Permit II CITY OF TIGARD ELECTRICAL PERMIT
'- . :, COMMUNITY DEVELOPMENT Permit #: ELC2011 -00339
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2011
Parcel: 2S 101 A D00400
Jurisdiction: Tigard
Site address: 6655 SW HAMPTON ST
Project: Hampton Oaks Subdivision: WEST PORTLAND HEIGHTS Lot: 14 -31, P
Project Description: Repair underground wiring from one light pole to another.
Contractor: BOBS ELECTRIC Owner: HAMPTON OAKS LLC
2700 NE BURTON ROAD STE A 6665 SW HAMPTON
VANCOUVER, WA 98662 2ND FLOOR
TIGARD, OR 97223
PHONE: 360 - 254 -7200 PHONE:
FAX: 360- 254 -8219
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 06/21/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/21/2011 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in acc ce ith, approved flans. This permit will expire if work is not started within 180 days of issuance, or it work is suspended for more the 180
days. ATTE ION: Oregon law r- , ires yo to follow the rules adopted by the Oregon Utility Notificati enter. Those rules are set forth in OAR
952- 001 -00 0 through OAR 952 - 001 - Y. obtain a copy of the rules or direct questions to OUNC by callin 03.232.1987 or 1.800.332.2�34 ; �� ^
Issued B • .. Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
------, CONTRACTOR INS ELATION NLY
SIGNATURE OF SUPR. ELEC' . i ,4 f Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM <WED > -JUN 22 2011 7:031ST. 7: 03 /14o. 8302825780 P 1
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Electrical Permit Applic • ii,t iCEIVED 1 . ( 1 1 4 (,l- i: li "F. l s f. c,. r:1
City of Tigard A 1 D wa & OE Pe N 5 4.
13125 SW Hall Blvd., Tigard, OR il�t4 21 2011 �`
Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit:
T 1 c; \ R rr Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: /uric H See Page 2 for
Internet: www.tigardor.gov r , , Notified/Method: Supplemental Information
: s'_... � ...� � xl'�?' � +-� ^M �+$s'(§?,?i- k ��k�, �.;3:: "C ro. � 1:, � rtr i"s Y "'�,�,•. #•, 'tt s # }�
-w I. 'cad 'r5' a't >
�: A'� .,..' � mra��.irti �F .<&xx`; m...,,...,..r c..e...... ;A� "3.�., .kY;:,.me �u,��"�:..i::i .. :�..5:n:�, �E�.. �d•�ic='�«``a��e��. zs�e m'r.. :: fe'� , s T�. v�`,' �« .a."........_.�w�'ron�.S�wszA .
Please check all that apply (submit 2 sets of plans w/items checked below):
❑ New construction ❑ Addttion/alteCation / replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Other: where the available fault current ❑ Marinas and boatyards.
�� �, " ,', "'z '� 1 r ' ``� "; f. "I� 4 4 r r �� exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
r7 ,7 1 .a' „„" .t" '' t , ' 4a. '""�'` . '`" ''' t u} t` ` ' Y" " less to ground or exceeds 14400 ❑Commercial -use agricultural
❑ I - 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
.. � n �,a r� €Ix �a c +, fprts � si s it ,al :z, .' �b ., 5, , 0 Emergency system larger separately derived system.
._ : : w '"r -- s a, t ;w —,.au i �,. :�.w ,i: . . a: ' -r. t F-i: _ - . ❑ Addition of new motor load of ❑ „A„ "V, . " -3 „
Job no.: 11 - 429 Job site address: 6655 SW Hampton St. IooHPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more
Cross street/directions to job site: Description Qty. Fee. Twat •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add 'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential '
.', 8 `"-' : . . r-u` : . 'e` ' 'ir ^a.s T. n. ' . 5 ate' 7500 2
max r . ii.'. ; .-: ,a,, 't�,t a:a ±s6`s « a r r '^� " = '`".. u,. (with above sq.
.. r i
Limited energy, multi-family 75.00 2
Repair underground wiring fron one light pole to another residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
. ,15 “,, r ` t: w_7'a ' z 'svr N ra. iqt.: 201 amps to 400 amps 133.56 2
,� uti ; s^" =-ta::a5:fia u2...4 -. : .M: fir` .: a,:: 'b as ' <,i ` ..s, ' 3 .�.. "u4` :. 'a- Pa P
Name: Hampton Oaks 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 6655 SW Hampton St. Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP. Tigard, OR 97223 relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 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. 4(11 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, , • r panel
Owner signature: Date: A. Fee for branch circuits with
`z:-:'1: "H u ,4 Nt . = . ,��• �` r , A ` iR � i= fir' `r=e" above service or feeder fee,
-i n? .4- ! �� �, ) , ... .r a a ro, :. F each branch circuit 7.42 2
,.. .�c...,t�.,u.:xa.zu�;s�s..q.... ....iz� _. � .,a.»a:..'xa�,... Year a.. - �^;t.l+u.,,s^w*scrr ,..yd
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'' branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
CitylState/Z1 P: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E Sign or outline lighting 67.84 2
,.. ' ;- ..a . V 1 f -, : , —:- a.,,.. ^ . :; � O ixr,acc^ ,.; - Signal circuit(s) or limited- energy
Business name: Bob's Electric panel, alteration, or extension. Page 2 _ 2
Each additional inspection over allowable in any of the above
Address: 2700 NE Burton Rd., Ste. A Additional inspection (I hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State/ZIP: Vancouver, WA 98662 Industrial plant (I hr min) 78.18/ hr
Phone: (360) 254 Fax: (360) 254 - 8219 Inspections for which no fee is 90,00 / hr
ificall listed (% hr mm)
CCB Lic.: 53136 (p r/ Electrical Lic.: 37-43 Suprv. Lie.: 4322S �" �'" "" raj' =' "" "', ` :75?- : - •
Suprv. Electrician signature, requiredt, Subtotal: 56.18
�+ Plan review (25% of permit fee):
Print name: Kevin Broselle Date: 6/21 /2011 State surcharge (12% of permit fee): 6/4
TOTAL PERMIT FEE: 62.92
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. 1,16.....)
1 :\ 13uilding \Permiss1ELC- PermisApp.doc 07101/10 440- 4615T(1 I/OS /COM/WEB