Permit �' CITY OF TIGARD ELECTRICAL PERMIT
�'' '= COMMUNITY DEVELOPMENT Permit #: ELC2011 -00319
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/09/2011
Parcel: 2S110DD90261
Jurisdiction: Tigard
Site address: 10835 SW MEADOWBROOK DR 26
Project: Subdivision: SUMMERFIELD BROOKSIDE CONDO Lot: 26
Project Description: (1) 200 amp service
Contractor: PORTER ELECTRIC INC Owner: MCMURTRIE, LUCILLE TR
7320 NE ST JOHNS RD 10835 SW MEADOWBROOK DR, UNIT 26
VANCOUVER, WA 98665 TIGARD, OR 97224
PHONE: 360 - 574 -1366 PHONE:
FAX: 360 - 573 -3723
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/09/2011 $100.70
Specifics: amps or less .
1 ea 12% State Surcharge - 06/09/2011 $12.08
Type of Use: MF 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 0 • '. 95i952-00_,0095. You may obtain a copy of the rules or direct questions to OUNC by cal!' g . 32.1987 or 1.800 32. 344.
Issued By: /d � ' �/ �� 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.
Electrical Permit Application ' - 'FOROF '. -
RECEIVED R eceived i �s.
City of Tigard Permit No.
I = 131 Hall Blvd., Tigard, OR 97223 Date/B : Q ` L�G�- �O���D
g Plan Review
Phone: 503.639.4171 Fax: 503.595.196 U N 9 2011
Date/B : Other Permit:
TIGARD inspection Line: 503.639.4175 . Date Ready/By: 10 See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: EMI Supplemental Information
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❑ New construction E, Addition /alteration/replacement Please check all that apply (submit 2 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.
�- +..� - f^ °��"" ��* ^ "`` % C A T ��::ef * =r �.;�4 -s , exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
: .n 4 .. i ;1 �. EGURY OF CONSTRU
CTyNs ;, , _°at ; . - k , �_ g s.
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' �''''' 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
/:,j may. -, „ ❑ Emergency system. larger separately derived system.
t JOBt SITE INFORMATION 'AND LOCATION ❑ new motor load of ❑ "A ", "E ",
.. r. . -.� », Addition "1 - 2" "1 - 3>
Job no.: Job site address: /) g5 Si/ /L .ie 100HP or more. occupancy.
V �$�G ❑ Six or more residential units. ❑ Recreational vehicle parks.
❑ Health -care facilities. ❑ Supply voltage for more than
City/State /ZIP: y g
� �YI12 -� � � . t / nI17• Z ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: �a ks ❑ Service or feeder 600 amps or more.
t it' "*„ tzwtx:' _ FFEE SCHEDULE ':._,".�. ^«.;' = >-:
Cross street/directions to job site: Description "' "" ”` " _ " "" �' . Total ¶ *•�
J Description 1 Ore. I Fee. � Total
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
o , 75.00 2
s
�c max.- _.. a:f ," . _ : _b- DESCRIPTION OFD WORK ... ;' `- (with above sq. ft.)
���� Limited energy, multi- family
7 ? - ,& rizov? 4 ! °� J +�0 A-WN residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
/1.O1/W Q Ir-O 0 - 200 amps or less / 100.70 /9 2
%;:i�',�.�h t PROPEKll'gO w le v p9® TIINANf rw: 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: ( ) 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, per panel
Owner signature: • Date: A. Fee for branch circuits with
;,t,, ,,v,, :a`.$;< - : ,—,,, ,5 v u ;:. _ . .° fee,
APPLICANT fi3p „ c ° „ ®CONT 1 'ERSON above service or feeder f 7.42 2
1 z each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first
Contact name: branch circuit 56.18 2
Each add'l branch circuit , . 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
:.: ..,,,,,;.,, ,.,,.,,.. �, Sign lighting 67.84
or outline
:s`, -- ... A..Y, .._ ,,:�., CONTRACTOR „ .,, . y. v `Q: r FrA.k _i <x
- . Si circuit(s) or limited-energy
Business name: PORTER ELECTRIC, INC. panel, alteration, or extension. Page 2 . 2
Each additional inspection over allowable in any of the above
Address: 7320 NE ST. JOHNS ROAD Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: VANCOUVER, WA 98665 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( 360 ) 574 -1366 Fax: ( 360 ) 573 - 3723 Inspections for which no fee is
specifically listed ('/A hr min) 90.00/ hr
CCB Lic.: 46678 0 2 A ectrical Lic.: 37 334C ! I ��prv. LTC. Z U r� ;<<<, ;, ' � # =,-x ELEGTRICAT EERMIT:FEESMAM .
Suprv. Electrician signature, required: A Subtotal: /60, 70
1/`"" l'L ^� �� Plan review (25% of permit fee):
•
Print name: KENNETH D. BOAL Date: State surcharge (12% of pennit fee): /2_ 0 7
TOTAL PERMIT FEE: 1,,7 8
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: * Number of inspections allowed per permit.
I:\Building \Permits \ELC- PermitApp.doc 07/01/10 440- 4615T( II/05 /COM/WEB