Permit CITY OF TIGARD ELECTRICAL PERMIT
V• COMMUNITY DEVELOPMENT Permit #: ELC2010 -00490
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/10/2010
Parcel: 2S101 DB00501
Jurisdiction: Tigard
Site address: 7505 SW CRESTVIEW ST
Subdivision: Lot: 0
Project: King
Project Description: Change panel and install 10 cadet heaters.
Owner: FEES
KING Quantity Description Date Amount
7505 SW CRESTVIEW
TIGARD, OR 97223 1 ea Services or Feeders - 200 09/10/2010 $100.70
amps or less
PHONE: 503- 624 -9483 6 crt Branch Circuits w /Purchase 09/10/2010 $44.52
Service or Feeder
1 ea 12% State Surcharge - 09/10/2010 $17.43
Contractor: Electrical
WPCS INTERNATIONAL - PORTLAND INC
PO BOX 509
ST HELENS, OR 97051
PHONE: 503 - 221 -0097
FAX: 503 - 397 -4381
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $162.65
Required Items and Reports (Conditions)
This permit is i • • -. t\he regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in = ccordance with approved plans. is permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. A ENTION: Oregon law require you to How the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 1 010 throu h OAR 952 - 001 -010 . ou m y ta' a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu • By: Permittee Signature: k / -
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' v.,,e Date: 9��0
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.
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Electrical Permit ApplicatioB EI V ED FOR OFFICE USE ()NIA
IN City of Tigard S E P 1 0 2010 Received ��� Permit No.: �,(� , 10 Date /B : /� / �,./ i —
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598 Date /B :
—
Other Permit:
Inspection Line: 503.639.4175 OF TIGARD turn
"t" Date Ready/By: BUILDING DIVISION Supplemental SeePent2nr
Internet: w ww.ti g ard- or. N otified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction jg 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
ig 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ". "I -
Job no.: 8 ? 7 8 9 Job site address: 7505 S &. C,Bis r 1'F co 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: %i 94gd 'Qf ja-'' 97.223 - 820 6 ❑ 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'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: 2,5/0/ 08 006 510 / Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
ChA/v 9 E / AAi E �/ /Nsr LL /0 C,� dfr .S/f4 Teas residential (with above sq. ft.)
J Services or feeders installation, alteration, and/or relocation
200 amps or less / 100.70 /00, 70 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: G
ti J 601 amps to 1,000 amps 301.04 2
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Address: 756 5 S, W. C jl E S r„ /Ea) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City / State/ZIP: 4A d QA. 97/2 3 - 9a 6 relocation
Phone: ( 543 ) 62 ' ?`/8 - 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
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 ex_ tension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, d 7 42 yy 52
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: Each manufactured or modular 67.84 2
tY dwelling, service and/or feeder
Phone: ( ) l 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 •
C+ r A �ON/1 6 - PoR riAN d
panel, alteration, or extension. Page 2 2
Business name:
w/��i -7 1it ER/V 1�/ C Each additional inspection over allowable in any of the above
Address: Rp, Be"( 50 9 42 7/ ed to s6 /.4 /Val. Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: $T/t/�, /6fr S ePtZ 9266 / Investigation (1 hr min) 66.25/ hr
/ Industrial plant (1 hr min) 78.18/ hr
Phone: (5o3) 2Z / -UO 9 7 ( Fax: (503 )397- y38 / Inspections for which no fee is
90.00/ hr
specifically listed (%: hr min)
CCB Lic.: / 792 Electrical Lic.: S- S G Suprv. Lic.: y966 - S ELECTRICAL PERMIT FEES
fhb f 'JI t Fir /#70 Subtotal: / VS. Z Z
Suprv. Electrician signature, requi Plan review (25% of permit fee):
Print name: ?s r& iz / O Ss Date: 9.. 9 .../ State surcharge (12% of permit fee): / z y3
TOTAL PERMIT FEE: j6 2. 6 $
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.
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