Permit CITY OF TIGARD ELECTRICAL PERMIT
NI COMMUNITY DEVELOPMENT Permit #: ELC2012 -00019
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/13/2012
Parcel: 1 S134DD00100
Jurisdiction: Tigard
Site address: 10621 SW TIGARD ST 17
Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: Electrical for heat pump installations: Units 17, 18, 19, 20.
Contractor: PREMIER ELECTRICAL INC Owner: RICHARDS, JAMES E & SHARON S
PO BOX P BY NORRIS & STEVENS
CORVALLIS, OR 97339 621 SW MORRISON ST #800
PORTLAND, OR 97205
PHONE: 541 - 758 -4284 PHONE.
FAX: 541 - 758 -4433
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 01/13/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/13/2012 $9.41
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 • ' •2 -001 -0090. You - • . _ - •r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By. ./� 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.
Electrical Permit Applica_ ti on : F OR OFFICE l' ICE USE ONLY
Krecived •
City of Tigard ® i� Permit No.: /.eaoi )._cx�vf/(
,� ^ O�� Dnte/B
s 13125 Sw Hall Blvd,, Tigard, OR 7 , ct , Pla Review
1 Other Permit:
Phone: 503,7123,2439 r'sx; Sp3.g9R' l . 0 A \ `� ( � r� Dnte/Dv:
I f.peCt i en Lin e: 50 \v 0^ pate Ready /fly:
I ®Soe Pm 2 foe
1,c:;Axv �5r�� Not Internet: www.tigard•or,gOV E i �od/A4cthod: , SV[Iplt mgntul [nfurmrtiOn
,% ' r ,r i; '.d i lru l � wry m `r,ri :I r Ytili 1 1 l '2.. - r Itt'p n re a ?rY( I.,' -. . a� ." t Nl..., 4 v4 ,' 1 1 .d1 Fi l { . p il ! t l 1. di {I li t;, a . ,. } "' {6t t t % ` affable . ,. u
"1, ,4„ „15 , , .,, (,,iT" iifl it+�,,niii : i;, . ,4 rti l(if �trl ;", a ia , ,, e 1 21401 t 11, _ i , i ..., ,i, ,� jj�d' til,iil.i ", , ,,,r )3L II +f�o-� � {��',SI-i 411 41... , ,!�" I �� t .,, I S� I� .. , , , ; t^ . ,?t....,,,c �r.ln4u, l ifill { 9�R
,,, 1,I hY, r r In A
e .v 1.1 cheek all tltnt imply (minim! / rots of plans w /items chocked below);
0 New construction � Addition /alteradon /r "la cat
❑ Service or feeder 400 amps or more ❑ Ituildin over throe stones.
❑ Demolition ❑ Other: whore the av:dhnblc (huh current ❑ Marinas and bontyartfs.
..,:ii ,,, ,..._,e r r,;, u.�., lPll tMV -> t n' IU w ..r '"
I I f I ft4Y4 r 4 f i . ' �, f ,,, d ; r a u It rf�tllh�a
P do 4 1 ! exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
" v I I, i��j I �� } 4 ? e�, s d 4 $�i : t I fl ,,, �,.,�, ,
less to KrOUnd, or exceeds 14,000 1:3 Commcrcial•tts¢ a
❑ 1- and 2- tamily dwelling ❑ Commercial/industrial ❑ Accessory building amps for nhi miner installaninn& buildings.
uln ftmlly 0
Master builder 0 Other: 0 Fire pump, Q Installation of 75 KVA or
? r�� � a a, ppr^ g Y t , l A � , i t ❑ Euwrgency system. larger separately derived system.
1; tl p , . J 4 H . r °"{�,.'� " v sd.1 A, Q.
i ,. t alt 1.iJ,. ,.: . , � 1 ■� ;,K^.",I ti I nt ,, r t � I itl t i 'h ❑ Addition of „ Ynntrrr load o f 'A ", "E ", "1.2", ^1.3 ",
I00HPor more. occt
Job no.: Job site undress;
_ 1 O Li . J ' I tr ..c ..", `,.) - E) S,a or more roridomial units. 0 Recreatm, Ch
r al v,cIe parks.
City /State /'ZIP: ' t t r.,_ •,-- r 1
0 l c 1 1 l le: l'aciliaiex. Q Supply volrago for more than
\ , � I � ` Q Hnz Service or feeder 600 imps or MO VC,
o 4 600 vplt< nominal.
ardou. I nc tt,nne
Su ite /bldg. /apt, no,: Project name: �V I ►V 1n t I 1 - / � more' ,
- i . 01 I7.rm .M l 111 f I a;" • ! a � i.; o, t t l . ;li 1,, lei (II t , I { klal G
Cross street/directions to jab site: We iin. � ® p
W w .'-_^T
New residential single- or multi - family dwelling unit.
Qt lakit / 7J " 11 " W Includes attached garage.
N
Subdivision: 1,000 sq. rt. or loss 168.54 4
f I Lot no.:
� M °" U ' " - - - Fa. ndd'I 500 sq. ft. or portion 33.
Tax map /parcel no.: I Limited energy, residential
� :,,, ,,u h l 7S. 00
:T• v 'V6. ;, �r� iV iiv'i'li iri.. � i I I ! ( / y�., 0ji, i 1 i 1I1 4i I I,W. r r r, al l l lll�.., r t
.1 1C . t w A IXIVC S . tt.
i t ', ! vp in .:11.:.,..1; r , ,,,.. , o . ,,. ,, ,.1��M ; ^; .,, 7 � r 1 " !, ;I • I, ',�{. t ...r .fr r,., ,u „, .., ly ,.., ,: I ;lr,'r rrl(� : ��_. W�-
�... . v ir,yy� ru 1t1�1,.Ilil,uu vI r j u. ,_ i
Limited energy, multi-family 75.00 2
r, residential with above sq. 11..)
Services or feeders installation, alteration and /or relocation
200 urnps or less — 100,70 13
,
I t Ir lt r.v,1 �a�, itv�tt .! n:)) t ,I 4 i y n,u ^* 1 tart r t a ,
I al; ,,,.; 11 Y a sioi iE "u .1„,, r vt G fC:: rtI tt1f41 re tl�i , r. h jet1 F4 f 201 amps to 400 Amps II 133.56
Name: 401 amps to 600 amps 20. II
--- - . ___ ,...,.., 601 amps to 1 000 Amps _ 301.04 El
Address: Over 1 000 amps or volts 552.26 2
Tempnrary services or feeders installation, alteration, and /or
C. ity /State/Z I Y; relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125 0R 2
Owner installation: This installation is being made on property that I own which is not 401 amps to ,599 amps ..... 16R,Sa 2
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. o
Branch circuits new, alteration, or extension. cr panel
Owner signature: Dale:
......... .........:.............__...... - ....... ......_..._... A. Fed for branch circuits with
,., , ; '
<.., ,. .,nn ;:,a�. ,. ei .............. .. ; ..,,,,.......,.......�.. r.: . :... ... .. .... ..,...� RS!,T1^f. , .. ..�. y,.:...,,.�..,...::.1 ,.., ., ':GI
, ,...,,.,, 1.�y`� :::....... ... .. a :,,,, :,:,, >111e ;y1ls:a:l;;;y,.;I_;II ..., :. t. „ ,; ,,i above service or feeder fee. ,
.ra I' �N',+Ai ;F 1i�'tiiiil'1iP1i 1' 1 1 r r,!:,.aann.,,uii G'4�!N1 ; ;�!Eh�S;t?i 1{ 116, t ! 1 7.42
,' , each branch circuit
Business name: B. Fee for brunch mains withwrl
service or feeder fee, first
Contact name: branch circuit 5 . / i 2 " • t
`__ .— -._.•, ,.,., •, -- - _ -_ -.. ; rut, add'l branch circuit .'I� _ "_ � 2 , ,
jO
Address: u t Miscellaneous (service or feedernot included)
trj; 1 Q �'� Each manufactured or modular
City /Stale /Z1P: C'"' —1 dwelling, service and/or feeder 67.84 2
Phone: ( rr ) l Fox_ : ( ) 1_I)' (3 :1 Reconnect only 67,54
T 2
Pump or irrigation circle 67.84 2
E .
Signor outline lighting 67 Rd 2
,: , ; ,,:: , ,:, ,� r• 4 , � ;t 1�,��r:. , ., ., � 1 . T , ,,, *, 1 t I r
...hudtrr'i`i . g .; ; ,.r gii ii� h i l l i i9i v y rv.Y i ligr Z i tf At j il l�l 1 i�i �i i �N1 Ill { {) i �p if� iS Ij�d i iEi fl ll,ll it i it y iill --. ., ....., .�.�...,.,.�.,,�....�......�
.. , . i ,iA'ii i li (ti' }'� 'H,4YMI;'trrrritni 1Y I �i�i)I�ill l , �Il Si l- Ti ' p Business name: ^, � - 1, to ration, or extension. . - ... Pic , W � - 2
C .P, vet 0 ;LT_ 3 C't Q_ VU s Each additional inspection over allo in any of the above
Address: P O e, Li.K t Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: C. 0 ; j ttit i t, S . 0r2 7 33'7
Industrial plant (1 hr min) 75.1$/ hr
Phone: (54 ( ) •7 ,. c9 (? } A• � ,� ?I/ Fax: (S ti I) - , J -- Le Li 33 inspections for which no fee is 90,00 / hr
sr`CifIa's listed Y: hr mitt
CCB Lie_: Electrical Lie.: rv, 1 i h f i ! rr2 a! A P r:iP +="""r'"'rl�;14R &tV.rf:Ji4;
Lie.: ( ,• 1 � � Z_� !� . Sur , c.: � { � 1� 5 !Il,lil. lHslli il.dilP,i �. lJ�'! �i1N�, ,:��`t1����"t.4���1.:,,: ; ;,l ;i! alt ;'r!� ? ::.. .:.:.::::�i:. -:,,.
Subtotal: *r ) 'Z_, r ; - ail
Suprv. Electrician signature, required:
Plan review (25r %ot'permit fee): Print name: i n �_._• pate: /.� � „� / - State surcharge (12% of permit fee): ' - / ci
'10TAL Pit :EMIT FF?F::
Authorized signature - -�� - T ,..,.(- i :- 7. y.5- ,,�,.....__.. � +. -- This permit application expires if a permit is not obi ' within 180
days after it has begin accepted as complete.
l'rint name: Date: • Number of inspections'allowed per permit.
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