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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2012 -00156 T I G A RI) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/22/2012 Parcel: 2S 102C B01700 Jurisdiction: Tigard Site address: 10365 SW PARK ST Project: Kimmel Subdivision:RTH TIGARDVILLE ADDITION, AMENC Lot: 32 Project Description: Replace electrical service. Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: KIMMEL, KRISTA L 1709 SE 3RD AVE 10365 SW PARK STREET PORTLAND, OR 97124 TIGARD, OR 97223 PHONE: 503 - 234 -9900 PHONE: FAX: 503 - 234 -1001 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 03/22/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 03/22/2012 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 thro e OAR • -00 r • u You may obtain a copy of the rules or direct questions to OUNC by calling 523.233.1987 or 1.800.33 344. / r Issued By: Permittee Signature: r� 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' s - I / ( 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. • • • t. ; ( K Electrical Permit Applicatieuv � j uio Foi orric F USI O\L ' • ' City of Tigard ,p el Dat / B d PennitNo.: ',r M �4/1-eV/3-4P n 131 SW Hall Blvd., Tigard, OR R i7149I? j g a V W ' � /a �`�- i 4 /1 - eV/ 3- 4 P / Review Other Permit: : -' --- i: Phone: 503.718.2439 Fax: 503.598.1960 DateJB Inspection Line: 503.639.4175? rt ''a " r'' Date Ready/By: rum: fa Sec Page 2 for t 11'C, A I D' Insp� f` Notified/Method: Supplemental Informadon - � Internet: www.tigard -0r.gov �'� � - pP ci l .�... -, ✓r ...... .. .. ... .. ... r.......... ..,., ..... .,.i .. - %Yip ..:.......::.. ... . ............ ....,_.., .,.... L ,QF O . . ,. ._ .., .. .. .::, -: -'::'•ftA 'iEVl1r3'fsfAp':�;;< N�s; �;q ❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 3 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over threo stories. ❑ DemOlitiOn ❑Other; ......:...: where the available fault curtent ❑ Marinas and boatyards. :.::;.,.� ,,.,. ,<,:..., � .. ..::.....:....:,:..- .. . „ ,. s at 150 votes or . .CA'I'E60RX:..OF....::�ONSTR�EI OPI�-` mrcecds 10000 amp Floating buildings. - . , , . . . , • , . .. ... .. ....... , , , ,.., ....... ... :... . .. „ lean to ground, or exceeds 14.000 ❑ Commercial-ace agricultural ® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ installation of 75 KVA or _ Emergency system. larger separat der system. > 1OB- s rE;:I00:11 fATION ANb Y.t)CAT1toN :::. ; " ., . °: ' :..'.,• . ..... ,,,,, : -, ,,. .: > - ... . , 4 _.....- ..., .. : , k; dition of �tv lootm load of ❑ "A" `E" "1 2" "l 3" Job no.: 82142 Job site address: 10365 SW PARK ST 100HP or more occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: TIGARD OR 97223 ❑ Health - care facilities. ❑ Supply voltage for mole than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: Project name: KRISTA K1111MEL ❑ Service or feeder 600 amps or more, ..,....;_ ;; S -z�a. 'FF.Er CHEDI3LB Cross street/directions to job site: Description I Qty. 1 Feu . Total I • -- -...,.. .._ ............ _ .- -. .--- ........_ New residential single -or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea add'I 500 sq. ft. or portion 33.92 1 Tax mapiparcel no.: hot .? ;..-...... • . •6;-. 7500 2 energy, i (with above -0 o e fl. RW f ) IDES O - sq• Q Limited energy, multi- family 75.00 2 REPLACE ELECTRICAL SERVICE _ residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less 1 100.70 100.70 2 - o . :PRO1'EIt,TY OWNER." . mil - - ..,.. fl..8 47::1JM ';.. „-, -„ - ., ._ ,._ 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 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 sale, lease, rent, or exchange, according to ORS 447,449, 670, and 701. Branch circuits – new, alteration, or extension, per panel _ Owner signature: Date: A. Fee for branch circuits with [} A #00 of CON1`.Att ; ERSON ;" a ve service `, er ee ' ,. •- � r' •• ' -- eac breach cirouit ' 74 2 2 Business name: B. Fee for branch circuits without service or feeder tbe, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Ci /State /ZIP: Each manufactured or modular 67.84 2 tY dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting 67.84 2 , - •'�:'`. - Signal cinvit(s) ur limilixhrncxa Business name: OREGON ELECTRIC GROUP panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above i i i Address: 1709 SE 3 AVE Additional inspection (1 hr min) 66.25/ br City/State/ZIP: TIGARD OR 97223 Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18 / hr Phone: (503) 234 - 9900 Fax: (503) 535 - 2763 Inspections for which no fee is 90.00/ br specifically listed ( /s hr min) v. Lic le •c.: 26- u 4818S Lic.: 203 Electrical L] S ' C • CCB 2 3 ;� >�� .... ?EIECI`RI A2Y { ° . ;r: Vi.d (/' Suit fie): 100.70 Suprv. Electrician signature, required: /��• Plan review (25% of permit fee): Print name: MARK WEINBENDER • ' Date: 3 -21 -12 State surcharge (12% of permit fee): 12.08 l! r q / TOTAL PERM 1T PEE: 112.78 Authurizrd si)piature: � r /^" T his permit appllcadon cxplres If a permit Is not obtained within 180 Print name: MARK WEINBENDBR Date: 3 - - daps L a has pe accepted as complete. • Number of inspections allowed per permit. IABoUdingi.PermitslE •LCPermitApp.doc 07/01/I0 440 - 461571 I u /05 /COM/WEB FAX TRANSMISSION To: 5035981960 From: Richard Ladd Subject: FW: Message from KMBT_C353 Message: PERMIT APPLICATION Rich Ladd Service Dept Oregon Electric Group 503 -535 -2660 desk 503 - 849-2754 cell r.b.ladd ©oregon- electric.com Oregon Electric Construction 1709 SE 3 AVE Portland, OR 97214 Tel: 503 - 234 -9900 Fax:503- 234-1001