Permit n CITY OF TIGARD ELECTRICAL PERMIT
.114 o • COMMUNITY DEVELOPMENT Permit #: ELC2010 00619
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/04/2010
Parcel: 1 S 136AA07100
Jurisdiction: Tigard
Site address: 7081 SW LOCUST ST
Subdivision: Lot: 0
Project: Tanz
Project Description: Installing generator transfer panel.
Owner: FEES
TANZ, GUY H AND Quantity Description Date Amount
BADZIK, KATHLEEN M E, 7081 SW LOCUST
TIGARD, OR 97223 1 ea Services or Feeders - 200 11/04/2010 $100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 11/04/2010 $12.08
Electrical
Contractor:
OREGON ELECTRIC GROUP
1709 SE 3RD AVE
PORTLAND, OR 97124
PHONE: 503 - 234 -9900
FAX: 503 - 535 -2763
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $112.78
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 • 2- 001 -0100. You may obtain a copy of 41brect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
• I
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.
! - 1
Electrical Permit A j gill l 5o t_ [tilt c�l_t lc 1 Lti I CM '
city of Tigard G� Receive Permit Nu.: _
Date /Bv:
I Blvd., Tigard, OR z 010 le
'a 13125 SW Fie. , i
g' % t. Pl R ev i ew
' C : • Phone: 503.718.2439 Fax: 503.598.196R1OV Date /By: Other Permit:
1' 1 G A It 1 ) Inspection Line: 503 �``►► \ ��� D t Da Re-iid - - t rnr a: 69 See Page 2 for
In www.ligard nr.gov • OF \O� No / Method: _ _ J Supplemental Information
r v 1L�11V REV O.*
TYRE QF WOE . ��� ::• ' P ; . `:
• � . • htems checked below)
r
❑ New construction - ® Adduivn /altcratl. Lleplacement Please check all that apply (submit 2 sets of plans w
0 Service or feeder 400 amps or more ❑ Building over three. duties.
0 Demolition ❑ Other: where the available fault current
❑ Marinas and boatyards.
` CAiTEG"ORYiOF CONSTRUCTION ; ; exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Icss ro ground, of exceeds 14,000 0 Commerctul -use agricultural
® 1- a nd 2-family dwelling
y g ❑ Commercial /industrial ❑ Accessory building amps for an other installations. braidings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ hrsiallation of75 KVA ur
0 Emergency system larger separately derived system.
i 8 s iNji4RivIATit yN' nrm ` tiocaTIO14
❑ Addition of new motor load of ❑ "A" '•F" • 12' `• 1 �.,
Job no.: 78025 Job site address: 7081 SW LOCUST ST 100HP or more. occupancy.
❑ Six or more residential units. 0 Rerinatioual vehicle parks.
City /State/ZIP: TIGARD OR 0 Health -care facilities. ❑ Supply voltage for more than
0 llarardous locations. 600 volts nominal.
Suitc/bldg. /apt. no.: I Projcet nanic: GUY TANZ ❑ Service or feeder 600 amps or more.
-..., "F
Cross strcctldircetions to job site: uerrir,ti rr , Fee, •tLW --
— - -- — "— — — rv ' "' New residential single - or multi - family dwelling unit.
includes attached garage,
S ubdivision: Lot no.: 1,000 sq. ft. or tens 168.54 4
Tax map /parcel no.: —� - Ea. add`( 500 sq. ft. or portion 33.92 _ v 1
t-intited energy, residential
RiPTION Qr WORK (with above . - R. 75 Z
DZSC
,m )
Limited energy, nwlti- family ?5.00 r INSTALL GENERATOR TRANSFER PANEL residential (with above Sq. 0.)
- '- Services or feeders installation, alteration, and/or relocation
200 amps or less I I 100.70 1(10.70 [ 2
7. .T ❑ 1'ROiiR'I•Y O% lER } ❑ TEN/04*.... 201 amps to 4110 amps i t 33.56 2
amps ps to 600 amps 1 200.34 2
Name: 601 amps to 1,000 amps 301.1)4 2
Address: , Over 1,000 amps or volts 552.26 2
- -- - "- - -._ --- ----- - -" "-- `- "• -' - -- Temporary services or feeders installation, alteration, and/or
City /State/ZIP: relocation
less 59.36 1 a mps or
Phone: ( ) - Fax: ( ) 2(10
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that l own which is not -- - - - --
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 mops 168.54
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
'Q; above service or feeder tee,
7 2
AI'P1�iCAA?T } ❑ C QN f ACC 3'ERSON .42
each branch circuit __1
Business name: B. Fee for branch circuits without
-- service or feeder fee, fast
Contact name: branch circuit 56.18
- - - -- - -- — Each add'I branch circuit I 7.42 2
Address: Miscellaneous (service or feeder not included)
Paoli manufactured or modular 1
City /StatclZIP: � dwelling servic and/or feeder 67.84 1 2
Phone: ( ) Fax: : ( ) i Reconnect only 67.84 2
- - - - -- - - -- Pump or irrigation circle 1 67.84 2
E - mail: ( - '
. . . . . - ........ t'. 2
_ -
_ Sign or outline lighting 67.84
: _ . - Signal circuit(s) or limited- energy �
Business name: OREGON ELECTRIC GROUP panel, alteration, or extension. Pagc 2 ,
Each additional inspection over allowable in any of the abov
Address: 1709 SE 3" AVE Additional inspection (I hr min) 66.25/ hr
-
City /State/ZIP: PORTLAND OR 97214 — Investigation (I ter min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 234 -9900 Fax: (503) 535 - 2763 I inspections for which no fee is 90.00/ hr
specitically listed (' /: hr min)
CCB Lic.: 203 i Electrical Lic.: 26 -95C 1 Suprv. Lic.: 4549S '-: `: :': 'c;;` ELECTRICAL.PERMIT FEES' :.:
� e Subtotal: 100.70
Suprv. Elecn ician signature, require "fti, � �, P lan r eview (2S °,<, of permit fee):
Print name: RICHARD MCELL1O11' Date: 11 -3- -100 State surcharge (12% of permit fee): 12.08
`
Authorized signature: { \ '. C, �}e TOTAL 112.78
nature: 1�:i::vx7` ` `>,�
g S '" • � This permit application expires if a permit is not obtained within 180
Print name: RICHARD MCELLiOTT Date: 11 - 3 - 10 •
days ni ft has been accepted as complete.
___-_-_ _ • Number of inspections allowed per permit.
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