Permit •
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00477
Date Issued: 08/31/2011
TKKARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S103DA00500
Jurisdiction: Tigard
Site address: 13180 SW WATKINS AVE
Project: MIGUES Subdivision: DERRY -DELL Lot: 5
Project Description: Solar photovoltaic system.
Contractor: PRO STAT SERVICES LLC Owner: MIGUES, RONALD P & DEBORAH R
2904 E 24TH STREET 13180 SW WATKINS AVE
VANCOUVER, WA 98661 PORTLAND, OR 97223
PHONE: 503 - 539 -7772
PHONE: 503 - 888 -6447
FAX: 360- 718 -7092
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 08/25/2011 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 08/25/2011 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 08/25/2011 $12.97
Electrical
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 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 OA' 952 - 001 -0090. You ma co of tr - • - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
-7-- C�
Issued By: _� � .� -� 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 -,ray Fog EFIcE, USE oNI V $
City of Tigard :� Received
City Date/B - j` Permit No . l'
13125 SW Hall Blvd., ard, OR 972 .° j
t „ 1. � �\ Ptan Review t Other Permit: / •
Phone: 503.631.4171 Fax: X03 t ``, Date B I 11 it - A i 1
TI Inspection Line: 503.639.417 � I :" Date Ready/By: H See Page 2 for
j r 7 Internet: www.tigard- or.gov 61,� i t 1 t itled /Method: j, Supplemental Information
.
_ - TYPF`:. C3F WORK c ' .. T - „ : , , - PLAN, REVIE _ • . • , �;�� _ �
w•
❑ New construction ®Addition /alteration /re � Please check all that apply (submit 2 sets of plans /i /items checked below):
- +` ❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
. CATEGOR OF CONSTRUCTION;`, exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB , SITE - INFORMATION' AND LOCATION ❑mergncy system_ larger separately derived system
,, .. , -. . ❑ Addition ofnew motor load of ❑'`A `'E" "I -2" "I -i"
Job no.: Job site address: 13180 SW Watkins Avenue 100HP or more. 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.: Project name: MIGUES ❑ Service or feeder 600 amps or more.
. •FEE.SCIIEDLILE • -
Cross street/directions to job site: Description. I Qtr. I Fee. I Total 1
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'I 500 sq It or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
2
.
' DESCRIPTION' OF "14ORX .. . . (with above sq ft.) 67.84
-- Limited energy, multi- family 67.84 2
Roof top Solar PV installation residential (with above sq. ft.)
Servicesor feeders installation, alteration, and/or relocation
14 modules 200 amps or less 1 100.70 it -7V 2
El PROPERTY OWNER TENANT , 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: MIGUES 601 amps to 1,000 amps 301.04 2
Address: 13180 SW Watkins Avenue Over 1,000 amps or volts 552.26 2
City/State/ZIP: /StateIZlP: Ti ard OR 97223 "Temporary services or feeders installation, alteration, and /or
y g relocation
Phone: (503)888 -6447 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 circuitswith
® - above service or feeder fee,
. APPLICANT.
❑ONTAC "T PERSON. = 7.42 7. 4 ,2. 2
each branch circuit
Business name: PROSTAT SERVICES B. Fee for branch circuits without
service or feeder fee. first 56,18 2
Contact name: Dale Krueger branch circuit
— Each add'] branch circuit 7,42 2
Address: 8122 NE 91 Street Miscellaneous (service or feeder not included)
Cit /State/ZIP: Vancouver, WA 98662 Each manufactured or modular 67 84 2
y dwelling, service and/or feeder
Phone: (503) 539 -7772 Fax: : (360) 260 -7064 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: dale.krueger(a7comcast.net
o ou lighting
CONTRACTOR - SignalSign r ciicuit(tline s 67.84 2
• ) orlimited- energy
Business name: PROSTAT SERVICES panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2904 E 24 Street Additional inspection (I hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Vancouver, WA 98661 •
Industrial plant (1 hr mm) 78.18/ hr
Phone: (503) 539 -7772 Fax: (360) 260 -7064 inspections for which no fee is 90.00/ hr
specifically listed ('h hr min)
CCB Lie.: 189902 FlectricalLic.: 0597 Suprv.Lic.: 5459S .„ ' ;,,;:Fl,ECTRi(:AL-PERMIT' FEES. •' . -. _
Subtotal: :
Suprv..Electrician signature, required: , C,•.....t Plan review (25%ofpermit fee): �
Print name: Garin I Iagedom Date: 8/23/11 State surcharge (12% of permit fee): ' , 4):
TOTAL PERMIT FEE: jG ' COQ
Authorized signatur11""*" . - .,, . `'�
`" This permit application expires if a permit is nut obtained within 180
days after it has been accepted as complete.
Print name: Dale Krueger Date: 8/23/11 * Number of inspections allowed per permit.
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