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Permit '.,.„ n CITY OF TIGARD ELECTRICAL PERMIT Is COMMUNITY DEVELOPMENT Permit #: ELC2010 -00131 T L G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/19/2010 Parcel: 2S 104ACO2700 Jurisdiction: Tigard Site address: 12550 SW 134TH AVE Subdivision: MORNING HILL NO. 8 Lot: 171 Project: Wilde Project Description: Add /alter (2) branch circuits for remodel. Owner: FEES WILDE, ERIN DANIELLE Quantity Description Date Amount 12550 SW 134TH 2 crt Branch Circuits 03/19/2010 $63.60 TIGARD, OR 97223 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 03/19/2010 $7.63 Electrical Contractor: OWNER PHONE: FAX: Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 thro gh 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. /1 Issued By: (l�Qk k,Vv1 C‘ WJ v ' ' Perm ittee Signature: OWNER INSTALLATION ONLY The installation is being made on prope I o'n which is not intended for sale, ease or ren.. // OWNER'S SIGNATURE .. / . . ! — i .�t�l l Date: / ( C l//6 ((( 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. CITY OF TIGARD ELECTRICAL PERMIT ' g .A.- COMMUNITY DEVELOPMENT Permit #: ELC2010 00131 !TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/19/2010 Parcel: 2S104ACO2700 Jurisdiction: Tigard Site address: 12550 SW 134TH AVE Project: Wilde Subdivision: MORNING HILL NO. 8 Lot: 171 Project Description: Add /alter (2) branch circuits for remodel. 11/30/10, reprint to change contractor. Contractor: MATES ELECTRIC Owner: WILDE, ERIN DANIELLE 11124 NE HALSEY 12550 SW 134TH PORTLAND, OR 97220 TIGARD, OR 97223 PHONE: 503 - 516 -4142 PHONE: FAX: 503 - 695 -6263 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 03/19/2010 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 03/19/2010 $7.63 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 - - -- - - 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. ENTION: Oreg• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-101-0010 through OAR 9 011-0090 You may obtain a copy of the rules or direct questions to OUNC by calling i o3'2 1987 or 1.800.3 2.2344, / Is ed By: / —e Permittee Signatur " 'io.i v 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 -------, c SIGNATURE OF SUPR. ELEC' 411/ , - /4/A:,, Date: LICENSE NO. Cali 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. h ;:71:7 t'i a:- i I r II I li Electrical Permit Application ` ' o " � � " p $' �r 1 . ,w 4 4 F S.U 'IzA k'�4 .0iiki Ali � tt �s4W ui 1 ' M ��;L I i '' CI of TI and MAR 19 201 Received `J g Date/B Permit No.: • , 0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' Phone: 503.639.4171 Fax: 503.598.1960 M' P ;r' G AF1I ) Date,B : Other Permit: Inspection Line: 503.639.4175 7 h !V t r� Date Ready/By: 1u ris: El See Page 2 for Ic n'ltl�''� p v�� l? 1 ) >1i w it / y r• g .! Internet: www.tigard -or.gov Notified/Method: 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): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: 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 ❑ 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 J SITE .INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. . ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ", Job no.: (Job site address: i 100HP or more. occupancy. 1 �� S u 3 U � ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: / / t � C ,_ - 7 0 facilities. ❑Supply voltage for more than / 1 (/ D � f� ❑Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: I J A Project name: N / ❑ Service or feeder 600 amps or more. / \ FEE SCHEDULE Cross street/directions to job site: eio , ` 1. \/ lei 4_ 1 /,,)Q ()/4 v * Description 1 Qtr. I Fee. 1 Total 1 New residential single- or multi - family dwelling unit. Includes attached garage. I/�,q O I I A a . 1 11 I 1,000 sq. ft. or less 168.54 4 Subdivision: 1 Y l 1\1 f W I 1 ' l Lot no.: Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: . _ Limited energy, residential 67 84 2 D RIPTI ©N- OF-VKO (with above sq. ft.) Imo_ F.N[ Limited energy, multi - family 67.84 2 l ito t d x q c i1• 1 n451 at � l residential (with above sq. ft.) v V iv V "r f `r v� Services or feeders installation, alteration, and/or relocation i " e i d i t i , 4 Aaj' - " i /sf t6 k ak o 1,/jA e ,- 200 amps or less 100.70 2 . C ® 74ROPERT,Y(.(OWNE I ❑ TENANT - 201 amps to 400 amps 133.56 2 q l. ( 401 amps to 600 amps 200.34 2 Name: R , (e l � // � L :a 601 amps to 1,000 amps 301.04 2 Address: . Z.? , 3 t t \ Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City /State /ZIP: - 7- 1 lam• 01,2_ relocation Phone: (5/)<1, c) r / C ,j2 Fax: ( 5 (.L,,. !�', -- 200 amps or less 59.36 1 f.E° ( 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, le. e, re or exchange, . ccording to 0 t S 44.7, 449, 670, d 70 401 amps to 599 amps 168.54 2 / Branch circuits — new, alteration, or extension, per panel Ownei•=Signatti 3 _ _ .,t. • 4 + , ' � ' Date: L ON �J A. Fee for branch circuits with ❑ 'APPLICANT above service or feeder fee, ❑ CONTACT P • each branch circuit 7.42 2 Business name: BcFeesforbi`arich cii"eiiiii wirhour cservicetor;feeder, fee b iistZ.i 1 Contact name: titanch�ciicuitZ 56.18 2 Each'add- f>iiiiilchcirctiiti I 7.42 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67 84 2 Y dwelling, service and/or feeder Phone: ( ) Fax:: ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (%2 hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: . . . ELECTRI PERMIT FEES Subtotal: Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): 1 TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained wiin 80 days after it has been accepted as complete. Print name: Date: * Number of inspections allowed per permit. I:\ Building \Permits4ELC- PermitApp.doc 10/01/09 440- 4615T(I1/05 /COM/WEB ! / • 1 0 Electrical Permit Application FOR OFFICE USE ONLY . . City Of Tigard Received Permit No O/C, — op/ 3 IIIII `J Date/B : Y / �� q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' ° Phone: 503.639.4171 Fax: 503.598.1960 Date/ : Other Permit: I" I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: 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): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: 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 ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family El 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 ❑ "A ", "E ", "1 - ", "1 -3 ", Job no.: Job site address: /Z 5 Q IV ( ! f' ` y/1I✓ � 100HP or more. occupancy. S ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: 77(7 q 02 722 ❑ 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 more. FEE SCHEDULE Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 " 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.) 75.00 2 Limited energy, multi - family 75.00 2 •' o2-/ / ` _ ( I '3 N e_ LLJ If-72- (� residential (with above sq. ft.) /` / �/ j Services or feeders installation, alteration, and/or relocation yd_+_-s,tt, - t o4 -t_ot 1-e4,7•207-- "}� - /2d' . O u7/'G7—, 4/5200 amps or less 100.70 2 ❑ PROPERTY OWNER J / ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 75 J /� /r ! G✓ - !/t-z1 „ a--t e/<- 601 amps to 1,000 amps 301.04 2 /fr Address: e7 (X/ /4 74 CO vt /c--Ov4,..4 ---. Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City /State /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 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 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, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 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: /State /ZIP: Each manufactured or modular tY 6 dwelling, service and/or feeder 67.84 2 Phone: ( ) 1 Fax:: ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited - energy • panel, alteration, or extension. Page 2 2 Business name: M647 5 G. G - % � C Each additional inspection over allowable in any of the above Address: /7/2 4` - ®1/ P. j1 -6.4 - y /) 4 6 Additional inspection (1 hr min) 66.25/ hr 7 City /State /ZIP: ib D Q- 7�L4rv,.Q t 7, _ .l L � © Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: (5 576 — /7 Fax: ( _P ) qJ 62_ S 3 Inspections for which no fee is 90.00 / hr specifically listed (% hr min) • CCB Lic.: (1 ' 7 / Electrical Lic.: 6 — r?21:3C.. Suprv. Lic.: 'JgrjLS ELECTRICAL PERMIT FEES Subtotal: Suprv. Electrician signature, required: 6GG�.��� —� Plan review (25% of permit fee): Print name: A,frj 4.; S Date: /i/o / r Gc/ v t / O State surcharge (12% of permit fee): TOTAL PERMIT FEE: Authorized signature: ,/1/( This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: 1 _,,, „„, Date: /Yc t - Zq /0 _ • Number of inspections allowed per permit. 1:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $67.84 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm n Garage Door Opener* n Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: • COMMERCIAL WORK ONLY: Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* n Medical ❑ Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC- PermitApp.doc 10/01/09 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* n Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls n Outdoor Landscape Lighting* n Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building \Permits \ELC- PermitApp.doc 07/01/10