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Permit
CITY OF TIGARD ELECTRICAL PERMIT 1 2 COMMUNITY DEVELOPMENT ` Permit #: ELC2012 -00210 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/10/2012 Parcel: 2S104AA04400 Jurisdiction: Tigard Site address: 12360 SW 127TH AVE Project: Crossley Subdivision: BELLWOOD Lot: 22 Project Description: Panel change. 4/19/12, adding (1) branch circuit for sump pump. Contractor: A & J ELECTRIC Owner: BANK OF NEW YORK MELLON, THE TR PO BOX 330 BY GREEN TREE SERVICING LLC FOREST GROVE, OR 97116 33600 6TH AVE S, STE 220 FEDERAL WAY, WA 98003 PHONE: 503 - 359 -5891 PHONE: FAX: 503 - 359 -1981 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 04/10/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 04/10/2012 $12.08 Type of Use: SF Electrical Class of Work: ALT 1 crt Branch Circuits w /Purchase 04 /19/2012 $7.42 Service or Feeder Type of Const: 0 ea 12% State Surcharge - 04/19/2012 $0.89 Occupancy Grp: Electrical Total $121.09 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 Notifi tion Center. Those rules are set forth in OAR 952- 001 -001 rough OAR 95 1 -0090. You may obtain a copy of the rules or direct questions to OUNC .232.1987 or 1.800. 2 Issued •f Q Permittee Signa (LA-) 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. CITY OF TIGARD ELECTRICAL PERMIT I I COMMUNITY DEVELOPMENT • Permit #: ELC2012 -00210 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/10/2012 Parcel: 2S104AA04400 Jurisdiction: Tigard Site address: 12360 SW 127TH AVE Project: Crossley Subdivision: BELLWOOD Lot: 22 Project Description: Panel change Contractor: A & J ELECTRIC Owner: BANK OF NEW YORK MELLON, THE TR PO BOX 330 BY GREEN TREE SERVICING LLC FOREST GROVE, OR 97116 33600 6TH AVE S, STE 220 FEDERAL WAY, WA 98003 PHONE: 503 - 359 -5891 PHONE: FAX: 503 - 359 -1981 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 04/10/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 04/10/2012 $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 through OAR 952 -0 0090. 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: iA� ids 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. Apr 17 12 03:05p Leeann Greason 503 - 359 - 1981 p.2 Electrical Permit Applica F CF J ED L Li 1 111 Fart. I ;F. 0:N1.1 City of Tigard R eceived t e 2 o*;/ : - pp D 1 7 2012 D: , : : . i Permit No.: ,�{�v • 13125 SW Hall Blvd., Tigard, OR 97 R Phone, 503,639.4771 Fax: 503.598.1960 tt : Review Other Permit: T I C A It I) Inspection Line: 503.639.4175 If` h PC Data Ready � CITY OF has ® See Page 2for Internet. www.tigard -orgov .I II min nivicli, � Nov cd/l�tethod SoppkmeMallrrformation a `.a "` .A. '.1" G. - !i t s^ , ; , 1 r z �" t _ _ = .. Z _ � 1 fir � -.f,-'° 7 .� ❑ New construction © Addition /alteration /replacement leecheck that apply (mbmit 2 acts of plans Whorls ducked below) El Demolition ❑ Other: ❑ Service or feeder 400 amps or mare ❑ Building over three stories. where the available fault current ['Marinas and boatyards. , . N :i `3 • I r t s it ,. 1 j -- 1 1F ' : exceeds 10,000 amps at 150 volts or ❑ F1oanig buildings. ., �. ,,: x,:__._.- - -., r :X e. , ,.. :,:_aw_ : :` 44 a_ _C.= less to orecceeds14,000 t and dwelling 01 �+ ❑Commercial -race cuttlual � � - 2 ! ❑ Comm; CommcrciaUutdtlstti ❑Accessory• building ❑ Multi fern/!/! ampefarallotbainstn�lodens. buildings. 0 Master builder ❑ Other: ❑ Foe pomp. ❑ Installation of 75 KVA or " Le tier ` ' = r " e _ ❑ Emergency system. larger separately derived system. . - t -7: a, - w.... .•____ c.a.rr... :.:r�!,...,,� ..-,. ❑ Addition ofncw motor load of ❑ "A'' "1-Y Job no.: Job site address: 12360 SW 127th lOOHPormare. occupancy. F. pancy. ❑ Six or mom residential units. 1] Recrenionel vehicle parks. Cily/Siald %IP: Tigard OR 97223 ❑Health -care facilities. ❑ Supply wane for mole than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: ❑ Service or*Wm 600 amps or more. Cross street/directions to job site: = : _ �+ d — ... Du.r.,pties ,1LC ..v{tiK Qh• Fe. : 1;141 • New residential single- or multi- family dwelling unit. . Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 168.59 4 Ea. Tax map/parcel no.: a add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential � ;ti .. + _ r ( 67.84 T r 2 "' c - _.. r�u „�._ _�� . l• : ? ._.u:� .... .�.`��.;:f .. ��; .... with above eq. ft.) Limited energy, multi family Add to permit # ELC2012 - 00210 for sump pump resida,tial (with above sq. B.) 67.84 I 2 Services or feeders installation, alteration, and /or relocation : .; s a • a ,! y�” u �+ 200 signs or less 100.70 2 ,:ii.; -r ' r 4a "` : . � , :1r ..,.. ._ -:4...r.:4-.:. - .:::: r �n4:i _ - ;- 201 ' ��?'� � amps to 400 amps !33.56 2 Name: Carl Crossley . 401 amps to600amps 200.34 2 Address: 601 amps to 1,000 amps ' 301.04 1 2 Over 1,000 awe or volts 1 55226 l 2 City/State/ZIP: Temporary services or faders installation, alteration, and/or relocation I Phone: ( ) Fax: ( ) 200 amps or less 5936 1 Owner installation: This installation is being made on property that I own which is not 201 amps 10400 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 Owner Signature: Date' Branch circuits- new, alteration, or extension, per panel A. Fee for branch circuits with -4 '`r' i � t r t, . 1� . ,tom '�3 efG .x -.: 4 :::v.: - .:"...;,', ,,- ,-- - . - - ^_'-" r- - A '°- - e' • - a 7az i � r .)- ..,'T, e r i c. _ i1. ?� Fr il. ir, .!?;Y.: t . , . above service 0f feeder fbe• 71 Business name: each branch circuit 1 7.42 ? • 42 B. Fee for branch circuits - Contact name: without service or feeder fix, 56 .18 2 first branch circuit Address: Each add'I branch circuit 7.42 1 2 City/State/ZIP: Miscellaneous (service or feeder not included) • • Each manufactured or modular - - Phone: ( ) f ( • dwelling, service and/or fader 67.84 2 Fax:: ( ) Reconnect only 67.84 2 E -mail: II EgttM6F., r r y Pump or irrigation circle 67.84 • 2 ��a`:t j ,77 .r_.z ` 4_ ,, F '- .�. r a�F 't -_... _Sign °I outline li ghting 67.84 2 Business name: A&J Elaine, Inc Signal circuit(s) or limited Address: YO Box 330 energy panel, alteration, or extension. Describe: Pagc 2 2 City /Slate /ZIP: Forest Grove, OR 97126 Each additional inspection over allowable is an of the above I Phone: (503) 359 -5891 Fax: (503) 359 -1981 Per inspection 66.25 Investigation per hour (t hr min) 66.25 i CCU Lie.. 959 l Electrical Lie.: 34-1c Suprv. Lic.: 959 Industrial plant per hour 78.13 1 Suprv. Electrician signature, required: ''J-: Lc -4- ~- ��T ". > c ';,y si„ ° 7, r -94 4.._J Subtotal: 7.42 Print name: Anthony Wilson I Date: 4//7/12 Plan review (25% of permit fee): Authorized signature: - State surcharge (12% of permit fee): Print name: TOTAL PERMIT FEE: B 3 1 Date: This Permit application mains it a permit is not obtained within Igo days after it has been accepted as complete. • e liudding'Pe, nitslE] C PernutApp.doc 10.'01i09 • Number of inspections allowed per permit. 44 C- 4 6137(1Ittr9COM VEA Apr 09 12 11:46a Leeann Greason 503 -359 -1981 p.2 RECEIVED Electrical Permit Application A PR 9 2012 FOR 01 . L t 1: t)\I.Y' _ City of Tigard Receive ° twit No.: (444 ` 13125 SW Hall Blvd., Tigard, OR 9 Phone: 503.639.4171 Fax: 503. X OF TIGARD Plan Review , Other Permit: t G .� r. D Inspection Line: 503.639.4175 r ING DIVISI Date Ready/By: Janis Set Paget for T Internet: www.tigard- or.goe Notified'Metlmd: , ® Supplemental Information j t •ac - ..�.". .' N ♦' ;' ,+w ,q` N + Fr F rr - - -. Sing ; t� ,. _ - .• .�,�.� as ., _._ .. Wig - ?x 7 ;, . ge ... ) y _� CI New construction E3 Additiottlaiteration/replacement " th in i h'( b"'h? 4pt�swr.iems cheekedbelow): Oilier. ❑Service or&sder400 amps ormore ❑ Building over three stories. ❑ Demolition ❑ were the available faun current ❑ Marinas and boatyards. �-: t? _,, .0 ., i 'k -,.".° - 4 r '°,^"' � '• r t ? • j t • exceeds 10,000 emps at 150 volts or ❑ Floating bwiidingv. - ''s . Lr . . : wr._._ ..v ..,. , . . -..t - <<c.'y. -.. :.. •..x=.( Iesstu wound, or exceeds t4,000 ❑ Commercial-use agricultural © I- and 2 -family dwelling ❑ CommerciaUindustrial ❑ Accessory building arms feral' other installations. buildings. ❑ Multi- family 0 Master builder ❑ Other. ['Fire pump. ❑ Installation of ?5 KVA or 4 . .,� o ; r : aid c� : ❑Emergency system. larger separately derived system. • : 1 4 , . .•._ , . - ' . . . S ❑Addition of new motor load of ❑ "A ", "E". "1-2", "1.3 ", 100HP or more. occupancy. Job no.: Job site address:3.2 360 SW 127th Ave ❑ Six or more residentialunits. ©Rocreationa] vehicle parks. ( ily/Statre7,IP: Tigard, CR 9722 3 ❑nth -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suilc/bldg.tapLno.: I Project name: 0 Service or feeder 600 amos or more. Cross street/directions to job site: Desaiplisti Qy, Fwd New residential single- or multi- family dwelling unit Includes attached garage. Subdivision: I Lot no.: 1,000 sq. tt or less 16854 I 4 Ea. add'( 500 sq. ft or portion 33.92 ' 1 Tax map/parcel o L r Limited energy', residential 67.84 2 .i 1 C ..f ^9., L rG - a :.i!. "...:.�-: .sa tY'r.12,e. _.. 4 ?Ta .: t.. ';i �... _ . ..,,: i .t d = (with ahiwe RI. f t ) Limited energy. multi - family 67.84 2 Panel change residential (with above sq. ft.) Sen'ices or feeders installation, alteration, and/or relocation l r 200 amps or less 1 100.70 10 0.70 2 - ",`... i. - - .� e.. " "l.' Fri:: �, , • �. > : . :_:..r_....�_ _ '.. . . ._ - ' = - a te - fx �::. ,,rhxr_ni . - � ` _. - 201 arr►ps w400 amps 13335 2 Name: Carl Crossley 401 mnpsto600amps 200.34 2 601 amps to 1.000 amps 301.04 j 2 Address: Over 1,000 amps or volts 55226 I 2 City /Stale/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) 1 Fax: ( ) 200 amps or less 59.36 I I 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 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits- new, alteration, or extension, per panel A Fee for branch circuits with �: rrr 7 4.1F- ' ` `f above servi or f ee d er f ee, . a' ..... FI -. vl 1 .. . e. `- .'ti? ..A iir� .: _•+:4 . , '-mc'F 742 2 a - a each brandy circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 56.18 2 first branch eirprit Address: Each addl branch circuit 7.42 2 Miscellaneous (service or feeder not Included) City, StatGZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) I Fax:: ( ) Reconnect only 67.84 2 E-mail: _ Pump or irrigation circle 67.84 2 s?.,,.r�s s2a,:f3 .�•4�"' ._:tM1L - 7 _... ..... Sign oroutlute 67.84 2 Business name: A &J Electric, Inc Signal circuit(s) or limited- I energy panel, alteration, or Address: PO Box 330 extension. Describe: Page 2 2 City /State/ZIP: Forest Grove, OR 97116 _ Each additional inspection over allowable in any of the above Phone: (S03)359-5891 Fax: (503) 359 -1981 Per inspection 66.25 lmcshgatton perhour(1 hr min) 66.25 L•CB Lie.: 9 j E lectrical Lie.: 34-lc I Suprv. Lie.: 959 ^InTTdus�tr�gtrniial plan erhour 78.18 j Suprv. Electric signatu required: G ,��%�_ Su b t otal: 10 0.70 Print name: Anthony Wilson Date: g 9/12 P lan review permit fee): Slat stuc harge (12 fee): Authorized signature: - TIOTAL PERMIT FEE: 112 .78 ,l Print name: o This permit application expires if a permit net obtained within 180 I Date: days after It has been accepted as complete. • Number of inspections allowed per permit. llauihllnaTerniLSELC- PermiL4apAx 1010:1afl 440.46!ST(I iicHiOwivna