Permit v CITY OF TIGARD
ELECTRICAL PERMIT
71 >rt: COMMUNITY DEVELOPMENT Permit #: ELC201000212
Date Issued: 05/05/2010
71GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S101 BC00900
Jurisdiction: Tigard
Site address: 12291 SW KNOLL DR
Subdivision: Lot: 0
Project: The Knoll at Tigard
Project Description: (1) 201 to 400 amp temporary service
Owner: FEES
THE KNOLL AT TIARD Quantity Description Date Amount
PO BOX 23206
TIGARD, OR 97281 3206 1 ea Temp Services or Feeders - 05/05/2010 $125.08
201 to 400 amps
PHONE: 503 - 293 -4038 1 ea 12% State Surcharge - 05/05/2010 $15.01
Electrical
Contractor:
JET INDUSTRIES INC
PO BOX 7362
SALEM, OR 97303
PHONE: 503 - 363 -2334
FAX: 503 - 363 -2622
Type of Use: COM
Class of Work: NEW Type of Const:
Occupancy Grp:
Total $140.09
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 es adopte• by the Oregon Utility Notification Cen r. Those rules are set forth in OAR
952 -001 -0010 through OAR 9 2- 001 -0100. You ma • . j. py of the rules or ect questions to OUNC by calling 46.6 or .800.332. 44.
— — •
Issued B , -../..., ✓ -- — �' � -----111.P..— 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 an inspection that business day.
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 (WED)MAY 5 2010 13: 211ST. 13: 20 /No. 7500000375 P 2 ..,...,,
Electrical Permit Ag1 P t :, , 4e ' =. ,t. I () It O F I I c 1 1 � I ( 1:1 ,, , < tr. "
City of Tigard , ' .. Received c� -s Penn" No.. -
tY g Date/B . 1 /G �Cai /D - DOa /.
; ` 13125 S W Hall Blvd., Ti ::T'� I R 97223 Plan Revie •
o. - " Phone: 503.639.4171 Fax: 8. k9(§ 2010 Date/By: Other Pe,m;r.� �o /0 W a - 3 3
4i I i !: Il Inspection Line: 503.639.417 pate Ready /By: .run
'htz ^ -�s Inle
sr 1 met: www.ligard- or.gov a. a it {1 Rp Notified/Method. Supplemental Information
ti 7 J �j/ / 1 HI See Page 2 for
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® New construction ❑ Addition /alteration/replacement Pkase check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ D emolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
5
,H1 ".' {11” s E, 11T ;+:� t ',?V s : ra x -
-- R r t t 1 1.1 r'} r exceeds 10,000 amps at 150 volts or , Floating buildings.
3 tl :.IEi4� .,,SI�:,:•}i I� G1ii111 x11£i y st..:: iv4 5 . 1 v ` I.H - It 1 Uki111 { } ❑ $ lt
,+,M,,,.L,IDS>!t •C�4 au K> �:, .,... ..Lvrf� : 1 f , .: 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.
® Multi- family ❑ Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or
, 01.1.1 fit` i< .t Y. l a w a . "1" , r 4:M . i .'. a. ` 't t l {` i.l,fgitl a ` 1Tai i u t ❑ Emergency system. larger separately derived system.
lf: V; IK:1 3 ;4:-. a.w s rlr.;rdiY: .re ,ls, e rnr . »t..t.., �'.<....:.(ili(lat'w rt..:,.F t ❑ Addition of new motor load of ❑ "A" "E' "1 - "1 -
Job no.: Job site address: 12340 SW HALL BLVD. 10OHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehick parks.
City/State/ZIP: TIGARD, OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: KNOLL AT TIGARD ❑ Service or feeder 600 amps or more
Cross street/directions to job site: neseripdoa 1 Qtv. 1 Fee. 1 Total •
New residential single- or multi - family dweWng unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. 6. or less 168.54 4
Ea. add'I 500 sq. fl. or portion 33.92 1
Tax map/parcel no.:
P/p _ Limited energy, residential
r :41 .1y �r �;i� b? r''3r1 .' 1 _ i iL X a;isx l . r I i i ia . I l t i { ,I l w l t� F a t ° "- .Mf tr (with above fl. 67.84 2
! r ` a , rte _ �a..,. " ail 1,1 1 i � ,M. f i , m )
Limited energy, multi - family 67.84 2
TEMPORARY POWER residential (with above sq. fl.)
Services or feeders Installation, alteration, and/or relocation
200 amps or less 70 2
. :/ r,•.> s Q u M � / It t i t j _ N li , 'a`" ...56 13356 2
.;c.��cCVr.: '., 1. lar- P�'..if!:rrt��u�ti
�k E�YPllr.>F'1.,��.- '14 . Ma i il�1� #l�l,�-?;ri��'I�a$.i -x2 . 201 amps to 400 amps 13356
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: s or volts 552.26 2
City /StateJZIP:emporaryye es or feeders installation, alteration, and/or
Phone: ( ) I Fa ( ) 200 amps or less 59.36 1 liV
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 ,6?S. Q� 2 .
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, r panel
Owner signature: Date: A. Fee for branch circuits with
i%
?r t, I i'g'7 s . ,a ..n M 1 u ( 1r4II'# s' '1'1 £P r . t m� . o , r '!4:1 i f 1 3 1'c above service or feeder fee,
'"t c l i „'(irtL4 „p,,,mH:1seres,., ;,,„ �?) .,1 ., i,.:4u m, ' 1&01? 71 alai :15x1, -.1. .0? ' -, _ >� �;I tf�... S,. ' each branch circuit 7.42 2
Business name: JET INDUSTRIES, INC. B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: CHUCK EVANS branch circuit
Each add'l branch circuit 7.42 2
Address: 1935 SILVERTON RD NE Miscellaneous (service or feeder not included) _
City/State/ZIP: SALEM, OR 97301 Each manufactured or modular 67.84 2
t3 + dwelling, service and/or feeder
Phone: (503) 363 - 2334 I Fax: : (503) 364 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail CHARLES E@JETINDUSTRIES NET Sign or outline lighting 67.84 2
- 4101 ' Ili.. S!li - i . v f g l r ero`ty°" 4-. 1 t i + 'l;.' . •1�. , ... �' i, . �v dr'> h3„t ' FUi _ Signal circuit(s) or limited-energy aa lur:.ba,ca.,, .ts,.�,au,�?� 1•�.It t li ,li�li &,::�s„.,,3.,,..,,,..,. �, �_ �
Business name: JET INDUSTRIES, INC. panel, alteration, or extension. _ Page 2 2
Each additional inspection over allowable in any of the above
Address: 1935 SILVERTON RD NE Additional inspection (1 hr min) 66.25/ hr
City/ State/ZIP: SALEM, OR 97301 Investigation (I hr min) 66,25! hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 363 - 2334 Fax: (503) 364 - 2488 Inspections for which no fee is
tficall listed '/s hr men 90.00/ hr
CCB Lic.: 3944 Electrical Lic.: C226 Suprv. Lic.: 5409S /6 I x e ( `- . -_;t 1 °' : < . '- la :,'
Subtotal: 133.56 , �
Suprv. Electrician signature, required: o
Plan review (25% of permit fee): t I
Print name: CHRIS DUNLAP Date: 5/5/10 State surcharge (12% of permit fee): I . 13 i e
TOTAL PERMIT FEE: ' 9.59
Authorized signature:
This permit application expires if a permit is not obtai , -: within 180
days after It has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit. O
e \Building\Pamiu 10/01 /09 440- 4615T(1r/05 /C0M,WEB I� (1 ,
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BUILUINu lily e�iviv
FROM (WED>MAY 5 2010 13:21/ST. 13:20/N.. 7500000375 V 1
let
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HEATING PLUMBING ELECTRICAL FIRE PROTECTION MAINTENANCE FOOD PRODUCTS
"Solutions far a sfrea,nlined project"
Date: s 151 , Pages including this sheet: 2
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• . Phone 503.363.2334 • Fax 503.364.2486.800.659.0620
• 1 35 •Siiverton Rd NE • Salsrn, OR 97303.. www. Ltindustries:net .
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