Permit CITY OF TIGARD ELECTRICAL PERMIT
;'11 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00490
IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/01/2011
T
Parcel: 1 S133CC80111
Jurisdiction: Tigard
Site address: 14178 SW BARROWS RD 1
Project: Scholls Village Condominiums Subdivision: SCHOLLS VILLAGE CONDO STAGE 3 Lot: 11 -1, BL
Project Description: (1) branch circuit.
Contractor: MPD SYSTEMS INC Owner: HEIM, DAVID L
10117 SE SUNNYSIDE RD STE F517 14178 SW BARROWS RD #11 -1
PORTLAND, OR 97015 TIGARD, OR 97223
PHONE: 503 - 334 -6315 PHONE:
FAX: 503- 387 -5123
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 09/01/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/01/2011 $6.74
Type of Use: MF 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 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 OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23447
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.
Fm:MPD Systems Inc To:City of Tigard (15035981960) 10:20 09101/11GMT-08 P. 02-04
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Electrical Permit Application ,i FoR ()Fnct. Lisi.:0NI.,
City of Tigard ,..,„, \ yos,,,,:: • %\,\ . Dat .., liimrsz
q 131S Permit No ,a I AI • • / -..
25 W Hall Blvd, Tigard, OR,9,7123 \ i-
ll Plan Review
' 13 ' Phone: 503.718.2439 Fax: 503t98;r960 Date/By Other Permit: . A •I _ q if
: .
. v. ii , Inspection Line: 503.6394175 , 4 C. ,,cy,. • 'NN NDate Ready/By: BI See Page 2 for
Internet www.tigard-or.gov i, .c. o\C-.).`" . Notified/Method: WIN Supplemental Information
t (.' '...s s•-•:..\."'n s -
. - . .
.. - . . .,... • .. - - 1. . .... . • .. TYPE Of W0121,6\ °,:,;,..,`,..N..;- .. :-,:,...- ...', . •:,,, '.. :' ', ' ' :'. ' ' PLAN REVIEW = :' - . L,.. •.•.- -. ., ,
0 New construction - 6, Additionialteration*Weinent Please check all that-apply (submit 2 sets of plans w/items checked below):
• 0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: ; where the available fault current 0 Marinas and boatyards.
- - .' CATEGORY OF CONSTRUCTION • - • ' - • . '‘.- " ' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
• . s . less to ground or exce.ects 14000 0 Commercial agricultural
0 1- and 2-family dwelling 0 Commercial/industrial El Accessory building - amps for all other installations. buildings.
AEI Multi-family . 0 Master builder 0 Other: 0 fire pump. Clinstallation of 75 KVA or
. ' 0 Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION - .- ' ' ' I •. - a Addition of new motor load of
; 100HP or more. occupancy,
Job no.: Z1 40 Job site address: ) Li / 7 .5 Lt.-) Nge.,.."- 0 t..A6 24:4 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: - 1 d a IQ i A - 7 '1- "2- 3 a Health-care facilities.
, El Hazardous locations. 0 Supply voltage for more than
600 volts nominal.
r i
Suite/bldg./apt. no.: .. Project name: 0 Service or feeder 600 amps or more.
FEE SCHEDULE ', • , , r. ' . . ,
Cross street/directions to job site: Description i 00% I Fee. I_ Tote i * ,
New residential single- or multi-family dwelling.unit.
• . Includes attached garage. _
• 1,000 sq, ft. or less 168.54 4
Subdivision: , Lot no.:
. Ea. add'! 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: . ,
. Limited energy, residential
75.00 2
(with above sq. ft.)
. Limited energy, multi-family 75,00 2
• f
b
residential (with above sq. l.)
•
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
- - . . . . • 0 PROPERTY OWNER ,. .. . .. .._. - . ...•-: -ErfiNikit' .. ., .. - 201 amps to 400 amps 13356 2
. • 401 amps to 600 amps 200.34 2
Name:
' 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
. .
Temporary services or feeders installation, alteration, andior
City/State/ZIP: .
'
, relocation
1
• Phone: ( ) • . 200 amps or less 59.36 . Fax: ( )
201 amps to 400 amps 125.08 , 2
Owner installation: This installation is being made on property that 1 own which is not
401 amps to 599 amps 16854 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, .er panel
Owner signature: . . Date: A. Fee for branch circuits with
fee,
0 APPLICANT - - -.• - . 'P,-,. . ... '. CONTACT PERSON '.„ .:- - : 7.42 2
each branch circuit
Business name: .. • B. Fee for branch circuits without
service or feeder fee, first k 56.18 5 Cr 2
Contact name: ' . branch circuit
,
Each add 'I 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
Reconnect only 67.84 2
Phone: ( ) Fax: : ( )
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 2
. . -
,...
, ' • '• . .4". . ''. .CONTIOLOVR. . • ' • ' • ' _ '- ' . - . "- ;. .. • Signal circuit(s) or limited-energy • panel, alteration, or extension. Page 2 2
Business name: 44 P0,5 11 4 1,&44 / ro..c, Each additional inspection over allowable in any of the above
Address: toil -7 y ' Si P.44 6 ;"1-t• F"S" I """7 Additional inspection (1 hr min) 66.25/ hr ,
Investigation (1 hr min) 66.25/ hr .
City/State/ZIP: CI 4 c ic s 0 4 ci 7 0 15
i Industrial plant (1 hr min) 78.18/1u
Phone: ( ) 3 1.1 if 6,3 t 5 i Fax: 6 3.37-5 1 z_y Inspections for which no fee is
90.00/ hr
specifically listed (Y2 hr min) _
CCB Lic.: / n 1 ro . Electrical Lie.: C3620 Suprv. Lic.: 533 - ".:,. ' - .. tutcratcAt. PERMIT FEES - ... .... ..
Subtotal: 5 fir
Suprv. Electrician signature, required: .,.,; -4/0"
sr :. ...../ Plan review (25% of permit fee):
. .
Print name: 3 e -c-cd c i 1-1,...: \\ Date: e t State surcharge (12% of permit fee): 6, 'V I
TOTAL PERMIT TEE: 62
. Authorized signature: • .. . lids 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: \ BuildiagTermits \ELC-PamitApp.doc 07/01/10 • 440-4615101/05/COM'WEB
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