Loading...
Permit a CITY OF TIGARD ELECTRICAL PERMIT 111 .>, g-, COMMUNITY DEVELOPMENT Permit #: ELC2009 -00286 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171 Date Issued: 06/15/2009 Parcel: 1 S133DA05400 Jurisdiction: Tigard Site address: 12820 SW GLACIER LILY CIR Subdivision: Lot: 0 Project: Project Description: Install /alter (1) branch circuit for hot tub Owner: FEES DENNIS, STEVE J & DANA L Quantity Description Date Amount 12820 SW GLACIER LILY CIR TIGARD, OR 97223 1 crt Branch Circuits 06/12/2009 $46 85 wo /Purchase Service or PHONE Feeder 1 ea 12% State Surcharge - 06/12/2009 $5 62 Electrical Contractor: LIGHTHOUSE ELECTRIC LLC 27750 SW 95TH AVE # 109 WILSONVILLE, OR 97070 PHONE 503 - 582 -9600 FAX 503 - 582 -8484 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $52 47 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 -0100 You may obtain a of the rules or direct questions to OUNC by calling 503 246 6699 or 1 800 332 2344 / �,�Q Issued By: . l. ♦ f ,ltXA.,L Permittee Signature: C_- A 'no 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 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. ----7-4; 4° n U p i , \ d Electrical Permit Application Ii ..),'' tl 1 I �r��a1>I, t, 1 Ni / lc Iti t' i' t w l , . C l of i � alydl JUN 1 2 2009 n �rc/s d .. 14 Perrnlr Nn,; • 4• -040a9-(0 "' I3125 SW Noll Blvd,, TIgard.OR 97222 plan Review Phone: 503 639.4171 Fntc; 503,599, I460 Date/n : Otbcr, Pttmit; 1 K:i , Inspcetion,Linc: 503,639.4175 CITY OF TIG t� , yi,endy/By. ,it 0 St!a Pape 2ihr r, , , Internet,: tw�vtv,ti5nrd- or.gov BUILDING DIVISIt7,tNotifodime"d: T"( ( :' Supplemental Information TYPE OF WORK I'LA1sll REVIEW ❑ New commotion 'A\ Add ition /alteration /replacement Plen6e check all that apply (tabntit 2 , eFpl1nt w I n checked lrelnw): ❑ Service or feeder 4dtl emu or more ❑ Building over three stories, 0 Demolition ❑ Other; where the available fault current 0 Marinas and 17ont5mrdl, CATEGORY QF CONSTRUCTION akt:aada 10,000 antes at 150 %flit er Q Pleating buildings • tai to prou+tA, OT nxeeeda I /1,000 ❑ Commcro 11.1ISt= ;rgrier+ittlral ❑ I- and 2- family dwelling [,{ Commaroinl /indui trial L A,cccssory building amps for all other inatallationa buildings. © Multi- Iitmily I ] Master builder ❑ Other: 17 Fire pump. I lnstaltntion of 7S TCVA or 0 5rncc6Inoy system, larger nepannely derived nyvem, .JOB g1TE INFORMATION AiND LOCATION 0 Addition of new motor load of Job no.: Job sill addrras: (� 8O 5 C k *.4I r- to /t f (� jd si.,,, or eons. occupancy. ! ❑ six nr rnere re4irlentlai ,.n {rR, CI Rccrcatinnai vehicle parks CiIy19txrt4/ P; . 0 Realfh.eare {militias ❑i Sulrkaly voltage fkrr more than ❑ Kn rtdaua lomitiona. 600 volt; nominal, $$uitofhldg. /apt. no.: Project nacre; . 0 SCryiet oft *Mkt 500 stn tl nr MOM FEE SCHEDULE Cross street /dircctiOlis 10 jOb Sire: Eiemrl tiara '--. NA. Fete Total New residential single. or multi '.family dwelling unit. lneluden att:Riled . rape. Subdivision: S nyry7 e.ria ,� I Lot no.: 1.000 sq, ft, or less µ I45 15 4 Ea. odd l 500 so. ft. or portion 33,40 1 Tam Tem map/parcel no - Litniked mom, resident 73.00 2 DESCRIPTION OF WORK (with above eq. ft ) nn J ' Limited energy, inulti•family 71.00 2 (�i -��; --#�J/ ` 11..> ? 'f h -, t'eaiderltftll (with above sq, el.) Services or feeders U to rt an alteration and /or relocation 200 innps or less III 80,0 2 - - I PROPERTY OWNER © TENANT 201 amps to 400 shops 106,85 2 N 401 itrtt.s to 600 ant-s 160,60 2 601 amps to 1,000 amps 111 244,60 mil Address: . Over 1,000 amps or vefts 454,65 City/State /ZIP: Temporary services or tbt:tlers inetan1]at:ion. alteration, And /or relocation Phone: ( ) Fax: ( ) 200 amps or IS 66,85 1 Owner installation: This installation is being made on propetty property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and '701, 401 arrE to 599 amps 133,75 2 Owner signature: Gate; Branch circuits- new alteration err r tenaiow. a 'r land __ A. Fee for brafrch circuits with rj APPLICANT 0 CONTACT PERSON alcove service or Ryder fee, 6,64 2 Business name: each branch circuit _ II. Fee tbr branch circuits 2 Contact name: : wtthvut se rvice or Nadir for, 1/ first branch circuit I 46.85 7 �' 7 r Address: Each add'i branch eircuit 6,63 R Miscellaneous service or feeder not included CiTyl9tata/7TF: Rich mttrilzfnetttre or modular 90.90 MIN dwelling, service arxlier feeder Phone: ( ) Fax: ( ) Reconnect only 66,85 mil f�srrlatl: Pu or irrigiltion circle 52.40 CONTRACTOR -- _ Sion or outline lighting 53,40 ` 13usi racs5 name: ` � � �� � ,L energy panel, a a 1 or limited e/ energy panel, ulir_retiatg or Addre C� extension, D¢Seribc: Paget III 2 City /State /7,,(P: wi Sr'd �IL��4 fto1 Q Erich additional ins eetroir over allowable in an of the above 0 . 10 MIr Phone; ( l • - , h OD FIX: ( . / ) • -FY Investigation per hour (7 hr min) 62.50 CCB Lie.: 15 re? 7 Electrical i 'c - 5 i Suprv. Lie,: 3,0 5 s Industrial . ]art er hour 78,75 II Suprv, Eltotaiciao signature, require+` - ELECTRICAL S" RMrr• FEES S rr , �J ,2 Subtotal: . OAP Print name: , • Data; L _(z.,..e' Plan review (25% of permit fee : �� Stare vurcliatge (12%o'tpettrdt fee): Authorized sigrlatttrc: TOTAL PBRM1T FEE: Mt+I Print name: Date: Thia permit application exp re: if a perrnft is not obtained within t 10 - - - --- - -. days after Ithaca been accepted a, rhmtilttO, " Number of Inapecr {one allowed Rer perrrlit, itIIundingPerrnitntnr4 , normilAbo.deo 05/27/06 440.AAI TOO /nS /COMMIP)