Permit n CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: ELC2012 -00475
TI G A.R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/13/2012
Parcel: 2S104AC12600
Jurisdiction: Tigard
Site address: 12620 SW 135TH AVE
Project: Beckham Subdivision: HANDY ACRES Lot: 32
Project Description: (1) branch circuit for ground service
Contractor: BADGER ELECTRIC INC. Owner: BECKHAM, GARVE & MARILYN JOINT L
4415 NE SANDY BLVD STE 205 BY GARVE A & MARILYN B BECKHAM TRS
PORTLAND, OR 97123 12620 SW 135TH AVE
TIGARD, OR 97223
PHONE: 503 - 288 -4756 PHONE:
FAX: 503 -493 -7173
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/13/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/13/2012 $6.74
Type of Use: SF Electrical
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 5 - 001 -00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/�
Issued By: Permittee Signature: OKI A Prot_ ` r1 f / -�7
DM_
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent,
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 603.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept In a conspicuous place on the Job site until completion of the project
Approved plans are required on the Job site at the time of each Inspection.
AUG -10 -2012 10:44A FROM: BADGER ELECTRIC,INC 503 - 493 -7173 TO: 5035981960 P.2
•
City of Tigard Ally, 4 i 3 (Z`� 1'tNo.ec -CotOa - a 1<
1312$ SW Mill Blvd., Tigard, OR 97223 1 3 2 0' � R ev 1 0w
Phone: 503. 639.4171 Fax: 503.598.1960 Date/By a hor Pest P4114 mote - 00
, , , i , . Inspection Line: 503.639.4175 CITY OF TIGAR Ii 'f 1 C o I Sapp e 2 hammer).
www.tigard.or.gov MDD WGDIVISION
�.YP OF WORK PLAN REVIEW
o New construction I A Addition /alteration/repIacetnent Please cheek all that a p p l y (sue1seaofplanswhimscheckedbelow):
O Service or Rieder 400 sops or more 0 Building aver tins stories. El Demolition ❑per
what the amiable fad meat 0 Menlo and boatyards.
CATEGORY OF CONSTRUCTION =rods 10,000 maps p 150 valet or p Floating buildings.
[ and 2- thtnily dwelling ❑ Commercial/industrial ❑ Accessory building to o euecds 14.000 O ings. Commercial agricultural
g amps for ill other hnaOatlom buildings.
❑ Multi- family ❑ Master huilder ❑ Other: 0 Fire pump. 0 Installation of75 KVAOr
JOB SITE INFORMATION AND LOCATION O rte. separately Ned � `i.
CI Addition of now motor load of p " A ", "E", "1.2' "1 ",
Job no.: I Job site address: MR 2.r, S W 13 IOOHP or mote. =witty. p Si: er owe =WOW aid p Rational vehicle podia.
City/State/ZIP: Ti 1 cyLvd_ b R. et ?era-3 o _.a�elbetiea. aSw� t�mme
O Hawdom locations. 600 volts nominal.
Suite/bldgJapL no.: I Project name: 114434,0",p...... O Service err feeder 600 amps or ma.
FEE SCHEDULE
Cross street/directions to job site: nsarlsWa I Ow. I tad I Tait T •
New re idential single- or mufti- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. E. or has 168.54 4
Tax map/parcel no.: Fa. add'I 500 eq. R or portion 33.92 1
Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above R. ai
Limited energy, mullyd>1mi1y 67.84 2
S ? N V L CA_. res ei (with above se>. it) ,
Services or feeders Installation, alteration, and/or relocation
200 amps or lea 100.70 2
❑ PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 133.56 2
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 55126 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or lays 59.36 I
201 mops to 400 amps 125.08 2
Owner Installation: This installation is being made on property that I own which is not
intended fbr sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch dreolts- new, atteratlo , or extension. Qer panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service ar Pour fee' 7.42 2
each brands circuit
Business name: 8. Fee for branch cihwia without
service or faodv fee, first 1 56.1 B 5/ 18 2
Contact name: branch circuit 1
•
Each add'I branch circuit 7.42 2
Address: Miscellaneous Navin or feeder not included) -
City/State/ZIP: Each manulhctured or m odular 2
dwelling, service and/or Ibeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation Gee 67.84 2
Signoroutline lighting 67.84 2
CONTRACTOR Signal citan(s) or limited-energy
Business name: cane% alteration, ore Brehm. Page 2 2
�n 1� �_� t� ( , r15..� Eaeb additional Inspection over allowable In any of the above
Address: 44 r3 n8_ Sr Q i 1� ii uS Additional inspection (1 lw min) 6625/ hr
Investigation (I hr min) 66.25/hr
City/StatrJZ1P: 1 '
Q �&ot — rr 1 3 Industrial plant (I In min) 78.1 8 / hr 1
Phone: (5( '�C6(4 - 47e7U I Fax: (�y( (.x({2 ('� 3 Inspections Br which no fee is 90.00/ hr
`"''' �J specifically hated (SS fir mm)
CCB Lis.:
IS oSci Electrical Lic.: 5 7 i(J Suprv. Lic.:5y733 ELECTRICAL PERROT FEES
Suprv. Electrician signature, required: Subtotal: 5(„, 1
Plan review (2.5% of permit fee):
Print name.l---t �,0 ,! 1 _ - , I Date, gal ` D I 1 y Mato surcharge (12% of permit lion): (f, 74 /
Authorized si � j,�,�y�I/� D /J TOTAL PERMIT FEE: i . �. v
" "1 l i (4
This permit application aspires Ha permit Is not abiabiell within
days Print name:le-MO 1 1i4 � days after u m bets accepted d complete.
I Date: K I (I I >. • Number of hawed= allowed per panMt