Permit J",.,::,;- II I v C ITY OF T GA RD ELECTRICAL PERMIT
it. rlt ` COMMUNITY DEVELOPMENT • Permit #: ELC2010 00027
'13125';SW Hall Blvd., Tigard OR •97223 503.639.4171 Date Issued: 01/19/2010
TI{'ARZ3, .Parcel: 2S1,02DD00400
Jurisdiction:' Tigard
Site address: 13816 SW Fanno Creek DR, OFC# Rec
Subdivision: Lot: 0
Project: SOLARES,
'Project- Description: ELS202699. Alter (1) branch circuit.
Owner: FEES
SOLARES HOMES L L C Quantity Description Date Amount
BY NORRIS BEGGS & SIMPSON, LOAN SVC
DEPT, 121 SW MORRISON #200 75 da Investigation-Fee (Equals 01/19/2010 $75.00
Permit Fee)
PHONE:
Contractor:
DURANT ELECTRIC
2727 SE 58TH
PORTLAND, OR 97206
PHONE: 503- 819 -2404
FAX:
Type of Use: COM
Class of'Work: ALT Type of Const:
Occupancy Grp:
Total $75.00
Required,Items and Reports (Conditions)
This p ermit is 'issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable .law. At 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 / AR R 952 --001- ' 01 , 60. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699.or 1:800.332.2344.
Issued 13y: �=-� `�1/l l lX Perm ittee 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
�. i
SIGNATURE OF SUPR. ELEC' Ii ` .f ` " . Date: •
s
LICENSE NO.
Ca11.503.639.4175 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.
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EElectrical l. Pe r r �'�:4 " \ ;- i, ott,
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Received /n� . ( �
City Of 'Tigard DateB : _ 6 Permit-No.: a l. t, ' V lido -7
Ill ( �
° 1312SSw H all Blvd, Ttgard 97223. IAN - 1 9 21110 PlamReview
9 ' • Phone: 503.639.4171 Fax:. 503.598,'1960 Date/B : OtherPermit; ,
I' I G A R D g g Inspection,Lme: 503.639 4175 ' CITY OF TIGARD Date Ready /By - ® See Page3,for
Internet: WWw.ti ard -or. Ov' N otified/Method: Supplemental,lnformation
BIIIL`DINC'DIVISION ■��'
TYPE_ - OF WORK PLAN REVIEW.
t
Please check all;t}iat apply,(sulimit;3 sets of plans w /items checked below):
❑ New constr � � Aaa on /alteration/ replacement _
r
El Service or. feeder 400 amps or more ❑ Building over three stones:
❑ Demolition ❑ Other: • where the available faultcurrenr ❑ 141annas and boatyards:
CATEGORY `OF CONSTRUCTION p exceeds 10,000 amps at.150 volts or •' Floating buildings:
' — - less to ground, or exceeds 14,000 • Commercial -use agricultural
1- and 2-family dwell ❑ Commercial /industr El Accessory build El
amps for all other installations. buildings' '
❑ Multi- family ❑, Mastep builder ❑Other: ❑ Fire;pump, ❑ Installaiibn •of 75 KVA or
__ - ❑ Emergency system. larger separately - derived system.
' - -, a JOB
SITE! INFORMATION "AND LOCATION •
• - -- - - .. • _ _. • :� 0 Addition of'new.motor,load of ❑ "A" "E `1 -2" "1 3»
/ i (a S .' . 1 /b G n ( 100HP or mare. occupancy.
Job no.: Job site address: / W �q� I` ❑ Recreational vehicle parks.
FY /" ❑ ; Six ti r more residential units: p
City/State /ZIP: n G FA RD ❑ Health -care facilities. 0-Supply voltage; for more than
❑ Hazardous locations. 600 volts nominal..
Suite /bldg. /apt. no.: Project rlaine: ❑Service or feeder 600 amps or more,.
.' . , ^ ' • FEE SCHEDULE,
Des
Cross street/directions to job site:
,] fription' -� 1 '. Qty. I Fee. - I Total, I "
New residential single- or multi- family dwelling unit.
Includes.attached garage.
•
Subdivision: Lot no.: 1,000sq.ft. or less 168.54 4
Ea.,add'I "500 sq. ft. or portion 33.92 1
Tax,map /parcel no.: Li ited`energy, residential
,.DESCRIPTION,OF WORK r: (with abovesq..0) 67.84 2
GA-Y Limited energy, multi- family 67.84 2
E Ly/✓ (-I )J G l C J,/[ Ti (�i1t j.-/ e 1 /✓,4 -i € 't- CC/� residential, with above sq. h.)
Services or feeders installation, alteration, and/or relocation
200,amps.orless - 100.70 2
❑ PROPERTY R, OWNE '.. , , ® ' TENAN .. 201 amps to 400 amps 133.56 2
Name: 401 amps :to 600 amps 200.34' 2 •
601. amps-to 1,000 anips 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation.
Phone: ( ) Fax::( ) 200.amps or less 59.36 1
Owner installation: This installation is being made;onproperty that l own which is not 201 amps fo 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. _40,I lam to 599 amps. 168.54 , 2
Branch circuits'- new, alteration,•or'extension, per panel
Owner signature: Date: A. Fee.forbranch circuits with •
APPL .. t -
r
ICANT - , ❑ CONTACT PERSON • , :.,',:; abovesetvice or feeder fee,
• 7.42 2
each branch circuit
Business name: . B. Fee.for'branch circuits
Contact name: without service or feeder fee, 56.18 2
first branch circuit
Address: Each add :I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or Modular 67.84 • 2
dwelling, service and /o•feeder
Phone: ( ) • F ( ) Reconnect'only . 67.84 2
' E - mail: Pump or irrigation circle 67.84 2
' CONTRACTOR' _._. - _ _ Sign or outline lighting 67.84 2
Business name; (/ • , Signal circuit(s) limited-
! ��� LC G T tZ t C energy panel, alteration, -or
Address: '? �-) S E 5 extension. Describe: Page 2 . 2
City/State /ZIP: DOLT (J jc�' 17 _2 ‘- Each'additional inspectionover allowable in 66y-of above
• Per inspection • - 66 25
' Phone: (s --03 ) e] "! /� v_'C , `- L Fax: ( ) . Investigation per hour (1 hi IMO 66.25 ,
CCB Lic.: / . (2_6 - Electrical Lic.: , -1 1 Z.0 Su prv. Lic .:, 54 6 8 S Industrial plantper hour 78.18.
ELECTRiCAL PERMIT.:FEES '.' -
Suprv. Electrician signature, required:
(-)� ` / . Subtotal:
Print name: Date: - Plan review (25% ofpermit fee):
L �/1Z1�11T � — (� State surcharge (12 %'of permit fee):
Authorized signature: TOTAL PERMIT FEE: "7"/S o 0
This permit application expires'if,arpermit is not obtained within 180
Print name: Date: days after, it has been accepted as complete.
* Number of inspections allowed per permit.
t:\ Building \Permits\ELC- PermitApp.doc 10/01/09 440 4615T(1 l /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:
•
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum. Systems*
❑ Other:
( COMIVIERGIAL`WORKONLY: , ",
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems . "
❑ Data Telecommunication, Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective: Signaling
❑ Other
Total number of••commercial systems:
*No,licenses are required. Licenses are required
for , all .` other in
I:\ Building \Permits\ELC- PermitApp.doc - .10/01/09