Permit CITY OF TIGARD ELECTRICAL PERMIT
• • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00404
T [GA A O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/09/2012
Parcel: 1 S125CD07100
Jurisdiction: Tigard
Site address: 9718 SW LANDAU PL
Project: McAllister Subdivision: LANDAU WOODS Lot: 8
Project Description: (2) branch circuits for home office remodel
Contractor: BOONES FERRY ELECTRIC INC Owner: MCCALLISTER
PO BOX 628 9718 SW LANDAU PL
WILSONVILLE, OR 97070 TIGARD, OR 97223
PHONE: 503 - 682 -4936 PHONE:
FAX: 503 - 682 -7946
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 07/09/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/09/2012 $7.63
Type of Use: SF Electrical
Class of Work: DEM
Type of Const:
Occupancy Grp:
Total $71.23
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- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. l r
Issued By: Permittee Signature: OM / A-PP t,e �1 1,^L
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.
Jul. 9. 2012 4:10PM ' No. 9304 P. 1
ECEIVE
Electrical Perl��t AppLcatlo FOR orF1cE USE ONLY
City of Tigard JUL 0 9 2012 Received 71 ft 1 y e.! permitt x(,� O0'rt/T
Date/By: l �1
13125 SW Hall Blvd., Tigard, OR 972 plan Review
' h Phone: 503.718.2439 Fax: 503.598. OF TIGARD DaLWBy: Other Permit:
T 1 6, :\ u I] Inspection Line: 503.639.4175 BUILDING DIVISION! Date Ready/By: rung ® See Page 2 for •
Internet: www.tjgard- er.gov Notified/Method: " l �a Supplemental Information
n .Mtl `t - :'P�I't;:i i-..., �,� .,J Mc � ::, :'. :rl. :4,11 „ et =Lcm71 :. : N ,. : . 71 . _ -� rr.L',!lll• :_F,1:
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building ova three stories.
❑ Demolition ❑ Other where the available fault cement ❑ Marinas and boatyards.
. 1�.. 4 ?c'�.._i { :'_ ?'r P�fl�' ^„ ,'a 1 -.' ;-��'?. :_ . _ : I., . -i..�; c= `FT_'= ' ''.i a' =__ ,
y ,"( : i,. ,.1 : , - r 1 :1.1 i .,C F , J .,c, °I r ,, __ exceeds IO.000 amps at 150 volts
i ;i.Lf,`t�+.� � � +':.� :� !1111 :���'�i ;��._;'I, 1_, 1 r ,L •�,i :��,1,13i � __ .� mps l 11sor ❑Flvatiagbuildings.
s r _ r _..., , r x s..� �'- t ?�4 ;a : :.., .3 �a , less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- 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
'ii
'E 1^ ,, - ;I T
` 1s. I' n�a c' . _ 4 '. :1, .,v,,. V a -7. 1- ._Fi,lti_;;I ;i" ;* r 7 ❑ Flaergency system. larger separately derived system.
„Y , 1..I,i:1 , +,i�t,mst _ a 'il1 h l , '�a d-1 f` '{' 1y� ' l 1
Fi. :..�k,.U: # r: �t. l: a t.^: L. .,�aiTr.,T- =_ ;i,_._..,.z - 1
_,:_�P • , , "� -_ s- -.7= si�lia. , r ❑Addition of new motor load of ❑ "An, `•E "1 -2", "1-3",
Job no.: 200412 Job site address: 9718 SW Landau Place I00HP occupancy. D Six or more residential units. ❑ Recreational vehicle parks.
City/State /Zip: Tigard OR ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: McAllister ❑ Service or feeder 600 amps or more.
_� i t r-ry n, . .
Cross street/directions to job site: = 1 � � �1 1 r ; � �!� } r =i 'a _ =� , -. , .1, _ r j•1 l ,, ,:::I.:Mi
New residential single- or multi - family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. it or less 168.54 4
Tax map /parcel no.: Es. add'I 500 sq. ft. or portion 33.92 1
_
:�` a Ta 1 ?`�, :'� ? ;,T ;le!1 +n;'1 +'c''.,i ; F- Limited energy,
' ^• -sr ._e- , a 1 rl t r 17 _ l i t 7 n .r.: �, :i , I .,.. 1 T 75.�� 2
- " - - 1 =_ -. -� . � ..' i / 1 1 , l .., u1q :i ,i e` -g�� =- _ (wish abovesq. ft.)
,
Li mited energy, multi family 75,00 2
Small remodel mostly in home office residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
s
r1,r,a a'r r, T: i .. ∎∎ :i;:rrc!:m nq a., ;:.: _,; F
�,, ; ; :f=.r_ :r '7 I ia'_', : ;, a 1 ,, . _ , � . 1. yh I YiP a K t ., , . 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
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
• Phone: ( ) Fax:( ) 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 co 599 amps 168.5 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - dew, alteration, or extension, per panel
Owner signature: Date; A. Fee for branch circuits with
X1-4 ••c:_a �r :;!.. ;r;: 1.71ii l iiir E': - - •:, :_ ;:•,. 5"•7 : = • _y :,:,z above service or feeder fee,
f. •ti{'Ir 1� n�'�`dE• li � 1 � � - ' . : ,� �d "l
?+ti' -L+!, :u {. .-.� - „ -� . - - , -Pa .�.:,,,i77r.,u._.,,� I trP'.?:Y a.�r',..19 `.,:;i :l, : ;l :.: each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 18 56.18 2
Contact name: branch circuit
Each add'1 branch circuit 1 7.42 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State /ZIP: 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
1 �.i ;irm,:'
• iii ' 1 Y 1 = - Ji ,p , ,`Iil!'. .- 1 - ..! 4 - rIghL :,I :j �), ... li :_� .
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v' L�,:a� ;:,...r 1. =-r : :U :.i :: � 7.-,•
. .. .... . . ._..._: �e.z., 9 �_ .._.. �L�� , , - , _,. - - - - a: ti�;aa7 Signal circuit(s) or limited-energy
Business name: Boones Ferry Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: PO Box 628 Additional inspection (1 hr min) 6615/ hr
City/State/ZIP: Wilsonville Investigation (1 hr min) 66x5 / hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503)682 -4936 Fax: (503) 682 -7946 inspections for which no fee is
s. - ificel listed h hr min 90.00 / hr
c.: 8 82 Electrical I c.: 3 -223C Suprv. Lic.: 3170 q , : 1up r ,_ , ..,.,...:. ,, ;,.;, : , :,.-:,, ;,�. -. - : -_
,,.,
f i _ •7 ;r - �.: • �1 L e �F i l i
CCB Lic.: 84 p S 1 E4_i,.:.l.if,.,. - - � ,,;I .11, I .a
Subtotal: 63.60
Suprv. Electrician signature, required: I�` ■ Plan review (25% of permit fee): N/A
Print name: Jan Herron �'� Date: 7 /9 /1 2 State surcharge (12% of permit fee): 7.63
Authorized signature: TOTAL PERMIT FEE: 71.23 `-""
This permit application expires if a permit is not obtained within 180
Print name: Date: • days after it has been accepted as complete.
Number of inspections allowed per permit
Ida Pamits\ELC- PamilApp.doc 07/01/10 440- 46157(11/05/COWWEB