Permit CITY OF TIGARD ELECTRICAL PERMIT
•• 8 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00241
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/06/2011
Parcel: 2S112BB02100
Jurisdiction: Tigard
Site address: 8280 SW COLONY CREEK CT
Project: Winowitch Subdivision: COLONY CREEK ESTATES Lot: 17
Project Description: Install ground rods due to water service replacement.
Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: WINOWITCH, CAROLYN
1709 SE 3RD AVE 8280 SW COLONY CREEK CT
PORTLAND, OR 97124 TIGARD, OR 97224
PHONE: 503 - 234 -9900 PHONE:
FAX: 503 - 535 -2763
FEES
Quantity Description Date Amount
1 ea Reconnect Only 05/06/2011 $67.84
Specifics:
1 ea 12% State Surcharge - 05/06/2011 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 .+• • - 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. AT ' NTION: Oreg• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0610 through OAR 9 '-06 -0690 • may obtain a copy of the rules or direct questions to OUNC by calling 50 32.1987 or 1.800.332.23 4.
Issued - r w ` �! � !' 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' • 1 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.
Electrical Permit Application RECEIVED
City of Tigard MAY 6 2011 Permit No.: ced : 5 /
Dal t� Q t1� �' � 2 .„ /1 _ ��
III
13125 SW Hall Blvd, Tigard, OR 97223 Plan Review
' I Phone: 503.7182439 Fax: 503.598. OF TIGARD Dale/BY: Other Permit:
7 I ; . ,, f: I) Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: runs: fig See Page 2 for
Internet www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
I;.:; r fo "' , s s ' s a , ON ° '" tv exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
ass lea ,. < - ,� I
® 1- and 2- family dwelling ❑ Commercial/industrial less all of a exceeds ons, ❑ Commercial -use agricultural
❑ Accessory building amps for all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
#' Y , , a _ a� v _ $ II • r . ❑ Emergency system. larger separately derived system,
n , § i ! € . ` : : a r r . r y t s a , - 1 . � ' ❑ Addition of new motor load of
Job no.: 79608 Job site address: 8280 SW COLONY CREED CT 10OHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: TIGARD OR 97224 ❑ Health facilities. ❑ Supply voltage for more than
❑ Hazardous locations, 600 volts nominal.
Suite/bldg./apt. no.: J Project name: CAROLYN WINOWITCH ❑ Service or feeder 600 amps or more.
s.1: , - , l,
Cross street/directions to job Site: `r ` NIO.V MA -� y'� { y� ... . :.
J Description 01Y• Fee. Tatel
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'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK < �r Ng .' ' (with above sq. ft) -
Limited energy, multi- tt<mily
INSTALL GROUND RODS. JOB #79608 residential (with above sq. ft.) 75'00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
4P , � ❑ PROPERTY OWNER .4:', ❑ 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
City /State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) J Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature Branch circuits — new, alteration, or extension, er panel
_ - ._. - .__ Date: ___ A. Fee for branch circuits with
x
w above service or feeder fee
a xl . ❑, APPL} CANT�NTI�N 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder rte, [list 56.18 7
Contact name: branch circuit
Each add °1 branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) J Fax: : ( )
Reconnect only 1 67.84 67.84 2
Pump or irrigation circle 67.84 > ., 2
E-mail:
rxacz � � t :,��G � � ? < 3h � � � �, � Sign or outline lighting 67.84 2
�
r , § _ ; .; t4 " " *s�, t ; stn.• i , :; e. CT`OIL`,� S _,.t `2t } .; a� a. * `� ', Signal circuit(s) or limited -energy
Business name: OREGON ELECTRIC GROUP panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: 1709 SE 3 AVE Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: PORTLAND OR 97214 Investigation (1 hr min) 66.25 / hr
Industrial plant (1 hr min) 78.18/ br
Phone: (503) 234 -9900 Fax: (503) 535 - 2763 Inspections for which no the is 9000 / hr
specifically listed ('/r hr min)
CCB Lic.: 203 Electrical Lic.: 26.95C Suprv. Lie.: 4549, i t, , e a . -,a ° t ) °° I OF, a
t ( t: , . ` �('�c".. .9 \��4 Subtotal: 67.84
Suprv. Electrician signature, required: -"' s �Ir , ` `
Plan review (25% of permit fee):
Print name: RICK MCELLIOTf Date: 5-6-11 ,, State surcharge (12% of permit fee): 8.14
•
Ilist a` TOTAL PERMIT FEE : ..............
75.98
Authorized signature: 1 C— � � L 33j�
This permit application expires if a permit is not obtained widths 180
Print name: RICK MCELLIOTT Date: 5 - 6 - 11 *
days after It ins been accepted as complete.
Number of inspections allowed poi permit.
I: \ Building \Penmits'BLC- PermitApp.doe 07/01 /10 440.4615r(11/05/CO).d/WEB