Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00158
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/22/2012
Parcel: 1 S125DB03001
Jurisdiction: Tigard
Site address: 9310 SW 74TH AVE
Project: BEKEY Subdivision: BOULEVARD HEIGHTS Lot: 5
Project Description: (2) branch circuits for hot tub.
Contractor: WILLAMETTE ELECTRIC INC Owner: BEKEY, RONALD
PO BOX 230547 9310 SW 74TH AVE
TIGARD, OR 97281 TIGARD, OR 97223
•
PHONE: 503 - 624 -3631 PHONE:
FAX: 503 -624 -2938
• FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 03/22/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/22/2012 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 - 001 -0090. You may obtain a co of the rul t 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.
03/22/2012 THU 9:08 FAX 5036242938 Willamette Electric !j 002 /002
Electrical Permit Anplica r ' i � OR OFF ICE USE ONLY
lig City of Tigard )1,1 v d Rawsr eview ,? j`Y :ii Pemut No.: L�2d _ Qp 1.5",() " 13125 SW Hall Blvd., Tigard, OR 97223 Flan R
.+, t Other Permit:
Phone: 503.639.4171 Fax: 503.5 2 2 20 2 Date/By:
—
T i GA RD Inspection Line: 503.639.4175 Date Ready/By: tutu; Ea See Page 2 for
Internet: www.tigard- or.gov TIGAF.ID Notified/Method: 7' Supplemental Information
.. ;. ; '3`Yf • �y{�1
o Pl ease check all that amply (submit a sets of plans w / items ch eckedbelow :
❑ New construction Addition /alteration l acement • )
❑ Service or feeder 401B amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: Where the available ffaalt current ❑ Marinas and boatyards.
• . r
- - amps at 150 volts Floatin buildings.
or g
- less to gsroun , or exceceds 14,000 ❑ Commercial -use agricultural
® 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps fo all other im stallations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: 13 Fire pump. 13 KVA or
. larger s derived system.
. .. - ,. motor load of 1
...:.... Emergency system
• . . � ., =�� ; '�1�;'��'i�(' . .. { ' :- . ... _. ❑Additiomofnewmc A ",'Ys
Job no.: Job site address: v 100HP tor more. occupancy.
-� v P ❑ Six or more residential units. ❑ Recreational vehicle parks.
CI
City /State/ZIP: 7 er s, l ("it Health slate facilities CI Supply voltage for more than
❑ Hazardous locations;. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: /3 e - .. ❑ Service er feeder 6010 amps or more.
Cross street/directions to job site: i ie:eriptiea ;;:. I Os,. I Fee. I .. •
. total I
New residential single- or multi- family dwelling unit.
Includes attached [garage.
Subdivision: I Lot no.: 1,000 sq. ffi or less 168.54 4
Ea. add'I 500 sq. ft. ow.portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00 2
.: TiESCRirl.KON; OP . WORK (with above sq. a.)) _
Limited emergy, multii- Sarnily 75.00 • 2
,,, ` e bie /,& / residential (with ahwve sq. ft.) ' V Services car feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
0 PROPElfiC* .`owNER . TEIl,tN3 201 amps to 400 ampsv 133.56 2
• •• - 401 am ps t10 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 service.® or feeders installation, alteration, and /or
City/State/ZIP: relocations
Phone: ( ) I Fax: ( ) 200 amps tor less 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps tto 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps'to 599 amps 168.54 2
Branch circuits— mew, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
i. er fee,
. .. 7.42 2
above I •. .. 0:: APPLIirJ11!)'1': •.:: : . . •, . ; •.(�:: . RF�ON:.. _ .. each branch circuit
Business name: B. Fee for branch circuits without
service or feeder few., first 56.18 --- , / ei 2
Contact name: branch. circuit
Each add'I branch circuit / 7.42 7 Y� 2
Address: Miscellataeous (serce or feeder not included)
City/State/ZIP: Each martatfactured on modular 67.84 2
tY dwelling, service and/lor feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
E - mail' • Pump or irrigation Girdle 67.84 2
,
Sign orosltl hog 67.84
: .pttA:._ °::` ;; : .;: .!: '.s:,i.: `� Signal cirit(s) or lb Lednergy
Business name: Willamette Electric Inc. panel, alteration, or exttension. Page 2 2
Each adilitional Inspection over allowable in any of the above ,
Address: P.O. Box 230547 Additional inspection (1 hr min) 66.2.5/ hr
City /State /ZIP: Tigard, OR 97281 Investigation (1 hr bun) 66.25 / hr
Industrial plant (1 hr rmin) 78.18/ hr
Phone: (503) 624 -3631 J Fax: (503) 624 - 2938 Inspections for which) no fee is 90.00 / hr
specifically listed ('h. `br min)
CCB Lie.: 75059 Electrical Lic.: 34-283C Suprv. Lic.: 4226 -S =;1010601111 .Et;4l3 10.4:la .::'..•.:::....'::
Suprv. Electrician signature, requi a Subtotal: / '; k*....- Plan 'review (25 %oof permit fee):
Print name: David Fife I Date: -.../77� /2,..... State sure:harge (12% of permit fee): —f .4
TOTAL PERMIT FEE:
Authorized signature: 7/ a/
This permit applicattion expires if a permit is not obtained within 180
Print name: I Date: days ati�r it has been accepted as complete.
N um b en•mf iospeetioms allowed per permit
I: lauildingWermie 'ELC-PermitApp.doe 07/01/10 44046151(II /05 /COM/WEB