :. � •.•�,r� � yy�, r' �,+.. .� � .. � , + � �y��'��� �. �i. :n ' . . • y� b: {EQ p r� • . ... • • (�•II, �f,G, �C : . �A � ,: '. „w v ,', n `� 1 I,Al,1 t,,.8�17 Lwel a, 1 , 4 � R �: ❑ New construction Addition /alteration /replacement Please cheek all that apply (submit 2 sets ofplans w /itmn, checked below): ['Service or feeder 400 amps or more ❑ Building Over three stories. ❑ Demolition Q Other: where the available fault clement 0 Marinas and boatyards. 14,; ,,o: '1 ' t out ",'Rif, 1 " "it r ,t"¢ „a;1 exceeds 10000 s ,a sat150voltsor Floating buildings. fit ,,. I , A")'4����,1 i i t i ° 1' l d P ❑ t., ,.. ,,. , , ,;,, rrAi ]ass to ground, or exceeds 14A00 ❑ Commercial-use agricultural P: I- and 2-flintily dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings ❑ Multi family [] Master builder ❑ Other: ❑ Fire pump. 0 tristnlladon 01'75 KVA of y �y yy �� y yy ,, �, " f,'vry sy q .,� `+ y n ❑ Emcracnc system. larger separately derived system. .� ;,.,,x T' F„ 4i , I d Al 4 ,111 1A �i. 1 ; 1°1 , , • E r. ,,,, .1i 1 r15'' , b " '�:� . :�Nt'`` �.. Vi n. gnl1, ❑ Addition of new motor load or ❑ "A ", "E•' "1 -2" "1 -3 ", Job n0.: Job site address; i` o' t..e 5Ntsf A„/'r 2 a . -- - - tOUhIP or Moro. occupancy. v�'v © Six or more residential units. ❑ Recreational vehicle parks. City /State /ZiP; -n oil_ qi 1...1-. • ❑ Health -care facilities. ❑ Supply voltage for store than _,...., . ..,.._.,_— ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name; - ❑ Service or feeder 600 amps or more, w ��} :; ' 1,''', r, �lt� i����. ',iirV ,�1'�l'd 1 y dt i t p�n��: I tla A i�( ��� '�;. �,: I l I Cross street/directions to job site: vend don 1CIlai® final _ New reeidential single- or multi - family dwelling unit. Includes attached garage, Subdivision: Lot no.: 1,000 sq. tl. or less _ 168.54 — 4 — , .. , ... " "" --.. 0sq. ft o r portion 33.92 1 - - - ° add' 500 'I ax map /parcel no.; Limited ; z.;, ,,;:; (with above ) it$0. ?41. ,off f Tt : I„ tq R 5.00 residential t ;den ' c Limited energy, multi - family 75.00 2 C+ C CA " +i � � N Q 1 � residential (with above so. .ft) — Services or feeders installation, altcration, and/or relocation 200 amps or less 100.70 Q''l0(IT '04�( 1 iii, , ir t, aa l a �yp rli " `," > 1'ti 201 amps s 133.56 ' r � , , ;,�% y},tt�� rg�, r. 1 : tllrnFuewe`2ti ir ��, r d4..; � I P amps amps to 600 amps 200.34 Name: • - _- _, 601 amps to 1,000 amps 301.04 Address: Over 1.000 amps or volts 552.26 13 • - -• Temporary services or feeders installation, alteration, and /or C ity /Statc /Gt P. relocation _ Phone: ( ) Fax; ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: 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 701 401 amps to 599 arms 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: _ Date: A. Fee for branch circuits with .7‘;.'•'''';:...' ryr y �' • l ; ,; above service or feeder fcc, 7.42 2 0 61 ! 1"I , IL:4 h I ..,. . : 4,.,, . „ ,( .' each branch circuit _ _ .. Business name; R. Fee for branch circuits without service or feeder tee, 1it51 I 56.18 0 ` I 2 Contact name: branch circuit , Each add'1 branch circuit 1.42 2 Address: Miscellaneous (service or feeder not Included) Each manufactured or modular 67.84 2 City /Slate /ZIP: dwellin_, service and/or feeder Reconnect Only 67.84 2 Phone. ( ) h'ax:: ( ) ... Pump or irrigation circle 67.84 2 • E ,.,. , . , Sign or outline lighting 67.84 2 •: r , ,. i pI 'i,: d: `, ; i '" `, '" 7, ^a /l Signal circuit(s or lindted-onergy -.. panel, alteration, or extension. Pale 2 2 Business name +r-eti;, St or, ti,lJ�J � - � �' , Each additional inspection over allowable in an of the above III Address: \ p1/411.9/A/ rov Additional gati in (1 h r mitt) (l hr min) 66.25/ hr Inv (1 hr min III ) 66.25/ hr (:ity /Stale /Z IP t A� C� ► �' Industrial plant (1 hr min) 11111 78.181 hr Phone: ( ) 0 Fax; (Scj" ) 5c1L 79 3 Inspections for which no fee is 90.00 / hr r S ° CIt1c¢II listed %a hr min CCB I.ic.: ktor a5( e) Electrical Lie,: .1 Suprv, l -ie.:C o_S • ' La1,.,- ' i,,, da` t . „ r 6 ;t oo a1° 15. Subtotal: Suprv. Electrician signature, required: , .'N -/ ( - ` C! Plan review (25% of permit fee); - . Print name; MX Date: , -'� ' ` State surcharge (12% of permit fcc): �' 7 um TOTAI• PBRMIT FFF.: (D 7. Authorized signature: l /�,P / 71tis permit applieaiioO expires if a permit is not obtained within ISO - ^ - ` days after it has been accepted as complete. Print name; ` Y e c s � Y l Dale: 15.- 1) * Number of ;impactions allowed per permit. 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