Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00006
TI ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/06/2012
G:
Parcel: 1S 136CD00401
Jurisdiction: Tigard
Site address: 7910 SW PFAFFLE ST
Project: Proforma Graphics Subdivision: 2006 -016 PARTITION PLAT Lot: 3
Project Description: TI
Contractor: DYNALECTRIC Owner: E &S HOLDINGS LLC
5711 SW HOOD AVE 8020 SW PFAFFLE ST
PORTLAND, OR 97239 TIGARD, OR 97223
PHONE: 503 - 226 -6771 PHONE:
FAX: 503 - 226 -7720
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo /Purchase 01/06/2012 $108.12
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/06/2012 $12.97
Type of Use: Electrical
Class of Work:
Type of Const:
Occupancy Grp:
Total $121.09
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' • - 001 -0090. You 1- • • - . •py of th ect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / f Permittee Signature:
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.
2012. JAN, 05. THU 13:58 DYNALECTAIC SALEM FAX No, 503 - 391 - 2817 P. 002
EIectrical Permit Applica i, u` ": cEivEn FOR OFFICE USE ONLY
City of Tigard Received sii permit No r-
° 13125 SW Hall Blvd., Tigard, OR 97 n Date/Review
; • 1 71 _ i / i i Ce
8 b ® 5 2012 Date/13 30 1 : Other Pennit; ' •
� : Phone: 503.718.2439 Fax: 503.598. Ui e1 patelB : 1 o�v
•1" I G
....
h Inspection Line: 503.6394175 Date Ready /By:. El See Page 2 for
Internet: www.tigard- or.gov CITY OF TiGARD 1Yoti6ed/Ivletltod: SupplementAl lnformntion
-rt a ,: ,f� 1y�, " ,�3raGd -p 2. ! ,s b0 , .., Z i 1 : c ;Y 4111 r r a 7 thy 7 , rw x, 4 , ;
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1;„:., ZJ; ���.., �bly� , .;�u•�IFmn , eChl; lv+rv a 3 tv t i �r.. Di�,?�J�I�uwGi�,�h.!^:".k � , . k:':YRI�u���a.�4y >. %L1 •n,:�!�"tuom,.... �., �..a htitir, .�.y71
❑ New construction Eli Addition /alteration/replacement Please check all that apply (submit 3 acts of plans w /items checked below);
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other. where the available fault ourrent ❑ Marinas and boatyards.
�
t / �I i 1 r , 7, 's ` l 3 m '+ ! 7 t r` ' ," ! t 1 1 r r ex ceeds 10 ,000 amps 150 volts or
i 0�+ �i � � 1 ` . r . .WIS n flt > ( Ll Mt10. r ,p 1ii; i t )„ tp tv lrj { P El Com Floating buildings. e a
.r...I c } N , " i, a,. «.....• L...,aon. . ,-, + u....L �. �r.�li,rv... loss to ound, ar exceeds 04,000
6r ❑Commercial -rise agriculhiral
❑ 1- and 2- family dwelling ® Commercial /industrial El Accessory building amps f ar all other i nstallat i ons. buildings.
❑ !� Multi family _ 7] Master builder 0 Other; r ❑ y Fito pump. ❑ Installation of 75 KVA or
'Ili iH I 1'C t{' ', fil Yr j�fi 1 tl i i ,`' 4 a} v �/ t� r'Q�,'�r� .(,� 1 14 1 tY C tl 0 t' , �Tt t {t� j 2,1'hr�j( �r �� ��7 Y.y1 �-t A o n o new m, larger separately derived system.
° g , ' • •ctrl( L i Ii., «:IS -4.1 .4� NV14 ��?;!4 lull k �� 5 4 „ ." 1 : ,' , Il`la ❑ Add o m otor toad o £ ❑ "A, ", "E" "1 - ", "1
Job no.: 1120921422 Job site address: 7910 SW Pfaffle St looliP or more. occupancy.
❑ Six or more residential units. ❑ R creational vehicle parks.
City /State/ZIP: Tigard, OR 97223 ❑ Health - care feeilitiet, ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Ferforma Graphics ❑ Service or feeder 600 amps or more. �y t g
i2.j�'r>klF1 $W3r m ;�r',, i > c,a >.zS Z,:r� l l ! i 11fv Y�.�i✓ 4 n
Cross street/directions to job site: Description Oty. Fee. Total
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no -: Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy. residential
A y &' Cp 6 ,� M�'t lt� +�"1° v +ila� �2 u�i Sp �(y t e ( i ,(i rf u:t ` zrnll..S , I P1 75n0 2
", :ail t '1 C :N ; yt
l ,, C , p ∎n, r4 '"I , ; . „ ,) E '"SR:. a.:'t .' .(...ti 7 , ,_ - 'i rtil y r a � r� ,: i (with above sq, R)
L,...Itle: ; E.c ]:i,.L. _r._ .a. A., , O , 4::� :, ....�,:.:.. ;,,:.;.. s.., i' *∎: �,,l'.; Limited energy, multi- fatally
TI WOrk-(8) Circuits residential (with above sq. ft.) 75.00 2
Services or feeders installatiionolteration, and /or relocation
200 amps or lass 100.70 2
q,l i, i . 'U 'VAS t ro er �) F } :,:, t S ,� M; ' +ry r , r 20
Ct r:+ i- 1 o tt„ at 1', 1aa.a`;o,," t' ..,, ' 1!"' r1 etl l i , „ tA', I tti w Iampsto400amps 133.56 2
,r,l ? „` ,) a,... —..� . ?• .�� -„ ,� r� ee, i .Rl,.. �� �2 s:..: �1�reR., r.. �r,T.', 4',.'7.-. y
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301,04 ” 2
Address: Over 1,000 amps or volts 552.26 2
— Temporary
City /State/ZIP: relocation services or feeders installation, alteration, and /or
Phone: ( ) I 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.
Bragch circuits - new, alteration, or extension, per panel
Owner signature: �{ Date: A. Fee for branch circuits with
.,rii; s ? zL ��11 11�C *�” �? 0: t �?:wi t L '1E:L ; t '' l i't :CV�9rea :12:10.,9P : O L '!'l'i 3N1iII: each bra nch circuit derfhe 7.42 2
Business name: Dynalectrie Company B. Fee for branch circuits without
service or feeder fee, first 1 56,
56,18 2
Contact name: Scott Carlson branc circuit
- - Each add'1 branch circuit 7 7.42 51.94 2
Address: Miscellaneous (service or feeder not included)
— —
Each manufactured or modular 67.84 2
City /State/ZIP: dwelling, service and/or feeder
Phone: (503) 226 -6771 Fax: : (503) 226 -7720 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: p p ! _ 0 t � } Sign or outline lighting 6784 2
:n. r.�l.. } ��l.'.� ,igu, l l � F... � .. a ��f:L Ml�ta . ' I �� i g g its
CC I
t +rk�ii,, � . ,, rt �� �� � "(�, ��� 1 �.� � t..,.., E ? Signal circuit(s) or
Business name: Dynalectric Company panel, alteration, or extension. Pale 2 2
Each additional inspection over allowable in any of the above
Address: 5711 SW Rood Avenue Additional inspection (1 hr min) 66.25/ hr
— City /State/ZIP! Portland, OR 97239 Investigation (1 hr mitt) 66.25 / hr
Industrial plant (I hr min) 78.18/ hr
Phone: (503) 226 -6771 Fax: (503 -) 226 -7720 Inspections for which no fee is 90.001 hr
� s•ecificall listed iahrmin
CCB Lie.: 66793 5 , - /iM Electrical Llc_: 26 -59C 7/0 Suprv. Lic.: 4653 -S i 3 k `��,'i `lg ,• , i 1 F c �" ; iRT,i' � , rs s_g l � " ;
Suprv. Electrician signature, required i o Sual: 108.I2
Plan review (25 /o of permit btot fee):
Print name: Ed Ryding Date: /05/2012 State surcharge (12% of penult fee): 12.97
- TOTAL PERMIT FEE: 121.09
Authorized signature: p'
....A .. ! YAP / ` This permit application expires If a permit is not obtained within 180
Print name; Lynne McEachern Date: 1/05/2012 * days after allowed has been accepted as eomp[ete
Y N of inspections allowed per permit
I:l avilding1Peetili1 1E,GGPennitApp.doc 07/01 /10 440-46151r(11/05/COPr/WEa