Permit CITY OF TIGARD ELECTRICAL PERMIT
°..= COMMUNITY DEVELOPMENT Permit #: ELC2013 -00363
Date Issued: 07/01/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S125D601301
Jurisdiction: Tigard
Site address: 9055 SW 70TH AVE
Project: Dye Subdivision: SHADY DELL Lot: 13
Project Description: Reconnect only.
Contractor: BECK ELECTRIC INC Owner: DYE, RALPH F & MARIBEL J
15600 SE FOR MOR CT #B 9055 SW 70TH AVE
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE: 503 - 656 -7396 PHONE:
FAX: 503 - 656 -4397
FEES
Quantity Description Date Amount
1 ea Reconnect Only 07/01/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 07/01/2013 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 95 - 1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: K / t / / / " -- e 7 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 603.639.4176 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.
Jun 2713 12:58p Beck Electric r � L , 'j, ��� (50 656 4397 p.2
Electrical Permit Application JUN 7 2013 FOR OFFICE LSE ONLY
ecei /Q t3 p ermi t N Aze
_ City W Hall Blvd., Tigard, OR 97223 Tigard Ru „�,8ved �: . X0 /3_ C�0
13125 Slay 1 iC �) ' f t I Pla Rev
Phone 503.718 Ins 2439 Fax: 503.595. I96���� � ° � J 1 �I� n ' Other Pests
Inspection Line: 503639 p..4175 ° UR \ G P t'1",lia ma te Rc tdy tins - 1 - See Pane 2 for
Internet
TIGARD Neill .. supple,urnt+l Informati
tvM�.v.tigazd -or gov � 1
i TYPE OF WORK PLAN REVIEW
❑ New construction A Addition!alteraticnireplaccment Please check all that apply (sub 2 sell 4 plans nations cimckrxl bclnty)
Service or feeder 400 amps or mete ❑ Rol di u: nver', star es.
❑ Demolition ❑ Other: where the available fault current C Marinas and boatyar ds
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts of ❑ Float :up builciut.
less to gro.md, or exceeds 14.000 ❑ Cr„nmer :ia -due agncul,utal
I - and 2- family dwelling ❑ Commercial /industrial E Accessory buil/.ing amps for all other installations b ;Iild:ngs
❑ Multi- family 0 Master builder ❑Other; D tire pump ❑htstallationof ISO KVAof
❑ Emergency system l sep:a:IlelY 616.44 sv :e. 1.
JOB SITE INFORMATION AND LOCATION ❑ Addition drew motm load of ❑'� 'L",' 1 _'. ` I - '
/� /� . ,Y I P7HP or more. ocaipance.
Job no.: 151 1 lab site address: j' 5 , U) 90± QtJ ❑ Six et mere tesidetltial u ❑ Recreational which: N ':s.
CityiS :ate'L.IP: 1 l yard 612 9 '72,23 ❑ dearth -care facilities. ❑ Supply , ,grudge for mrrc llt.iti
❑ liar,•.rdous locations WU volts keruunl.
SuitelbidgJapt. no.: Project name:
❑ Service or feeder &CO amps or mot_
FEE SCHEDULE
Cross street/directions to job site: ocs<r. Qty. Fre ___ • - --
New residential single- or multi - family dwelling unit.
Includes attached garage. __ — — _
Subdivision: Lot no.: 1. sq. ft. or less I 6 . d — _ -- , 4
Ea add 50C sq. ft. or portion — 33 _ --
Fax map /pafcel no.: Limited energy, residential 75.4J0 : 2
DESCRIPTION OF WORK (with above sq, ft.)
Linihcdcnergy, multi- family Ott;
�/ residenrral (with above sq. ft) � ' -
��'� _.31/4/C. ' Renewable Energy ❑ See Paac'2
Services or feeders installation, alteration, andinr relocation
❑ PROPERTY OWNER ❑ TENANT
203 amps or less i IOO.;tI
201 amps to 400 amps 133.56 f
2ti0 �4 ' 2
Name: 401 amps to 600 amps — _ _—
' Address: 601 amps to 1.000 amps 3(1 04 1 ?
- ' — Over 1,000 amps or volts 552.21 '
City,'State,' "LIP: Temporary services or feeders lostallarinn, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less _ 5 1
Owner installation: This installation is being made on property that I own which is no 201 amps to 400 amps 25.0,S _ I
intended for sale. lease, rent, or exchange, according to ORS 447. 449. 670. and 701. • 401 amps w 6V. 5 . 599 amps I _
_ _ __ _.
Owner signature: Date: Branch circuits - new, alteration, or cstcusiorl, per pane!
❑ APPLICANT ❑ CONTACT PERSON A. Fee For branch circuit; wail
above service or feeder tea- L_ 7.42 — -
Business name:
coca branch circuit
B. Fee for branch c I rood is Witham] to
Contact name: service or feeder fee. first S., . I3
branch circuit
Address: Each add'1 branch c:rcuit 7 42 1
Miscellaneous service or feeder not included) _ -_
City /State /ZIP: Each manufactured or modular
67.84
Phone: ( ) Fax: ) 2
dvvxllir.. service and/or feeder _
-
Reconnect only 67.04 I—
E -mail: Pump or irrigation circle 67 04 — -
CONTRACT R Sim: or outline lighting 67 04 •
r- - rr �!�� i wtslorlim.ted- cncr ; ,y 'we
Business name: �r�. _ e E' !(� � C __ ra Stg nd. lcirc alteration. or e.Nten;ior. . Poe.•
Address: /15 c � it C/t'e
E -- film G , Each additional inspection over allowable in ally of the above
- _ Additiona'- inspection 11 hr mini 66 25r hi
Cit■:'StraciZIP' _/ _ , 4 0 11, 17615 _ _ Investigation (I hr min.) 6525r'tr
: Phone: (58 11J 5 - 6- 73rji Fax' Industrial plant (I hr min) . �S.IS r: _ -
lr.spec :ions for which no foe is 93.00/ hr
CCB Lie.: O Z," Electrical Lie.: 3- �Suprv. Lic.:50Z S specifically listed (Si hr min)
I r /0 �/ ELECTRICAL PERMIT FEES
Suprv. Electrician gndlure, required: ( . f e � Q, / Subtotal: 1.01.
Date: to 2, _ Plan review (25'.4: of perm.' feel -
Print name:
(�,o [,I (.Q_: 1n V► l5 1 3 _ Stale surcharge (1 ;of porma Ice)'
Authorized signature: (� C , • � , - TO F,- L PI :RM1_Ifl' I'h.f:: 5.1
C L/
1L5 This permit application norms it a permit is tint ohtnined nithiu ISO
C
Print name: lams �,.n1s Dales 1 I days after it has m
s been accepted as caytete.
•
Number of nispectiors alIosed per roes.
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