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Permit IN �. CITY OF TIG ARD ELECTRICAL PERMIT 1 - COMMUNITY DEVELOPMENT Permit #: ELC2013 -00234 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/25/2013 Parcel: 2S111AA04900 Jurisdiction: Tigard Site address: 8660 SW INEZ ST Project: Downes Subdivision: GREENSWARD PARK Lot: 25 Project Description: (1) 200 amps or less to upgrade panel Contractor: WINNER ELECTRIC INC Owner: DOWNES, T KEILY JR 5950 SW PROSPERITY PK 8660 SW INEZ TUALATIN, OR 97062 TIGARD, OR 97224 PHONE: 503 - 638 -5028 PHONE:, FAX: 503 - 638 -4242 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 04/25/2013 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 04/25/2013 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 -001- 090. You ��may / obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 11.8 Issued By: °�w"�' Permittee Signature: 010- / 1f 7O&L / 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. Apr.24.2013 01:07 PM PAGE. 2/ 3 Electrical Permit APDIicati ECEWED City of Tigard 1. Received i3 ll R 4 3 Pumit Nu.: 3� voa 35 ■ 13125 SW lido Blvd., Tigard, OR v7 R 2 4 2 013 Plan R Phone: 503.718,2439 Pax: 503.598. t natality. Other Permit: i I -, i 1 InepaCtit>tl Line: 503.634.4175 Hato Ready/Hy: RJ Sec Page 2 far T – Internet: www,tigard- or,5uv CITY OF TIGARD Notified/Method SuPPlemental Inibririmlan _ TYPE t14 DIVISION PLAN REVIEW ❑ New construction Addition/alteration/replacement ` Please °hock all that apply (eld+mit a sets of plans w /items chocked below)_ 0 Service or feeler 400 amps or more ❑ Building over three dories, ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Fluting buildings. :Elf I- and 2 - family dwe[lirtg ❑ CottltnerciaUtadustriel less to gmund, or exceeds 14.000 0 Commercial-um ricultural ❑ Accessory building ae amps for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑ Other: 0lire pump. ❑ installation of 75 KVA or © Emergency system. tarter separately derived system, JOB SITE INFORMATION AND LOCATION — _.______� ❑Addition of new motor load of ❑ ^A^ °p y.2 • ••1.3^ Job no.: Job Site Address: S �) iWHPor more. occupancy. -Vti e - Z ❑ Six or more residential units. ❑ Rexxeeatiewal whielo perks. City /State/ZIP: � ID Flcalth -care facilities ❑Supply voltage for mute than Q 'I ( J ` ^(� ` - `� ❑ Hazardous locations, 600 volts nominal, Suite/bldg. /apt. no.: 1 Project "MX - (- )AA :)\r\Q '--- ❑Service or fader 600 amps or more. ^ »„ FEE SCHEDULE Cross street/directions to job site: 1 I Qtr. I Few. ! ins 1 — New residential slunk- or multi - (sadly dwelling unit includes attached garage. Subdivision: Lot no.: 1,000 es- ft or less 168.54 4 Tax map /parcel no.: T.a. add'l 500 sq. ft or portion 33.92 1 Limited turcrgy, residential 75,00 2 DESCRIPTION OF WORK _ with above sq. ft.) — Context energy, multi-family i t (- 0 C\ii? _ ` (_ , � 1 residential (with above sq. ft.) 75,W 2 C3 ���� Renewable Enemy O See Page 2 Servicee or feeders tnatallatien, alteration, and/or relocation _ ❑ PROPERTY OWNER ❑ TENANT 200 amps or less _I 100.70 [0(0 2 " - - "" 201 amps to 400 amps �4 133.56 2 .Name; - - -. ,, ... .........__ 401 amps to 600 MIA 200.34 2 Address; 601 smog to 1,000 amps 301.04 2 City/State/ZIP: Outs 1,110) amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or Phone: ( ) r Fax: ( ) relocation — 200 amps or less h 59,36 _ 1 Owner installation: This installation is be made on property that I own which is not 201 amps m 4t0 amps 125.08 - 2 intended for sale, lease, rant, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168,54 2 Owner signature: Date: Branch circuits -- new, alteration, or extension, p er panel ❑ APPLICANT 1 ❑ CONTACT PERSON A. Nix: for branch circuits with - Business name: above service or (ceder fee, each branch circuit 7.42 2 D. Fee for branch circuits wallow Contact name: service or feeder fee, first 56.18 2 branch circuit Address: Each add'1 blanch circuit 7.42 2 City /SteteJZiP; Mlacellrncooa (service or feeder not included) Each manufactured or modular 67.14 2 Phone: ( ) Fax:: ( ) dwelling, service and/or feeder E-mail: Reconnect only 67.84 2 Nap or irrigation unite 67.84 2 CONTRACTOR Signor outline lighting v 67,84 2 Business name: S' j \ v\ y e l,� -_._ rr`� \.e_ c _A_ , ` G rgrud circuits) or litnithltnemgy satin, alteration, or extension Hags 2 2 Address :S c 5 1) c- ,. • c. . a ., . t~ ` y ei - � Each additional inspection over allowable in any of the above t� Additional inspection (I hr stun) 66.25/1u City/Slate/ZIP. TUC C3�k \ V\ Q -. ee �"l0 to ,_ htvestiga ' 4� _ tian {1 hr Min) G6.2S/ hr Phone: - C 66 3) 6-, (6_, S 0 . 4 c, Pax: ( 56:3) 6-55S , t- \'a t-. industrial plant (1 hr min) 78.1 R/ hr btspeetiams for which no fee is y0. W/ hr CCB Lie.: I Lt.-tC1 L Electrical Lic.:'si.,t - 5C ( Suprv, Lie.: S specifically listed(% hr min) ELECTRICAL PERMIT FEES Sultry, Electrician signature, required: / . v i L ,(A)c - t- C Subtotal: I l oQ ,,'1 fU Print name: p aw: Plan review (25% of permit foe): I. ��L / `d `� —' k State surcharge (12% of permit fee): I' o c6 Authorized signature; _ TOTAL PERMIT F RP: F \'1 r1 r� Print name: Date: This wadi application ea been permit is not obtained wIlb i tM stays accepted as complete_ • Number of inspections allowed it Ivor permit. r:varatteRUensatgti_Pereaeapp Mtnra.auc ua- aorsrtrtrosnxuttVEn Apr.24.2013 01:07 PM PAGE. 1/ 3 Winner Electric Construction, Inc. 5950 SW Prosperity Park Rood; Tualatin, Oregon 91062 Phony (5031638 -5928 - Fax (50318384242 FM COYER SHEET Numbers of Pages Including Cover: 3 ToCAAA,s ccl AWN; eC f' \ 4 J VNA.VVS Fax Number: Cr5, 5c($ - ' Firom: D ( . Regarding: cb 0 - 5 LO k-k(\WW4 CCU 14194 - Oregon License #: 54 --15OC Washington License#: Winnoo*05ON5 �� 9090Vi et n` W®: www.tvhinorelestriamos