Permit •
71-1 CITY OF TIGARD ELECTRICAL PERMIT
li COMMUNITY DEVELOPMENT Permit #: ELC2012 -00349
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/10/2012
Parcel: 1 S 135ACO2500
Jurisdiction: Tigard
Site address: 9304 SW MANDAMUS CT
Project: Longstaff Apartments Subdivision: ASHBROOK FARM Lot: 25
Project Description: New MF. Building 5 (6 units).
Contractor: GARNER ELECTRIC Owner: J.T. SMITH CO
2920 SE BROOKWOOD AVE A 5285 MEADOWS RD SUITE 171
HILLSBORO, OR 97123 LAKE OSWEGO, OR 97035
PHONE: 503- 648 -4552 PHONE: 503 - 975 -7639
FAX: 503 -642 -7925
FEES
Quantity Description Date Amount
709 Electrical Permit 07/10/2012 $708.61
Specifics:
85 12% State Surcharge - 07/10/2012 $85.03
Electrical
Type of Use: MF
•
Class of Work: NEW
Type of Const:
Occupancy Grp:
Total $793.64
Required Items and Reports (Conditions)
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordan . approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTI• •: Oregon =w re— =- -u to follow the rules adopted by the Oregon Utility Notificat • • enter. Those rules are set forth in OAR
952- 001 -0010 ro gh OAR 952 -0• 0090. • ay obtain a copy of the rules or direct questions to OUNC b Iii t= 32.1987 or 1.800.332.23
Issued : � � —� �lL i i Permittee Sigma •
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR STALLATION ONLY
SIGNATURE OF SUPR. ELEC' _� Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,i, - 7.5.mgrtricz.vmmi&-Trazt3.siapl i t - g.azz--zwarinfitilm
Electrical Permit Application
„,,,„,
:17, City of Tigard Received / 40 1 ; 6 0 , , Permit No .:62-e e■7042-4e)0•571/9
. ::411. - '41 13125 SW Hall Blvd., Tigard, OR 97223
1114 ate/By: ( P
4 ': Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: °tiler Pe nui ettP0 2 042 ''' 000Yo
Inspection Line: 503.639.4175 Date Ready/By: Jurir. Efl See Page 2 for
:TIGARD, •
Internet: www.tigard Notified/Method: Supplemental Information
AVAV:t-$.:'1M,Wrfif.'Fg.'-,ZjPWEoiiitsgOVTNS%i.cR:4ir:R-Mg%r,Vtrp-Mb.1 R...t.AMite
,4„..,..„...............,,,,,,,,,_„.„,....:.,,.....#,-h,,.„.2,:,,.2.-...„,_zo.:,....„„..,, A1..„..........„, -- .,,,, :: ,..,' :,"., :, s-' - ; • . .. •
Er construction 0 Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/iteins checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
Trekir,e'nfSire:F:irgn4N..t::g','.,WUtj.Xre,. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
...,....,..,....A.,,,-,:_,,2Ms.:::M.;,i,.:;:4‘,./ic:1311*-.,,,ts:.;■:kaA less to ground, or exceeds 14,000 0 Commercial-use agricultural
?d 2-family dwelling 0 Commercial/industrial 0 Accessory building amp s for all other installations. buildings.
Multi-family 0 Master builder El Other: 0 Fire pump. 0 Installation of 75 KVA or
t ,WATIRrfog,...,-q,,,pitrits-iti,..,,,,,...„,,,,,,,,,,,,,,,oN gI
.AND.; ..,, s. .. . . 3 .-„.
. 0
1 ....,• , 0 Emergency system. larger separately derived system.
'''Z'agV ... ` • '..... . ,s,- ' ' .., ,' Addition of new motor load of 0 - A". "E". "1-2". "1-3".
1001-IP or more. occupancy.
Job no.: Job site address: 9 3L,_ a 2 e " .. 4 2 „ t h A ikelig.. .
• / -- 1 , . 7 4 7 1 'I .aa / I .... a. ---.. Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: dr: dat q 7221 oh 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite&apt. no.: 5 I Project name: frejuVirri.v.- ....54 141- 0 Service or feeder 600 amps or more.
, i ' .:''';...i'....'•:-.:f:--.... .: .: ' . ' . ' " :
Cross street/directions to job site: / 7 1 1,4040 _ 2.,/ 7 /- Kay Description I Qtv. I Fee. I Total I •
New residential single- or multi-family dwelling unit.
tp ' C U/ 4 1 b 6 / ' / ti Se4/ MaAvrlethiS Crx cy-. ...shah Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less rt 168.54 it 4 1
' Ea. add'1500 sq. It or portion I 33.92 ,3,
Tax map/parcel no.: Limited energy, residential
75.00 2
i't _._ _____ with above sq. It)
Lim al energy, multi-family
el.ecti we, / 4rns1-ri. /Dr,- Fees re: idential (with above sq. ft 75.00 7 .) _
1
Sc S amps CCI o r fee s ers d installation and/or relocation
Aet -Ji Z 41 4 1-16 AAA -Catr t! 2 r les
- 1
- ' '• - -,'" '''' :•:;,.,.?-..,..: ;., - ... 01 amps to 400 amps 133.56 2
Name: i
.i ='.'.7.&: ?.
401 amps to amps to 600 amps L 200.34 2
601 1,000 amps , 301.04 2
Address: 5 717€4 j, Over 1,000 amps or volts , 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: ZA,k.e Os c,Je_J-4 oe. .9 7e./35 relocation
Phone: ( 975 7‘31 (Fax: (5,d3) 620(— a / oz. 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, irr panel
Owner signature: Date: A. Fee for branch circuits with
gaiathaFpr ko.0-04k - a fee.
742 2
Business name: j", s/ - 4 Co B. Fee for branch circuits without
. service or feeder fee. first 5618 2
Contact name: Ch ,, ' l_,,.....-- branch circuit
Each add'I branch circuit 7..42 2
Address: 5 Z.F5 -- 7-eeta, 5 ...--7-. ,
Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: 1,2A. asicieje, / Ae 'i' 2e13- dwelling, service and/or feeder 67.84 2
Phone: (503 ) 9 257- 7 6 3 9 I Fax: : (503) 68- eyoz_ Reconnect only 67.84 2
Pump or irrigatMn circle 67.84 2
Sign or outline lighting
67.84 2
Signal circuit(s) or limited-energy
Business name: Garner Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2920 SE Brookwood Ave. #A Additional inspection (I hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State/ZIP: Hillsboro, OR 97123
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 648-4552 I Fax: _03) ;42 , Inspections for which no fee is
90.00t lit
specifically listed (Yr hr min)
CCB Lic.: 121159 Electrical Lic.: 3 05C A Sup'. Lic.: 3707-S gyi: •:..• .. - - • •
> :' :- e
' ,•6.1••,,?:•,'1,-. Subtotal: 70 f . bi
..
Suprv. Electrician signature, required: ., .1/2/ e- 4-
Plan review (25% of permit fee): i 77 is
Print name: Chuck Gamer Date: State surcharge (12% ofpermit fee): ( rs. 6.3
TOTAL PERMIT FEE: Ciff2d/r-opir
Authorized signature:
This permit application expires Ir a permit is not obraTned within 180
days after it has been accepted as complete.
Print name: I Date: • Number of inspections allowed per permit. ,
193% V !
IABuitdingTerrnits%LC-PcrmitApp.doc 07/01/10 410.461 MS/COM/WEB