Permit CITY OF TIGARD ELECTRICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00100
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/18/2011
Parcel: 2S114BB09900
Jurisdiction: Tigard
Site address: 10374 SW PICKS WAY
Project: PION Subdivision: SWANSONS GLEN Lot: 40
Project Description: (1) branch circuit for water feature.
Contractor: BOONES FERRY ELECTRIC INC Owner: PION, ALBERT L
PO BOX 628 10374 SW PICKS WAY
WILSONVILLE, OR 97070 TIGARD, OR 97224
PHONE: 503 - 682 -4936 PHONE:
FAX: 503 - 682 -7946
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 02/18/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/18/2011 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 -0090. You may obtai • of the - . •irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �! =�_ Permittee Signature: i
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 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.
Feb. 18. 2011 11:23AM No, 5971 P. 1
Electrical Permit Application A N,. I0R OFFICE USE ON I:1'
City of Tigard ' f:-\ , . Received � �( •
- +�'\ Plan Review Date/By: 19 l S /1 OTT— Pemlit No,:
4 13125 SW Hall Blvd,, Tigard, 01 9 r L0
P hone: 503.639.4171 pax: 5038 9 •�� Da Other Permit:
I G.4 R D Inspection Line: 503.639.4175 ` <� r , C Date Rcady/ runs: el See Page 2 fir
Internet: www.tigard -Or.gov C �E'y �c,) Notified/Method: t.i.;"6,? Supplemental information
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0 New construction , Addition /alterarlotl/ceplaeement Please check all that apply (submit 2 sets of plans w /Items checked below):
'V" ['Service or feeder 400 amps or mom 1j Building over the
stories.
❑ Demolition ❑ Other
x. ,
,. .. .0% ...t ., ... - ' `R .,-. r. ro "grv.c 'F: '. c m.cs.,o ':r ■:cFi S'0 . ,,, " . ""' 'S;" ".,
: . ,:.:x• , R:; r_.! ;N• ^at e.... ,.. , r�r r of � .:.', ,:. � :... .,, .,, - T 1r _
.. „ .. { . „c:.r.A •ac.:ri;, ,,,.,:xe::.uv+,x^ _ �
where the available fault current and boa
'.,� 3 r a � > i a a , p � £ r y a exceeds 10,000 amps at ]50 volts or ❑ Flowing buildin
loss to grputld, or exceeds 14.000 ❑ Commoreial -use agricultural
1Z1 1- and 2- family dwelling ❑ commercial/industrial ❑ Accessory building amps for all other installations buildings.
Multi-family ❑ ❑ Fu um In stallation o 7 KVA ❑Master builder Other: e pump, ❑ f K A or
s ,x r , ' -F'rrr ` ^ . >°• 'gym` r 'a7 " w r n ^r+r 7 .'4 n ' n Eme[ 5 tern.
u ° ? � > P'� � ri , fi � 'r : , {' 't , �, , • t u - "�` 1 '' ,-� g�5' Ys larl?et separately derived system.
wrr <,a� s,' . .,., ., »,�v:,,,5,a.. U1_ -.. . i_ __-- t __-_ s., r, . , , , „ .c.' +> , -_�3 , t 'aa,!�„2 . : ,' . ,r ❑Addition of new motor load of 0 ••A „ "1 - 2• , •`1_3"
Job no.: I 1 ( I C Job site address: / 0 ' 7 1-1. S w f'; (k S looirF or mor. occupanc
0 six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: - 7 - ; r o r' v a R ❑ Healthcare &chines. ❑ Supply voltage for more than
Cl Hazardous locations. 600 volts nominal.
- Suite/bldg. /apt no.: I Project name: pc U , El Setvice or feeder 600 amps or more.
;. {y, . Y'!. i t."'. y '""'" , ,•. 1:: cy^% p "G ^: ^,xr... ^•,y' ":Y¢..�.
Cross street/directions to job site: , ip {.a xu C •ate yam. ... 4 c.. ,..w , ,,,,,., „ : i „•_
1 Deecripriotl
Qh- Fe< Toul •
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'/ 500 sq. ft. or portion 33.92 1
Tax map /parcel no.:
�. - - -- : - -- .- ...:. -_:; _._.. _ _ ..__ ............._...... _.......... flat
. ,:: r s f -, n - ,M .n ! r - y c�T ' M > c a> Limited energy, Q ft )
Limited energy, multi - family 67.84 2
residential
67.84 2
A ::f , .,,.., e . ,. ",r ,IlliY.,,, t a.',;.pl,u:5R? r r, ::-..i r5 f , aV15 4 , , •� ��..
...., , a- .+r- ..,a..r.....: --, z _. . ,,.f,.....,.,..z. (With abOV® S ft.)
r
C 10 c� r � u 1' x.- `As\ •i' v r f residential (with above sq. ft.)
Services or feeders installation alteration and/or relocation
200 amps or less a 100,70 2
r S r .,.5'. .sY a i? x x c r y ^ r
> r q xp, +.•
, r n r ! i : r: r 4 ° K a ? c r o t r t re i t+ rr ' i } ” 1 nfi 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
ddress: 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 59.3 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not -
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, p panel
Owner signature: Date: A. Fee for branch circuits with
M
. �. a':+.::: � '<.:::- ::• :...:.::;;,�: �....._ ::_A'�•x::-•�u:.__. ....... w,•�..- above service or feeder fee,
a'a
'� ':r.:; a : :. .:. .. ,, r .. ... .�'�> . •`�' . . .... ......:::..::.:�::: wear
:.................:..: ^.. -: r .,,,. . .a :....J. .... ' s F F-9 o' ° a'.: < 7.42 2
. . �, �, c1 . �..:�" : •�>:•..�;»r.^.^ , ---i_. -.: �' ?.: „_,__rww �.�.r�,v� - =-- _� � :+ . 4:w ..: .)'..,...,'..a.l�, ..�.�•r each branch circuit
Business name: B. Fee for branch circuits without
service o f eeder f ee, first ) 56.18 ... .. - 6 r t' O 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
dwelling, service and/or feeder 67.84 2
Phone: ( ) I Fax: : ( ) Reconnect only 67,84 . 2
- - Pump or irrigation circle 67.84 2
E -mall Sign or outline lighting 67.84 2
4 .:..u.iL �: _.. mr< x,u ru, h ,n Mat z .s 1 , r.>. ? :, .. .w.o( w w.",9J Si circuit(s) or limited -energy
Business name: Booties Ferry Electric
panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: P.O. Box 628 Additional inspection (1 hr min) 66.25/ hr
City/Statc/ZIP: Wilsonville OR 97070 Y Investigation (I hr min) 66.25/ hr
_ Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 682 - 4936 Fax: (503) 682 - 7946 Inspections for which no fee is 90.00/ hr
s. ciftcall listed (ya hr min
'mat :.:41ar..x5" �t= i >d" F !dl.N. ',. 7 9:!' _ " ^:a' C ^ ^ •.A N :.: }^Z :.;"
CCB Lic.: 88482 Electrical Lie.: 3 -2.3C sll pry. Liu- fl`9 I g .S ,r, ,�;k,w >.r;.�J:...,,, .. , ,,:.<..�. .:2d1:,.. . . �r.... ........ .....:.... ^
Subtotal S 6 , l $
Suprv. Electrician signature, required: �, !r� Plan review (25% of permit fee): - - --
Print name: S }e, „ l3 e"-(,) I Date: .Z 7 i g / zo I) State surcharge (12% of permit fee): 6 , ") '4
/ I TOTAL PERMIT FEE: ' 2, , 7 2 ,
Authorized signature: Thi permit application expires if a permit is not obtained within 180
Print name: Date: days after It has been accepted as complete.
Num of inspections allowed per permit.
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