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Permit CITY OF TIGARD PERMIT 111 s • COMMUNITY DEVELOPMENT ELECTRICAL ELC2012 00544 Date Issued 09/18/2012 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 2S111 DA09000 Jurisdiction Tigard Site address 8948 SW GRAVENSTEIN LN Project Wachsmuth Subdivision APPLEWOOD PARK NO 3 Lot 83 Project Description (2) branch circuits for hot tub installation Contractor OWNER Owner WACHSMUTH, TED K & STEPHANIE M 8948 SW GRAVENSTEIN LN TIGARD, OR 97224 PHONE PHONE 503 - 309 -4462 FAX FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 09/18/2012 $63 60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 09/18/2012 $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 0 ' 1 -0 i 90 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344 YAW Issued By '■_,.../1111kow. Permittee Signature /o 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 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 HVE Electrical Permit Application REC'JEi FOR OFFICE USE OiNL City of Tigard Date/By 7 /a Permit No �L����� _ 6:90 13125 SW Hall Blvd , Tigard, OR 97223 SEP 18 2012 _ Received 0 Plan Review Phone 503 718 2439 Fax 503 598 1960 DDate/By -' y Other Permit TI V A R D Inspection Line 503 639 4175 G'" ' d ��iA I Date Ready/By Juris ® See Page 2 for Internet www tlgard -or gov � � Notified/Method 76 Supplemental Information TYPE OF WO PLAN REVIEW ❑ New construction g Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service or feeder 400 amps or more ❑ Building over three stones ❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards CATEGORY 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 ❑ Other ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately denved system ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "l -3 ", Job no Job site address $Q y g S I C , 5TE ) , J I ,, ,,-- 100HP or more occupancy L . ❑ Six or more residential units ❑ Recreational vehicle parks City/State /ZIP 176,a a 2 q -) 2 - 2, y ❑ Health -care facilities ❑ Supply voltage for more than ❑ Hazardous locations 600 volts nominal Sulte/bldg /apt no Project name ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site pA(a,L aNy Te ti,u, ot L ' vt.'. -.1 Description I otv I Fee I Total I • New residential single- or multi- family dwelling unit. I N A (P LX PA 2- Includes attached garage. Subdivision A Pf o A ip PA a� Lot no 1,000 sq ft or less 168 54 4 Tax map/parcel no Ea add'I 500 sq ft or portion 33 92 1 Limited energy, residential 75 00 2 DESCRIPTION OF WORK (with above sq ft ) I I Limited energy, multi - family 75 00 2 A D iD 1 N 1-- l., - E1. CAA, cads A N h`r Q residential (with above sq ft ) Services or feeders installation, alteration, and/or relocation 200 amps or less 100 70 2 01 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133 56 2 Name "' W A gm 401 amps to 600 amps 200 34 2 601 amps to 1,000 amps 301 04 2 Address gq 9 8 S,,J ‘nA, ve")s - )1. LA ",E Over 1,000 amps or volts 55226 2 City/State /ZIP �! �n Temporary services or feeders installation, alteration, and/or 1 11-A no , ` t G1 �) Z Z Y relocation Phone ow ) 3 a 9 . LH 6 2 Fax ( ) 200 amps or less 59 36 1 201 amps to 400 amps 125 08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168 54 2 Intended for sale, lease, rent, or exchange, ac in ORS 447, 449, 670, Branch circuits — new, alteration, or extension, per panel Owner signature 7,Q_ Date 1 1 Z A Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7 42 2 each branch circuit Business name B Fee for branch circuits without service or feeder fee, first Contact name branch circuit 56 18 ��• 8 2 Each add'I branch circuit / 7 42 '7.42- 2 Address Miscellaneous (service or feeder not included) City /State /ZIP Each manufactured or modular 67 84 2 dwelling, service and/or feeder Phone ( ) Fax ( ) Reconnect only 67 84 2 Pump or irrigation circle 67 84 2 E - mail Sign or outline lighting 67 84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name f - AJ/ 1 4 - panel, alteration, or extension Page 2 2 Each additional inspection over allowable in any of the above Address Additional inspection (1 hr min) 66 25/ hr City/State /ZIP Investigation (1 hr min) 66 25/ hr Industnal plant (1 hr min) 7818/hr Phone ( ) Fax ( ) Inspections for which no fee is 90 00/ hr specifically listed (V2 hr min) CCB Lic Electrical Lic Supry Lic ELECTRICAL PERMIT FEES 0 Supry Electrician signature, required Subtotal .6. 1,6 Plan review (25% of permit fee) Print name Date State surcharge (12% of permit fee) 71603 TOTAL PERMIT FEE 7/ a3 Authorized signature This permit application expires if a permit is not obtained within 180 Print name Date • days after it has been accepted as complete Number of inspections allowed per permit I \Building\Permits\ELC- PermitApp doc 07/01/10 440- 4615T(I1/05 /COM/WEB ` Electrical Permit Application - City of Tigard ' - Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: j (RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other COMMERCIAL WORK ONLY:- `.„ 71 Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems *No licenses are required. Licenses are required for all other installations I \Bmldmg\Permits\ELC- PermilApp doc 07/01/10