Permit t CITY OF TIGARD ELECTRICAL PERMIT
'PI COMMUNITY DEVELOPMENT Permit #: ELC2013 -00247
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/30/2013
Parcel: 1 S134DB01200
Jurisdiction: Tigard
Site address: 11015 SW 114TH PL
Project: Thrasher Subdivision: WINTERS ADDITION Lot: 6
Project Description: (4) branch circuits for kitchen remodel
Contractor: PRO CIRCUIT ELECTRIC LLC Owner: THRASHER, HAROLD DEE AND
PO BOX 3948 KOVAC, LISA THRASHER
WILSONVILLE, OR 97070 11015 SW 114TH PL
TIGARD, OR 97223
PHONE: 971 - 563 -8211 PHONE:
FAX: 503 - 266 -1349
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 04/30/2013 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/30/2013 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 5 -001 -0 90. You ay obtain � a copy of the rules or direct questions to OUNC by calling 503.232.1987 1.800.332.2344.
Issued By: � -wl Permittee Signature: PU c 4-11 0
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.
Electrical Y ___ ;. it A nligACEIVED
City of Tigard FOR OFFICE USE ONLY
R
• 13125 SWHaiI 131vd.,'fi Tigard, p
* 2O 1 3 Received �Q /
Permit
C Phone: 503.639.4 17J Fax O R 9723 Date/B : Na: E r i 3
II 5 03.598.1960 Plan Review V r� LZ7�4/
TIGARD inspection Line: 503.639.41 CITY OFTIGARD
Date ay.
Internet: wuvw.ti QtterPe:rni':
— Pard- o r.goV Dalc Ready/13y:
e
Juripc I ► G DIVISION NoIificd/M
elhod: -�/ Ed Sec Pale 2 for
_ TYPE OF WORK Supplemental Information
❑ New construction PLAY REVIEW gAddit ion/alteration / replaceme
0 Demolition
check all that apply (submit 2 gds of plans w /ilerns chcd ed below);
0 Other: ❑ Service or fonder 400 amps or more El A.TEf: where the available f Building over three stones.
ORY OF CONSTRUCTION at& current CI Marinas and boatyards.
PI 1 -and 2 - family dwelling to ground, or exceeds 14,000 Q Commercial/industrial exceeds 10,000 amps at 150 volts Cr
❑ Accessory building 0 Mooting bal -use agricultural
a-
0 Multi - family _
, 0 Emergency system.
larger separx derived sysreo
amps fora!! ❑Commercial -trsc bural
❑ Master builder Other: P otter installations. buildings.
JOB 511-1E INFORl41ATION ❑ Fire pump. ❑Installation of 75 KVA or
AND LOCATION
❑Addition of '
Job no Job site address: I r, slew motor load of
- 100F1P cr ❑ ore ❑ ,. ,.1 2 i j„
City/State/ZIP: g. PL. occupancy. ❑ Si x more residential or un i ts 0 Recreational , mhick
0 Six or puke
Suitt /bldg. /api. no.: care facilities. ❑Supply volt fee
Project name: 1 0 Hazardous locations. T ore than
- 600 volts ncmina'..
Cross street/directions to jolt Slle: 0 Service Or -i der 600 amps or more.
FEE SCHEDULE
Bac ri.iiou
New residential single- or multi- family dwelling nit.
Subdivision: Includes attached g
•
Tax mapiparcel no.: id
Li Lot no.: 1,000 sq. Q. or Is
168.54
Ell
Ea. add'! 500 sq. ft or portion -�
C �� DESCRIPTION OF K'OR[C Limited ener residential 1
r— . t 11111 67.
I
r C+� f ` [� with above 2
I r _1 1 _� ��� , L energy, mufti - family
residential with above sq. (I.) 67.84 2
Services or feeders installation, alteration, and/or relocation
IR PROPERTY OW YER 209 amps or less
Name: �— ❑ TENANT i 100.70 2
� 120 t amps to 400 amps
133.5G
401 amps to 600 amps
Address ` 200.34 2
601 amps to 1,000 amps
Ci[ylStatrJLIP: Over 1,000 amps or volts 301.04 �
!'hone: ( ) ear: ( ) Temporary services or feeders installation, alteration, and/or
relocation
Ow ner installation: ' This jnsta.lation is being made on property that I own which is not 200 amps or 40C a mps -
intended for sale, (case, rent, or exchange, according to ORS 447 _ , Date 449, 670, and 701. 401 amps to 599 amps 59.36 � 2
201 am
Owner signature: 125 as 2
168.54
Branch circuits- m
new, aftetion, or extension, Cr and
❑ APPLICANT �-- A. Fee for branch circuits tvlrh
❑ CONTACT PERSON 3us name:
�L about service or feeder fcc,
each branch circuit • 2
Contact name - 1 B. Fee for branch circuits
Address :-- rvrthoia service or feeder fee,
first branch circuit 56.18 t� 1 2
branch circuit
Ci[y /S[atcJ7IP:
Each add'! llll"''
'< 7.42 2 ,
• r �--
Miscellaneous service or feeder not included
Phone: ( ) Each manufactured or modular
dwcll service anct or feeder � 67.84
E -mail: - 2
_-
CONTRACTOR
Reconnect only
I Pump Cr irriga circle
Business name: nn \� 67.84 12
l= l" 1` ' /) C V Sign or outline lighting
Address: — -
energy panel, alteration, or
--‘3), Z signal circuit(s) or limited-
2
C�
Addre tate ' /ZIP w� j � O L a extension. Describe:
l��y �� 07 Ea
Phone: ( J [P S� additional inspection overallo �
g � y r + } ax: (. ,_ -� / ( 3 Nablc in an of the above --
u. 0 Per inspection
CC8 Lic : investigation per hr. ur (t hr min) : 66.25 � -
L ect;ical Lic.: - { z ,
• ` Suprv. Lie.: 1 o7- $ Industrial
INIMIKEIMINIMI
Suprv. Electrician signature, rcquinad: t P1antFcrhour
Print name: — '
J� /�'� � Date: �t / ,
--
Subtotal: J
Authorized si `. Plan review ( %of pcmrii fcc):
gnattrrc:
State surcharge (12% of permit fee): Winn
Print name:
Date: This TOTAL- PERMIT FEE: n
�auddin P permit application expires ,/
S' ermris1ELC -PamdA d 10/01t92 p rH d permit q not obtained within j 1 ci
nr. oc d ays after it has been accepted as complete
4 ' 0 - ! 6 1.57(! uosi oxInv Number of inspeclior.s allowed per permit
Z d 6b£ 199Z809 al.liaal3 }ina_IiC Old d80 80 8l 6Z adb
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
11015 SW 114TH PL, TIGARD, OR, 97223
Residential - Electrical
120 Electrical rough-in
05/02/2013 00:00
ELC2013-00247
PASS
Violation Summary:
Inspector Contractor