Permit CITY OF TIGARD ELECTRICAL PERMIT
I • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00441
T (G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/29/2013
Parcel: 25111 DD00201
Jurisdiction: Tigard
Site address: 15943 SW HALL BLVD
Project: Cozy Nails & Spa Subdivision: SUMMERFIELD NO.7 Lot: N
Project Description: (6) branch circuits for TI
Contractor: ALL WAYS ELECTRIC LLC Owner: ROSEHILL INVESTMENTS LLC
PO BOX 68456 2001 SIXTH AVE STE 2300
MILWAUKIE, OR 97268 SEATTLE, WA 98121
PHONE: 503 - 652 -5142 PHONE:
FAX: 503 - 513 -6614
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 07/29/2013 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/29/2013 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
Required Items and Reports (Conditions)
This permi s issued subject • the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don in accordance with appr•ved • -ns. Thi permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. TTENTION: Oregon law • fires ,yo to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0 1 -0010 th •ugh OAR 952- 001- 1 Yu f' ay tain a copy of the rul• s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
i
Issu By: fl' Permittee Signature:
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:
ONTRACTOR INSTALLATIO. ONLY
SIGNATURE OF SUPR. ELEC' ��� ,, / ,�1 , /� Date: p-`/ /3
LICENSE NO. / -) 5
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.
FROM : Panasonic FAX SYSTEM PHONE ND. : Jul. 26 2013 10:04AM P1
Electrical Permit Application Ii ii iuk
City of Tid
al 13125 SW Hall Blv Tigard. OR 97223
RI
Phone: 5113.639.4171 ;' 503.598.19h°
t 139.4175
Internet: www.ttgxd-orgov . D- ? og f / 3 rgnmit
[ Plan keel°. -....
Othei Pciir■t:
inSpcztion Lin 50.6
Lthslc Repitylly: kris • I M Sr* bop 2 tis7
Notified/Method , ....,_____ _.,... .. _ 1 Sapplesoestal loionnatIon 1
,
•• • • • • - -
, Al • :-.....,,,,. : •:....... _ . • . . - *TYPE OF WORK - .... .
0 New construction Addition/alterkt i An 4r.placcrnc III - . F: . 17.; ehmk oil .ht apply (st ssits " -
if plies vdsterci cbck ): 1
0 Sem,. or feeder 400 amps or mate 0 Itoiltlina over )sr te 1
0 Demolition Other: whets the available feuti current 0 Marinas Initd beards.
CATEGORk. OF 'CONSTRUCTION
. . • . .
otecc4s fo,000 amps at 150 WORT Ilr 0 f footing huitdings
a lesstutoo r ai
nd lu l 14,000 0 commsrsid.usa stasoinsit
0 1- and 2-farnily dwelling mmermaiiindustrial 0 Accessory building mpsfa buildin9s.
ID Multi-family Master builder 0 Other: 0 rim pump. 0 Insolation of 75 KVA or
. . - 0 gnu:mewl hIcs)). LtrEet separately derived system
‘ '•-•••• t - • ..”: , ;f:''':' ' ' :101• SITE INFoRm -,+Ngl•.Lociv0000.•. . .. . • . • ,... DAdditinn of ceu etotio 10,4 of 0 "A" "E", - 14 - , -1.3".
Job no.: j Job site address: /5Z1t3 sp. itirS/vd, os
100IfP or S i 1,1 relidential units, 0 otenpanoy•
Iceeroatiorml vehicle ossice.
City/Suite/ZIP: 7 a ti.,P 0E40 dc- y 7_2.744 .._, 0i:feeds (Kisses.
' 0 Hazaidoto locomen. 0 Supply sqtltagn for more than
600 wits nocidoe!.
i/
Suireftildgiapt. no.: 1 Project name: c VAI tt S e4- ! 0 Service or feed,' 690 imps or mate
. . . •. ,
- 1 • -. ''...• • :' lilt ..e! , I ' 01 •••• - - .: : ,. . - •
. _
Cross streetldirec to jcb sire: ! ss _ el.., ss,, ma OM
1 New resIdontilaliTegie: or multi-finnity iwelling malt.
. . ,.
. . ii. - .
• ---- .
- . r... - no. - - • ' Includes attached garage.
- --- SUbdiVsion Lot
1 ' 1,000 so. I or Iess
1.----- Ea. addl 500 slit oriortion .. .. .
• •
168.54
33.92 .
Tax map:parcel no.: ._,--
Limnod energy, residential
1 67.84
','-': -'•'-'',!...."•.,,:• •'''...•:••:•, - .. . -. • .- .. :,'• :- DIFSCRPTI9N 01 is,WORIC • . : • • • , • • • • -:: . • I (with above im. ti.)_ -
Limited energy, mulo-family 67 84 2
Pif..re Ci iii ! I resideidia1 ..iith above sti. ill 1 . . _
___L_
- - - I tervicei or feeders installation altenakm.angi74) relocation
2 amps or less 1 I 100.70 I 2
--, - . __._ . • 00 .... - -
.....,...:.;••.:, #itortip .. :. • .1 '. . 0 ictiANT .. 201 amps to 400 amps _ 1 4 2
401 mats let 600 amps 200.34 2
Nante:
- - 601 amps to 1,000 amps 301.04 2
Address: Over 1.000 amps ur vo ...1 '
lts 552 26 1 2
City/Stater7
- - . -----. -
Temporary services or feeders installation. alteration,
_
-- _._.
Phone: ( ) ___ _
Ti:(
_i _ ___.
) ___ i reloeatMa
' 200 amps or less
-
....--- -
---r- ,
,.... ,
Owner installation: This installation IS being made on property that I own which is riot [.. 201 "'Vs I'' 400 a mp s (- - 2
125.08
intended for salc, lease, rent, or exchange, according to ORS 447. 449, CIO, and 701. i 401 amps to 599 amps i 68.54 2
1 Branch circuits nesi or extconitmater Imel
[ Owner signature:. ; ___ Iii --------:: r i! branch cirouits
. • isrlitik ANT . ' ' .'..:'... f :".'.-. . ca o.,..'--Tirroc. above service or 7.42 2
. ,' - ..::( sh feeder fce,_
S . r
each branch circuit
Business name:
- . li. fee for branch circuits
1 ! leasuisr service or feeder fec. !M 5632 , ri I • -
2
L Contact. name: i_ Ma branch circuit _
Address: .. ._......... ' ! . _...
' ! d_i_sch add'i branch circuit r2 1 - 1 7 42 2
-- -
...- ---- ------------- -•--------•----..- 1 I_ aliuslInueous (service or feeder . nut include
City/Stint/ZIP: 1 1-fach manufactured or modular
•
-••• - dsuilling,:iiirvice andlat feeder .. - 67.84 ' 2
• •••PhOtio!'( - ' - ) • - 1 Fax: : ( ) Reconnect only • . ' • . - • 111111 '': • 6784 • '.' i • '. ' •',... or •
.." • ______
Smail: Pump or irrigation circle - 67.84 LI
'..::!•'.'::;:1::!•:.:! .'.:--:• - ..-...t.00rFice :'1- .;:! .:- ti(P at Imam) liglIcti _ 67.84 2
Signed circuit(%) or limited-
t Business name: jr- IS CC- t-1- c...• 7 1 I energy psnel. shoration, or
p ..--- --
i AadrC5S! 411119 (9 6:t 14-1-4 kittens Mn. Describe. 1 Page 2
City!StateJZIP: I ad , e cv . 72.6
-
Phone: g13.261,2: I v.. 57 yz
L. CCB Lic...11120, .,. ,r14 ,...., _ 1 ____.______ -_.... k _
-
I 10 4: ($03
Electrical Lic,,C4 S - Suprv. Lie.: ) zie ,
striaIplant p
1 I ___ , .1.--......L..._.4
Lach additional inspection over allowable in any of the above
Per Ms ction 66.25
Irnigatton pt7ibou r (1 Iv min) I 1 1 - 66.25
Indu hour ..,...,..... J j_ 78.18 ....
/ -- ..':''..-,•••:,':-','.'•!.-.•.-- tlfACT,RICAL-PERMIT .1FILILS Fj. ; .7. -',':'.. ..:-:
Ito/A f aksT st
i Suprv. Electrician signature, r inrell., .,, ' ubuni: 3
I_ _ . ..-1
TM I .
P • i 1111 C74 Date: 7 - 6,-- )'- I MP review (25% et p reo, - /I
, 4 Suite surchtugc (12% of permit fee): er.
Authorized signature: TOTAL PERMIT FEE'
_ - V
. --- • - ---- ..--
- . _____ _, ____ I
. -
ibi. prak n application .spires If • permit is oat ari;sieed *lads ISO
Print name: -- - Date. J
day: afar II has bath ..°
accepted as complete. _.,
4 7
• sh,..t.or of ipa
nsction, ellerwed per permit. --- /0 If
11804ing■PeremsZLC-Psimiiityp.1oc 10,45/09 410461M l I fos:COMAYF1:
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