Permit IN q CITY OF TIGA ELECTRICAL PERMIT
8 " COMMUNITY DEVELOPMENT Permit #: ELC2011 -00168
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/01/2011
Parcel: 2S112BA04400
Jurisdiction: Tigard
Site address: 8030 SW FANNO CREEK DR
Project: WAINWRIGHT Subdivision: WAVERLY MEADOWS Lot: 11
Project Description: Panel replacement.
Contractor: BADGER ELECTRIC INC. Owner: WAINWRIGHT, CHARLES
4415 NE SANDY BLVD STE 205 57985 TIMBER RD
PORTLAND, OR 97123 VERNONIA, OR 97064
PHONE: 503 - 288 -4756 PHONE:
FAX: 503- 493 -7173
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 04/01/2011 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 04/01/2011 $12.08
Type of Use: SF Electrical
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 952 - 001 -0090 You y irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
grO J t
Issued By : a'a 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.
MAR -31 -2011 10:45A FROM: BADGER ELECTRIC, INC 503- 493 -7173 TO: 5035981960 P.2
11 City of Tigard '�\ R «eivcd
g Q Permit No. v
13125 SW Hall Blvd., Tigard, OR 97223 1 �' n.teiny: / // if 1 C ZIl rl -[ ".'� ■ r"
Plan Revie Other Permit
Phone: 503.639.4171 Fax: 503.598
turn Date/ny:
Inspection Line: 503.639.4175 Date Ready/By: turn la Ste Page 2 for
Internet www.tigard-or.gov Naitied/Method: p, ( Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction rAddltionIalteration/repincement Please check all that apply (submit lees of plans wlitems checked below)
['Service or feeds 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other
where die available tlrult canent ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
p I- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building less to ground, r all o a exceeds ran ❑ Commercial -use agricultural
g amps fix all other installations. , buildings.
❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
• FOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A", "E", "1.2" "1 -Y
Job no.: SCt 2 Job site address: �p3 x lJ h r� ? !MP or mots. Occupancy.
n
l a W Q f �{ [I six or MOB residential unite ❑ Recreational vehicle perks.
City/State/ZIP: -1- / • , y d C p cr 7 ,., ? - '4 ❑ Health -taro facilities. ❑ Supply voltage for mon: than
❑ liaminious locations. 600 volts nominal
Suite/bldg. /apt. no,: Project name: Wt[ (v) i.t.Ar( ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross si eet/dirrctions to job site: o.scrtNw. I orv. I Fee. 1 Tatal I •
New reildendal single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. R. or let, 168.54 4
Fa. add 500 sq. II. or portion 33,92 1
Tax map/parcel no.: Limited energy, residential 67,84 2
DESCRIPTION OF WORK (with above sq. IL)
Limited energy, multi -tinnily
—40diVrtV1 C.-PAR-trap residential (with above sq. tt) 67,84 2
Services or feeders installation 5 alteration, and/or relocation
200 amps or his 1 100.70 I C) .70 2
0 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/Stale/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 5936 1
201 amps to 400 turrps )25.08 2
Owner Installation: This installation is being made on property that [own which is not
I 401 amps to 599 amps 168,54 , 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, Per panel
Owner signature: Date: A. fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 n,2 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56,18 2
Contact nacre: branch circuit
Each add branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufacturer) or modular r 67.84 2
dwelling, service and//or leader
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
CONTRACTOR Sign or outline lighting 67.84 2
Signal circuit(s)or limited- energy
{� panel, alteration, or extension. Page 2 2
Business name:
1n, -\ ► t( ; 50,c_____ Each additional inapecdon over allowable he any of the above
Address: 4 , nom e �� b , 4. Additional inspection (I hr min) 66.25/ hr
City/State/ZIP: Q, s 4(Iurtik (It - 3 Investigation (1 hr min) 66.251 hr
v ' Industrial plant (t hr min) 78.18/ hr
Phone: ( 2,S(! . Li--.1 )1.Y I Fax: ( ) L[(e..)--7 1"'13 Inspections for which no fee is 90,00/ hr
C � specifically listed (14 hr min)
CCB Lic.: (S D5�i / I Electrical Lic.: .3 5",d Suprv. Lic.:5(,/73S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: ! d •70
Plan review (25% of permit fee):
Print name n.0 d t ., , (_ . -. Date: 3 (l Slate surcharge (12% of permit fen): 1 ,
TOTAL PERMIT FEE: z
Authorized si /�� 1 Iyf/ to
V " 1 ' 1 hats permit application expires if a permit V not obtflatd within 180
name. � Date :3` 30 ' I ` a days after bt has been accepted as eomptete.
�� � � �' Number of inspections allowed per permit.