Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
Permit #: ELC2010 -00136
t. IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/24/2010
Parcel: 2S 111 AD18300
Jurisdiction: Tigard
Site address: 14906 SW JONAGOLD TER
Subdivision: LADY APPLE Lot: 7
Project: Bremner
Project Description: Add /alter (1) branch circuit for heat pump.
Owner: FEES
BEACON HOMES NW INC Quantity Description Date Amount
12703 SW 67TH AVE
TIGARD, OR 97223 1 crt Branch Circuits 03/24/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 03/24/2010 $6.74
Electrical
Contractor:
BOBS ELECTRIC
2700 NE BURTON ROAD STE A
VANCOUVER, WA 98662
PHONE: 360 - 254 -7200
FAX: 360- 254 -8219
Type of Use: SF
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: CrThitjra . tj i j 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' ' O 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.
Electrical Permit Applications ' ' l FOR OFFICE USE ONLY
I I I
City of Tigard MAR 2 4 2013 Received
Date /By: Permit No.: E 0 ,.,y
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0;
Phone: 503.639.4171 Fax: 503.598.19K. ); 3' Date /By: Other PermitiNC��Q .05 I`/
T I G A K D Inspection Line: 503.639.4175 `�.. o •and -or. ov Date Ready /By: ® See Page 2 for �
Internet: www.tigard-or.gov '�.{±c,),
g g s . - . i.or. t Notified /Method: � s , Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14.000 ❑ Commercial -use agricultural
® I- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of
Job no.: Job site address: tooHP or more. occupancy.
10-318 14906 SW Jonago ld Terr. ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 9 7224 ID Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or snore.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 'total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
Limited energy, multi - family 67.84 2
Heat pump connection. residential (with above sq. 0.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34
Name: Andrew Bremner 601 amps to 1,000 amps 301.04 2
Address: 14906 SW Jonagold Terr. Over 1,000 amps or volts 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
Tigard, OR 97224 relocation
Phone: ( 971 ) 235 -6720 Fax: ( ) 200 amps or Tess 59.36 1
201 amps to 400 amps 125.08 2
'Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modula 67.84
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mai I:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: t panel, alteration, or extension. Page 2 2
Bob's Electric Each additional inspection over allowable in any of the above
Address: 2700 NE Burton Rd., Ste. A Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Investigation (1 hr min) 6625/hr
Vancouver. WA 98662 Industrial plant (1 hr min) 78.18/hr
Phone: ( 360 )254 -7200 Fax: ( 60)254-8219 Inspections for which no fee is
specifically listed ('/ hr min) 90.00 / hr
CCB Lic 53136 Electrical Lic.: 37 31c Suprv. Lic.: 4322S ELECTRICAL PERMIT FEES
Subtotal:
Suprv. Electrician signature, required/ Plan review (25% of permit fee): 56.18
Print name: Kevin Broselle Date: 3/23/10 State surcharge (12% of permit fee): 6.74
TOTAL PERMIT FEE: 62.92
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
1: Building .Permits PermitApp.doc IO. /01/09 440- 4615T(11/05/COM /WEB