Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00657
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/29/2011
Parcel: 25111 DB04000
Jurisdiction: Tigard
Site address: 9165 SW SUMMERFIELD CT
Project: KNITTEL Subdivision: SUMMERFIELD NO.8 Lot: 426
Project Description: (2) branch circuits for gas furnace and A/C.
Contractor: JACOBS HEATING & AIR CONDITIONING Owner: KNITTEL, MARTIN D & MARJORIE C
4474 SE MILWAUKIE 9165 SW SUMMERFIELD CT
PORTLAND, OR 97202 TIGARD, OR 97224
PHONE: 503 - 234 -7331 PHONE:
FAX: 503 - 808 -9108
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 11/29/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/29/2011 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 -161 -0090. You ma obtain a copy oft a ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.234.
Issued By: ��.7 Permittee Signature:
1 11116. . NER 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.
RECEIVE:
'
al Permit A 11"ti°11' FOR 0 FFICEUSE.ONLV
14 City of Tigard 0 it li Elf I ili .. .,„ ' u , :racz
_ ,
g I .1 1 1 5 SW Hall Blvd , T■le,111Y1, OR 9727.? 8 20
.
1 : • l'honc: 503.718..2439 F. 03.5i/S, I 91504T y OF TIGA , .12,11.e.'ilv. rms.
LO.SpatiOn Line. 503.639.-1175 ? f 1 ILDING DI Ru n,i1 [6:34;ay - ------- 1 0111g2 P 1 ,•"' 0 ,,,,, Pagt.' 2 (ti7 --!
Et OA ItD i , titur no WW
: w,I.ilild-Ovitos' VI'S/0 Norifilaalcsilui - ' ( _p1 LotT212I.JI2
—.----...
. .
" '!'. . . YPE: .or .wopg:::.„ ::;',•i:.. •:.:" . • , - . • .. • N.A.N 'REVIEW . — 1
„„----
--,-...
L'INJA1.2 t1.1 ;Ili I 4;1 k 41.1 (S11111111C 1 itt & Or plamiN I 01,04 11 1714107
0 'N't con:aruaion / , ' 17,Ailditiontislwrillicri/roplacenumt
LI s,:■•,:c+J ‘,, f 400 41111p or nio.:■.: 0 Boil log o VS: 11
0 i)CtIlUil I fail /- 0 Other wliactlipsiviiiit,i)fc ilault CUT1 0 111lliAS i:ia,111,;,11),"41‘14.
• .. ...: h m ia , g
:.PKEEPP4V.10:;cP.Ns,DP.Pc.':c4,9:1;i"... .. . : ,•,::;.! L,, ... ...,,_:, , .,..ds .1o,w)(1 amps aL 1 '4 O, MI 0 Flo:vi; b,1,1,,,
1LL i.olgOurid, kl:It:Crtds I -1,00D 0 CaLT:4141041-tp4 uiziLillutz,1
r ,-. 7 1 .1 ::;01t1 .- -'-tionily dwelling El Conuner4;diinalusirial 0 Acccsory building ampt fug ail 0147 imt:Illigions buclduir
71 0 NI,,[ti.lhrrill 0 Awtt:r builder 0 Other. . 0 rtrc 2.Lnp 0 tittiallutma of 7'5
. . .. ' 111,n61'10.• i).&tqcr, 1,Ir',4;.: 4;pai.;;,:.1 ;.1,:riv a ..);■:::1'il
• f ------ 7 :::7'.. n .. '.0.B :4141,,i7i7.1.4,60 0 Et
5$4. . :: " ::i:::,.....•••': •• . 0 Addition C;1 E/C1.4' 1,;11(1 !I:c.ry ■jf 0
r I 1114-11' ur litorc. kli,;(:;),A1W;'
Job sire address: "`-'1 / (,,,,_ „..] ta,j '.,,,,,L,L,p1 v .;„ , .. (4;1 C " u sb or mulio ,,,
fv.i..v111...11 mills. .1:) R4qt.,;;;;1 ‘ Ali lu pal k;;
i t" - ------...--
.
1:11 ruciline. ID S'Illuil vd/la•,:v ii:J ulut,;. II.JJ;
CilyiStaluiZiP: . 1 --- ,,C. , \ t . t"::) .1.,, ("'" — 7 ,;2_, Li
__ ,......,....____ ___,,, 0 1.1:1.esnlosr6 local rol 4 6(11) volt.: lionliciai
FAIiIl2/1)143■01. 110.: t -J ,.,,, IP1'021,1 Milne: 4, rl , - •" , ( 1:1$.o.vi“ nt fegrler tilio .iiiipi ut MO c e.
......,..,..,„.., -...-..................,....-
"-- - " ....:!.. '.] 4' ''.;:.' ''' . ' BTE SOLE:1)111:;E: . .. .
1 Csoss sireot/dircenemi to job shu:
DIACli II.;Op
r
------' Nov YcSidoissialsIsrgie:(1r lou:Iti-fa,saly dIrAliss;,.. Jaiii.
. I Isccludul a iiaelied tvrite.e.
•
-- ----, —,-, I,
i Subdivision: I . G004 4. 11., or less
,....,...._ r i t•-,s
, ,...,
_....„.....„...
I 33,92 I! 1 1
E. adO'l 1:10414, n. us pumun ;
--1
I ‘1":04. tn.q.iptireel no,:
Liznitce energy, resirioititti
75.0o1
1 • " . 1 ? I gSc419 -7- 70N Qlf0Y,OgKl!..:" :':' • : ':.. ::1% '.... ''.: . ' .:.:..:; (witli it i 1 ...._.. .......__ ,
l I 7
Limilot1 energy. Inti:ti.ramily l
5 k 2
r
I:. C,_ L:fk-,. r \ fn 74 I-: _...._ susido onilii thuvu sq It ) I
-- --
Servters or fq..k((lorrs insoulla non. alteroliun, antlior rriq
CC (2.01C(.. l s S n, . r
. 00 amp or 11:::6 1 i 00
7-7 . PR oPEaTY:.0wN.Pt . •:. • :••• !.::•‘•"':•• ..: ..:-..! :a ATPANNT • , • :, 20J ;LgIrni Il) 400 amps [
i .....,...
r------ .•..),,, - , 1,./ ' .1 ;ono:: to G 00 alus 1 200,11 '.-- _
------ 1 2
i N ; IL( ( 4- Nv '--1 Y 01 Y \ e_, r , .e -1 VI L 4+ e s 604 imp & tu 1,0D0 amp:, I V21.D.4 I 1 2
- ---- 772
AilLiTe:
OVV1 I .000 111111)26 a ■(.111 1 ! Sn.2L I : 1
Li:6J'SL;':kv./Z1P.: --- , Teceporitry service s. (It feeders insra,mr o „ti ut
relocation
--- , .
Phone,: r` .1 ( 2 I t 6 - ,t," LI t F. It ) . 200 woos or less I . ..L . _ 3 0 IL U: I
201 aniN to .100 amps _ , 123
1Z;;;;;;;Tr tallitri an: This in3ialtatioa Iteingrnatju on property dint I (PA Cl 1 i ti riot
1 I 162 ; 2
I iinunticd 'or sok, lerk,5c, rent, or exchange. according to ORS 4147, -149, 670, luta 401 Z11115 Co 59qamps 7
701. .. . —
Branch cirellitS .. IILIV. 31 te ratilni. or cstension..11cr timid
Owner signatule: Date; ___ A. Fud for bssmok eircults with
....
.0:.: ::.: :, : .. : : . : 1 '• . , • CI:c,;(0;itx.c:T"II.1{.40N . :; • . ,..:..... zibov.survice or feeder for:,
7 ..11 .,
. . .. .. .
=it branch circon .
LI ustates;r name: B. 1 u‘• fur branch ircuil withJhr
,,,„,,, --_.....„.....,.,,,,_-__ Strvi4 or fri:clul 1:..v.
CrAin tat I na Mu; branch 11 , . :it'. :s !::.''
„
.,
- ----------------- Each aLl'I braid) cocurt
1 Addros$: ,......... ____,
, 1 lisctfla ticous (herviel or feeder nor 414,1ca} _
-..^- - - . --„ ..,
alth Mat141;:igkared or n;040,147 J
i City' StatetZIP:
7,s.. i = 1
dwellin .. Unice amliat reerlet i
r PlIone: 1 ) I.ox. : (
- 1 . - ) Reconnect. only l 67.$
_ r . TF,
„,.,_
...,...... - -- .. Pun:, a irrigion, c.1“:1q 1 I 67 s.1 1
; Li-mail:
-,."'"'"7.7"."....-- 7 Silo ur uutlineliglitin I 61.84 •-$ 1
: , ONTILIAcTOR . , , ,.,.;•,.,,,,........:. : ,• .
. ... -,'....';:'• •.•'•••••.• • ••••••.-• • •• • . , Si4l1lo1 Citcuil(s) or Ilmiludustagy
0 ,'.1 /‘ , atia alit:ration, or 0510(1010(5. Paw 2 .1.
8Li"S'; 1.411" 1
: ;" \CR--; ' ''"r"N\ T.' ',"."'''' t''' C-47-1\2\-L17..,,,..'' p
' 1 2. — f \ ' Loch luldti)onsil inspiminst uvrr allowablv ill any of ilullibovc
17ddivgs,41/12., Ll ' i. t,kj :. )44it ',,.„ Addikono] 4)4v:cam (l li: min) L 1 ,,,,,,--,..,...... 77)
... ,...___
i„t,,,,.,,,mt (, 1; ruin) _ I
i City,'SUtofZIP: p . ..,:. ,,,,2,±,L
Incluatritd Muni rt h'r mill) 1 i 7S.1 /
_ , .
., Phu= (;572: ) ,3 - 73,3 I Fox: (1 "ii 'fls, -i .,. o .,s' 1 1„,„,,„„.$ ,,, ,,, n„ pr.7„
_.
1 ...),, ,.„„: „, i
, . , ,p.ific.th. li,w4 ,'.'s kr ithoi I [
,' :. • : *EiEC,71tICAL PER-NUT trcr, ...
- -
2::" 1 1 , gubIQUII: { - •) - (2' C'
I (2
'4e ' - ,.,. .. .. _
,),....... . , . .., pl:,,,,..i.,,,v 3% of pcnnil i'oe):
j
.......2 I:de surd-u (12% or permit 1=1'
Atillarrii
?riot name: J. „ c , „,.. (... ,i.'.., ,...::) - , : :- in k 1 ' : ,, i
od signatur: .,....ii---4
TOTAL PERMIT FEE: ' i , 23
,
■ ,. - kl,,s' —...........-,
. Tisii siefoul applicitioJI iss.pirc it. :i purnir hum ciElmilivif s 181 -2
Pril9l mac; 1 M y, 'S--k-•&_ `11±trr:-.,-,7 i'i _ ____ __ _
Dar:: 1 ,. k i . , • dap, arm il hos IN.vil ll‘Cupled us cum plutv.
-..........-.,
.".0 i
, d. ,, ps•l:LI■1/;> alloo.cd , 11:71,11,t,
....
I 1 07.1:;i1
4 ; i.V51.(.1.5.1,WEil
90/Z0 39Vc1 ONIIV3H seoovr LSZEET8E09 60:1T TTOZ/8Z/TT