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Permit Ill C I TY OF TIGARD ELECTRICAL PERMIT . COMMUNITY DEVELOPMENT Permit #: ELC2009 -00126 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/18/2009 T Parcel: 2S102AA03801 Jurisdiction: Tigard Site address: 12425 SW ASH AVE Subdivision: TIGARD HIGHWAY TRACTS Lot: 23 Project: Asher Traditional Homes Project Description: Panel change. Owner: FEES ASHER, BRIAN W AND SUSAN P Quantity Description Date Amount 15795 SW SERENA CT 1 ea Services or Feeders - 200 03/18/2009 $80.30 TIGARD, OR 97224 amps or less PHONE: 1 ea 12% State Surcharge - 03/18/2009 $9.64 Electrical Contractor: WINNER ELECTRIC INC 5950 SW PROSPERITY PK TUALATIN, OR 97062 PHONE: FAX: 503- 638 -4242 Type of Use: MF Class of Work: ALT Type of Const: Occupancy Grp: Total $89.94 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 952-001-001 t rough 0 952 -001 -! 00. You may obtain a copy of the rules or direct questions to OUNC by calling % .2 • •.6699 or 1.800.332.2344. ' Issued BJS ( j �/' � iL<� /mot Perm ittee Signatur � / - i- // 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'N --P . ,r (---1"-------) Date: / LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. • t Electrical Permit Application F OR �fFICL 1 SE ONL1 n j �. ° m �>� 4 o i Permit ho.: A t' / 111 �_T r SW 1Ia11016Ix'd_ Tsang. OR 9P1,3 > 1fvN ev�i*_aa' rI� },tom I�Nonnne:: 5)035&417I )Faex: 509.59L ➢ 1 tholic{%e I Oxh rPeumoa -A : R.D:, brogerlim Lime: 5111639.4175 Emile its thBx- 1 Janis I El See t'•e _ for 6muu mnelt: mtmtu ttlivaaes l-ne' gamy' 6dta➢ ciAill tkaa'. I Seoppbe muceu t itafuauaariiaa TYPE OF WORK: PLAN REVIEW gip.- cwus D llllta�, / tMiise• check all that apply t submit 2 secs of plans w,'items checked. below): �� � O'' service or feeder 400 amps or more ❑ Building_ over three stones L amml slit ttio)n D Other: I aahere the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION G exceeds 10.000 amps at 150 volts or ❑ Floating buildings less to mound. or exceeds 14,000 ❑ Commercial -use agricultural $ 1 - and 2- family dwelling ❑ Commercialiinoustrial 0 Accessory building amps for all other installations. buildinigs yEflafluiti- family Q Master builder ❑ Other. ❑ Fire pump ❑ Installation of 75 1:VA or FQB SITE INFORMATION AND LOCATION 0- Emergency system. larger separately derived syste ❑ Addition of new motor load of ❑ "A "E "I _ I -? ., 1tb0AHP or more. occupant?:. I I iioln anti.: Job site address: 1 a / j 25 sto A L4 j 0 Six or more residential traits. ❑ Recreational vehicle parks. �/ �..n 71 ❑ Health -care facilities. Su 6 vottare for more dear, F ataL� ZI, : KT`�i -VJ O � � 7 �'� , ❑- pp .. I'��•� ❑ Hazardous locations. 590 volts oeawnintal. , Saniut:/bidg =-rapt_ no -: 1 P'ro ;le;,i name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cinciisys. stg t.lalirexztions lo lob she: I i t _ s tlesccinnxo 1 QR. I Fee. j Tout I I ? New residential single- or multi- family dwelling unit. Includes attached garage. Suh'fiivisiont: I Lot no.: 1.00(1 sq. ft. or less I 145-1_ , Ii Tam_ intraptiiarcell no-- Ea_ add'! 500 sq. tt. or portion I 33.40 Limited eneres'. residential t , DESCRIPTION OF WORK (pith above sq ft.) t,., ; Limited energy, multi- family nn }}����� y fi 1 1 : Tniu-e.4..... 0140)0y't residential (with above sq. - P P Services or feeders installation. alteration. and6or relocation 1 200 amps or less • 1 € 80.30 '5. 3 : PROPERTY OWNER i ❑ TENANT 201 amps to 400 amps r 106.55 l : N c: B A / J/� /-)s /_ / i - ! 401 amps to 600 amps 160.60 �V 7 q 601 amps to 1,00(1 amps 240.60 A 5s " � S79 5 5' 1 4 c ---- ? P � A- C Over 1,000 amps or volts 454.65 : City/State/ZIP: ‘ 7" - (& IN—J t ) J 92 2 ci Temporary services or feeders installation, alteration, and /or relocation Phone: S , 78'0 .- ' f OC Fax: {Q3 ) ' 2 —c 63 200 amps or less 66.85 Owner installation: This installation is being made on property that I oXVtt which is not 201 amps to 400 amps 1.00.30 intended for sale, lease_ rent, or exchange, according to ORS 447. 449. 670. and 701. 401 amps to 599 amps , 133.75 : Branch circuits — new, alteration, or extension. per panel Omneir si:eantn➢e: Date: ( h _Fee: for branch circuits with • D APPLICANT II p A ❑ CONTACT PERSON above service or feeder fee. �' I i G.6- each branch circuit ' Business name: B.. For for branch circuits • mrlighour service or tied; r fee_ Contact naaua'__ Last branch circuit i ` Adldlm ss: 1 Eadm atddl branch circuit I 6,_&,? : Miscellaneous {service or feeder not included) CindSlate,iZIP: ' Farb manufactured or modular ' dwelling. service audio' feeder 901'.40 Phone: d Fan : 9 Reconnect only II 66.8'5 �' ' B - nsatil: ' Pump or irrigation circle 53.40 : CONTRACTOR ! Sian or outline lighting 53.40 : Sistai circuit(s) or limited - Dinsvness name: 1,L! 4, 10 L i~ IL -A.',- i energ panel, alteration, or Mist 7 extension. Describe: Page 2 ". l .5 S c,_. pr.?, 5 (t : =,, �� r- Let • City /State /ZIP: 'Z.-it/4-1 o r i1. 1 2 I Each additional inspection over allowable in any of the above / jj Per inspection I j 62.50 i I , Phone: ( .5113 63 s J z_ f:: C' 1 Fax: ( Se. 5 E' ) 3 J' 4c1- `i) 2 i ) i Investigation per hour t f hr urn, 1 i 6_.. CCR .Lie_: 1 42 1 -II. ` II Elleznica1 Lii: :'3 q__, j1' L I S rx:. Lie. .t� , s( ,` ' industrial plant per hour I I 73_75 1;t ELECTRICAL PERMIT FEES .'`nst r . _ Eiec ric i'alt sig rinur se : en'r d: :\ , ,. .>1 / y l e 'L t.tiU �t � e �P/L �%,� Q� Subtotal: la 9 Print name: 1 t i?.tte: /� Plan re iew (25 of perotit fee): .�L✓� fAA J 1 State surcharge (12% of permit fee): 1 thorized signature: TOTAL PERMIT FEE: I Print This permit application expires if a permit is not obtained within 180 i name: Date' days after it has been accepted as complete. * lict nbes of in pections allowed per permit. I I 'enudthe s'.enriri ?- Prrnan&ap:iln_ . 3tsrI' 400o25-aiii, /tn.a"Lnta1UEM