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Permit q CITY OF TIGARD ELECTRICAL PERMIT ; '7 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00296 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/17/2009 Parcel: 1 S133DC10000 Jurisdiction: Tigard Site address: ,13135_SW SHORE_DR —, • Subdivision: Lot: 0 Project: Vincent • Project Description: Install /alter (2) branch circuits. Owner: FEES VINCENT, MADELINE C E Quantity Description Date Amount 13135 SW SHORE DRIVE • 2 crt Branch Circuits 06/17/2009 $53.50 TIGARD, OR 97223 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 06/17/2009 $6.42 Electrical Contractor: PRO CIRCUIT ELECTRIC LLC PO BOX 3948 • WILSONVILLE, OR 97070 PHONE: 971 - 563 -8211 FAX: 503 - 266 -1349 Type of Use: SF • Class of Work: ALT Type of Const: Occupancy Grp: Total $59.92 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,Q100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. t^� Issued By: VM_C)CE A l X �._� /1,3 Permittee Signature: /V ti J(1 �• OWNER INSTALLATION ONLY 11"" Y " 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. • Electrical Permit A licatio CEIVED City of' Received ' FOR OFFICE L K ONLY ' • ; • 13125 S W Hall 503.639.4171 l blvd., Tigard, UatuEy: I Permit No � � c • G00% P F 5 598 94 16 2009 7 Pl an Review r ! c n 1t Inspection Lime: 503.639.4175 Date/By, Permit: Internet: www.tigard- or.gov Date ®Seepage 2 or OF Notified/Method: iC Sup pk menta I I aG on TYPE OF :1: DING 1 ❑ New construction PLAN REVIEW �Addiiion /alteration/replacement Please check all that apply (submit a sets of plats nfirems checked below; ❑ Demolition 0 Other: ❑ Service or (cedar 400 amps or more ❑ Building over three stories. CATEGORY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards. Mar exceeds 10.000 amps at 150 volts or ❑ Floating huildings. tess ]- and 2- family dwelling ❑ Commercial/industrial p Accessory building l to ground, or exceeds 14,000 ❑ Comrnacial -use agricultural Fire pump. rallathc iastallations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: 13 Fire pump. ❑ Installation of75 xvA or JOB SITE INFORMATION AND LOCATION ❑Emergency system, larger separately derived syst Job no.: f ❑ Addition of new motor load of ❑ "A• "E ••1 -2'•, °I ". Job site address: W e P, 1001 - if' or Mort. oamp,aoy. ❑ Six or more residential units. ❑ (recreational vehicle palm. ��� ❑Health-care facilities. ❑ Supply voltage for more than Suite/bldg. /apt no.: Project name: OFiarrrdous lot Lions 600 volts nominal. ['service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE New residential single- or multi- faa dwelling roe,( Subdivision: Includes a ttached garage y unit. • Tax ma Lot no.: 1,000 sq. S or less ��_ 4 plparcel no.: Ea. add'I 500 sq. R. or portion 33.40 l DESCRIPTION OF' WORT( Limited energy, residential 1111 C (with above sq R.) 75.00 2 � Li mited energy, multi - family ._ ����— residential with above .. IL) Ill 75 2 Services or feeders installation, alteration, and/or relocation PROPERTY OWNER 200 amps or less 2 ❑ TENANT 80.30 201 amps to 400 amps _ Name: ,r . 1_ J � r 11111 106.85 2 t^i•'t'/" 1 _ ' 401 amps to 600 amps En i 60.60 2 Address: 601 amps to I,000 amps 240.60 r 2 Over 1,000 amps or volts MI 454.65 2 — Temporary services or feeders installation, alteration, and/or Phone: ( ) relocation Owner installation: This installation is being made on property 200 amps to or less 66.85 ] intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. not 201 amps to 400 amps 111111 10030 _ 2 O wner signature: 401 amps to 599 amps 11111 133.75 2 Date: Branch circuits— new, alteration, or extension, „ r t : net ❑APPLICANT A Fee for branch circuits with ❑ CON7 AC f PERSON above service or feeder fee, Business name: each branch circuit 6.65 � Contact name: B. Fee for branch circuits without service or feeder fee, eAddress: fi t branch circui Each add'I branch circuit 6.65 11111111111E11 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( Each manufactured or modular III dwellin •, service and/or feeder 90 � � Reconnect only 66.85 CONTRACTOR Pump or irrigation circl e _© Business name: s Sign outline lighting 53.40 MU EMIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII .L 7 Signal l circuits) or limited - - Address: MP energy panel, alteration, or extension. Describe: Page 2 City/State/ZIP: i i Q Q^7 Phone: (q71 ) �' l [, Each additional ins , ectioo over allowable in any of the above • • Fax: (5b 4 Per inspection 62.50 CCB Lie.: 1(0 . Z El r Investigation per hour ( hr min) - ; Electrical Lic.: 62.50 _. _ � L S uptv. Lie.: 5107. S ]ndustrial plant per hour 1111111111=11111111 Alemmiiin Suprv. Electrician signature, required: Subtotal: nalll Date: review (25% of permit fee): Authorized signature; San Z State surcharge (12% of permit fee): TOTAL PERMIT FEE: • • Date: This permit applicarion expires if a IABoUti lP da •s permed in not obtained n itbiq 180 arEalli as amnetiEt C -eo, tmnvv.doe a$/ -j/pb days after it has been accepted as complete. • 440.46 t5Tfrt/aSiCOMtwFg Number of inspections allowed per patait. -- Z'd 6VEL99ZE0S o )!noi!O did dE0 60 60 SI. unr q CITY OF TIGARD ELECTRICAL PERMIT ; '7 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00296 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/17/2009 Parcel: 1 S133DC10000 Jurisdiction: Tigard Site address: ,13135_SW SHORE_DR —, • Subdivision: Lot: 0 Project: Vincent • Project Description: Install /alter (2) branch circuits. Owner: FEES VINCENT, MADELINE C E Quantity Description Date Amount 13135 SW SHORE DRIVE • 2 crt Branch Circuits 06/17/2009 $53.50 TIGARD, OR 97223 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 06/17/2009 $6.42 Electrical Contractor: PRO CIRCUIT ELECTRIC LLC PO BOX 3948 • WILSONVILLE, OR 97070 PHONE: 971 - 563 -8211 FAX: 503 - 266 -1349 Type of Use: SF • Class of Work: ALT Type of Const: Occupancy Grp: Total $59.92 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,Q100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. t^� Issued By: VM_C)CE A l X �._� /1,3 Permittee Signature: /V ti J(1 �• OWNER INSTALLATION ONLY 11"" Y " 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.