Permit CITY OF TIGARD ELECTRICAL PERMIT
I.- COMMUNITY DEVELOPMENT
Permit #: ELC2012 -00437
T [GAR L3 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/24/2012
Parcel: 2S104BC06600
Jurisdiction: Tigard
Site address: 14255 SW WALNUT LN
Project: Pounder Subdivision: BAILEY WOODS Lot: 2
Project Description: (3) branch circuits for A.0 connection and 2 service plugs
Contractor: BOB'S ELECTRIC Owner: POUNDER, MICHELLE & GAYLAND
2700 NE BURTON ROAD STE A 14255 SW WALNUT LN
VANCOUVER, WA 98662 TIGARD, OR 97223
PHONE: 360 - 254 -7200 PHONE: 503 - 358 -6691
FAX: 360 - 254 -8219
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 07/24/2012 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/24/2012 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 5 - 001 - 00990.. A
.Li You may lain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. �� `'
Issued By: � OV Y t Permittee Signature: BAj A- P/C64- / LOLL
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.
FROM '(�'''+ (FRI ) JUL 20 2012 22: 68 /ST. 22:57'No. 8302826820 P 2
Electrical Permit ApplicatioJ EC FI )It e ll l R- F I ',I ()\1 1
City of Tigard JUL 2 3 2012 Da. : Received : Z a( I Pert L e'd'O p1 -00Cf3
:� • 13125 SW Hall Blvd., Tigard, OR 97223 Pan Review
I Phone: 503.639.4171 Fax: 503.598 1 I , OFTIGARD Date • : Other Permit:
T t C . I +. I, Inspection Line: 503.639.4175 Date ReadyBy: 65 See Page 2 for
Internet: www.tigard-or.gov BUILDINGDIVISION Notified/Method: /Method: �,� Supplemental Information
❑ New construction ® Addition/alteration/replacement Please che-ch that apply (submit j sets of plats w/iterns checked
❑ Demolition ❑Other; O Service feede 400 a mps or more 0 Build over three stories
where the available fault comet I] Marinas and boatyards.
5-_ "" r ' , t''l j exceeds 10,000 amps at 150 volts or Clawing buildings.
u- .._ .
.:r_, . , -_ _ „! _; ...,,
.1 � �
.,. __3. _ _ -
f . G.)-
.. ,
s. ...w.. kssto Found, or exceeds 14,000 0commercial- useagricltual
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amp for all other installations. buildings.
❑ Multifamily ❑ Master builder ❑ Other 0 Fire pump. 0Installation of 75 KVA or
"-. t 2 t. - ? + 1 k _ y = ` , Q E nergency system. larger separately derived spoon
.„,-;-.-.:;_!-...-t-.1.."....
c�a.._ _�.:_.. .__.S.:. ,.:,,,._.__(r_. k_e:_u.....:r_...,7 .....__ ...a_, O Addition ofmw motor load of 0 "A ",`E ", "1 -2, 1-3 ".
Jobno.: • -:14 Job site address: 14255 SW Walnut Lane rmore. occupancy.
❑ Six Six o or r more residential units. 0 Recreational vehicle parks.
❑ Healthcare facilities. 0 Supply voltage for more than
- - 0 Haardoes locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: 0 Service or feeder 600 amps or mare
Cross street/directions to job site: ' r •, Qty. yea. Pax: Tohl •
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'I 500 sq. ft. or portion 33.92 1
Tax map/parcel no
,= =� ? Limited energy, residential 67.84 2
u (with above sq. ft.)
c �. ^-� ? _X._ . ,, i -: ,,.r ? , ... , I:. _ '. .o.o.,wr, .,... v... ...._+. Limited energy, multi- family
A C connection & 2 service .lu: s residential (with above sq. ft.) 67.84 2
Services or feeders itastalladon, alteration, and/or relocation
200 amps or less 100.70 2
i + , '_,,_ . , t '' n _ .. _. .. , ..!, , _ . ,-.... ., t' r , . ■ 201 amps to 400 amps 133.56 2
401 amps to 600 amps 2 00.34 2
Name. Michelle & Ga land Pounder . ' 601 amps to 1,000 amps 301.04 2
Address: • Ova 1,000 amps or volts 552.26 2
- City /State/ZIP: Ti: and OR 97223 Temporary services or feeders installation, alteration, and/or
Phone: ( 503 ) 358 -6 . ' 1 Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
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. Fee for branch circuits with
=. P " • ; .
ti
r a above service or feeder fee,
t l ' - ,..::',:-_;::'.:., - 21. :: i , . _ _. ;. ,,, ' ,,. • _ . .. _ each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first
Contact name: branch circuit 1 56.18 56.18 2
Each add'I branch circuit 2 7.42 14.84 2
Address: Miscellaneous (service or feeder not Included)
City /StateJZ1P: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mat] I 67 84
� - Sign or outline lighting 2
_'ftafit :J �.P .s-_:;'.. ., ,. . .. , r . _. r .-.. �:`_ i _ 1? Signal circuit(s) or limited-energy
Business name: r panel, alteration, or extension. Page 2 2
Bob's Electric Each additional inspection over allowable in any of the above
Address: 2700 NE Burton Rd. Ste. A Additional inspection (I hr min) 66.25/hr
Investigation (I hr min) 66.25/ hr
• ' = • Industrial plant (1 hr min) 78.18/ hr
P •ne: ( 360 ) 254 -7200 Fax:( .0 )25 -8219 inspections for which no fee is 90,00 / hr
millimmir = ' fecal listed y h hr min
ltril Li t' ` z,i -- - -r :_11,.,- T
eccac. .1 - I C 'u rv. Lic.: ="` . ley -�:-;
Suprv. Electrician signature, required: = ` -�'
' 11 Subtotal: 71• s
Plan review (25% of permit fee):
Print name: Kevin Broselle Date: State surcharge (12% of permit fee): 8.52 /
Authorized signature: TOTAL PERM Cr FEE: 79.54 ✓
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.
IAsuitms8\Permis1ELC- itApp.me Iar01/09 44046lST(Ilros/COM/WEB