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9640 SW DARMEL COURT 0 d rn r n E t r i 9640 SW DARMEI. CT CITY OF TIGARD ELCCTRICAL PERMIT PERMIT,'r: ELC2003-00546 DEVELOPMENT SERVICES DATE ISSUED: 8/29/1", 13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 2S111CA-13500 SI-rE ADDRESS: 09640 SW DARMEL Cl SUBDIVISION: DARMEL N0.2 0NING: R-3.5 BLOCK: LOT : 0:17 JURISDICTION: TIG Project Description: Reconnect only. _ RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS 1000 SF OR LESS- 0 200 amp: PUMP/IRRIGATION: EACH ADD'L 500SF: 201 - !00 amp: SIGN/OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL: MANF IfM/SVC/ FDR: 601+amps - 1000 volts: MINOR LABEL (10): —_ SERVICE/FEEDER —BRANCH CIRCUI'S ADD'L INSPECTIONS 0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 'st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: -- _— _ _ PLAN REVIEW SECTION 1000+ amp/Volt: —4 RES UNITS: A >600 VOLT NOMINAL: Reconnect only: 1 SVC FDR—225 AMPS: CLASS AREA/SPFC OCC: Owner: Contractor: KURTJOHNSON (WAS FORMER RENTER, WHO BOUGHT HOME) Phone: Phor-- Reg #: FEES Description Date Amount Required Inspections [ELPRM I j Ll t'Permit 8/2903 $66.85 -- [TAX]8%Sr,<< I x 8/29/03 $5.35 Elect'I Final Total $72.20 This Permit is issued subjed to the regulations contained in the Tigard Municipal Code,State of OR.Specialty Codes and all other applicable laws. All work will be done in accordi�noe with approved plans. This permit will expire if work is not started within 180 days of issuance,or if work is suspended for mgre-than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set for in OAR 952-001-00110 trrough OAR 952-001-0100. You may obtain copies of these rules or direct questions to OUNC at(503)246.6699 or 1- 00-332-2344. ISS ed 14 By: r � — Permit Signature: ^— OWNER 114STALLATION ONLY _ The installation is being made on property I own which is not intended for sae, lease, or rent. OWNER'S SIGNATURE: _--_-.- -- ----------^-.-----_--- DATE: C-.)NTRACTOR INST ALLATION ONLY SIGNATURE OF SUPR. EL.EC'N: DATE:_ LICENSE NO: Call 639-4175 by 7:00pm for an inspection thA next business day Electrical Permit Application Received — ij Electrical , 11 Dete/B : Permit No.: City of Tigard pea ing Approval — Sign Permit No.: 13125 SW Hall Blvd. Plan Review Other Tigard,Oregon 97223 Date/By: Permit No.: Phone: 503-639-4171 Fax: 503-598-1960 Post-Review Land use Internet: www.ci,tigard.ot.us Date/By: Case No.:Contact J See Paqe 2 for 2 i-hour Inspection Request: 503-639-4175 Name/Method: /a I Sn lemental Information. 1;r'�'���;�T +�'s..��O�VCJ tit - ,•sect ''� ��• Pte____.". _ New constructior ❑ Demolition El Service over 225 amps- 11 Health-care facilaN Addition alteration/re 18CCment ❑ Other: ❑conarercial ❑Hazardous location Service over 320 amps-rating of ❑Building over 10,000 square feet, �+`'• t — v-'- y" I&2 fantily dwellings four or more residential amts in I &2-Family dwelllnL]Commercial/Industrial ❑System over 600 volts nominal one structure Access0 BuildI T Multi-Famil Building over three stories ❑Feeders,400 amps or more rYY Occupant load over 99 persons ❑Manufactured structures or RV park Master Builder Other: ❑Egress/lighting plan ❑Other: Q7 Submit sets of plans with any of the above. Tire above are notapplicable to tem rorar construction service. Job site address Cj E�I ,�• t.. yys�` .- -,� f _ Suite Bld ,/A t.#: L Number of ins ections pe, ternut allots ed Project Name: II r.a.'T Description Qty Fee(ea.) I Total New residential-single or multi-family per + Cross sheet/Directions to job site: dwelling unit.Includes attached garage. Service Included: 1000 sq.ft.,r less _ _ 145.15 4 Each additional 500 sq.ft.or rtion thereof 33.40 1 Limited^.ner ,residential 75.00 2 Subdivision: Lot#: Limited energy.non residential 75.00 2 Ta.:map/parcel#: Each manufactured home or modular dwelling WON s- service and/or feeder 90.90 2 Services or feeders-Installation, alteration or relocation: _`1--� - -- ----- -- 200 amps or less 80.30 2 201 ams to 400 amps 106.85 2- 401 ams to 600 amps _ 160.60 2 601 amps to ;000 amps 240.60 2 Over 1000 araps or volts 454.65 Name: �•: 4,��C s Reconnect only 66.85 2 Address: �'�/�" r t c t i` ( Temporary services or feeders-installation, Cit /Statp'Zl . ' �1 c- t alteration, le relocation: p� ✓ / t''C� ' ' � L / ��� 200 amps or leas 66.85 1 Phone: If 7/-2)9 -/C'C' Fax: 201 ams to 400 ams 100.30 _ 2 401 to 600 ams 133.75 2 Branch circuits-new,alteration,or Name: _ extension pe-panel: Address: A.Fee for branch circuits with purchase of service or feeder fee,each branch circuit 6.65 2- City/State/Zip: Cit /State/Zi : B Fee for brunch circuits without purchase of service or feeder fee,first branch circuit 46.85 _ 2 F Phone: ax: Each additional branch circuit 6.65 2 E-mail: Mise.(Service or feeder not included): Each pump or irrigation circle 53.40 2 Each sign or outline lighting 53.40 2 Job No: Signil circuits)or a limited energy panel, Business Name: alteration,or extension Pae 2 2 -- — Description: Address: City/State/Zip: Each additional Inspection over the allowable in aril of the above: — — Per inspection - -- - - - — pe per hour(min. 1 hour � 62.50 Phone: _ Fax: Investigation fee: _ CCB Lic. #: Y Lic. # Other Supervising electricianI `_ Subtotal $ F. signature required: I Plan Review 25%of Permit Fee S Print Name: Lic.#: 1 _"—State Surcharge(8%of Permit Fee) S _ TOTAL PERMIT FEE S '7RA_J Authorized 1 t 1 -� A Notice: This permit application expires if a permit is not obtained within Signature: l/\�yl�J ✓�'v � Date:-ZV 180 days atter it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. (Please print name) — i:\Dsts\Permit Forms\ElcPetmtApp doc 01/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Feefor 511 systems............................................................ $75.00 Check Type of Work Involved: 0 Audio and Stereo Systems* Burglar Alarm Garage Door Opener* Heating,Ventilation and Air Conditioning System* Vacuum Systems* Other _ COMMERCIAL WORK ONLY: _ Fee for tab system......................................................... $75.A (SEE OAR 918-260-260) Check Type of Work Involved: M Audio and Stereo Systems Boiler Controls Clock Systems Data Telecommunication Installation Fire Alarm Installation L' HVAC DInstrumentation EJintercom and Paging Systems DLandscape Irrigation Control* Medical Nurse Calls Outdoor Landscape Lighting* Protective Signaling Other --- ——- __Number of Systems * No licenses are required. licenses are required for all other Installations i:\Dsts\Permit Forrm\ElcPermitAppPg2.doc 01/03