Permit II CITY OF TIGARD ELECTRICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00258
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05!04/2012
Parcel: 1 S135BB00800
Jurisdiction: Tigard
Site address: 10655 SW GREENBURG RD
Project: Ewing Irrigation Subdivision: HILLSBORO Lot: PTS 1 -2
Project Description: (26) branch circuits for TI
Contractor: HILLSBORO ELECTRIC LLC Owner: EWING IRRIGATION PRODUCTS INC
21185 NW EVERGREEN PKWY #110 3441 E HARBOUR DR
HILLSBORO, OR 97124 PHEONIX, AZ 85034
PHONE: 503 -439 -9666 PHONE: 602 -497 -9530
FAX: 503 - 601 -3680
FEES
Quantity Description Date Amount
26 crt Branch Circuits wo /Purchase 05/04/2012 $241.68
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/04/2012 $29.00
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $270.68
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. ATTENT n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 rough OAR 2 -00 9 You may obtain a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Yo/
Issued By: a�" (. -4M SFA\.j' 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 503.839.4175 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.
From:Hillsboro Electric,LLC 5036013680 05/02/2012 10:03 #862 P.001/002
Electrical Permit Applicat ' i � �l ED FOR of hlcl- usl c j_�
City of Tigard Receives
h g Date/B D � ) Permit No.: pro? --evass•
° 13125 SW Hall Blvd., Tigard, OR 972? ^ 2 2012 Plan Review
i • Phone: 503.718.2439 Fax: 503.598.198I Date/By: Other Permit: 45 -eze
`I c ,� r.7 Inspection Line: 503.639.4175 - �/ r1 Date Ready /By: funs: ® See Page 2 for
. Internet: www.tigard- or.gov D Notified!Method:
�± lJ 1Vi510N Supplemental Information
TYPE OF OF TIGAr� ' G PLAN REVIEW • . •
❑ New' construction l Ad dition /alte CITY 1 0 0 F
Please check all that apply (submit 2 sets of plans w items checked below.):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14.000 ❑ Commercial - use agricultural
❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. 0 Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ID Emergency system. larger separately derived system.
❑ Addition of new motor load of
Job no.: Job site address: / - L L 1
I00HP or more occupancy.
�7�� f � / W �J� .7 �✓ 6..,,,,,,„ b (l✓�j �D 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Ti 5 4,- 6 OR. 9 7 a a3 ll ❑ Health -care facilities. 0 Supply voltage for more than
1 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: 1 t ❑ S ervice or feeder 600 amps or more.
3 EA) c j , M� � o v, FEE SCHEDULE
Cross street /directions to job site: vi D,tptio„
I Qty. I Fcv. I 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'l 500 sq. ft. or portion 33.92 l
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 2
7. residential (with above sq. ft.) 75.00
Services or feeders installation,,alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER 1 ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 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 services or feeders installation, alteration, and/or
City /State/ZIP:
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 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 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fce for branch circuits with
❑ APPLICANT I ❑ CONTACT :PIE SON above service or feeder fee, 7 q� 2
each branch circuit 1
Business name: B. Fee for branch circuits without
service or feeder fee, first
branch circuit 56.18 ,1 2
Contact name: _
Each add'l branch circuit 7.42 I e � $1: 2
Address: Miscellaneous (service or feeder not included) Q•'
City/State/ZIP: Each manufactured or modular -
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
:CONTRACTOR Signal circuit(s) or limited- energy
Business name: Hillsboro Electric, LLC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 21185 NW Evergreen Parkway #110 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25! hr
City/State/ZIP: Tigard Industrial plant (1 hr min) 78.18/ hr
Phone: (503)439 ,0 1\ ta Fax: (503) 601 - 3680 Inspections for which no fee is 90.00/ hr
/J C
Q specifically listed ('A hr min)
/CCB Lic.: 134481 Electrical Lic.: 34 -499C Suprv. Lic.: _< ! 9L / S „ _ 1 '• a ELEcrkICAL::pERMn. FEES �� ; ::i.•:' ,'tuii i
� Subtotal: V
/� V
Suprv. Electrician signature, required: ' ' Plan review (25% of permit fee): 1„L eV
Print name: 0 7 C , I , l Lam) Date: s _ a _) , State surcharge (12% of permit fee): Xi, O`)
Authorized signature: ! 7 V TOTAL PERMIT FEE � 7O a
This permit application expires if a permit is not obtained within 186
days after It has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
1-d uitdinasPcrme mELC- PermitApp.doc not '10 440 -46 t 5Ti 11 /OS 'COM•WEB