Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
CITY OF TIGARD ELECTRICAL PERMIT 1 1 1- g H p COMMUNITY DEVELOPMENT Permit #: ELC2011 -00533 13 125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 09/28/2011 TIGARD . Parcel: 2S103BB02900 Jurisdiction: Tigard Site address: 12148 SW 125TH AVE Project: Hughes Subdivision: BROOKWAY Lot: 29 Project Description: Permitting panel work done by previous owner Contractor: OWNER Owner: HUGHES, GARY A & SANDRA L 12148 SW 125TH AVE TIGARD, OR 97223 PHONE PHONE. FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 09/28/2011 $100 70 Specifics: amps or less 1 ea 12% State Surcharge - 09/28/2011 $12.08 Type of Use: SF 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 ccordance th 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 TENTION Oregon la. e• i - you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in 0)R 952 -00 -0010 thr•ugh OAR 952 101 -00 •u may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1 87 r 1 800 332 2344 is k e r 4/.. Issu d By: . _ P ermittee Signature: -- __ OWNER INSTALLATION ONLY ' The installation is being made on property I o which is not intended for sale, - a - e or rent 1 OWNER'S SIGNATURE x / I , / / �`v �/ T Date: / il l CONTRACTOR I TALLATION 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. CITY OF TIGARD ELECTRICAL PERMIT 2 `- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00533 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 09/28/2011 Parcel: 2S 1038802900 Jurisdiction: Tigard Site address: 12148 SW 125TH AVE Project: Hughes Subdivision: BROOKWAY Lot: 29 Project Description: Permitting panel work done by previous owner. 11/1/2011. Reprint permit to add (1) branch circuit for outlet. Contractor: OWNER Owner: HUGHES, GARY A & SANDRA L 12148 SW 125TH AVE TIGARD, OR 97223 PHONE PHONE: FAX' FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 09/28/2011 $100.70 Specifics: amps or less 1 crt Branch Circuits w /Purchase 11/01/2011 $7 42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 11/01/2011 $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 OAR 952 -0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 1987 or 1 800 332 2344 Issued By: /C (/ 1 "—`— Permittee Signature: l OWNER INSTALLATION ONLY The installation is being made on prop I own which is not intended sale, leash Arent / /f / OWNER'S SIGNATURE ` A Date: / ! l / CONT CTOR 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 - F012 OFFICE OFFICE,USE • `J Tigard DateBy. Cl of Ti aril Received / � ri / Penult No e - Q�'S33 III I q 13125 SW Hall Blvd , Tigard, OR 97223 Plan Review / O Phone 503 718 2439 Fax 503.598.1960 Date /By Other Permit T IGARD, Inspection Line 503.639.4175 Date Ready /By runs ® See Page 2 for Internet' www.tigard - gov Notified/Method Supplemental information TYPE OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans whtems checked below) ❑ New construction 11 Addition/alteration /replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings ❑ 1 -and 2-family dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural y g ❑ 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 ❑ Emergency system larger separately derived system ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "I -3 ", Job no.: 1 Job site address: 2 L //' 9 . ' W ' __ ' / 100HP or more occupancy 1 t I� 2 ❑ Six or more residential units ❑ Recreational vehicle parks City/State/ZIP: y i t ✓ / O 9 2 2 ❑ Health -care facilities ❑ Supply voltage for more than 1 ❑ Hazardous locations 600 volts nominal Suite /bldg. /apt. no.: Project name 6 a ,,r y 4 /`i t tt P -s ❑ Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I " 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. ft or portion 33 92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq ) 75 00 2 ft Limited energy, multi -family residential (with above sq ) 75 00 2 ft Services or feeders installation, alteration, and /or relocation 200 amps or less / 100 70 /Oa 70 2 ❑ PROPERTY OWNER n ❑ TENANT 201 amps to 400 amps 133 56 2 C. J 0.N ,Ll 401 amps to 600 amps 200 34 2 Name ` �� S 601 amps to 1,000 amps 301 04 2 Address: 1 4 Over 1,000 amps or volts 552 26 2 Temporary services or feeders installation, alteration, and /or City /State /ZIP: l 1 , 7 0 . . . r d c0 a 9 7 2 2 ' 3 relocation Phone: (8 L_ " -- 9 - 0© ._ �`7 //� 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, lea e, ent, or exchange, ording to RS 447, 449, 670, a 701. 401 amps to 599 amps 168 54 2 ` Branch circuits - new, alteration, or extension, per panel Owner signature: . �/ Date: 9 8/20q A Fee for branch circuits with ❑ APPLICA1N I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: B Fee for branch circuits without service or feeder fee, first 56 18 2 Contact name: branch circuit Each add'l branch circuit 7 42 2 Address: Miscellaneous (service or feeder not included) Ci /State /ZIP: Each manufactured or modular 67 84 2 ty dwellmg, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67 84 2 Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting 67 84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: /i { } panel, alteration, or extension Page 2 2 �'CJ ILJ Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66 25/ hr City /State /ZIP: investigation (1 hr min) 66 25/ hr Industnal plant (1 hr mm) 78 18/ hr Phone: ( ) I Fax: ( ) Inspections for which no fee is 90 00/ hr specifically listed (% hr mm) CCB Lic.: Electrical Lic.: Suprv. Lic. ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal 70_ 7O Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee). /p _Oq TOTAL PERMIT FEE i 9.... ' '7 Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. Number of inspections allowed per permit. I \Buiidmg\Permits\ELC- PermitApp doc 07/01/10 440- 4615T(11 /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* n Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I \Bmldmg\Penmts \ELC- PermitApp doc 07/01/10