Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00418
T E GA.RO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 1 S136AD01901
Jurisdiction: Tigard
Site address: 6910 SW OAK ST
Project: Botteron Subdivision: VILLA RIDGE Lot: 1
Project Description: Remove and replace 125 A panel with same and add 8 circuits
Contractor: EDCO ELECTRIC Owner: BOTTERON, DAVID & CONSTANCE E
PO BOX 180 6910 SW OAK ST
GRAND RONDE, OR 97347 TIGARD, OR 97223
PHONE: 503 - 935 -7434 PHONE:
FAX: 503 - 206 -7466
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 07/16/2012 $100.70
Specifics: amps or less
8 crt Branch Circuits wo /Purchase 07/16/2012 $108.12
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 07/16/2012 $25.06
Electrical
Type of Const:
Occupancy Grp:
Total $233.88
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 9 2 -001 -0 90. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Aft .
Issued By: Permittee Signature: O&L.. TQk) .
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 503.039.4175 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.
Electrical Permit Applicatiol E 'I J; FO S: OFFICE U.5 F: ONLY
L.Y
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City of Tigard micro : lbauived -I�li'! i .
13125 SW Hall Blvd.. Tigard, OR 97223 JUL 16 2012 PlaoReview Oihal�er�l.�S-r 1a� DDD •
Phone: 503.718.2439 Fax: 503.598.1960 Date/By:
,, ;., i s t, Inspection Line: 503.639.4175 CITY O � F Ts1 ARD Dal° eadY/ C /. El Sec Page 2 fbr
Internet: ww.tigerd Notified/Method: .or.goV . BUIL -DINE etVIS Ykr : - Print name:
U New constnu3ion Addition/alteration/replacement r .
.. PLA .R EVIEW.
❑ Demolition • ❑ ether Please tJ k all that l submit sets of law wiitesu checked below): 00 or
• • :• ; : CATEC0R :O)F. CONSTRUCTION' Imp _
1- and 2- family dwelling ❑ CommereinV ndustrial U Accessory building ❑ � the �� fault went e ❑ Building war three
straits.
❑ M111Q -fermi y Master builder ❑ Other: 10,000 amps at 150 volts or ❑ Marinas m
lees to pound, or exceeds 14.000 ❑ Floatin buildings
' • ' .'..40111 SITE_I1VI'OBMATION AND. •.t.oCATION .. .. amps for all other insrallauoas.
❑ Coen nerei .ruse
Job no.: Job site address: r j ' id ,. w ORE pump. agnculnral
A
� � ❑Emergency system. buildings.
City/S1ate/ZIP. ! 7 4 / /` ❑Addition of new mow load of ❑ Installation of 75 KVA
4 � /G 10011P or more. a<
Suite /bldg. /apt. no.: Project name: 20 2
larger separately derived system.
❑ Six or more residemial units
Cross street/directions to 'ob site: ❑ ❑ A. E. "1 -2 ". ")..r.
J H ealthcare facilities.
oeeupaney.
❑ Hazardous locations. ❑ Recreational vehicle
l... .- ..- .. ❑ Service err feeder 600 parks,
Sllbdi nn: Lot no.: amps Sr mare ❑ SuPPIY voltage for
Tax m ap/pamel no.: • . ethic than
..: .'...:' 1� .
600 nominal
.. • .. ...... P Ol'� .W01 ,
8 I . /25- 4. NJ ' 7/4 1 r; : z SCHEDULE • • ;
Aa+irta> m . I Gn. Pao 1 taw h
,/ , /A 4 Gd _ New residential tingle- or meld- tbnsjly dwelling unit.
. �.iE NANTf;';.: attached fie
es
P1s()PIBBT]" (*Ilk ' 1 ,000 sq. R or beta 168.54 4 •
Name: Ea add'I 500 tq. ft or portion ° 33.92 1
• Limited energy, residential
(with above sq. t) 75.00. 2
Address:
Limited energy, mule- family 78.00 2
City /State/ZIP: — - residential (with above sq. Itt
Services or Wales instalation, alteration, and /or relocation
• Phon • . • ) Fax: ( ) 200 amps or lose 1 100.70 04, ? l ) 2
T installation: This installation is being made on property that I own which is not 201 amps to 400 amps 133.56 2
. for sale, lease, rent, or evehnnge, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps _ 200 .34 2
Owner signature: Date: 601 amps to 1,000 amps 301.04 2
.NT: . 2g..: . � . P PER Over li amps services n, alters r
I:[CA : :.: G'QIY131C :... feeders do and /o
Tam se installation, n.
Business name: r n , y reloradon
Contact name: a , / " 200 amps or lets 59.36 1
_jet s d s/ 201 amps to 400 amps 125.08 2
Address: ° 401 amps to 599 amps 161154 2
Branch circuits - new, alteration. or emission, per nand
City /State/ZIP. 7 _ [� A Fee for branch circuits with
ne:( ' 1 ?3, f,�T I ( ) ebove an ch ci its er ri: tee, ,J ) FsX:: cash branrcuit 7 2 Pho
B Fee for branch circuits without
E-mail.
.. - • .. , wake or feed
aOw,�wccoa,.
branch oneuit a fee,
56,18 2
Business n ame: . . - .�1 A Hach add•1 branch circuit 7.42 - - , 7
' s • - MisorLameoua (service or feeder not included)
Address: manufactured or modular 684 2
i C y / - Eaehma Jr. souvece and/or feodor
City/Staterz>P: Cv -. . 1611.7-9.1a. -..7 di/2. (7734/7 Reconnect only _ 67.84 2
Phone: ), A r V r3 Fax: ( , 3 ).2 P� or irrigation e ciucle 67.84 2
. Sign or outline lighting 67.84 2 ,
,CfCB Lie.: -' �(, G • e - : rc bc.: ✓ ', Signal citrnit(s) or limi c4- energy
• ' I - panel, alteration, or extension Page 2 2
Suprv. Electrici . ,. 2 . . - required: / • ( 1 Each additional Iuspecllan over allowable in any of the above
.,, _ . 1_ Additional ins ca tion (1 hr min) 66.25/ Iv
r
Print e: • � �i - . e Dates -7 ng
nin I (1 hr min) . 66.25/ I
j Industrial plant (1 hr min) 78.19 / hr
Authorized Signature: `
� J . • ., . a « inspections for which no ire is 90.00 / hr
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Jul. 13. 2012 1:04PM FRED MEYER #375 CSD 503 620 -1866 No.2082 P. 3
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Jul. 13. 2012 1:04PM FRED MEYER #375 CSD 503 620 - 1866 No.2082 P. 1
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