Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00678
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/02/2011
Parcel: 25111 CA14200
Jurisdiction: Tigard
Site address: 15025 SW 98TH AVE
Project: ONNIS Subdivision: ALDERBROOK FARM Lot: 8
Project Description: Service replacement and (6) branch circuits for garage and entry.
Contractor: SAM HARDING INC Owner: ONNIS, DORIS A/ROBERTO
23833 NE GLISAN 15025 SW 98TH AVE
WOOD VILLAGE, OR 97060 TIGARD, OR 97223
PHONE: 503 - 492 -3697 PHONE:
FAX: 503 - 492 -3978
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 12/02/2011 $100.70
Specifics: amps or less
6 crt Branch Circuits w /Purchase 12/02/2011 $44.52
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/02/2011 $17.43
Electrical
Type of Const:
Occupancy Grp:
Total $162.65
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 obt -in a co. • • - • - direet.questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ Permittee Signature: —
1 NER 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.
12/01/2011 21:12 5034923978 SAM HARDING INC PAGE 01
Electrical Permit Application
RECEIVED — 1.t-i .01..n" 1 -1 1.... 0, \ IL
City of Tigard Received ., ,,,/, . „
a Datc/By; / I 0 1 I 0727 —
Pcnnit No.; kt,,c_g --
1 ....._. Phone: 503,718.2439 Fax: 503.59 13125 SW Hall Blvd., Tigard, OR 97223 n c r 2 2011 Plan Review Other Pcnnit
II ' 8 li Le ''' Date/13 :
. RI
: ---- 1. ,:, -- , - Inspection Lino; 503.639.4175 RD
' — Internet www.tigard-or.grry CITY OF TIGA iiiii inns: See Page 2 flw
te Supplemental Information
TINISIO '
8,61/1411DIN ' ' ''• ' •
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• ' . • :•• ... •:.. .::' ....... ''': ,: .::'..,,. :: ''.1 .•;!„..:., •,. ,:. ••••.: .. : •-,•..••• '...• ., , , :. .. ..:::, • • ,•'-.; • : : ,:.•,.;;,::.•;';:;•;.:::•.• '.:•:::,,'•• ' • • • '';'i . . -.• ' . ''' : e •:•••,‘•••••'•!':•''":". '.',••:,• ', ' '''.
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New construction Addition/alteration/replaCeMent
ple cheek all that apply (submit /sets of plans w/items checked below);
0 4
C Service or feeder 400 amps or more El Suiltling over three stories.
0 DeMOliC1011 0 Other: where the available Fault current 0 Marinas and boatyards.
•
' • :. ' ..• ., .* • •.' •• ;: '••••.•• • ' ' :•••::. ttkatitV,ttitit '... •••';:: ...'..• : • ' ;.:. fl'...... exceeds 10000 amps at 150 wilts or 0 Floating buildings.
ra 1 - and 2-family dwelling ID Commercial/industrial El Accessory building amps tbr altother installations. buildings,
0 Multi-ihinily CI Master builder 0 Other: 0 Fite pimp. El Installation of 75 KVA or
0 Emergency system larger separately derived system.
:. ..• , ,.: . , • ''' .:,::, .:•'.. .:'.. • ' 401 (,*# :. ;# 4 0PR,S.iMIW, '? -0 1 .*05/0010 41 , '.,,%:',:. :..,'. ::: • •.. ''' .•:••:::•...... ' :. 0 Addition of new motor load of El "A", "E", "1 "1-3"-
1.00HP or more cyccupancy.
Job no,: Job site address: 15025 sw 98 Ave El Six or more residential units, 0 Recreational vehicle parks.
City/StatcJZIP: TIGARD, OR. 97223 0 Health-care Ihcilities. U Supply voltnge for more than
Cl Hazardous locations, 600 volts nominal.
Suite/bldg,/at. no,: Project name: RODGERS/5),NRS.- oA//V I „s 0 Service or feeder 600 amps or more.
., ,:.7),.i.;;:.. .: ':"?. leaff. 1 ),MS,'"''.:,.!'.',.'', :, H:i: " ...,' ' ' ' ..' ■
Cross street/directions to job site: Dietcritnirm QV. Fes, Taal •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot. no.: 1,000 sq. it. or less 168.54 4
_ Ea. add'I 500 sq. ft. or portion 53.92 1
Tax map/parcel no.: Limit:Xi energy, residential 75_00 2
. • ' ” ' : ' ; ' ' • ' • *.•: ......:•:. ' IMS,C110140/4417tVoitit:„ .'. • , ,.• ,...,:*..::!,„ •:,.,: •,'" .:':•:.■:'•• : : (vrith above sq, ft.) .
Limited enerey, multi-family
SERVICE CHANGE; 3 CAR GARAGE & ENTRY residential (with above sq. ft 75.00 2
.) .,
Services or feeders installation„altera ion, and/or relocation
200 amps or less 1 100.70 100.70 2
. .. ,. .... ...1:21 .1,...........':. '.'. . ..,;VoSixt :.:•:-, .. ',::::.:.:... :.:.: ::,...'.:dalittiSANT,.. ,,.......: .... ',.'.....:;::.:,..; 201 amps to 400 amps 1.3356 2
401 amps to 600 amps 200.34 2
Name: OMNIS, ROI3ERTO & DORIS
.., . . 601 amps to 1,000 amps 301,04 2
Address: ABOVE Over 1,000 mops or volts 552.26 2
Temporary SerViCeS or feeders installation, alteration, and/o
City/State/ZIP: relocation
Phone: (503-)933-1056 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449 401 amps to 599 amps 168.54 2
, 670, and 701. ....
Branch circuits — new, alteration, or extension
Owner signal Date: A. Fee far branch circuits with
. :: .... 0. ,.' Ail e ilitiiiit . .:.„.,.;:7„ :: ,,.: .... ".....,, , ., .„:„. , ,,. above service or .reeder fee, 6
742 44,52 2
each branch qimit
Business name: B. Fee for branch circuits without
service or feeder tee, first
56,18
Contact name: branch circuit . 2
Each addl branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manuactured or modular
67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax ; ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
: • ' . .. :'.:.... '.. :. ' .. .. .:.i.l ...'..:. CHNtitifinThC":;. . :.. .:. . ,..... .... I.. ...... :., .. " . : • • - i- .i. r • d
• . .. Signal circuit(s) or .unite.-encrgy
Business name: SAM HARDING rc panel, alteration, or extension, . . . Page 2 2
Each additional Inspection over allowable In any of the above
Address: 23833 NE GLISAN ST Additional inspection (1 hr min) 66.25/ hr — ..
City/State/Z1P: WOOD VILLAGE OR . 97060 investigation (I hr min) 66,25/ hr
teduatrial plant (I hr min) 78.18/ hr
hOTle: (503)780-3159 Pax: (503)492-3978 inspections for which no fee in
90.00/ hr
specifically listed eh hr min)
cal Lie.: 1 - A l 1,fif Electrical Lic.: 26.7 49C "7 4 i i i ,. Su. . Lic.: 3376-S id , / ; .....i,c.',. ":...,.,,.. : ;:. ',.;'....•:,'..?...,', • ::
Suprv. ' ectrician siiit s t equired: .e:,Ailly.,a(ejr7APrAlgll Subtotal: 14522
Pio review (2$% of permit fec);
,w
Print name: SAMUEL P. HARDING Date; 1241-11 I ` State surcharge ((2% of permit Ito): . 17.43
TOTAL PERMIT FEE:
Authorized signaure 162,65
This permit application expires IF ii permit In not obtained within 180 -
Print name:
•Dale: days after it has been accepted iri cominott,
* Number of inspections allowed per permit.