Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00636
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/09/2011
Parcel: 25101 DD00400
Jurisdiction: Tigard
Site address: 6825 SW SANDBURG ST
Project: Vigilant Subdivision: SALEM FREEWAY SUBDIVISION Lot: 2
Project Description: TI
Contractor: MCCOY ELECTRIC CO INC Owner: VIGILANT
2014 SE 9TH AVE 6825 SW SANDBERG ST
PORTLAND, OR 97214 TIGARD, OR 97223
PHONE: 503 - 234 -7521 PHONE:
FAX: 503 - 234 -9473
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 11/09/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/09/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 or . • - • • of the r -s or direc c uestions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .�_ f�` � �— Permittee Signature: / / .e4__..
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.
Ei. v 102 11PM Mc C ,
No. 7059 P. 1
Jlica ° PI
OFFIC I. .
— - -- - --------- - ,- R E ---- — - --- ------ - -- _
City of Tigard Rect aleo md : 1 friLMM, Pennit No.: "7, 1 v / .... ,
lIl I 4 13125 SW Hall Blvd,, Tigard, OR 97223 NO V 0 9 2011 an Review
" II Phone: 503.718.2439 Fax: 503.598,1960 Date/131: Other Permit:
TIGARI, Inspection Line: 503.6394175 Date Ready/T3y: kris: 171 See Page 2 for
Internet: www.ligard-or.gov CITY OF TIGARD Nolifi.umohod: -- cp_ .; .....&., I suppkmenlal Information
0 . **". , " 7 '? , ': .131 ..,.. [ : . r ' Z'T: ''':' 7f .i .: .; '.'f :T7 ..'': : . ;:,. 1 s '-''''
El New construction El Addition/alteration/replacement Please check all that apply (submit a sets of plans whierns checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition l=1 Other: where the available fault current D Marinas and boaryards.
... '•' s' ..- • . ,,+ •. itl. 'i '6 6 ,...7';:' '.1' ' ^',44 ;:, .7, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
''• ' ., • , . •.• ., . •ii••=r - -4, ,.ii.m,ri .wrr t:tair 7 . , . ' !.;11 ;1;.:ra*::,
less to ground, Or exceeds 14,000 0 Commercial-use agricultural
0 1- and 2-family dwelling El CommerciaVindustrial 0 Accessory building amps for all other installations. buildings.
El Multi-family Li] Master builder D Other: El Fire pimp, 0 Insiallai■on of 75 KVA Or
.g.sx,..0.7t_.5-tr,7-T,':F.eVT-9) ''i .""ir*. -... - 4 40'4 0 Emergency system.
a . At - 4 , EN.Af..A 40 LOCATION : :: . • . -: • ‘.:.:. : :.: 0 Addition of new 'lime load of 0 larger separately derived system.
Job no.: D6331 1 Job site address: 6825 SW SANDEURG STREET 1001 or mare. occupancy,
El Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 97223 0 Health facilities. n Supply voltage for more than
El ffaurdow loolions, 600 volts nominal.
Suite/bldg./apt. no.: Project name: VIGILANT 0 Senice or feeder 600 amps or mote.
iti
Cross street/directions to job site: Deterlpiton oi.j e. J Toil I .
New residential single- or multi-family dwelling unit.
Includes ft Rached garage.
SlibdiVision; I Lot no.: 1,000 sq. ft. or less 168.54 4
-- Ea. add'l 500 sq. fl, or portion 33.92 i
Tax map/parcel no.:
Limited energy, residential
iD.,
7 7, . e..e , "; : ::S"47. 72iffifEEtWiti ""WiiI,W, ■ : "*::.'iLi:;11"i'' If ... -:'ilf . ,:.. 41v, (with above sq. n.) 7500 2
.. 1..,., • ; ,;:::: ' • ,,' ,■..- - ... 1%rkt-nalFr. ,Ita ',:. 741 b. ': .4 . . 11 ,r;!0i,"; — ',:
Limited energy, multi-family
LIGHTING RETROFIT residential (with above sq. ft.) 75.00 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 100.70 2
El kft(jOitcrir!:'(*/80];1 :::,;':'1?4e, 7,17 201 amps to 400 amps 133.56 2
,.. ., r• , ■ ' :. 'Fl•.' V1'.;tk : . 1 ' '■.7.. d
Name! 401 amps to 600 amps 200.34 2
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: ( ) I Fax: ( ) 200 amps or less 59.36 i
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 circuitsienh
••• •:'• i;;;' '. • ' '• ‘• ' 0 . CONTAdf, PERSON. above service or feeder fee.
each branch circuit 7,42 2
— —
Business name: LI. Fee for branch circuits irithour
service or feeder fee, first 1 56.18
56.18 2
Contact name: branch circuit
Each adcPI branch circuit 1 7,42 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP:
dwelling, service and/or feeder 67.94 2
Phone; ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E
- ,_., . . . Sign or outline lighting 67.84 2
. ., .
0'aPtA .' . :: j ::. :'' ."'.. '... •T . '''' ' ': Signal circuit(s) or limited-energy
•
Business name: MCCOY ELECTRIC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable In any of the above
Address: 2014 SE 9 AVENUE Additional inspection (1 hr min) 66,25/ hr
Investigation (I lir min) 66.25/ hr
City/State/ZIP: PORTLAND, OR 97214
Industrial plant (I hr min) 78.18/ hr
Phone: (503-) 234-7521 I Fax: (503) 234-9473 Inspections for which no fee is
90.00/hr
50ificaliv listed (4 lir inin)
CCI3 Lic.: 8277 Electrical Lie.: 26-: r Suprv. Lie.: 5208S Tler:W1 'i':
Al Subtotal: 63.60
Suprv. Electrician signature, required: 9/ Plan review (25% of permit fee):
Print name: ZACK ARMSTRONG ., • ate: 11/9/11 State surcharge (12% of permit fee): 7.63
TOTAL PERMIT FEE: 71,23
Authorized signature:
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: Date:
• Number of inspections allowed per permit.
IADuildlicskPerirdtaLC-PtinitApp.doc 07/01/10 440-16151-(11/05/COMIWELI