Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
�� CITY OF TIG ARD ELECTRICAL PERMIT COMMUNITY DEVELOP Permit #: ELC2011 -00193 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2011 Parcel: 2S110DCO2300 Jurisdiction: Tigard Site address: 11555 SW DURHAM RD A -1 Project: JB OBRIEN'S Subdivision: Lot: 0 Project Description: (8) branch circuits. Contractor: ECOLECTRIC LLC Owner: HIP WILLOWBROOK LLC 4650 NW 166TH AVE BY TAX DEPARTMENT PORTLAND, OR 97229 PO BOX 2708 PORTLAND, OR 97208 PHONE: 971 - 269 -9050 PHONE: FAX: FEES Quantity Description Date Amount 8 crt Branch Circuits wo /Purchase 04/13/2011 $108.12 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/13/2011 $12.97 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $121.09 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 ac • • : - • • approv - • 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. ATT ' ION: Oregon - req res to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0410 thro gh OAR 95 r 1 -0� y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987...or- 1.800'. 344. i Issue By: ■ d "Lil / ■14 PermitteeSignature: l �f„ /,( 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: ONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' / Date: LICENSE NO. sf� 75 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. Electrical Permit Application RECEIV l I 1111I(I 1 sI ()vl 1 City of Tigard Iv a my � � l� P N 1 �QI� �/� 2 • IINI •. e/B : 0000❑ J 1 3125 SW Hall Blvd., Tigard, OR 97223 p P❑ 9 Plan Review C Phone: 503.718.2439 Fax: 503.598.1960 APR 3 G 0 I I Plan Re : ❑ ❑ ❑ ❑ ❑ Sher Pennitc ❑ T I G A R D Inspection Line: 503.639 Date Ready/By HUD ❑ ❑ Juris: 0 See Page 2 for g g CITY OF TIGA N otified/Method: 0000❑ °O° Internet: www.ti and -or. ov Supplemental Information TYPE OF WOIIUILDING DIVISION Print name: II I I 1 10 0 L LI New construction ICJ Addition/alteration/replacement ID Demolition El Other: ❑ ❑ ❑ ❑ ❑ PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below): CATEGSNtY OF CONSTRUCTION ❑Service or feeder 400 amps or more ❑ Building over three LI 1- and 2 family dwelling Commercial/industrial U Accessory building where the available fault current stories. ❑ Ot her: 00000 ❑ ❑ ❑ ❑ exceeds 10,000 amps at 150 volts or 111 Marinas and boatyards. El Multi Master builder less to ground, or exceeds 14,000 ❑ Floating buildings. JOB SITE INFORMATION AND LOCATION amps for all other installations. Job no.: ❑ ❑ ❑ ❑ ❑ Job site address: 0 O ❑ ❑ ❑ i j 65'6" S0 Doi n'l >� ❑ agricultural Commercial ❑Fire pump — ,--- agricultural system. buildings. City/State /ZIP: ❑ 0 0 ❑ O . I I a r i l / D 2 q 7ZZ/f DAddition of new motor load of ❑ Installation of 75 KVA 100HP or more. or Suite/bldg. /apt. no.: ❑ 04 Project name: ❑ 0 ❑ 0 0 i ) R (> . S ❑Six or more residential units. larger separately derived system. Cross street/directions to job site: 0 0 0 0 ❑ qq /A 7, 1') h ��, ❑ Heald, - ca re facilities. CI ( occupanc El Hazardous locations. ❑ 3 ❑ ❑ ❑ ❑ Service or feeder 600 ❑ parks. Recreational vehicle Subdivision: 0 0 0 ❑ ❑ Lot no.: ❑ 0 ❑ ❑ ❑ amps or more. ❑ Supply voltage for Tax map /parcel no.: ❑ 0 0 01 more than 600 volts nominal. DESCRIPTION OF WORK 0 0 0 0 0 6 FEE SCHEDULE � avtck tit /G:✓r�� hhQ rGL/tLl K / J /l tLkscnption I Qty. I Fee I Total I. 00000 New residential single- or multi- family dwelling unit. ,�._,,�� Includes attached garage. ❑ PROPERTY OWNER I [ TENANT 1,000 sq. ft. or less 00 168.54 00000 4 Name: ❑ ❑ ❑ ❑ ❑ j ti Ea. add'I 500 sq. ft. or portion 0 ❑ 33.92 00000 1 ✓4 - 0 F "� Limited energy, residential Address: ❑ ❑ ❑ ❑ ❑ (with above sq. ft.) 00 75.00 00000 2 Limited energy, multi - family ❑ ❑ 75.00 001100 2 City/State /ZIP: 0 0 ❑ 0 ❑ residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation Phone: (00000)00000 Fax: (00000)00000 200 amps orless 0 100.70 00000 2 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 0 ❑ 133.56 [10000 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 00 200.34 00000 2 Owner signature: Date: 601 amps to 1,000 amps 0 ❑ 301.04 ❑ 0 0 ❑ 0 2 ❑ APPLICANT I ❑ CONTACT PERSON Over 1,000 amps or volts DO 552.26 00000 2 Temporary services or feeders installation, alteration, and/or Business name: ❑❑❑ 0 E c O /e c -f t G , L L C relocation ,n � 200 amps or less 00 59.36 ELI ❑ 0 ❑ 1 Contact name: ❑ ❑ ❑ ❑ ❑ y' tit- t7 v ILl 1 / is— 201 amps to 400 amps 00 125.08 00000 2 Address: 0 0 ❑ 0 0 .q'4 z) f u t-ti /64 Ill /4/1- 401 amps to 599 amps ❑ ❑ 168.54 00000 2 Branch circuits — new, alteration, or extension, per panel City /State /ZIP: ❑ ❑ 0 ❑ ❑ P© r-/-6 I , D k q 7 2,19 A. Fee for branch circuits with above service or feeder fee, 00 7 42 0 ❑ ❑ ❑ ❑ 2 Phone: (3 0 0 0 0) 0 0 0 ❑ ❑ V/ /69 ?oft, Fax::010000) 0 0 0 0 ❑ each branch circuit E -mail: 0 ❑ ❑ ❑ ❑ l2l//tl'i . GC> EC � ' � i G c B. Fee for branch feeder circuits without f, � U /Yjt' � !. 6 r service or ft;eder feee, first 4 56.18 ° 2 CONTRACTOR branch circuit Business name: ❑ 0 0 0 ❑ Each add'I branch circuit ri 7.42 I 1451711 t* Miscellaneous (service or feeder not included) Address: 0 0 0 0 0 Each manufactured or modular [ii 67.84 00000 2 dwelling, service and/or feeder City/State /ZIP: 0 0 0 0 0 Reconnect only 00 67.84 00000 2 Pump or irrigation circle 0 I 1 67.84 00000 2 Phone: (OLIO ❑❑) 0900❑ 1 �� _ Fax: (00000) 00000 Sign or outline lighting 00 67.84 00000 2 CCB Lic.: eq 3 f'iectrieai Lic.: : .:A l(( kuprv. Lic.: 01441`1]8 Signal circuit(s) or limited - energy '` panel, alteration, or extension. ° ° Page 2 ° ° ° ° ° 2 Suprv. Electrician signature, required:( j / 1 , Each additional inspection over allowable in any of the above / Additional inspection (1 hr min) ❑ ❑ 66.25/ hr 0 ❑ ❑ 0 4 s; - . ��rh D ate: ❑ ❑ ❑ ❑ ❑ l l ��/ / 0000 Print name: 0000111 �� Investigation (1 hr min) 0 ❑ 66.25/ hr Authorized signature: 0 0 0 ❑ Industrial plant (1 hr min) ELI ° 78.18/ hr ❑ I: Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11/05 /COM/WEB