Permit i • !�
rt CITY OF TIGARD ELECTRICAL PERMIT
III 1. - COMMUNITY DEVELOPMENT Permit #: ELC2010 -00054
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 1S134CB12800
Jurisdiction: Tigard
Site address: 12290 SW MILLVIEW CT
Subdivision: MILL VIEW Lot: 28
Project:
Project Description: (2) branch circuits for washer and dryer in garage
Owner: FEES
CRAIG, PHILLIP & JENNIFER Quantity Description Date Amount
12290 SW MILLVIEW CT
TIGARD, OR 97223 2 crt Branch Circuits 02/03/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 735 -5658 Feeder
1 ea 12% State Surcharge - 02/03/2010 $7.63
Electrical
Contractor:
ROSS ELECTRIC INC
2870 SE 75TH AVE #203
HILLSBORO, OR 97123
PHONE: 503 -642 -2800
FAX: 503 -642 -5815
Type of Use: SF
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 OA 52-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 rr or 1.800.332.2344. , /
Issued By: Penittee Signature: d = / ��L�� �% -O r V
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 603.639.4176 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept In a conspicuous place on the Job sits until completion of the project
Approved plans are required on the Job site at the time of each inspection.
02/02/2010 13:00 5036425815 ROSS ELECTRIC INC PAGE 01/02
l RECEIVE :r
Electrical Permit Application FOR OFFICE Ii ONI.,
City of Tigard FEB 0 2 2010 nay z 3 /o Permit No
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Ea'aoio 7000.53/ Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TIGAR I! °at°Th ' Other Permit:
T I c A ir I , Inspection Line: 503.639.4175
Internet www.a�ara- or,go� BUILDINGDIVISI!I 8 ��� ,: j� S n taJ IJ
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ID New construction :' Addition /alteration/replacement Please check all that apply (submit 2 gars of plena w /items checked below)
0 Service or feeder 400 amps or more I:1 Building over three stories.
❑ Demolition ❑ Other:
? 6
+ j y; „u t a. w � '?I" tr' ^ r c 5 _' •ry s} w i s( y where the available fault current Marinas and
_ c at s , ,�� 7" exceeds 10,000 amps at 150 volts or ID Floating buildin �
ii ir -r •-•,.;,,,,., , - - t . . 4 . , ; " - .a., ..,._...... "i . , ..=,.._..,.>.. t Ions to ground, or car cds' 4,000 ❑ Commercial - use agricultural
1- and 2- family dwelling ❑ Commercial /industrial ID Accessory building amps for all other installation buildings.
❑ Multi- family [] Master builder • ❑ Other: ❑Fire Paull ❑ Instanarion of 75 KVA or
'tic "r - . , 7 ,, , -r r .Z-7.7-7,7'.7"--77:',=-- , ❑ Emergency system,
' `M -, : , ' r, c - . '$ ; 21 `( _ < c E i r y. r El' i t i t' r `�, larger d¢P i
r. - Lh... . 7 . , : „�c ?c:5. -..: .ci? .at.l.- ..4._, _.-L .... ., .. ., .- :?.�.'.n 'I%: E�. I Br y derived 1-3 SySrt
ti. ❑ Addition of now m otor t oad of ❑ ..q ^, "E", "I -2", - 1.3"
Job no.: Job site address: )).9 looHP or more. occupancy.
,c) 0 �vi Thh ' ` v c.No (-4 0 six or ore m residentiai units, ❑ Recroationat vehicle parks
CCity/State/ZIP: f r
,� , f4 U ,(hh . �-y. A7 ❑ Heeltb-care facilities
D Iiaxerdous locations. . CI voltage for more than
' Y 1 \ i 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: ❑ service or feeder 600 ton. or more,
Cross street/directions to job site' c . II .. ?
x r4 ''.' :' 1A -',., .- C s "A� pia
J e � 01 " �. /Y► 4 U r lti C--F : e w e .: rebel -sex :-
•
_ e °�� Qty. rem
New residential single- or meld - family dwelling unit.
Includes attached garage.
Subdivision: 1,000 sq.
Lot no.: g. R or less 1 145.15 4
Tax map/parcel no.: ^ Ea. addl 500 sq. ft. or portion 33.40 1
_ Limited
:�,. -" -, r --. a ' --ss.x - .,:-', .,- ; r •x - cc •�•- energy, residential
ti f rM bi.? a ._ ?'K : t� :E t , -` -' ; -' r . -".
a s�..,:, -� F� : :au r� C 75.00
� `^ � 1 �• h.lS � , . ... .k ,s:.ht. r, ,., �M�t S'✓'i ,--.'-".'4".•';`-' (withsbo 2
t of a Limited energy, multi- family
f V b Q walS 1'tQ)" ' r ( 1 acc residential (with above sq. ft.) 75.00 2
v Service or feeders installadon and/or relocation
�' �� • a _ 200 amps or less
l 80.30 L 2
s = 4:,_ ?., 'i s4 ...., M - ' u,. ,.tMi ;., . 4 - i�' '.51 .` x TM r 201 amps to 400 amps 106.85 2
Name: ���(,�� �Tt�N� � /6-- 401 amps to 600 amps 160.60 2
Address: 601 amps to 1,000 snips 240.60 2
. Over 1,000 amps or volts 454.65 2
City/ State/ZIP: Temporary service or f eeders installation, alteration, and/or
relocation
Phone: (Si 3) 73_.5- 5? I F ax: ( ) 200 amps or less 66.85
W t7 _ 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 surfs to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
.... , ri "� Z.:.: r . 'r A. Fee for branch errcults will!
7,a . �,- e ig;:.- ...r:,,,, ry t '.0 r a S � i ♦ 1 . _ •r � „ . '' ": >. above S0
,J'. n:, r r r, >2_,,. - i � �'e.W, . a- r ir: -:a n�_.... ?: t , x -- service or feeder fee 6.65
Business name: each branch circuit 2
-- B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 46.85 7 1 ,6 gs 2
Address: Each add'l.branch circuit I 6.65 E 1
City/ State/ZIP: ilIiseellaneou servlee or feeder not included
Each manufactured or modular
Phone: ( ) I Fax: : ( ) dwelling, service and/or fheder 90.90 1
R - mail
Reconnect only 66.85 2
? - Sz r r k a } x r F : �Y 1 M� Pump Or irrigation circle 2
53.40
• ,-
- - r a ., z - ;..`. . - , . ;-4 -� 7 .,. �r2y ti r :.,,,::..11-.;;;;,'1,4:--:::-- t:: 3 .: : : : Ol1t)mfllgllt7
,,�. � ...,, �� ` Sion or 53.40 2 I
Business name: Ross Electric Inc. Signal circuits) or limited -
energy panel, alteration, or
Address: 2870 SE 75 Ave extension. Describe: Page 2
City /State/ZIP: Hillsboro, OR 97123 Each additional in r eetion over allowable in an of the above
Phone: (503) 642 -2800 Fax: (503) 442 -5815
Per inspection 62.50
CCB Lic.: 157891 ✓ 1 Investigation per hour 0 hr min) 62.50
Electrical Lic.: 34 -436C I Suprv. Lic.: I /2328 '� / /� Industrial plant 'et hour 73.75
Suprv. Electrician signature, required: /l r f Subtota
F a '� i 5 f i: K _ � ;
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I.
Print name: Stephen Ross I Date: 01/15/2009 Plan review (25% of permit fee):
State surcharge (12% of permit fee): !' - - I �j , � W
Authorized signature:
TOTAL PERMIT FEE: � L
Print manic; Date: This permit application expires tf a p b note , d wtthi 80 0
days after it has been accepted as complete. • Number of inspections allowed per permit. )'
I: 10 uildinglPermlhr�ErF- PmnirAPPd aa5/23/06 430.4615T( 11/05/COTN/WEB / ' O t