Permit CITY OF TIGARD ELECTRICAL PERMIT
III s COMMUNITY DEVELOPMENT Permit #: ELC2013 -00005
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/03/2013
Parcel: 1 S135DB05600
Jurisdiction: Tigard
Site address: 11400 SW 95TH AVE
Project: Galinat Subdivision: MILLER Lot: 9
Project Description: (6) branch circuits for kitchen remodel
Contractor: PRECISION NW ELECTRICAL Owner: VIRTUE, LISA R
12020 SE ANNA CT GALINAT, RAYMOND A
DAMASCUS, OR 97009 11400 SW 95TH AVE
TIGARD, OR 97223
PHONE: 503 - 413 -9870 PHONE:
FAX: 503 - 594 -2873
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 01/03/2013 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/03/2013 $11.19
Type of Use: SF Electrical
Class of Work: ALT •
Type of Const:
Occupancy Grp:
Total $104.47
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 OA 9 2 -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
LL
Issued By: y Permittee Signature: of A 1. f Ll e 4 n U�
/( 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.
01/02/2013 21 35 FAX 5035942873 ��,'f-t,(' D NW a002/002 Electrical Permit Application `+�� jjJJ
roiton1( :orq.1
JAN 03101
City of Tigard Received 3
t , " 13125 SW Hall Blvd., Tigard- OR 97223 CITY OF TIG • a I °'t`'Bv • Phone: 503 718.2439 Fax: 503.598.1960.
TI R. tit, Inspection Line: 503,639 4175 DUILDINGDN; IS f. otlgt Permi`.
Internet www tigerdor gov , Puri.
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..10,44 1 S .(:,.a ldR • :.13a"Y;;y16p,i11.1. f.41 , ,,,. :. , �,.. . - ti, � .v ' ; ' .F . uu •. :.;.•,....
❑ New construction Addition/alteration /replacement M. .lt- �.,,..,;.,vG�jl }: check �a u b :i x ' . , i o � pl:n e ms a t low).
.
t subla,l � sets Of plans w /rtem� i
Demolition 0 Other
D
Ell Service or feeder 400 amps or more ❑ nu0ding over three storms
i 7 rA lid tilt' r we the available hunt current
I w`1'..t...41•.tlt�' MEII'1. `w'1""I i r .i r ; Mt .x ', :xt a . ,;w .' fi "!'z t41, ;r . exceeds 10,000 am x a t 150 volts 01 CI Mamas and boatyard:.
.. :. -: N....:- .:xt,t' '• P ❑ Floating ia•u a buildings.
1- and 2- family dwelling • Commercial/industrial ❑ Accessory building less m ground, or aniseeds 14,000 El t :ommcrcial. use agricultural
amps for all other installations buildings
f 0 Master t i
� M
0 ulti-family ^' �a+a.tit a t� H ` r l t f _ � Other: ❑ Fire pump. CI installation of 75 KVA Or
1ladislll '' ....ern t wt o r iv ? I w1,1 14tu t / s ill / „, ❑ Emergency system. larger separately derived system.
�. a v n . h nw... ".. a t!lr ,a ° , I , S” wp %v , r.. , , :x, ' ltr t ❑ Addition of new motor load of
CI "A ^. ••F•• "t -2° °t -t••
Job no.:
Job s a r c
1t( S i .}� #ate � 10Ultp or more. occupancy, 11
City/State/ZIP: 1 t • �'WV ` I• � ❑ Si: or more residential units ❑ Recreational vehicle parks.
❑ Health -care facilities. 0 Supply voltage for more than
Suite /bid /a l no.: ❑ Ilaxatdous locations. 600 volts nominal.
$ P - Pro ject nails' ❑ Service w Pcedor 600 ampr m mare.
— Cross street/directions to job site: I'd
D 1 jllr;l, p , ,• r ua��+' +I `�� r V Si n t 4 f " l y jw� , ! S�rr �y�!��+r�*•'�
` aeri. Poo 1 �.. `''A�'".ti •
"" New residential single- or multi-family dwelling unit. ter,/
Includes attached garage,
Subdivision: _ Lot no.: 1,000 sq ft. or less 168.54
Tax map /parc no.: Ea. add'I 500 so n. or n
r portion 33.92 �O
nw• •• t ::t'�t G. w;.r7 Rtryyt S r . r; ,{,�Iy,. n ,.,,.. .
1151.Jc• ;Of "t liica ds�r :z. . ; ,. J * .�.,.. `S.kJ'ki , t' hrn 161 ? .. ' i `1 n . ° 'h' Limited
o e . r - ft enual 1X1
NtlL i ( ab In 75 111
Lim energy, nr multi-family above •.
V./v..- 1 �> t ide i
Ic ar with above s., ft) 75
Services or feeders installation alteration and/or relocation
"UaC!�F+r " 1 v P M a r 200 amps or less 100 70 2
it; :is_ ii ..' � • i rtmh� ri .in r ,� ee.k >wz ,..,, v r ......It: y Y ; 1 :11 201 amps to 40o amps 13
Name: Ci4S's(� ^� 3.56 2
l�r S 1 t 401 am
to 600 amps 20034 2
Address:
601 amps to 1.000 amps 301.04 2
Over 1,000 amps or volts f 552.26 2
City/StatcJL1P; Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 1 Fax: ( ) 200 amps or less 5936 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1 25.08 2
intended for sale, least, rcpt, or exchange, according to ORS 447, 449, 670, and 701, 401 amps t 599 amp 168 Sa 2
_
Owner signature:
DAIS: A Branch
F ee t r circuits c new
ircut t: with
alteration, or extension, , cr psis/
6"7 •lya:.1.r wnr�w �� e . . , Pee for branch c
A P circuit:
( d a above service or sed tee
. ✓ : :. il4f"y.y. , Lwl.x;+e ... h"r�4 huCN`a y, :s" rL.9rt, _.x•:r ....s>t '' .L.i ... each service
circuit 7.42 2
Business name: B. Foe for branch circuits without
service ❑r feeder fee, that
Contact name: branch cirmsit 56.18 Mill
Address: — Each add'I branch circuit 7 • Al 2
Miscellaneous (service or feeder not included)
City /S(Ale /ZIP: Each manufactured or modular
67.84 2
dwelling, service and/or feeder
Phone Phone: I h•ax:: ( ) Reconnect only 67,84 2
( )
: t� iU7 j ! µ {��y,y ` { 1S Pump or irrigation circle 67.84 2
!':fit. `t'u`t „r +NN rl : liit"t% "w"I ,•.s.v.o:.0 �ILC:.,:. , ti0.t ?1;ate Ciw'�...I'�i: r +! fli .�'f�ji,e. a dN l "t+ Sign ia' circuit(s) (s) lighting 67.84 2
ss• "` � k .i „e: .: i. >u t 1 . :., Sigma/ Cireuil(s) or limited- energy
Business name: Le St 0 V S.A eA V 4 �. panel, alteration or extension _ Page 2 2
�}`� Each additional Inspection river allowable In any of the above
Address: I s� �� Additional inspection (1 hr min) 66 25/ hr
City /State/ZIP: IN Cv{ C etlO c . Investigation t hr min) 66.25/ hr
i �'"J Industrial p lant (1 hr min) 78.1181 hr
Phone: (' J7J 4 -cilaR U Fax: (T VS ) c ct i -t 1 3 Inspections for which no fee is
s ctflcall listed ('h hr min) 90.00/ hr
CCB Lie.: Ito 3 Electrical Lie.: � Suprv. Lic. 3 4 ;ia, i , iti 1. GlG11 .... "`" I , '�! ..'° ii�� i ,i "n
Suprv. Electrician signature, required: Subtotl. �r�
J Plan review (25% of permit fee):
Print name; Date: --7� State surcharge (12% of permit fee):
Authorized signature' TOTAL PERMIT FEE: 12_1. I V I
C ,, .i[ J■- "-c ma permit apdicattoa expires if a permit is oat obtained within 1n0
Print name: �1 �i.ze p . _O C J Date: � j `Q days Lions it has heels accepted as complete.
°. • Nwnber „f inspections allowed Per permit �/ �f
I \P, LC- ft mn App.doc 07/01 /10 440 -46! 51111.fit COMnWEE /0
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11400 SW 95TH AVE, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
03/20/2013 00:00
ELC2013-00005
PASS - No C of O
Garage blocked at panel , outlets etc
Violation Summary:
Inspector Contractor