Permit II CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00065
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012
Parcel: 1 S134DD00100
Jurisdiction: Tigard
Site address: 10543 SW TIGARD ST 69
Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: (4) branch circuits for ductless heat pumps in units 69, 70, 71 & 72.
•
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: Electrical
Class of Work:
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 0 952- 9 090. You may obtain a copy of the rules or 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 Application � - � + FOR OF IC F, 11SE ONLY
eaei d .c"4/./..---
City of Tigard , 40. � D atol By y:. I 7 /.Z Permit Ne. : F1C'�j/2 DODI
w 13125 SW Hutt Blvd., Tigard, OR 972 3� P Revirw Other t'<mmr /� n
Phone: 503.718.2439 Floc: 503.59 1'x A r t _ L Date/By; �t ,0Q .z)✓
T I G A R Inspection Line: 503.639.4175 ��,\\ 1 Date Ready Illy; J11ris pi " , Ill Sec Flip far
Internet: www.tigard- or,gov Not'liod/Method:
,p\ c j i , Supplemental Information
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❑ New construction ® Addition/alteration P *1 • ° t' ' Plum check all Ihal apply (submit Z sets of piano w /items checked below):
❑ Demolition El Other: %).% ❑ Service or feeder 400 ampa or more ❑ Ateilding over three stones.
f tp where the available fault cumuli ❑ Marinas and boatyards.
{t r 1 1 r w�e 1 i'i , ly trlE ,E?I �k { t le awM t 'l ' 11 4 ��f1!. t r t IS
exceed, 10,000 amps at ISO volts or ❑ Floating buildings.
.�I 1i fll e�l � i1 #� � T ill , dd P 1 , r ff((u jj E+ tl S g fl� rt,
Y1 4i ! t 1l�iiiax�da w�Mik Mx ! 11j )4i w lass to grreimrd, or exceeds 14,000 ❑ Commercial -me agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations, buildings,
ej Multi family ❑ Master builder 0 Other ❑ Fire pump. ❑ Installation of 75 KVA or
v �E ov en rt rE xr ,1 1 r , + ❑ Emergency system, larger separately derived system,
r t r ��r^. i� 7E+ 1t1','4't ^r rf ,, a r to C rr
I l(������1( ( r • ' r;r }f 1 t aA ! frk . 44 tsky i a !, t . )1/1:1 {, x, A { I . i lk 1!
r}4�MyC! f�1 � " 1 �� :r �L�E 8 1tr.�I vn,t !ECer1 rrh�trpllr 1 � �1�IiE111tr.� 1n!tusrt ra rA tNl � � � �i�Ei #���{�i�� ', . C3 Addition anew motor load of C] ' A „ E•' "1.2", ..1.3 ",
Job no.: Job site address: 10543 SW Tigard ST 69
t001-EP or more, occupancy.
0 Six or more residential unim. ❑ Rucrustioonl vehicle parks.
City /State /'LIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for mom than
,,,^ 0 Hazardous locutions. 600 volts nominal,
Suite/bldg. /apt. no.: Project name: /� / ` { ❑ Scrvwo or feeder 600 amps or more.
M I LL.-- (j r ::1�[ E ` 7 tjlf��;.41 r }f i 1 " "',f1N J fo p"" ) , w Wugw,v ; .r,x t � l r r, ,�� r I I {t r }y
""' � � � ,fi!i I {I.1;.'',�„ rr 1t� 1> 'If )� ri { !Y Y4 -, r�,{ A 1111 IN l � �S ;lYil l ', 1 8s ,,1r :' ipri sit 1:'$
Cross street/directions to job site; � z7f EAll l Drrr I Vry Fee. 'rated
New residential single or multi - family dwelling unit.
Includes attached garage. r
Subdivision: Lot no.: 1,000 sq. It or less 168.54 4
--• Ea. add'I 500 sq. ft. or portion _ 33.92 1
Tax map/parcel no { Li mited en ergy, residential
11}} ��epr'I. yllirli jkC l' i + wwlrE VefE P, W { l a m I l rt 4 7 E 111 � BUM t r Mi. 75.00 2
'
iTli y ;Ll`Git t11?fraliN:��l 1, lf1!1Eill'a'd�+ u gilt {' 181r )�1 e twOmi�i j . lr. ,i E tl� t i I , I (wi above ft )
Limited energy, multi - family 75.00 2
Electrical for heat pump installations: Units 69, 70, 71, 72 residential (with above sq, tt.)
Services or feeders installation. alteration, and /or relocation
_
200 amps or less 100.70 2
)+{ t1 .. , 1y7 I r>r ptrE 7 m •n' r IX t r 1 s {, 1 a^ v et r 1 y� 1 t..' S
fJll 1! {:. �n l: ; r t, E' t tOd� ± lC ` t pXJ 7 R J/ iE 1{ ! $, i ✓ 2 01 amps t o 400 am ps 133 fi 2
i .ila iadt. OZU'A/ 0:44Yothf lh Char ,W � 1 C. IJ6�Ni l USAi e f.
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 services or feeders installation. alteration, and /or
City /State /ZIP: reification
Phone: ( ) F ax: ( ) 200 amps or less 59,36 I
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 salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, A1tCr,ltit or extension, per panel
Owner signature: Date: y A. Fee for branch circuits with
ail: IC�,17 stun >r +�M 1?' rag= { t�f y1'', " 41pnle t "1 N �1 ri� { q above service or feeder foe.
i � qr !1r r wed r { ; , l r�llr 4l fi t �t,'!aeA 'raR6� lE w'ir5 lf i4�1}3� . .15 , 1 each branch c 7.42 2
l3usincsS name: B. Fee for branch c ircuits withoaw
service or feeder fee, first 1 56.1 R 56.18 2
Contact name: branch circuit
Each add'l branch circuit 3 7,42 22.26 2
Address: Miscellaneous (service or (ceder not included)
Each City/State /ZIP: d w !ling service und/u ceder 67.84 2
Reconnect only 67,84 2
Phone: ( ) � Fits; : ( ) �-
_ Pump or irrigation circle 67.84 2
E-mail: � �� rtuj p�� p�� `'�} t ����� Sign or outline lighting 67.84 2
iNbt7i�l�i {"rERIN �� 1dF ? I $u...a:.0 ;, „'ltlMECEM T2~E,121;31 T1 (lltXt lid t11.'�t�1 SIENEtiIC If Si circuit or limitod-cner
Business name: Premier Electric /met, alteration, or extension. Page 2 2
-,,.. Each additional inspection over allowable in any of the abov
Address; PO Box P Additional inspection (I hr min) 1 66,2SJ hr L
C investigation (1 hr min) 66.25/ hr
ity /Statc/ZIP: Corvallis, OR 97339
Industrial plant (t hr min) 78.18/ hr
Phone: (541) 758 -4284 Fax: (541) 758 -4433 lnspeetions for which no fee is 90,00/ hr
s cificul ,/ listed 'F, hr min
CCR Lie.: 151749 Electrical Lit:.: 2 - 84C Suprv. Lie.: 4933S I n$iE tf t11'`
Subtotal: 78.44
Suprv. Electrician signature, required: Plan - review (25% of permit fee): —
Print name: Rob Bloom Date: 1/23/12 State surcharge (12 %of'permit fee): — 9,41 L
'^ - M TOTAL PERMIT FEE: 87.85
Authorized signature: This permit application expires if a permit is mat obtained within 180
—r ,.—....--
^^ days after it has been accepted as complete.
Print name: Date :1 a 7 ^-/,1- • Number of inspections allowed per permit.
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