Permit v CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00119
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/28/2012
Parcel: 2S112DD00900
Jurisdiction: Tigard
Site address: 15700 SW UPPER BOONES FERRY RD
Project: Subdivision: 1994 -006 PARTITION PLAT Lot: 2
Project Description: (1) branch circuit for new pool equipment.
Contractor: BOONES FERRY ELECTRIC INC Owner: BHGAH TIGARD LLC
PO BOX 628 PO BOX 1670
WILSONVILLE, OR 97070 WILSONVILLE, OR 97070
PHONE: 503 - 682 -4936 PHONE:
FAX: 503 - 682 -7946
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 02/28/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/28/2012 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 OAR 9 2- 001 -0090. You may obtain a • r of th: erect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .!= — _ Permittee Signature: ra
400
� 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 503.839.4175 by_7:00_ 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.
Feb. 27. 2012 4:14PM No. 8561 P. 1
Electrical Permit Application O
City of Tigard R Permit 01 6 SW Hall Blvd„ TigardOR 9 i . _ LC. zc7, —,o1 0//? '. ' ' Phone: 503.639.417I Fax: 503 `1 Date//By: Other Forma:
T I C, A F: i) Inspection Line: 503.639.4175 q % Q e Reedy/By: Fd see Page 2%r
0 Q
Internet: www.tigard ' eoned/Method: srtppkmeotaf information
:17;-: ._.- :- t... i ......, ,., , , ,, -.. •: .J t + r r -- _ A _ [ � : `,. A.` r .
❑ New construc tionAddition /alteration/r - `– Please check aq thst apply (submit 1 eats rf gs pin wlihms checked b
❑ Demolition El Other: p ) _ \ E l to feeder 400 amps or more O Building over three stories.
: available {suit current inas Mar and .
: r r f,
-
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“^-'--,';',7:-., -, s - .';' „ ' -,, '._ : ' ,- :: -. : T. 17/ 77 „..;' , exceeds 10,000 amps at ISO volts or O Floating buildings. .
❑ 1- and ' , > f_ ., : . . , .; ... , :, : :. lees to ground, or exceeds 14,000 ❑ commercial -ase age:altme1
2- family dwelling ARCommeroial/mdustrial ❑ Accessory building amps lbr all other iastaoationa. buildings.
0 Multi- family ❑ Masan builder ❑ Other: O Fue pump. 0 Installation of 75 KVA or
❑ Emergency system. lug& separamb' derived system
' ., ,..i ; ... _. _. _ ,... , •r r _ , ❑Addiliop of new motor load of ❑ "A”. "S", "1- 2 ", "1.3",
Job no.: 20 E 7 O Job site address: 15 7 00 Sys up B.... 100HP or more. occupancy.
ip v, A' 0 Six or more residential wits. ❑ Recranional vehicle parka.
City/State/ZIP: Eillesith-eze facilities- ❑ Supply voltage for more than
['Hazardous locations 600 volts nominal.
Suite/bldg./apt. no.: I Project name: nee /by y /NA/ bicipAirs ❑ sauce W feeler 600 amps or more
r
CrOSS Street/directions .
/directions to job site: Deetriptiao Qty. Yea. r ,
New residential single- or multi -family dwelling unit.
Includes attached garage,
Subdivision: I Lot no.: 1,000 sq. ft. or less - 168.54 4
Tax map/parcel no .
Ea. add'I 500 sq. ft or portion 33.92 . 1
Limited energy, residential 67.84 2
? ... .... ,..: „ ' , - . '. (with above sq. ft.)
Limited enei y, multi-fami�
13 GA CkInj •fall flea. /2,Oo, ketNi')pn+ - residential (with above sq. ki 67.84
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
r 201 amps to 400 amps 133.56
2
200.34 2
Name:
401 amps t0 600 amps
601 amps to 1,000 amps _ 301.04 2
.ddress: Over 1,000 amps or volts 552.26 2
City/State/aP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) F ax: ( ) 200 amps or less I 5936 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 ernes to 599 amps 168 Sd 2
Owner Signature: Date: Branch circuits — new, alteration, or extension, per panel
f4 Fee for branch circuits with
- t i # <` a b sem vi ce fisader fat;
........, , � . .... :.. _, ,.. F -. < ,... , ,_ .... ., ,: � <:• t -. -. _.... _, r 7.42 2
branch
p er: B. Fee for branch circuits widmra
service or feeder fee, first ) 56.18 2
Contact name: branch circuit
Each add' I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manacnued or modular
City/ State / ZIP: dwelling, se rvice and/or feeder 67.84 2
Phone: ( ) I Fax: : (. ) Reconnect only 67.84 . 2
—
E-1. Pump or imgation circle 67.84 2
d outline 67.84 2
S of oar � 1'
_c . . . . ..... . L � .. .: . N , .�.. _ §i. Signal cilt uit(s) or limited-energy
Business name: Booties Ferry Electric
panel, dictation, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: P.O. Box 628 Additional inspection (1 hr min) 6625/ hr
City/State/ZIP: Wilsonville OR 97070 Investigation (1 hr min) 6625/ hr
Industrial plant (1 hr mkt) 78.18/ br
Phone: (503) 682-4936 Fax (503) 68'1 7946 /O //� Inspections for which no fee is
t8ra1y listed '1a hr mm) 90 00/ hr
' ,, C CB Lic.: 88482 t Eleciri• Lic.: 3- , " Suprv. Lic.: 3 s , ,,l',,;' .... , ,; = .
0 Suprv. Electrician signature, r . Subtotal: SX , (i
.. � Plan review (25% of permit fee):
. c'riilt name: i7 J a j-e e / __ Date: State surcharge (12% of permit fee): 67 if
•
TOTAL PERMIT FEE: 62, , TZ
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Date: • days after it has beau accepted as amplete.
Number dinspccrions allowed pet pentad.
L'BaadmglPamitelELC- PVmdApp.doe 1010119 4404615T(1I/05/COM/WEB