Permit Iiii CITY OF TIGARD ELECTRICAL PERMIT
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PERMIT SUED: #:
COMMUNITY DEVELOPMENT DATE IS 7/24/2007 ELC2007 -00509
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S111DB
SITE ADDRESS: 15215 SW 94TH AVE ZONING: R -
SUBDIVISION: SUMMERFIELD NO.12 LOT : 646 JURISDICTION: TIG
PROJECT: JONES
Project Description: (2) branch circuits for a/c and furnace outlets.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JONES, RICHARD NEWTON JR BADGER ELECTRIC INC.
15215 SW 94TH AVE PO BOX 55446
TIGARD, OR 97224 PORTLAND, OR 97238 -5446
Phone: Contact #: PRI 503- 288 -4756
FAX 503 - 493 -7173
FEES
Description Date Amount Reg #: ELE 3 -57IC
[ELPRMT] ELC Permit 7/24/2007 $53.50 LIC 156851
[TAX] 8% State Surcharge 7/24/2007 $4.28 SUP 4951S
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: 4i/ _ >, .' LI Permittee Signature: ...e..0, Ape [; ('
OWNER INSTALLATION ONLY V
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'N: 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.
JUL -23 -2007 01:39P FROM: BADGER ELECTRIC, INC 503 -493 -7173 TO:5035981960 P.1
-
City of Tigard LA 1r I. ) Received : PemtitNo': EL Z -00509
Plan 13125 SW Hall Blvd., Tigard, OR 97223 ' Review
2'� /
Pn R Review Other Fermi(:
Inspection Line: 503.639.4175
Phone: 503.639.4171 Fax: 503.598.1960 JUL 2 n 7 ' • ' ' l Date/By:
���� Y y ' luris. RI Bee Page 2 for
' . . .. ..... �� `
Internet: www.ci.tigard.or.us Or 3 y i, , r U eO . Notified/Method: � f5" -. Supplemental Information
E olEiVQ'RK (3 DiMlON PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply:
[] Demolition 0 Other: ❑Service over 225 amps, coma, ❑Hazardous location
❑Service over 320 amps - rating ❑Bulldog over 10,000 sq. R,
CATEGORY OF CONSTRUCTION of I - and 2- family dwellings 4 or more new residential
- end 2- family dwelling ❑ Commercial/industrial ❑ Accessory building DSysttmt over 600 volts nominal units in one structure
(Building over three stories ❑Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
JO8 SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: C ' _ p ,.,/�.� OHealth -care facility ❑Other:
21 JVv � Submit j sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: ~ 97 J
atleriatiep FEE* scl � I Fee Teat .•
l
Cross street/directions to Job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. R. or less _ 145.15 4
Subdivision: I Lot no.: Ea. add'( 500 sq. R. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK _ Each manufactured or modular
4 dwelling, service and/or feeder t 90,90 2
4 C SSWE 0A,\ T-1... Services or feeders installation, alteration, and/or relocation
\ 200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 -
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1.000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
2000 0 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 , 2
Owner signature: Date: Branch circuits - new. alteration. or extension, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder foe, each • 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: rvUhout service or feeder fee,
each branch circuit 1 46.85 , 2
_
Address: Each euld'I branch circuit _ % 6.65 ( ( 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Fax: ( ) Pump or irrigation circle 53.40 2
Phone: ( )
I Sign or outline lighting 53.40 2
E - mail: Signal circuits) or limited-
. CONTRACTOR energy panel, alteration, or
� f L
extension. Describe: Page 2 2
n
Business name: I.y .�++
Address: l>"0- ''BC 5 Each additional Inspection over allowable In any of the above
Per inspection 62.50
City/State/7_1P: 70624nA \ x"1') Investigation per hour (1 hr min) 62.50
l b7
Phone: (�,_ psi TI Fax: I (55b - ',) 493 � "'1 1 13 Industrial plant per hour 73.75
•�+.T ELECTRICAL PERMIT FEES*
CCB Lic.: � `"LQ[ ' Electrical Lic.: '; - 5"11(_, Suprv. Lic.: 49S Subtotal 57. 5ti
Suprv. Electrician signature, required: � Plan review (25% of permit fee) 6 ��`j
Print name: (ate: State surcharge (8%a of permit fee) �
��5 C '�� TOTAL PERMIT FEL
Authorized signature: - This permit application expires If it permit Is not ohtalq IRO
days after It has been accepted as complete
Print name: I Date: • Fee methodology set by Tri- Cooney Building Industry Service Bond
•• Number of inspections per permit allowed,