Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
= COMMUNITY DEVELOPMENT Permit #: ELC2012 -00050
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012
Parcel: 1 S134DD00100
Jurisdiction: Tigard
Site address: 10633 SW TIGARD ST 21
Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: (4) branch circuits for ductless heat pumps in units 21, 22, 23 & 24.
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 $87.85
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through R 1 -009$. 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: / / � / Ce9 :�t V
y: 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• OFFICE IISE ONLY
Received
iti
City of Tigard 1 1 7: / //�7/ ..*V . Pr rr °. -t� /e? - 00050
Hall Tigard, OR 97223 1312 SW Hu Blvd., gar, Vli&ts,\I
+ ti e w' �
r�,`` q plan Revi Other yernr
Phone; 503.718.2439 Fax: 503.598.1VCON a Om/Fiv: EeO� /.2—MO-3>
Inspection Line: 503,639.4175 I\ ?�� Date Ready /By: Jvris: tit sec PIRe 2 for
TtcAr,I� g B O \ ®N
t' Supplemental information
Warta www.ti ardor ov �,`-� F , v` Notified/Method: S n PPlemon ,p r
ugly > 1 Y r
' +; t r 'r 1 ( 1 } nnr r(Yrr w} , / nx o n { v 111 ; t y r t M . y; .�, lr s .VV .yy I - yg dip 1 l d i �{�y gl 1.. .. �1 , i I r " sip fr1 'f� d 6i
r t r, r r• 1b °.i 1 i 31+ {f?-t7'� 41 fC �i.
f 1 �y' , .I.r � �� r Jib. .,.
t de . Y rrrMa��� �xi� i 1, �►! �rl�. P!a �I 1 i edh,r�, ,t l ,, � ;� � Jru;c checked 18..
❑ New construction ® Addition /alteration /replacement Please chock all that apply (submq acts of puns w /items checked below):
El Service or feeder 400 amps or more Q Building over three stories.
❑ Dcmulition ❑ Other: whore the available funk current 0 Marinas and boatyards,
�q�J Jq. 1 � i z r i�j { w 1'�h' �Ar Grp lm I n a rf})� A n,r,,,e 7,177cpr! � 1t7 $N3j,l(i'm I " i pill � �(r� , r �f iy exceeds 10.000 amp ar 150 volts or 0 Floating buildings.
2iiiU� 6 &f ►0 1 1f y 34611I1aod� � rFrY idhl w /40101>a d i1 4W1r er G1w��i , JtA17�••�il��,i?t{'1 1 4.4 1 ia 4 load toKruurtd. exceeds {4,000 ❑Commercial -use agricultural
0 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building, amps for all other installations. buildings.
® Multi -family ❑ Master builder ❑ Other: 0 Fire pump, ❑ Installation of 75 K VA or
inft g (" ' i n w� '�'. r ) e + wYr orsA;eryrye roruerlt" , a 11 �u ++ Ar 1 { r ; 'wz r ; , " „ n 4 w }y r� ty,1 . , rr t r+l�( I ({ +c)r, + ;1'{ � I : tr y CI Emergency system. larger separately derived system.
i �i ltii fi+1R i ll�,rl," a,n ,a, i raw {rd�lra . ' r 1 nt r ''�l iflMtiff, r�$htST 2 't 1 AtN li tfl,II E{ � V TRIT i (t O Add allow motor load of
A 1,' Jj r t. ,w 1,'i '1 rrl ,: i t 7 a, a I {{ ,1 s �a t t' ✓ {
Job no.: Job site address: 10633 SW Tigard 1001 ll 0r more. occupancy.
U Si s or more residential units, U Recreational vehicle parks.
City /State /GIP: Tigard, OR 97223 [j Health -care facilities. 0 Supply v ltagi or store than
_____ _ ❑ Hazardous dous locations, 600 volts
Suite/bldg./apt. no.: Project name: 0 Service or feeder 600 amps or more.
1 C!I /N d /"l /L t,t1� r k i i ro�a r ' '� T " R � , �'
s�,, {I11�ir�l:uli�i�i��I�{'!i�, Jl,r y1, w " r�w�'� ' i i �f�ya1 t 59,, i,� ��,r
Cross street/directions to ,job site: g--/°,1-4_7-7--t&—A/7--s• Description Tate -
New residential single- or multi - family dwelling unit.
Includes attached garage.
.-
Subdivision: lo no.: 1,000 sq. It or less 168.54..., 4
.. - - • in, add'I 500 sq. II. or portion 33.92 1
Tax map /parcel no . Limited energy. residential —
{(F Y �1�1,1, ili f 1 1 fnr l r l r l rpl i Y 1 (�� r r/A ; tn, \'gsAArw,Y,t M ," t l 1 Y " 1rr Or 1 t t1j Ia' )" Y } r aA Y " }I i'p W1Lh above $ • t t, 75,00 2
!lrEl fit�lliii�iit �i:�i �vIrArM° s i,iiEf 1�1� ti(ill tijrAi'd ;a�. it, ' 'ri> ,1, 1 1�,r1d, 'f ,, ,1iG tt x,1111 1i�41ff r 3 edible sE /19 11111 S q )
Limited energy, multi - family 75.00 2
Electrical for heat pump installations: Units 21, 22, 23, 24 residential (with above sq, tt,) ,
Services or feeders installation, :duration, and /or rclocattion
200 amps or less [ 1 00,70 2
r n NM,ptYJ:YY 1, ptl A r 1 r ,' I 1' l n A-x , Yr ,Ir I Y
y' t � �n alt " , 4 t � ��) r l rM ¢ { ,r 1 } !" t gi I l� i{� ( �) . � 201 amps to 400 amps 133,56 2
I1 .1 rC! �11f1 ',�� r lirr,llaES�teih �x,�rirle,Itl ; s . i, i �l I a, ; EAWI i f l �l .'„4i 'rt�� '' ' 6r rli IY , ' r �,
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 /Z1P: relocation
Phone: ( ) Fax: ( ) 200 amps of less 59.36 1
201 amps t0 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not -
401 amp to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits • new, alteration�r extension, p r
Owner signature: Date: A. Fee for branch circuits with
(fY u ^ a x5 YrJ, A 1 r 'r; rt r, rgrrn aria r dpi i above service or feeder fee, 7.42 2
g#� f i d " �1 rr l ii ha , ,li Y ' t r i 1, ? " t j IgY •J ' i >s 1 ivi ii i' t:' t - , ' f{�
lfC,�{3�" r 111 rtR rm�nlvuuu°Ivr4t �e Y6 tt�du�iw�+l lsmlaawtA iGk � each brunch circuit
Business name: B. Fee for branch Circuits without
service or feeder foe, first 1 5d 18 56.t 8 2
brunch circuit _
Contact name: Each add' I branch circuit 3 7.42 22.26 2
Address: • Miscellaneous (service or feeder not included) -
• Each manulhcturcd er modular 67 1 2
City /State /ZIP: dwelling, Service and/or feeder J-
— Reconnect only 67.84 2
Phone: ( ) Fax: : ( )
., Pump or irrigation circle 67.84 2
E-mail: —
Sign or outline lighting 67.84 2
M i `� �{ � fryt , r 1 C' nr- °w C " ", fi r" 1y12t �r ;'" f, "f "JrH} It r a Yom, ,Y qp' a 1 1r I t
. P{�k;i1," ' t.. tE t (�r�� � j1i11 1lL.iE I fA` A „z hrl'n�;,iE 4.1�t .LL,i{ �tA!1{1�fiI7t,E��t{i all l�itf�,e w� iglu; It�1t�Yifl�l��t ' { signal eil'euit(s) or limited- energy -
Business name: Premier Electric panel, alteration, or extension. _Page 2 __ 2
, Each additional inspection over allowable in any of the above
Address; PO Box P Additional inspection (1 hr min) 66.25/ hr
""”' -- investigation (1 hr min) 66,25/ hr
City/State /ZIP: Corvallis, OR 97339 Industrial plant (i hr min) 78.18/ hr -
t'honc: (541) 75S -4284 Fax: (541) 758 -4433 Inspections for which no the is 9000/ hr
s citicalty listed eh hr min
CCB l.,ie,: 151749 Electrical Lie.: 2 -84C Suprv, I,ic.: 4933S 1 1 j j m " E^ I' , he+ Ei 1 ;x ; 0 8 1 " " "' t n 1t x', •
'"- Subtotal; 78,44
Suprv. Electrician signature, required: W. Plan review (2,5 %ol'permit fee):
Print name: Rob Bloom Date: 1/23 /12 State surcharge (12°x6 of permit ace): 9,41
' TOTAL PERMIT FEE:: 87.85 r/
Authorized signature: This permit application expires if a permit is not ubtpined within IRO /
/ days after it ha., been accepted as complete.
Print name: Date; / • Number of inspesiinnx allowed per permi
l' lnuildingTermi1, \F1.C- PermitApp.duo 07/01/10 440- er,I51 /COM /W PA
OZ00 /C000 E ,' DIUIDd1E 2iBI1fid2Id CCixb85LTb5 XVd ltd 0: Z ZTOZ /CZ /TO