Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00234
Date Issued: 04/24/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 4/24/2 604200
Jurisdiction: Tigard
Site address: 12270 SW MARION ST
Project: PRICE Subdivision: WILLAMETTE NO.2 Lot: 21
Project Description: (4) branch circuits for bathroom remodel.
Contractor: BADGER ELECTRIC INC. Owner: PRICE, JOHN H & NORMA J
4415 NE SANDY BLVD STE 205 12270 SW MARION ST
PORTLAND, OR 97123 TIGARD, OR 97223
PHONE:
PHONE: 503 - 288 -4756 •
FAX: 503 -493 -7173
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 04/24/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/24/2012 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
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 OAR 952- 1 -00 0. 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: 2t" 197°/94 Ge-�-77ON
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 603.639.4176 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 -23 -2012 08:02A FROM:BADGER ELECTRIC, INC 503 - 493 -7173 TO:5035981960 P.2
RECEIVE )
City of Ti APR 23 2 01, � i rol l " o C - / .• — i i - 3
IIIII 13125 SW Hell Blvd.. Tigard. OR 97223 Plan Review
R ' Phone: 503.639.4171 Fax: 503.598.1960 Datelar Other it
, . , , , Inspection Line: 503.639.4175 CITY OF TIGAR t• . • ReadylBy: aaic a See Page far
Internet: www.tigord- or.gov BUILDING DIVIS ' f.' ' .' I Supplemental Information
T1fP OF WORK PLAN REVIEW
l New construction L 1dition/alteration/replacemuun ' Plea died all *et apply (submit 1 sets of plum videos checked below):
['Soviet) or Bed& 400 aka or more Cl Building over three stories.
❑ Demolition ❑ Other. where the available Galt current 0 Mutts and hatymds.
CATEGORY OF CONSTRUCTION mac 10,000 amps at 150 volts or C) Floating building.
tes to ground, orcxceeda 14.000 O Commercial -ma agricultural
- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building amps fbr all *dm lomaatiun. buildings.
❑ Multi- family ❑ Master builder ❑Other O Fire pump. O taso ItmIaof75KVAor
0Emergency Dorm JOB SITE INFORMATION AND LOCATION fl yderivedsYwm
I 1 )]Additiorrofoarrmotorbfd Q "A :"E : " I,2". "1-7 ".
t� 1 Job site address: I aa- 51� MQ.r( ��-S 1 0 �
Job no mmotaidmta units. ORocradiooat vehicle parks.
City/StatrJZlP: ! 0H azard ouo Mendota O
i `� _ O looms Mendota Ego volts nominal.
Suite/bldg./apt. no.: I Project name: ti, 1i Lt...., O Service at feeder 600ampa
FEE SCHEDULE
Cross street/directions to job site: oAnyrwm 1 ow. 1 Wok 1 YaW 1 • ,
New residential single- or multi-family dwelling unit.
lagades attached garage.
Subdivision: ( Lot no.: 1,000 sq. IL or less 168.54 4
ED. add'I 500 eq. (L or portion 3392 1
Tax map /parcel no.: Limited energy. resdndlal _
DESCRIPTION OF WORK
with above sq. IL) 67.84 2
Limited energy. torrid/- lbmily 1 6714 2
C.. - Ht 1 . to tdet (with above sq, R) .
Services or feeders Iaatalladoa,dteration, and/or relocation
200 amps or lass 100.70 2
❑ PROPERTY OWNER 1 ❑ TENANT 201 amps to400amps 13156 2
Name: 401 amps to 600 mops 200.34 2
, 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 mops or votes 55126
2
City/State/ZIP: �L Temporary > or is taatalldon. alteration, and/or
Phone: ( )
I Fax: ( ) 200 amps or les 59.36 i I
201 mops to 400 turps 125.08 2
Owner installation: This installation is being made on property that f own which is not
401 166.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. m eD s990°
Breath &cults— new, Ogaden, or ex tension, per panel
Owner signature: Date: A. Foe for March drcaim with
❑ APPLICANT I ❑CONTACT PERSON branch c a Bader Ike,
7.42 2
Business name: B. Fee for branch circuits vhleom
branch circuit first ( 56.18 5 l6 • I i 2 '
Contact name: 1
Each add'I brandm circuit 1 7.42 1,"2 . Af _ 2
Address: INtsedlaneoa (service or feeder not included) _
Each nummatured or modular
City/State/ZIP:l� 67.84) 2
dwelg, service and/or fbeda
Phone: ( ) ( Fax:: ( ) Reconnect on 67.84 2
Pump or litigation Otte 67.84 2
E-mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal dreuit(s) or limited-nag
Business name: (�.� r panel. alteration,ar extension. i Paae2 2
\ 1( • C \ ►( � t(1 L..- Each additional Inspection over allowable In any of the above
Addres: Lj 4 5 f )1 i S(.:,/N A. 51 Vv.) ') Qc Addkimal inspection (I hr min) 6625/ br
� � C . '�
investigation siplant hr min) 6625/hr
City /State/ZIP:
f.0 \ kG'i.fli:. - 1 fl,� tadnnstrielptard(1IvmIn) 78.181 hr
P . nc (l) , - it" , tax: ( f` ) L L — 1 t 'J • Inspections for which no fa is 90.00/ hr
specifically listed (lc hr min)
CCB Lic.ry . j • 'leaden! Lic.: -/ -S ] 1( �uprv. Lic.: C 73 r/ ELECTRICAL PERMIT FEES
■ - Subtotal: 1 a • Li J
Suprv. Electric km signature, required:
Print name• , . � I —, r
Pion review (25% of permit (be):
i ' �. Date: 4/€>3)I 2 SUM St surelmige (12%ofpermit fee): 9 •4 TOTAL PERMIT FEE: , . �
t
Authorized signets i This permit appti tian taping If m p to sot °Waloodd within Ise
mr{
Print name r d L t l )'i ',
: ! r r l • days after It has been accepted as complete.
�� ; k ) 1.. .-1 e't 1 ( Date: "1 ) r Number of rose pions allowed per tea