Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2012 -00467
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2012
Parcel: 1S133CD12100
Jurisdiction: Tigard
Site address: 11889 SW WILTON AVE
Project: Faust Subdivision: COTSWALD MEADOWS NO.3 Lot: 153
Project Description: (3) branch circuits for storage shed wiring; (1) 200 amps or less
Contractor: RED'S ELECTRIC CO INC Owner: FAUST, AMANDA
6336 SE 107TH AVE 11889 SW WILTON AVE
PORTLAND, OR 97266 TIGARD, OR 97223
PHONE: 503 - 233 -6467 PHONE:
FAX: 503 - 233 -1281
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 08/06/2012 $100.70
Specifics: amps or less
3 crt Branch Circuits w /Purchase 08/06/2012 $22.26
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 08/06/2012 $14.76
Electrical
Type of Const:
Occupancy Grp:
Total $137.72
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 -00 0. You may obtain a copy of o the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332,2344.
Issued By: . d & .LEI Permittee Signature: D ' �k A PP'-^I 64'1 7 )'')
D &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 503.839.4175 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.
Aug. 6. 2012 8:13AM No. 1783 P. 1
E1 r p --
Electrical Permit Application REG:. R trill OFFICE IISE, oNI,l'
City of Tigard Received • toil y t Pemril No.: tG l� dol (Jp
= ° 13125 SW Hall Blvd., Ti ard, OR 97223 4 1 ! r O 6 O RevIli iew Plan Review
Phone: 503.718,2439 Fax: 503.598.1960 CITY r tray. Other Permit:
f 1 Ci A till Inspection Line: 503.639,4175 Cli l a OFTIGA ". to Ready/By: Jam+ See Pegs 2 for
Internet: uww.ligard -or.gov BUILDINGDIV1; i i,dim shod.: I BJ Supplemental lorormah
' TYPE' OF .WORK. . : - . ...
:. 'PLAN .REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit j sets of plans whims checked below):
❑ Service or tbeder 400 amps or mom ❑ Building over three stories.
[] Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY. OF CONSTRIICTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. .
" " "" 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: D Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFQItt�IATION AND. LOCATION • : ❑ Emergency system. larger separately derived system.
..... :"' . . .. • . D Addition of new motor load of ❑ "A ", "B ", "1 -2 ", "1 -3 ",
Job no.: 68746 Job site address: 11889 SW WILTON AVE 100HP or mom. Occupancy.
D Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name; ['Service or feeder 600 amps or more.
FEE SCHEDULE—.
Cross street/directions to job site: Di•eripuee I QM. I Pee. I Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 I 4
Tax map /parcel no.: l En. add'1 500 sq. R. Or portion 33.92 I
Limited energy, residential 75.00
• . DESCRIPTION. OF WORK . '. Swish above sq. (1) i
Limited energy, multi - family 75.00 2
STORAGE SHED WIRING residential (with above sq. ft.) f
" Services or feeders Installation, alteration, and/or relocation
200 amps or leas I 100.70 100.70
Q. PROPERTY OWNER.• ' ❑ TENANT. .•' • :. .. 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
Temporary services or feeders installation, alteration, and/or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 5936 I
"
Owner Installation: This installation is being made on property that I own which is not 201 amps lo 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168 2 -
Branch circuits — new, alteration, or extension, per panel
Owner signature; Date: A. Pee for branch circuits with ,
❑ APPLICANT I ❑ .CONTACT PERSON _ . above service or (Ceder fee, 3 22.26 •
• 7,4Z 2
each branch circuit
Business name: B. Fee for branch circuits wlthour • t
service or [ceder fee, first 56.18
Contact name: branch circuit _�
Each add'I branch circuit 7.42 .,
Address: Miscellaneous (service or feeder not Included) _
City/State/ZIP: Each manufactured or modular 67,84 2
t) : dwelling, service and/or feeder
Phone; ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: Sign or outline _ 67.84 2
CONTRACTOR .. Signal circuit(s) or limited - energy
Business name: REDS ELECTRIC panel, alteration, or extension. Page 2 2
Each additional Inspection over allowable in any of the above
Address: 6336 SE 107 AVE Additional inspection (I hr min) 66.25/ hr
City/State/ZIP: PORTLAND, OR 97266 Investigation (I hr min) 66,25/ hr
•
Industrial plant (I hr min) 78.18/ hr -
Phone: (503) 233-6467 I pair 3 5 Z$; 1281 Inspections for which no tee is 90,00/ hr
err. - L specifically listed (% hr min)
,t2CB Lic.: 4443 Metrical Lic_. 26-152C Ii.Baprv Lic.: 5010 - S . - . ELECTRICAL PERMIT..IEES '
122.96
Suprv. Electrician signature, required: , Subtotal;
Plan review (25% of permit fee);
•
Print name: JIM FERRIS Date: 08/06/12 Slate surcharge (12% of permit fcc): 14.76
... TOTAL PERMIT FEE: 137.72
Authorized signature:
This permit applicali0n expire If a permit La not obtained within 1a0
Print name: I Date: days after it has been accepted as complete.
N um b er of inspections allowed per permit.
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