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Permit
- CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2009 -00132 T I CARD„ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/20/2009 Parcel: 2S 102 DA00800 Jurisdiction: Tigard Site address: 13335 SW HALL BLVD Subdivision: Lot: 0 Project: Fanno Creek House Project Description: Install (3) branch circuits. Owner: FEES TIGARD, CITY OF Quantity Description Date Amount 13125 SW HALL BLVD TIGARD, OR 97223 3 crt Branch Circuits 03/20/2009 $60.15 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 03/20/2009 $7.22 Contractor: Electrical OREGON ELECTRIC CONSTRUCTION INC 1010 SE 11TH AVE PORTLAND, OR 97124 PHONE: 503 - 234 -9900 FAX: 503 - 535 -2763 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $67.37 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. t� Issued By: � k �Q ■ Q 1. 1 Permittee Signature: ` 11 C � li ` 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'N Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. 9 RECEIVE' - Electrical Permit Application • • volt 01.:Flc 1 -. 1 shi.().1. �m /t �2 . `{ City of Tigard MAR 18 2009 Oat& Received a 3.i8. o q PennitNO.:� ©QQ' VIJG 7 Date /ay 13125 SW Hall Blvd, Tigard, OR 97223 Plan Review ry .' a ^ • Phone: 503.639.4171 Fax: 503,598.1 OF OF TIGARD llat /By. Other Permit: (. wp ' QO T , , . ihl4 Ct Inspection Line: 503.639.4175 l bate ReadyiBy; bu q r � s � WI S 1 - ,L ee Pate Z for . Internet: www.tigar-d- or.gov BUILDING DIVISIONN Otilled/Method: t 7 \ C. Supplemental Information M1 TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition /alteration /replacement Please check all that apply (submit L seta of plans w /items checked below): 111 Demolition Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories, where the available fault current ❑ Marinas and boatyards. i CATEGORY OF CONSTRUCTION exceeds 10,000 amps at I 50 volts or ❑ Floating buildings. I �— less to ground, or exceeds 14,000 ❑ Commercial-use agricultural El 1- and 2- family dwelling 0 Commercial/industrial l] Accessory building amps for all othcr. installations. buildings. El l Multi -fund ❑ Master builder i y ❑Other: 0 Fire pump. ❑ Installation of 75 KVA or INFORMA' I 5-S W LOCATION ❑ Emergency system; larger separately derived system. ! JOB SITE 1 I i � ❑ Addition Of nyw moron load of El "A", "E "1 - 2 ". "1 Job no.: 80016407 J Job site address: -ALL t00HP or morn. occupancy. ❑ Six or more residential units. ❑ Recreffironal vehicle parks. City /State/ZIP: TIGARD OR ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg- /apt. no.: Project name: CITY OF TIGARD ❑ Service or feeder 600 amps or man. 1 w FEE SCHEDULE Cross street /directions to job site: Darcri eon I Q. I Pee. r l Total I New residential single- or nmultl- faintly dwelling unit. 1 Includes attached garage. Subdivision: Lot no.: 1,000 sq. it or less 145.15 4 Tax trap /parcel no.: — Ea. add'l 500 sq. ft. or portion 33.40 I Limited energy, residential DESCRIPTION OF WORK (with above sq. B.)_- . 75.00 2 NEW CIRCUITS FOR AC Limited energy, multi 11 75.00 2 residential (with above ve sqsq. R.) ' �� Services or feeders installation. Hlteratiotc, and/or relocation 200 amps or less 90.30 2 ❑ PROPERTY OWNER �— ❑ TENANT 201 amps to 400 amps 106.85 2 I 401 amps to 600 amps 160.60 2 Name: ,.,, - -- 601 amps to 1.0 amps 240.60 2 ■ i Address: Over 1,000 amps or volts 454.65 2 City /State/ZIP: Temporary services or feeders installation, alteration, and/or �, relocation Phone: ( ) I Fax: ( ) 200 amps or Ics5 66,85 1 °` 201 amps to 400 amps 100,30 2 j Owner installation: This installation is being made e 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 133.75 2 Brunch circuits - new, alteration or extension, per panel Owner sig11at111e: Hate: A. Fee for branch circuits with a bove service or f eeder fee, ❑ APPLICANT ©CONTACT PERSON 6,65 2 each branch circuit Business name: B Fee for branch circuits Contact name: without service or feeder foe, 1 46 85 46 2 _ first branch circuit Address: Ea a dd'I branch circuit 2 6.65 13.30 2 ,. - Mi scellaneous (service or feeder not included)', �— City /State/Z1P: Each manufactured or modulate 90.90 2 dwelhg service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E Pump or irrigation circle 53.40 2 i CON'T'RACTOR • Sign or outline lighting 53.40 2 I B usiness name: OREGON ELECTRIC Signal circuit(S) Or limited- ] energy panel. alteration, Or Address: 1010 SE 11 AVE extension, Describe: Page 2 2 City /State/ZIP: PORTLAND OR 97214 Each additional inspection over allowable in any of the above Per inspection 62,50 Phone: (503) 234 -9900 Fax: (503) 535-2763 Investigation per hour (1 hr min) 62.50 CCB Lic.: 203 Electrical Lic.; 26 -95C Suprv, Lie.: 4549S Industrial plant per hour 73.75 - — `- ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: 60,15 Print name: RICHARD MCELLIOT f [ate: 3 -18 -09 Plan review (25 % of permit fee): — i State surcharge (I 2 °.o of permit fee): 7.21 Authorized signature: C••Z.Sal V`J TOTAL PERMIT FEE. 6.7,64,----(e 7. 57 Thin permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. I w Number of inspections allowed per permit. 1: \Buildiet miis \ELC- PramirApp,doc 05RI /06 �f� ` ,ST 440- 4b15T(r f /OS /COM/WEB I ��jv .