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Permit CITY OF TIGARD ELECTRICAL PERMIT ` s''. COMMUNITY DEVELOPMENT Permit #: ELC2011 -00085 I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2011 T Parcel: 2S105DD00700 Jurisdiction: Tigard Site address: 15165 SW SUNRISE LN Project: McKee Subdivision: Lot: 0 Project Description: Panel change and (2) branch circuits. Contractor: WILLAMETTE ELECTRIC INC Owner: MCKEE PO BOX 230547 15165 SW SUNRISE LN TIGARD, OR 97281 TIGARD, OR 97223 PHONE: 503 -624 -3631 PHONE: FAX: 503 - 624 -2938 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 02/08/2011 $100.70 Specifics: amps or less 2 crt Branch Circuits w /Purchase 02/08/2011 $14.84 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 02/08/2011 $13.86 Electrical Type of Const: Occupancy Grp: Total $129.40 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 rdance approved plans. This permit will expire if work is not started within 180 days • ' - nce, or if work is suspended for more the 180 days. A ENTION: Oregon - re• i - you to follow the rules adopted by the Oregon U " " ication Center. Those rules are set forth in OAR 952 -00 0010 thr•ugh OAR 950 1- 009 You may obtain a •py of the rules or direct questions to OU 'C by calling - "N.40.1987 or 1.800.332. 344. ' Issu By: _ — / 4 4 2 Permittee Signature: � � / /Zof---.-- 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' r Vim, , Date: �� �! viii ► ._ LICENSE NO. .a a, 5 Call 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. 02/07/2011 MON 11:27 FAX 5036242938 Willamette Electric lj 002/002 Electrical Permit Application I FOR OFFICE USE ONLY City of Tigard � Received /�' oQo/ c il " $ Da 1 Permit No.: � �DODO� ' tclII ���■�► , 0? 13125 SW Hall Blvd., Ti ard,62�9•T223" ' Plan Review Phone: 503.639.4171 Fax: - ,503.598.196 Other Permit: TIGARD Inspection Line: 503.639.4175 N'' C "� Wt�_ Q Da te/By: , Date Ready /By: orri,: Ed See Page 2 for Internet: www.tigard- or.gov ` \Q - ( AO\ A Notified/Method: Supple Information TYPE OF WORK , .-. v • 'PLAN REVIEW • Please check all that apply (submit 2 sets of plans w /items checked below : ❑ New construction Ej Addition /alteration/replacement ) ❑ Service or feeder 400 amps or more ❑ Building over three stories. ID 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 JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "F, ", "1 -2 ", "1 -3 ", Job no.: 6 6, E°..) Job site address: , 10013P or more. occupancy. / a J r 5 ` rtes -k ' M` & ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: 7;:,_ f Yi f ,�! ❑Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ivi p ❑ Service or feeder 600 amps or more. — ii^^,, FEE SCHEDULE Cross street /directions to job site: r7 r1 3t to , 4'. cR0 V Description I Qty. I Fee. I Total i !J t 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 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) n ' Limited energy, multi - family 75.00 2 Y"i7 ti t / e. iiii residential (with above sq. ft.) _ Services or feeders installation, alteration, and /or relocation 200 amps or less ( 100.70 /0 d ,2 i.1 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: ' 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: 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 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, 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 ©CONTACT PERSON above service or feeder fcc, 2 7.42 i t - I 41 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 adc1'1 branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City /State /ZIP: dwelling, service and/or feeder 67.84 2 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: Willamette Electric Inc. pancl alteration, or extension. Page2 , 2 Each additional inspection over allowable in any of the above Address: P.O. Box 230547 Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Tigard, OR 97281 Investigation (I hr min) 66.25/ hr ._ Industrial plant (I hr min) 78.18/ hr Phone: (503) 624 -3631 Fax: (503) 624 -2938 Inspections for which no fee is 90.00 / hr specifically listed (%o hr min) CCB Lie.: 75059 Electrical Lie.: 34 -283C Suprv. Lie.: 422 -S ELECTRICAL PERMIT FEES < Subtotal: i (�, a Suprv. Electrician signature, requ' Plan review (25% of permit fee): Print name: David Fife Date: �� 2.'- /f State surcharge (12% of permit fee): 13 • ' TOTAL PERMIT FEE: / 7, Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. Number of inspections allowed per permit. I: \ BuitdingWcrmitsrELC-PermitApp .doc 07/01/10 440-46 15T(1 I /05ICOM/WEn