Permit V CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00473
T t G AR L3 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/08/2012
Parcel: 2S112CD02100
Jurisdiction: Tigard
Site address: 7895 SW BOND ST
Project: Mallicoat Subdivision: BOND PARK Lot: 1
Project Description: (7) branch circuits for kitchen remodel
Contractor: EAGLE ELECTRIC LLC Owner: MALLICOAT, SALLY J
PO BOX 931 7895 SW BOND ST
ST HELENS, OR 97051 TIGARD, OR 97224
PHONE: 503 - 397 -9017 PHONE:
FAX: 503 - 366 -4252
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo /Purchase 08/08/2012 $100.70
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/08/2012 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 001 -0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 5 or 1.800.332.2344.
Issued By: �+V Permittee Signature: OA( ' ` PYLI lJ"T7704-
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.
RECEIVED
Electrical Permit Application, I OR offir: 1_ 0 \I.1
City of Tigard AUG 0 8 2012 Received
5 r rLA O( 1„ p O l CZ3
13125 SW Hall Blvd.. Tigard - OR 97223 n Plan Review � g / Y P ermit No.:
Phone: 503.7182439 Fax: 50 3. 5 0 l1FTGt�I� Dete/B : Other Permit: P a�I"J.• CO �"T
T IC. . E1 Inspection Line: 503.639.4175 BU r I1. r0 DIVISION Date Ready/By. uric Sea Paget for
Internet: www.tigard Notified/Method: 'n CO Sapptemental information
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❑ New construction Li Addition/alteration /replacement Please check all dal apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: Service or feeder 400 amps or more 0 Building over three stories.
•
where the available fault current ❑ Marinas and boatyards.
':e. y „i: ` t1 - :r. lc`- i - I.:2..r�,:s .•_..._.,, - au. a J l M - ..': 4-e. a ..:.tj. --.r: ti " less�toground_or exceeds14.000 ❑Commeraial.u:eagricultural
Eii 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
e ; � � � � � :.t ,T1• N .. , + ? . ,- 57 c . +. 1 - { ''s"� :' ❑ EmergemcY system. larger separately derived system.
..' . tom _,:. t en„ , vl i,. t r tr ❑ Addition anew motor load Of 0 "A °@.., 1-2" 1-3 ",
Job no.: la- Pi/- 4- Job site address: '/tq 5 Sw s Q/i( Si-. 10011P or more. occupancy.
I7 Six or more residential units. [3 Recreational vehicle parks.
City /State/ZIP: - . d DA, el ? e.4 ❑ Health facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal,
Suite/bldgJapt no.: Project name: 7'1,0 ❑ Service or feeder 600 amps or more. agrW
Cross street/directions to job site: Daeriptfoa ow. pee- Tarn/ ,
' New residential single- or multi- family dwelling unit.
Includes attached garage. _
Subdivision: I Lot no.: 1.000 sq. ft or less 168.54 4
-
Tax map/parcel no. Ea. add'l 500 se.. ft. or portion 33.92 1
Limited energy,
'.1.. ,�i •., ' ,r � ,. , .
s� +> . , . n_ residential ) 75.00 2
:, r5', �) .4 , ! 'F ^ + i . j ,r ! '.,•=, ' •:, f.., ,,` -Y tr (with above sq. ft.
7 Cn il� l -..S -roe_ 6- Limited energy. multi 75.00 2
De_ k J t #eJl e NI 'R rnotieL. residential (with above sq. ft)
Services or feeders installation. alteration, and/or relocation
•
200 amps or less 100,70 2
yam.. {"i; , rc '' , ”:7,: r, ci , 1'- f 4 °ti"
tz- n:`c!t 2 ,,}'r• f 201 amps to 400 amps 133,56 2
`-''''f''.'.; _ , . 1 .t�.id• • .4...3.:.at, tS •c ve.: f.,� ,..,. -zi lezi...'�1_ za,:e:FJR CL•K i:1 rierz LL•+ =!
Name: • 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Ci / State/ZIP Temporary services or feeders Installation, alteration, and /or
l�' : relocation
Phone: ( ) I Fax: ( ) 200 amps or less 5936 l
201 amps to 400 amps 1255.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 1 68.54 2
intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. ranch csrcnits - new, alteration. or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
; -: ( i' .':?' . :uu ,,1 �i:✓GT "c �� r ,'li S ? _ rr1.r.('• fee, 1� 1`...--,:-.g.:',..:4-. ' 1 I r .ri • ' � • v. + 1 2 n u' ¢ r 1; ` +`• f' above service or feeder f 7.42 2
' • .� - :;e;: :i:�i�,'i ,.r..!,.; . •L: •, .�,. � � : ::.u�y � ,"' each branch circuit
Business name: B. Fee for branch circuits without f
service or feeder fee, first I 56.18 �Jtti• 19 2
Contact name: branch circuit
Each add'/ branch circuit (p 7.42 4-1-.62.... 2
Address: latscellaneous (service or feeder not included)
City/State /ZIP:
Each o feeder 67.e4 2
Phone: ( ) I Fax ( .) Reconnect only . 67.84 2
Pump or Irrigation circle 67.84 2
E -mail:
� ��,,,, Sign or outline lighting 67.84 2
., ' :i ~'1 n ;Yy.��'atiNty4` _ .. :v:i4lly':.9 •+f l oo } .�F y1
,': :.I :1s•; = . r ...i- P Si circuit(S)or limited.energy .
Business name: Eagle Electric, 1,1_,C panel alteration, or extension. pace 2 2
. Each additional inspection over allowable in any of the abov
Address: P.O. Box 931 Additional inspection (1 hr min) ( 6625/ hr
City/State/ZIP: StH 78
elens, Oregon, 97051 Investigation (1 hr min) . hr •
Industrial plant (1 hr min) 78.1818 / hr
Phone: (503) 397 -9017 I Fax: (503) 366 -4252 Inspections for which no fee is 9000/ hr
s. - iftcally listed Ii hr min
CCB Lic.. 192277 Electrical Lic.: 680 ,� , Su Lic.: 5677S <'s' `� r .� , t - 4 =--:F -
Subtotal: !OD .70
Suprv. Electrician signature, required: `- Plan review (25% of permit fee):
• Print name: Danny Pharr ' Date: E3/B / /4. State surcharge (12% of pemiit fee): /p.at
�,r r / �. TOTAL PERMIT FEE: in / , v72
Authorized signature:
_ t LfC/L/Z�l� _ This permit application expires If a permit is not obtained within 180
f ,a Pfd I Date: f g / f � s
days after it has been as complete.
Print name:
� 11•I¢a4 � / Number of inspections allowed
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