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Permit • CITY OF TIGARD ELECTRICAL PERMIT 114 8 , COMMUNITY DEVELOPMENT Permit#: ELC2013 00607 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2013 Parcel: 2S101AB01401 Jurisdiction: Tigard Site address: 7355 SW HERMOSO WAY Project: Lyman Subdivision: HERMOSO PARK Lot: 4 Project Description: (1)branch circuit for re-grounding panel for replacing less then 100"of water service. Contractor: VIKING ELECTRIC INC Owner: LYMAN, KYLE M 4326 SE WOODSTOCK BLVD SUITE 518 7355 SW HERMOSO WAY PORTLAND,OR 97206 PORTLAND,OR 97223 PHONE: 503-775-3479 PHONE: FAX: 503-772-0105 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 10/21/2013 $56.18 Specifics:, Service or Feeder 1 ea 12%State Surcharge- 10/21/2013 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 952-001-0090. You may o• - -_.i - - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. � Issued By _ —_��_ 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: 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 Pe p ti g"0. t n RECEIVED FOR OFFICE USE ONLY IN Receive) t e eadi_g Aid J �.if j Permit No.= i f r City of T�'j rd a1i3 9 ' 'Z Date/B : /O 4d .. /� 13 125 S W Hdll lid.,Ti�ar OR 97223 Plan Review Other Pcrm k ,2Q/,j--�►Q 6 ti 7 Phone, 503.718.2439 Fa; 8.1960 DatclB Iris eti 50 l 16 k CITY OF TIGARD Date Ready(By' JO,:!� H See Page 2 for T 14 A R D , VISI NotificdiMe hod: Supplemental Information Internet: e .IDA JILDING DNISI® 13UIL TYPE OF WORK PLAN REVIEW ❑New construction ❑AdditioNalteration!replacement Please check all that apply(submit 2 sets of plans writcros checked below): 0 Service or feeder 400 amps or mere ❑Building over three stones. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. --- less to ground,or exceeds 14,000 ❑Commercial-use agricultural 1-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. CI Fire pump ❑Installation or 150 K V A or ED Multi-Family ❑Master builder El Other: © g } m larger lar separately derived syslcln Emergency s aleo' Y JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑'A","1"',"1.2 7 I00HP or more. occupancy. Job no.: Job site address: '�`� 5 v-,s 1ej� ❑Recreational vehicle parks. ❑Six cr more residential units. l'. ❑Supply voltage for more than ❑Healthcare facilities. City/State/ZIP: l ❑Hazardous locations. 600 volts nominal. ❑Service or feeder 600 amps or more. Suite bldg_/apt no.: I Project name: Ly�,av FEE SCHEDULE Cross street/direclions to job site: - escriptiwi 1 Qty. Fee. I Total I _ New residential single-or multi-family dwelling unit. Includes attached garage. , J00 sq.R or Icss 168.5 t _ 4 1 Subdivision: I Lot no.: 33.92 I Ea.add'l 500 sq.It.or portion _ Tax map/parcel no.: Limited enemy,residential 75 00 2 DESCRIPTION OF WORK (with above sq.It) . Limited energy,multi-family 75.00 2 /� residential(with above sq.ft.) ()The �Y���� ^ Renewable Energy ❑ See Page 2 CX \ Services or feeders installation,alteration,andlor relocation_ } 200 amps or less 100.70 2 ❑ PROPERTY OWNER I ❑ TENANT 133.56 2 201 amps to 400 amps 1 Name: 401 amps to 600 amps 203 3-t 2 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts Address:rC55: 552 26 2 i City/Statel7_IP: Temporary services or feeders installation,alteration,and/or relocation Fax:( ) 59.36 l Phone:( ) 200 amps Owner installation:This installation is being made on property that l own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449.670,and 701- 401 amps to 599 amps 160_54 2 Owner signature: Date: Branch circuits-new,alteration.or extension,per panel I Q APPLICANT I El CONTACT PERSON A.Fee for branch circuits with above service or feeder foe, 7.42 42 2 each branch circuit Business name: B.Fee For branch circuits without service or feeder fee,first I 56.18 2 Contact name: _ branch circuit Each add'I blanch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:( ) I Fax: ( Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail: O) (.I/,M lc.,-- e ,�.•I In/11li3 /�- T. 2 CONTRACTOR Sign or outline lighting 67.84 Signal circuit(s)or limited-energy See 2 Business name: V ‘V��ry t:=1,pp(- Q�(-J panel,alteration,ore ctension, Page 2 �`1-______ \ (C Each additional inspection over allowable in any of the above Address: t` . �v Additional inspection(I hr min) ' 66.25!hr City/Stale/ZIP:---e j 0'2_ 19 Investigation(1 hr min) 66_25/hr --� Indeemalplant(Ihrmin) 78.1 St hr Fax'(4;2) ��c�� Phone:({�t� )��r ?j { 1 Inspections for which no fee is 90.OD;hr Electrical Lie.: �y Suprv.Lie.: 2 f 'r Sc a specifically listed(%:hr min)CCB Lic._� ��� �/^Lt`r X w ELECTRICAL PERMFf FEES Suprv. Electrician signature,required: �- I2CLL___4- tlllrlll3 Subtotal: ■ `-✓ ` Plan review(25%of permit fee): Print name:t)Q� C VUL Date: tL�i l� State surcharge(12%of permit fee): i; TOTAL PERMIT FEE: (2 Authorized signature; This permit application expires if a permit is not obtained within 180 I Date: days after it has been accepted as complete. Print name: • Number of inspections allowed per permit. I:'.BuildinuVenritstELC_PemritAp_1=LR_EtZE,dee Rev OS!2112013 44G-76[57(1!/05/COMME15 L•d 90 L0-ZLL-£09 ou10e13 61-1iVn eti9:L L £l 60 100