Permit CITY OF TIGARD ELECTRICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00104
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/22/2011
Parcel: 1S125DC00202
Jurisdiction: Tigard
Site address: 7190 SW BARBARA LN
Project: FLANAGAN Subdivision: BOULEVARD HEIGHTS Lot: 26
Project Description: (3) branch circuits for heat pump, GFI outlet and air handler.
Contractor: HILLSBORO ELECTRIC LLC Owner: FLANAGAN, JOHN C
21185 NW EVERGREEN PKWY #110 818 NW 17TH AVE STE 7
HILLSBORO, OR 97124 PORTLAND, OR 97209
PHONE: 503 - 439 -9666 PHONE:
FAX: 503 - 601 -3680
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 02/22/2011 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/22/2011 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 • •.' 952- 001 -0090. You may�copy of e rules or direct questions to OUNC by calling 5 " 1987 or 1.800.332.2344.‘
Issued By: AIL .g.- 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 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.
From:Hi I Isboro Electric,LLC 5036013680 02/21/2011 07:53 #078 P.001/002
Electrical Permit A licati , `� 1 FOR OFFICE USE ONLY
p } .
lig • City of Tigard p j 1 O � \ R e eB * ' // IN I 1 I NI
-, 13125 SW Hall Blvd., Tigard, OR 9 23 `. `t6 i .)�U, Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ` C� ' .. ` ,.Dale/ : Other Permit: V F „ , a ,
1 1 t : n r, 1, inspection Line: 503.639.4175 "'.. \ -, 0 ' It ate Ready/By: - - -- — la See Page 2 for
Internet: www.tigard-or.gov
C Notified/Method: IM Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 1 of plans w /items checked below):
❑ New construction '. ddition/alteration/replacelnent
❑ 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 1 0,000 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", "E ", "1 -2 "13 ",
1001W or more. occupancy.
Job no.: 3C Job site address: "\ t ?.ter'
r ` 1 ❑Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: 752,( I Ore._, ! C%1 � ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name:V\T,v-11 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or les 168.54 4
Tax map /parcel no.: Ea. add'/ 500 sq. ft. or portion 33.92 1
Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
���
�� Limited energy, multi - family
]4e.Gt TbtvIp f G 'i. r < k, 2Xw'( residential (with above sq. ft.) 75.00 2
`` t Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
' 401 amps to 600 amps 200.34 2
Name: 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 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, er panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT above service or feeder fee, ❑CONTACT PERSON each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first 1
Contact name: branch circuit 56.18 So .vg 2
Each add' I branch circuit .5 7.42 Z Z, , 'L(o 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /Z1P: 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 _
panel, alteration, or extension. Page 2 2
Business name: Hillsboro Electric, LLC Each additional Inspection over allowable in any of she above
Address: 21185 NW Evergreen Pkwy #110 Additional inspection (] hr min) - 66.25/ hr
Investigation (1 hr mm)
City /State /Z1P: Hillsboro OR / 97124 78.r
Industrial plant (! hr rain) 78.1 1 8 /h B/ hr
Phone: ( 50 439-9666 F (503 ) 601 -3680 Inspections for 90.00/hr
CCB Lic.: 134481 Electrical Lic.: 4-499C _ Suprv. Lic.: 110 / ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Plan review (25% of permit fee): ,,----'^
Print name: V . \ .\1`1 Date:Q ,DA . k State surcharge (12% of permit fee): S . 47_,
TOTAL PERMIT FEE: . .. � � ��-
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: 0 Number of inspections allowed per permit.
I' ,eunding\eermitsiELC- Permnnppdoe 07/01/10 440- 4615T(11/05 /COM/'Ea