Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00536
Date Issued: 09/29/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel: 2S110DCO2300
Jurisdiction: Tigard
Site address: 11555 SW DURHAM RD A -3
Project: NW Tan & Nail Subdivision: 1998 -128 PARTITION PLAT Lot: 1
Project Description: (1) branch circuit to connect RTU.
Contractor: HUGHES ELECTRICAL CONTRACTORS INC Owner: HIP WILLOWBROOK LLC
10490 NW JACKSON QUARRY RD BY HARSCH INVESTMENT CORP
HILLSBORO, OR 97124 PO BOX 2708
PORTLAND, OR 97208
PHONE 503 - 647 -2221 PHONE:
FAX 503 - 647 -7754
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 09/29/2011 $56 18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/29/2011 $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 acco r - • - 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. ATTE, ION Ore••n la. -quires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952-001-011 0th ough OAR • - 001 -01:0 u may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1 7 o 1 800 332 2344.
Issued -y: I L � LL ✓ / Permittee Signature: 4
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' A 7 Date:
11111111.1111r -
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.
� p ' � ,s. -1 ,: 1 ('' ,.q tr 4 1..n'1 11 5141. 3 f, r ,tit r lit ,
Electrical Permit Application i, 11
nil °. "p Received
111 i" 13125 SW Hall Blvd , Tigard, tf C of Tigard � Date/13 , Olin, ;MI Permit No ^ '7LL, , -- .A.. s,; .
d, OR vb j .'tt: tl
c / Plan Review
► Other Permit
i Phone 503 718 2439 Fax 503 • Date /By
_t Inspection Line 503 639.4175 11 Date Ready /By. Juns ® See Page 2 for
. a�. - �:- .-:.a
�TI as 1 Internet' www Ugard - gov � � Noti fied /Method Supplemental C O P �o I
TYPE OF W Q lw x - [ R 0 PLAN REVIEW - ,
El New construction ® Addition /alter �{ �ig Of 5 �— Please check all that apply (submit 2 sets of' plans w /items checked below)
V ❑ Service or feeder 400 amps or more ❑ Budding over three stones
❑ Demolition 11 Other: B where the available fault current ❑ Marinas and boatyards
CATEGORY 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 E Commercial /industrial ❑ Accessory building amps for all other Installations buildings
❑ Multi - family ❑ Master builder ❑ Other ❑ Fire pump ❑ Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A" "0" "I -2" "I -3
Job no I OOHP or more occupancy 11A432 Job site address 11555 SW Durham Rd ❑ R ecreational vehicle parks
❑ Si', or more residential u m
p<
nits
City'''. ate /ZIP: Tigard, OR 97224 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite /bldg /apt. no . A3 Plo,leet name: Reitmeier - NW Tan & Nail ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to lob site. Den moon I QIV• 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'' 500 sq ft or portion 33 92 1
Tax map /parcel no : Limited energy, residential
75 00 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multi - family 75 00 2
Connect roof top unit residential (with above sq ft )
Services or feeders installation, alteration, and /or relocation
200 amps or less 100 70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2
401 amps to 600 amps 200 34 2
Nam:
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, and /or
City /State /ZIP: 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
401 amps to 599 amps 168.54 2
intended for sale. lease. rent. or exchange. according to ORS 447. 449. 670. and 701
Branch circuits— new, alteration, or extension, per panel
Owner signature: Date A Fee for blanch circuits with
❑ APPLICANT ® CONTACT PERSON above service or feeder ice 7 42 2
each branch circuit
Business name: Hughes Electrical Contractors B Fee for branch circuits without
service or feeder fee, first 1 56 18
56 18 2
Contact name: Tony Mulcahey branch circuit
Each add'I branch circuit 7 42 2
Address. 10490 NW Jackson Quarry Rd Miscellaneous (service or feeder not included)
City /State /ZIP' Hillsboro, OR 97124 Each manufactured or modular 67 84 2
dwelling, service and /or feeder
Phone (503) 816 - 8053 Fax. (503) 647 - 7754 Reconnect only 67 84 2
Pump or irrigation circle 67 84 2
E - mail. hec@hugheselectrical.com hugheselectrical.com Sign or outline lighting 67 84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Hughes Electrical Contractors panel, alteration. or extension Page 2 2
Each additional inspection over allowable in any of the above
Address: 10490 NW Jackson Quarry Rd Additional inspection (I hr min) 6625/ hr
Investigation (1 hr min) 66 25/ hr
City /State /ZIP Hillsboro, OR 97124
Industrial plant (I hr min) 78 18/ hr
Phone' (503) 647 -2221 Fax (503 -) 647 -7754 Inspections for which no fee is 9000 / hr
specifically listed ('L hr nun)
CCB Lie . 49850 Electrical Lle 34 -281C Supiv Lie 5350S ELECTRICAL PERMIT .FEES
6 ' � 3 -7/1P I i(�(/,13 Subtotal 5618
Suprv. Electrician signature, required
Plan review (25% of permit fee) 0 00
Print name' David Trapp Date. 09/29/11 State surcharge (12% of permit fee) 6.74
TOTAL PERMIT FEE 62 92
Authorized signature. This permit application expires if a permit is not obtained within ISO
days after it has been accepted as com plete.
Print name' Date: * Number of inspections allowed per permit
I A Budding V Pe, mils VELC- PermuApp doe 07/01/10 440- 4515T(I I /05 /COM /WEB