Permit CITY OF TIGARD ELECTRICAL PERMIT
' 4 COMM DEVELOPMENT Permit #: ELC2009 -00332
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/07/2009 —
Parcel: 2S111AD17900
Jurisdiction: Tigard
Site address: 14826 SW JONAGOLD TER
Subdivision: Lot: 0
Project: Venturini
Project Description: (1) branch circuit for a /c.
Owner: FEES
BEACON HOMES NW INC Quantity Description Date Amount
12703 SW 67TH AVE
TIGARD, OR 97223 1 crt Branch Circuits 07/07/2009 $46.85
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 07/07/2009 $5.62
Electrical
Contractor:
BOB'S ELECTRIC
2700 NE BURTON ROAD #A
VANCOUVER, WA 98662
PHONE: 360- 254 -7200
FAX: 360- 254 -8219
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 ac 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. ATT TION: Orego N law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0 10 through OAR 95 01 -0 0 You may obtain a copy of the rules or direct questions to OUNC by calling 50 or 1.800.332.23.4. K � 1
Issued y: � �l � �1 Permittee Signatur- _� 1 , i� ' i C.) .
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' _ A .I // 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.
1 .• ` , 1 jj
Electrical Permit ApplicatioCEAVED " FOR OFFICEUS'E ONLY`� ¢ �r
'v�„d • M x §� �' - n � „ •mm'4?+sPTy,a w t"�+'� srn
City. Received of Tigard ��II II 0 1 2009 Date /By. 7 �� � • Y Nenm A Pert �C. ,,,160 ��33 .
- 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Phone: 503.639.4171 Fax: 50 3.598. 19 60 Date /B •: Other Permit:
TIGARD Inspection Line: 503.639 4175 CITY OF TIGARD Date Ready/By. B See Page 2 for
Internet: www.tigard- or.gov
WILDING DI
VISION Notified /Method: / ICS Supplemental Information
r s, - ` 'r' TYPE'OF =s. • „ PLANY REVIEW= r
❑ New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans wiitems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
” = "' CA_TEGORY OF " CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14.000 ❑ Commercial -use agricultural
ni 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations, buildings
❑ Multi - family ❑ Master builder El Other: ❑ Fire pump ❑ Installation of 75 KVA or
Emergency system. larger y derived system.
separately
' ) = ::>.i`JOB;SITE AND- - LOCATION . "` el .. ..
- ,., ' ❑Addiuonoi'newmotorloadot "A', "E ", "I -_ I - 3
100HP or more. occupancy
Job no.: 09-,.592 Job site address: 14826 SW Jonagold. Ter.
r� ❑ Six or more residential units. ❑ Recreational .vehicle parks
City /State /ZiP: i.gat d , OR 97224 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
-FEE' _SCHEDULE -,- - ; ^
Cross street /directions to job site: Description I Qty. I Fee- I Total I
New residential single- or multi- family dwelling unit.
includes attached garage.
Subdivision: Lot no: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
75.00 2
;DE OF WORK,.'- `); , ; (IN itli above'sq. ft.)
Limited energy, multi- family
75.00 2
A/C Connect ion - residential'(with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
- :PROPERTY;OWNERI ` ;: - r , i :',,, !; ;', 0, '.TENA . 201 amps to 400 amps 106.85 2
Name: M 401 amps to 600 amps 160.60 2
Micheal Venturini 601 amps to 1,000 amps 240.60 2
Address: 14826 SW J onago 1d Ter. Over 1,000 amps or volts 454 65 2
City /State /ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 1 66.85 1
Owner installation: This installation is being made on 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 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: • Date:
A. Fee for branch circuits with
: . :. -- ❑ APPLICA CONTACT_ PRSO above set ice or feeder fee,
F.7, < E 6.65 2
each branch circuit
Business name:
_ B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 2
, first branch circuit
Address: , Each add'] branch circuit 6.65 2
' Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone:
( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
<(' ' CONTRAGTOIi '•'' "''x«: II ;Is- 4).':r, ° Sign or outline lighting 53.40 2
Signal panel, or limited -
Business name: Bob's Electric
energy panel, alteration, or
Address: 2700 NE Burton Rd. , Ste. A extension. Describe: Page 2
1 I I
- -
City /State /ZIP: Vancouver , WA 98662 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 360) 254-7200 Fax: (r3 6 0) 254-821 9 Investigation per hour (1 hr min) 62.50
CCB Lie.: 531 3 6 Electrical Lie.: 37 4 31 c__.- uprv. Lic.: 43 2 2 5 Industrial plant per hour 73.75
r " ' ?.;, : : :,,.': :471:0 — CTRIGAL PERiVIIT ° :,. ,
Suprv. Electrician signature, required: / / __... Subtotal: 46.35
• Plan review (25% of pennit fee):
Print name: Kevin B r o s e l l e Date: � 25 � 0 State surcharge (12% of permit fee): 5. 2
Authorized signature: TOTAL PERMIT FEE: 52. 47
-
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
i * Number of inspections allowed per permit.
t