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Permit q CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00618 Date Issued: 11/03/2011 TIGAR.D 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 2S111AA03400 Jurisdiction: Tigard Site address: 8625 SW GREENSWARD LN Project: MCCONNELL Subdivision: GREENSWARD PARK Lot: 4 Project Description: Rewiring main floor and replacing panel. Contractor: VAST ELECTRIC Owner: MCCONNELL, BRIAN A & 1525 SEATTLE SLEW DR. SE MCCONNELL, MARGARET M SALEM, OR 97301 8625 SW GREENSWARD LN TIGARD, OR 97224 PHONE 503 - 566 -7274 PHONE: FAX: 503 - 585 -8828 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 11/03/2011 $100 70 Specifics: amps or less 8 crt Branch Circuits w /Purchase 11/03/2011 $59 36 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 11/03/2011 $19 21 Electrical Type of Const: Occupancy Grp: Total $179 27 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' •52 -001 -0090 You may obtain a copy of the les arTttrec uestions to OUNC by calling 503 232 1987 or 1 800 332 2344 Issued By: �1. Permittee Signature: i 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 qq6 j� 1'Cix c ?I'l °lc ,e ,l �> 1 -i C of Ti and � �b � O f , Received -d \ Dni B �1 Permit No.: -(it.�• ll..- • [ , 13125 SW Hall Blvd., Tigard, OR 97 l: Phone. ■ 503.718.2439 Fax. 593 5 98 h ' o� r- � A t;t� ` e, t Other Permit T1 G/i RD Inspection Line: 503.639.4175 C� �vS'� a Read 61 Sec Page 2 for Internet: www.ttgard �, ®< � � �� NonfiedNl�ethod: Sepplemental lnformation TYPE OF WORK 4 r�." � PLAN REV[EW — ❑ New construction ® Addition/aiterdtion/repl J" t Please check all that apply (submit 2 sets of plans w /items checked below) J` ❑ Ser mee or feeder AQO amps or more ❑ Building over three stories. El Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings leas to ground, or exceeds 14,000 ❑ Commercial -use agricultural ® 1- and 2- family dwelling ❑ Commercialiindustrial ❑ 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 El Emergency system larger separately denvcd system. © Addition of new motor lead of ❑ "A ",' E ", "7 -2', "t -3 °, Job no.: Job site address: 8625 Greensward Lane 100HP or more, occupancy. ❑ Six or more rasidential units. ❑ Recreational vehicle parks. City /State /'LIP: Tigard OR 97224 ['Health-care facilities. ❑ Supply voltage for more than 13 Hazardous locations 600 volts nominal. Suite /bldg. /apt. no.: Project name: McConnell ❑ Service ar feeder 690 amps or more. FEE SCHEDULE Cross streetidirections to job site: Description I Oty. 1 Fee. I Tout 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 ft or portion 33.92 1 Tax neap /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq 11.) Limited energy, multi - family 75 00 2 Re wire main floor due to fire and panel change residential (with above sq ft.) , Services or feeders installation, alteration, and /or relocation 200 amps or less 1 100 70 100 70 2 0 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: i 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 532.26 2 City/Slate/ZIP: Temporary services or feeders installation. alteration, and/or 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: Dale: A_ Fee for branch circuits with ® APPLICANT I ❑CONTACT PERSON above service or feeder fee, 0 7.42 59.36 2 each branch circuit Business name: Vast Electric B. Fee for branch circuits without l i service or feeder fee. first 5618 2 Contact name: Tim Vander Stoep branch circuit Each add'l branch circuit 7.42 2 Address: 1525 Seattle Slew Dr Se Miscellaneous (service or feeder not included) City /State/ZIP: Salem OR 97317 Each manufactured or modular 67 84 2 dwelling, service and/or feeder Phone: (503) 566 - 7274 i Pax: : (503) 585 - 8828 ' Reconnect only 67.84 2 Pump or irrigation circle 67 84 2 ' E -mail: vastelectric @comcast.net Sign or outline lighting 67 84 2 CONTRACTOR Signal circuit(s) or limitedenerg Business name: Vast Electric panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: 1525 Seattle Slew Dr SE Additional inspection (1 hr min) 66 25/ hr CityiState/ZIP: Salem OR 97317 Investigation (1 hr min) 6625/ hr Industrial plant (1 hr min) 78 - 181 hr Phone: (503) 566 - 7274 Fax: (503) 585 - 8828 Inspections for which no fee is 90001 hr specifically listed (%z hr min) CCB Lic.: 175531 Electrical Lie.: C - 280 Suprv. Lic.: 51865 ELECTRICAL PERMIT FEES � ^ Subtotal: ; 160.06 Suprv. Electrician signature, required: Plan review (25% of permit fee): j Print name: Tim Vander Steep Date: 11/02/2011 State surcharge (12% of permit fee): 19.21 TOTAL PERMIT FEE: 179.27 Authorized signature: .�. - i -�L��i! "���i This permit application expires if a permit is not obtained within Intl Print name: Date: days after it has been accepted as complete. i. Number of inspections allowed per permit. I l Build ingtPermiiditt.C- Per,nitApp doe mein 4404615T4 11/OS!COM/WEI3 . Z'd 9Z98 'out 0il10e13 lsen 0 80:60 1.1. ZO AoN