Permit _ , CITY OF TIGARD ELECTRICAL PERMIT
11 1 1 = COM MUNITY DEVELOPMENT Per mit #: ELC2012 00067
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012
Parcel: 1 S134DD00100
Jurisdiction: Tigard
Site address: 10539 SW TIGARD ST 73
Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: (4) branch circuits for ductless heat pumps in units 73, 74, 75 & 76.
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: 503 - 624 -9856
FAX: 541 - 758 -4433
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 01/27/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/27/2012 $9.41
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp: R -
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 O • -. • I 0 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23344.. ^ � `
Issued By: : __ �_ %L��� !�� Permittee Signature: / 80 G1C�'/ / / o/V
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 Application OFFICE USE ONLY
f Tigard Raco;vad nnicNu,. ELC
III City o g \ti 0,.L./4 . /497 o2D/� 'DAD
II 13125 SW Ball Blvd., Tigard, 0'4 ' '� `�� I' m Review Other pe O /
Phone: 503,718.2439 Fat: 503, 9..1900 la DateBv: "' oc — d0
•f 1 G A 1: n
Inspection Line: 503,6394175 p \v `P -4
(�� ^d� Date R lur 63 ter Page 2 for
Internet: vwvw.tigard- or.goy ,! �\ - NonneWmetbod:� i • Sunplemerour ierurmattoa
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® Addition/alteratit�nY7 l
,' h"cemcnl 1 cheek all der apply (submit 7 set of plans Wing three est below):
0 Ncw construction
❑ Service or feeder 400 amps or more ❑ Iluitdiag over thre stories.
❑ Demolition 0 Other; wh the available f wli Current ❑ Marinas and boatyards.
'�v t {" 1 s � mails r.1 i
t1! t+ i 1;t171� t1 t 1 It, m� 1i j lihT It I I Itr^ " +
� Z"' ii i ' k �� ik. r , n 44 �� , / t11 t �• H i n ' e rt e i l � exceeds ground, or exceeds c I 1 vats or Floating buildings,
is mg a,
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❑ I - and 2- family dwelling ❑ Commercial /industrial C] Accessory building amps tur:,ll other installations. buildings.
® Multi family 0 Master builder ❑ Other: ❑ lai pump. in installation of 75 KVA or
u tT7 "r rt ", r�lrl; y a i) ve,rf { y r e° r rq'� + `r,,jr4i' (I W i t .C , 1mIt A y ,p , ° p is " f� � N mar 11∎ tai„ ❑ Emergency system. larger separately derived . yste,n.
`glsaai w i21l111. , k i y O n1(ii I t � + rllurfi 0 i4IA M/4C �?yw4.ht I, i P4!.lj xi C i s° ... �U•J�N tY4' f ' Addition anew mow load of "A", t ' l -2 "1-3",
Job no.: Job site address: 10539 SW Tigard ST 73 10011i/ (h. more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
—
City/State/ZIP: Ti ard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage; for iu rl` than
Ty g ....... ❑ Hmatrttour locations. 600 volts nominal,
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Project name:
Suite/bldg./apt. no.: El Service or feeder 600 amps or more.
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Cross street/directions to job site: 4'1) I- g' � np,rr7rrinn 9 • ® 1�
New residential single- or multi family dwelling unit.
Includes attached garage.
Subdivision: m ^ Lot no.: 1.000 sq, R, or leas 168.54 4
Ea. add`I 500 so, R. or portion 33,92
Tax map /parcel no.: Limited energy, residential
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75,00
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i., f am il y 75,00
Electrical for heat pump installations: Units 73, 74, 75, 76 residential with above. . tl.
Services or feeders installation, alteration. and /or relocation
200 amps or less 11.1 100.70 NM Ell
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it t41!tirl r i,tVV40111,1: ii {a f ��, 14 hip ,. 14 1 1 , x(1113 �; c4 r iql stn to 400um s 133 56
401 amps to 600 amps 2(10.34
Name:
601 amps to 1,000 amps MI 301,04 —
Address: Over 1.000 amps or volts 552.26 2
City/State/ZIP: 1 Temporary services or feeders installation, alteration, and/or
Y relocation
T
Phone: ( ) Pax: ( ) 200 amps or lens 59,36 I
201 amps to 400 amps 125,05 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 maps , 1 65,54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new alteration, or extension, (tc r_panel
Owner signature: Date: A, Fee for branch oir uius with
y " 1t +vr" r wr f" ) t t t py tntlp W,a t y,M ,rq�, r +r 7ir i rt^ l., shove service or lead fee.
wog 'e� ■ ii", „ { , {w;,, „' � �>1 " aR � i t” ' 'rl s I l�� ' r f@ t t nt : 1ri I ____ r�,�it1�ie
" d∎ Al' 1,h . it Idli c k1 hit' 11 7.42 2 „� & "F..l 2,111tH�! dw�M r =m em 1 CuL'h bl7lnl.�1 e7Ralt
D. Fee for branch circuits without
Business n service or feeder fee, first I 56.18 56 2
Contact name: branch circuit
Each addl branch circuit 3 7.42 22.26 2
Address: Miscellaneous iservice or feeder not included)
Each manufactured or modular
67,34 2
City /State /ZIP: dwelling, service and/or tenter
Phone: ( ) Fu: : ( ) Reconnect only _ 67,84 2
Pump or irrigation circle 67,84 2
E-mail:
r t r t s t p -�- ro s r t o t w art Sign or outline Iigtttutg 67.84 2
it1. I Sf f1 , k ;!t 1 . �" 1w )!' .l�,t��rwhr ftli .L. �91.� t 0:''', 4'. , I lilli tA1Ci ill t ,: e Signal circuits) or limrtat.energy
Business name: Premier Electric - fit c; alteration, or extension, Page 2 2
Each additional inspection over allowable in any of the above
Address: PO Box P Additional inspection (I hr min) 66.25/ hr
City /State/ZTP; Corvallis, OR 97339 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr ruin) 78.18/ hr
Phone: (541) 958 -4284 ' — 1 Fax: (541) 758 -4433 Ittspcctien for which no Ice in
90 ,00/ hr
s calculi listed h hr nun
CC13 Lie.: 151749 Electrical l.ic.: 2-84C I Suprv. Lie,: 4933S 3 OrI f E�ril i tl l =a al, ( 1 11d71r' ` llf� , jl " 1 i i!) i i�lililil,l ,,
Suprv. Electrician signature, required: Subtotal: 78.44
_„ „ ,, - - Plan review (25 %of permit fee):
Print name: Rob Bloom Date; 1/23/12 State surcharge (12% of permit !cc): 9,41 /
Authorized signature: .1..-•---..." TOTAL PERMIT FEE: 87.85
7� T This permit application empires if n permit Is not obtained within 1710
w days after it has been rtxepted as complete.
Print name: Date: —? 3''" Number of inapections allowed per permit.
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