Permit 4 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00511
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/17/2010
Parcel: 2S111AD12000
Jurisdiction: Tigard
Site address: 15080 SW 89TH PL
Subdivision: SCHECKLA PARK ESTATES Lot: 39
Project: Metcalf
Project Description: (5) branch circuits for kitchen lighting /switches
Owner: FEES
METCALF, RHETT Quantity Description Date Amount
15080 SW 89TH PL
TIGARD, OR 97224 5 crt Branch Circuits 09/17/2010 $85.86
coo /Purchase Service or
PHONE: 503 - 998 -1061 Feeder
1 ea 12% State Surcharge - 09/17/2010 $10.30
Electrical
Contractor:
CARTON ELECTRIC INC
PO BOX 860
AMITY, OR 97101
PHONE: 503 -435 -1600
FAX: 503 - 835 -0539
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $96.16
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: 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.
Electrical Permit Applicatio F U FOR OFFICE USE ONLY
CL of Ti and � �... i ° ® Received , ddl permit No
�' g Date/B : 7 / 0 ..T i i1 �LCa /0 '",,s/ _
13125 SW Hall Blvd., Tigard, OR 97223 ( EP 1 7 2010 Plan Revie
Phone: 503.639.4171 Fax: 503.598.196 Date /By: Other Permit:
T I G A `R D Inspection Line: 503.639.4175 Date Ready /By: kris: El See Page 2 for
1 Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: -71G Supplemental Information
TYPE OF LNG DIVISION PLAN REVIEW
❑ New construction fir 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
Al 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 ", "I -2 ", "I -3 ",
100HP or more. occupancy.
Job no.: Job site address: 1 5ly 3 ` \ Q - ._ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
- T, qP� a R 9`l nay
0 0 Hazardous locations. 600 volts nominal.
O ,
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
_ (1 � L energy, multi - family
-k &ne , - emeX.� tkttU 1 �, n p
o •o' . v As (with above sq. ft.) 75.00 2
■ Services or feeders installation, alteration, and /or relocation
recA r 7' gs p 0 \1 5 200 amps or less 100.70 2
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
i (7.4\ „^ j G,N V 401 amps to 600 amps 200.34 2
Name: �, 1V 1 vv 1, 601 amps to I ,000 amps 301.04 2
Address: 1 5 0 b a SW gck41n P I Over 1,000 amps or volts 552.26 2
`;� ) Temporary services or feeders installation, alteration, and /or
City /State /ZIP: _! relocation
Phone: (6 1 1 - 0 6 1 Fax: ( ) 200 amps or less 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, d 70 401 amps to 599 amps 168.54 2
__ 2 Branch circuits — new, alteration, or extension, .er panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ 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 56, II, 2
Contact name: branch circuit
Each add'I branch circuit t-1 7.42 - .fa 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: CRRT N E LE c RI panel, alteration, or extension. Page 2 _ 2
Each additional inspection over allowable in any of the above
Address: . ir3 -z,OX 8 .,O Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City /State /ZIP: P,.„1t� ( / O>R oil 1a1 Industrial plant (1 hr min) 78.18 / hr
Phone: (rjo3) 35- I boo Fax: (503) 835- 0539 Inspections for which no fee is 90.00/ hr
specifically listed ('A hr min)
CCB Lic.: 15`i1 J Electrical Lic.:3 /0_ a c. Suprv. Lic.: 5o75 -S ELECTRICAL PERMIT FEES
' y / na u / L (,
Suprv. Electrician s te, required: / DI P /� � Plan review (25% of permit fee):
Print name: OFNO CikC' r Date: c ` `( I \ O State surcharge (12% of permit fee): / 0- SO /
TOTAL PERMIT FEE: IC, 1 ,./
Authorized signature: C �., This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: c_s,,.,„„,„), C f . f"6p >-:N Date: ql 11 I ao \ 0 • Number of inspections allowed per permit.
I: \Building \Permits \ELC- PermitApp.doc 07/01/10 440- 4615T(11 /05 /COM/WEB
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15080 SW 89TH PL, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2010-00511
David Young
Violation Summary:
Inspector Contractor