Permit CITY OF TIGARD ELECTRICAL PERMIT
:; COMMUNITY DEVELOPMENT Permit #: ELC2012 00026
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/18/2012
. Parcel: 2S104AC06800
Jurisdiction: Tigard
Site address: 12551 SW MORNING HILL DR
Project: Stone Subdivision: MORNING HILL NO.9 Lot: 211
Project Description: (4) branch circuits for kitchen remodel.
Contractor: PDX ELECTRIC LLC Owner: STONE, BRIAN T & MICHELLE L
7933 WHITFURROWS CT 12551 SW MORNING HILL DR
DURHAM, OR 97224 TIGARD, OR 97223
PHONE: 503 - 639 -9708 PHONE:
FAX: 503 - 200 -1362
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 01/18/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/18/2012 $9.41
Type of Use: SF 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. ATTEN N: Or bn \ law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 hrou h OAR 952 .001 O. u may obtain a copy of the rules or direct questions to OUNC by calling 5• 32.1987 or 1.800.332. , 3 ,. 4-4..
Issued By: � .(� Permittee Signature �� /! i 1�._-----._
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' wry= 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.
1/16/2012 6:13 DM (GMT) From: PDX Electric LLC 503-200-1362 To: 15035981960 Page 2 of 3
Electrical Permit Application RECEIVr — FOR OFFICE USE ONLY
City of Tigard Tigard OR 97223 RTEeived
: 0 E461,00frj-oefeal*
JAN 1 7 20 Date/ Tiy: / / 7 / / Permit No.:
-1
B 0,: lan Reviesv
.: • 7 13125 SW Hall Blvd , ,
Phone: 503.71(4.2439 Fax: 503.598.1960 cr n r ,
I
D ate/By: Other Permit:
. i 6 Ako Inspection Line: 503.639.4175 ' t u TIGAR hu is. Iii See Page 2 for
' Internet: www.tigard-org UILDINGDm.
ov Notified/Method: Supplemental Information
,
TYPE OF WORK PLAN REVIEW
.....
New construction Addition/alteration/replacement
Please check all that apply (submit 2 sets of plans wiitcms checked below).
0 Ej
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition El Other: where the available fault current 0 Marinas and boatyards.
—.....
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial-use agricultural
(2) I- and 2-Family dwelling E Commercial/industrial p Accessory building amps for all other installations buildings,
0 Multi-Family 0 Master builder 0 Other: 0 Fire pump. 0 Installation (1E75 KVA or
0 Emergency system larger separately denved system.
JOE SITE INFORMATION AND LOCATION
0 Addition of new motor load of
Job no.: Job site address: 12551 SW MORNING HILL DR 100111' or more. occupancy.
0 Six or more residential units 0 Recreational vehicle parks.
C:ity/State/ZIP: TIGARD/OR/97223 0 h ealth-care facilities. ID Supply voltage tbr more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: T P.) ?..-- 0 Service Or feeder 600 amps or more.
...
FEE SCHEDULE
Cross street/directions to job site:
otseetjatoa 110.=Ze= Totai__J
New residential single- or ntulti-family dwelling unit.
Includes attached garage.
Subdivision:
l
Lot no.: 000 sq. ft. or less 168.54 .........
4
Ea. add'I 500 sq. ft. or portion 33.92 1
'fax map/parcel no.:
Limited energy, residential
2
DESCRIPTION OF WORK (with above sq. ft.) 75.00
Limited energy, multi-lamily
75.00 2
KITCHEN REMODEL residential (with above sq. ft.)
- _ .......
Services or feeders installation, al term ion, and/or elocatinn '
200 amps or less I 00 70 2
0 PROPERTY OWNER 0 TENANT 201 amps to 400 amps 133,56 2
............,
401 amps to 600 amps 200.34 2
Name:
601 amps to L000 amps 301 04 2
Address: Over 1.000 amps or volts 552.26 2
_......_ ............... ........
• Temporary services or feeders installation, alteration, and/or
City/State/Z __ . IP:
relocation
Phone: ( ) 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 1 own which is not —
I
intended for sale, lease. rent, or exchange. according to ORS 447, 449 401 amps
, 670, and 701. to 599 amps 68.54 2 - ---
Branch circuits - new, alteration, or extension, per panel
()wrter signature: Date: A. Fee for branch circuits with
........_
above service Or feeder fee,
El APPLICANT 0 CONTACT PERSON 7.42 2
each branch circuit
Business name: PDX ELECTRIC LIC B lee for branch circuits without
service or feeder fee, first 1 56.18
56.18
Contact name: MARTY PALMER branch circuit
Each add'I branch C i ICU It 3 7.42 22.26 2
. ,
Address: 7933 SW WIIITFURROWS Cl Miscellaneous (service or feeder not included) _
_ _.,..
- Each maufactured or mo
City/State/ZIP: P n nd/or feeder dular
PORTLAND/OR/97224 - 67.84 2
dwelling, service a
Phone: (503) 639-9708 Fax: : (503) 200-1362 Reconnect only 6784 2
---••• - Pump or irrigation circle 67.84 2
E-tnail: INFO(iSPDXE LECTRIC.COM
..,. Sign or outlaw lighting 67.84 2
CONTRACTOR
Signal circuit(s) or limited-energy
Business name: PDX ELECTRIC LLC _panel, alteration, or extension. Page 2 2
.........
Each additional inspection over allowable in any of the above
Address: 7933 SW WHITFURROWS CT Additional inspection (1 hr min) 66 25/ lir
_....
.... _ ......... ..........
Investigation (1 hr min) 66.25/ hr
Ci ty/State/ZIP: POR'FLA ND/OR/97224
_.....„... Industrial plant (1 hr min) 78.18/hr
Phone: (503) 639-9708 Fax: (503) 200-1362 Inspections for.which no fee is tam h
specifically listed (' hr min)
C:CB Lie.: 192731 Electrical Lie.: C696 . Suprv. Lie.: 5612S ELECTRICAL PERMIT FEES
--
..........
/ / Subtotal: 78.44
Suprv. Electrician signature, required: 2 , l
V 2/
, - / Plan review (25% of permit fee):
Print , / nt name: MARTY PALMER Date: / State surcharge (12% of permit fee): 9.41
5.0
TOTAL PERMIT' TEE: 87.85
Authorized signature:
This permit application expires if a permit is not obtained within 180
..... .
days after it has been accepted as complete.
Print name: Date:
• Number of inspections allowed per acront.
—
1 ild Inv:Term its \ELC-Permti A pp. dor 07/01,'10 440-451 I'll 11/05/CONMEri
. ....