Permit CITY OF TIGARD ELECTRICAL PERMIT
1111
• COMMUNITY DEVELOPMENT Permit #: ELC2012 -00289
T [GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2012
Parcel: 1 S 135ACO2500
Jurisdiction: Tigard
Site address: 9350 SW MANDAMUS CT
Project: JT Smith Subdivision: ASHBROOK FARM Lot: 25
Project Description: Temp service and feeder
Contractor: GARNER ELECTRIC Owner: TRA 43 LLC
2920 SE BROOKWOOD AVE A 5285 SW MEADOWS RD #161
HILLSBORO, OR 97123 LAKE OSWEGO, OR 97035
PHONE: 503 - 648 -4552 PHONE:
FAX: 503 - 642 -7925
FEES
Quantity Description Date Amount
Specifics: 200 ea Temp Services or Feeders - 05/21/2012 $118.72
200 amps or less
1 ea 12% State Surcharge - 05/21/2012 $14.25
Type of Use: MF Electrical
Class of Work: NEW
Type of Const:
Occupancy Grp:
Total $132.97
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 OA 9 2-001-0 90. You may obtain o�of the rules or direct questions
Signature: calling 50 198 1.800 332.234
Issued By:
I / �C�C � f a PPU
/ 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.
I /Cr I 11 _.... ST
Electrical Permit ApplicatidnoLC I :e LE •, ., FOR OFFICE USE ONLY ; L Pit
City of Tigard MAY 17 2012 p oo.i 51.44/4- st FM,,,it No. .,i4061_ 00
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Rcvicw other Permit: 0
1 . : Phone: 503.718,2439 Fax: 503.59. F . pate/By Or I�J� ; Date Rend /B Jar' Ri Sec Page 2 rnr
TI GAl2 f7 inapcction Line: 503,639.4175 Y o d: Supplemental B UILD!I`l Dl�; ~ (�P NotificdSupplemental Informnrinn
Internet: wwwrtigand- nr.guv ! !
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. r Plat at appl (submit 2 seta of plans w
New construction ❑ Addi ' n / &iteration /r lacement D serviee or fccdcrdnn amps or more ❑ Building over three A10110.
Demolition Q Other: where the avnilahlc.huh current ❑ Mennas and hoatyards.
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.,., ,•::, I ...:.::::..:: I:;1; ,l;r; ,: ..r , r:; exceeds 1 ,000 amps at or D Floating h uildinxs.
„r•..,. n: I,I,;.,.I ,, r „r.. I.. ,.. ,... . :.,.. 0 ISOvoltao 'load
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• ' '..I�`:!:�• >1 �;'I:.I :,`' •.. ........ • .... , r�'. '' ".. • :• , . , • . le e4 to ground, or exceeds 14.000 ❑ Con,nttctcinl• use ngric,nleunll
', ' 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps fnr all other insinuations. buildings.
ion of 75 KVA or
Multi - family ❑ Master builder ❑Other: Pero pl' m. l] larger s derived System.
• ::: ,'
I
Y Emergency system.
' , a , l! ” ,•� `
liil' '; „� iiOCA'E'LOPt ❑ Addition of new motor load of ❑ "A" "E". . ,,. 11,,...3!1 Sf[t I , bR tih37nN.' 1C1V'D, , "1-2", .. _,,,
•'rii6r ;: + +, F'Ir.hrl:l +iC� it i!•i.a • '. � - I OOHP Or mnro.
occupancy.
Job no.: Job site address: 9350 SW Mandamus Ct ❑ Six or more residential units. ❑ Rccm:ltlnual vehicle parks.
❑ Health•care facilities. ❑ Supply voltage Sir morc than
City /State /ZiP: Tigard, OR ❑ Hazardous locndnns. ono volts nominal.
Suite/bldg. /apt. no.: I Project name: JT Smith D Servlee or fbedcr on amps or mom.
... • • VEE S.CFII;Dart
Cross street/directions to job site: or,ciiniwn - (Sty' I nee. 1 • Total 1 •
New residential single- or multi- family dwelling unit.
includes attached garage _
Subdivision;
Lot no.: 1,000 sq. R. or less 1651.54 4
- Ea. add'I 500 sq. Il, or portion _ 33.92 — I
Tax map /parcel no.: Limited energy, residential 75.00
:' , :.,;•''�;o - ,;::I' •:it'll ':J'a•;:5 ?i (with above sq, R.)
;,, r tr rr ' I•'I' 1 . ,' i :!:: +.1 ..:IF ,,1. •,. e!:'riS' CJ1' ii'i�l' is ..
I:•4 +:r�.'FIu4 Ir(.I .I, r,l 11, .l li•. ! . . ...... ........ i i , ._.'il i....- ;i:;. "......:...
Limited energy. multi - family 75,00 2
---->• Temp service and feeder residential (with above Be. fl.)
Services or feeders installation, alteration, and /or relocation
200 amps or loss 100.70 2 400 amps 133.50 2
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: .. amps to
401 amps to 600 amps 20U 34
Name: 601 amps to 1,000 amps 3111 2
Address: Over i U00 amps or vnity 552.20 2
( Tempornr 'se Ices nr feeders installation, alteration, and /o
City /State/ZIP: _
Phone: ( Fax: ( ) 20(1 am or less 2 59.30 1 18,72 I
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 ,
,, ,,,,,,,;r:.;;; ::;;: °' ''� ; r1'.. ;' - .. iee or fbe r fcc, 7.42 _ • r
:� :.. • ,...... above scry de
Y IV!f'
:.. .... ,.... ag , �!P � �A '. • :�� •C .. h circuit
Business name: Garner Electric R. Fcc for branch circuits n,lthoul
service or feeder fee. first
56.1R
Contact name: branch circuit —
— Each add'I branch circuit 7.42 2
Address: Miscellaneous service or feeder not included
Each manufactured or modular 67,84 ?
City/State/ZIP: dwelling, service a nd /or f eeder
Phone: ( ) Pax: : ( ) Reconnect only 07,84 2
Pump or irrigation circle 67.84 2
E - mail: Sign or pudine lighting 67.84 2
.. . .� .. � .l)F':�'; 1':
lCi'ri I•.:. .';1: 1i:`• ••o �:�ili';••r; •.r;:J:,::G:: .:;,' .:,. '!:` ';�!i:�: -:��r�r:'e
.' I r r '`'' I I', n . l ;'6 ;.: i> , ,1r,..,r,✓I Ij!�l J' l q + , ,.11 "',, . i Signal circuits or limited - one
r;
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Business name: Garner Electric panel, alteration, or extension. Page 2 2.
Each additional inspection over allow hie in any of the above
Address: 2920 SE Brookwood Ave. #A Additional inspection (I hr min) 06,25/ hr
Investigation (1 hr min) 66.25 / hr
City /State/ZIP: Hillsboro, OR 97123
Industrial plant (I hr min) 78.18/ hr
—
Phone: (503) 648 - 4552 �,�• / Fax: ) r : - 2975 D (Ir13 Inspections for which no fee is 90,00/ hr
- specifically listed ('/ hr min)
/CCB Lie.: 121159 3 ,Fiectrical Lie.; 34 5C )ep 3707S . • ELEC'1'R AL; :'P'GII411T FEES
1 ,. Subtotal: 118.
Suprv. Electrician signature, required: llt. ,
Y
'F',,, -...r j ? =' .'...c. Plan review (25% of permit fee):
Print name: Chuck Garner Date: 5/17/12 State surcharge (12 %ofpermit fcc): 14.25 _
- TOTAL PERMIT FEE: 132.97 /
Authorized Slgtlature: This permit application explr'ca If a permit i• not otrtuineil within IHp
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
1: 1al tildintt \Permits151,C•ra'lnknpp.doc 07/01/10 440,40151111 m5tr-.nM/WPa