Permit a CITY OF TIGARD ELECTRICAL PERMIT
N I
° COMMUNITY DEVELOPMENT Permit #: ELC2012 -00501
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/27/2012
Parcel: 2S104CD10100
Jurisdiction: Tigard
Site address: 13620 SW TRACY PL
Project: McKinney Subdivision: HILLSHIRE ESTATES NO.2 Lot: 100
Project Description: (1) branch ciircuit for electric vehicle charger in garage
Contractor: IES COMMERCIAL INC Owner: MCKINNEY, FRANK D & LISA M
16135 SW 74TH AVE 13620 SW TRACY PL
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 648 -1900 PHONE:
FAX: 503 - 670 -9572
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/27/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/27/2012 $6.74
Type of Use: SF Electrical
Class of Work: ALT
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 52-001-0090. You � may � obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.
Issued By: � rSW1�i L! Q Permittee Signature: //L..l AP L/ C I'1 T /t'd
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.
08/27/2012 13:32 5036709572 IES COMMERCIAL INC PAGE 01/02
Electrical Permit AaplicatiorRECEIVED FOR C)1 USE ONLY
City of Tigard
i r' SW H d., Tigard, OR 97223 Received
Dmet 8 _1 g / / a ' Penn" N° ' . g - e-e-- 0 bcrls
1 11‘ 13125 all Blv Plan Review
.:.-' • Phone: 503.718.2439 Fax: 503.598.1.960 2 7 2012 Datc/ay: Other Permit;
TrGAR1)
Inspection Line; 503.639.4175 CITY OF T IGAR Dale Ready/By: ruin: Ed See Page 2 for
Internet: www.tigard-or.gov BUILDING niVISPON Notified/Method: nCo Supplemental Information
...; ...i-•,. ;•.; ••• , . • . •,;-- •. •••i.; •-•, 1.; :9 :::::::,:,.;:11 : virtink;1; : .,;; ,,; :-;;;;•;....; .; .: , :•!:•••; •••; ••• • • • • •••: ::::•• .' :: '1'1'; ...!:.i.1..... .:: . ;: . .;;;;••; . 1; ‘ : , i . .: ; ;• .. .• -1,1; : .;j:
z •:.' :;.;::". .:: , ;.::: C.,:....: 7.: ::". ',-.::" .:,:::.:,:", , • • .. 1: ■ ....... z..... ,.....,.. ; :, : ... .. ';.:': :: . . " ..: ' .... - . - . ,.. 1 ,- ..-: , - , . - ,',.- , -- .
please cheek all that apply (submit 2 acts of plans w/itcrns cl;eckecl bolow); ..
0 New construction El Additirm/alterationfreplacement
0 service or feeder 400 amps or more CI Building over three stories,
0 Demolition 171 Other: ..
where the rivailnble fault current ' 0 Marinas and boatyards.
.!
• :. : .... :;.:!::.;' ., . •:.'::'.:;-:: ::..::::.: .';':1;;I:aititObje,it..(0!- . ' % ' •; • ::: ... ••• .:... . !:-; ':;:.: .:.• ;.-: • exceeds 10.000 amps st I SO volts or 0 Planting buildings .
less to ground, or exceeds 14,000 0 Commertial-ute agricultural
W4 and 2-family dwelling E Commercial/industrial 0 Accessory building maps for•all other installations. buildings.
0 Multi 0 Master builder 0 Other: in Firc pump, 0 Installation of 751CvA or
0 Emergency system. larger separately derived system.
..: ::::, ..::: - • ::.;-;':: ; : :40*•:SretitStifbliStittOICANtfitotAtoN.: :: . • . : • • . - • - - 0 Addition of new motor lord ef CI
100HP or more. occupancy.
Job no.: loos' - Job site address: 13420 51) TPA-0i 04c. e a Six or more residential units. 0 Rem:optional vehicle parks,
—
0 Health-cum flicrifiries. 0 Supply voltage for more than
City/State/ZIP: 11 4 44. 0 a 97 22.3
0 Hazardous locations, . 600 volts nominal, '
Suite/bldg./apt. no.: Project name: 0 Service or feeder 600 amps or more,
P I 0: .::';' !-:.: l' .. : :.; '' • .i .-:
Cross street/directions to job site: nmeripdon I QtT. I ' Foe; I ratio 1 .
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less
16833.9254 4
- En. add'l 500 sq. ft, or portion 1
Tax map/parcel no.: Limited energy, residential '
75.00 2
: • .:E ••!:.; : :: • • '... ;;;;.,. „ ; ;; ,,;• ,ilt$Otrittibt.4..'0;Votti&::: .....: : ..::::.::. - • • • . ::.::-; .:-..;.:.,i. (with above sq. ft) . ,
. Limited energy, multi-family -
00
74 5 7) il0A oer -go elec4-rf c... Vek.r--tt- residential (with above sq. ft.) _ 75. 2
Services or feeders installation, alteration, and/or relocation
aukr ,ef ( r■- 44. / A- C., 200 amps or less 100.70 2
:I t'11t)1itit.01:0):ii.NTS.; 1: :::::-,,.:..::;.::.;• .: jtrt■TANt:: - . :::: . : : !!.! , 201 amps 10 400 amps 133,56 2
Name:
401 soaps 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
Temporary services or feeders installation, alteration, and/or
City/8tate/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or leis 59.36 1
Owner installation: This installation is being made on property that! own which is not 201 amps to 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 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature; Date: A. Fee for branch circuits with
.; ::; '..-;.:::.! ':. -: i. :r :tElkSON ::: - above service QT feeder fcc,
each branch circuit 742 2
Business name: B. Fcc for branch circuits without
service or feeder fee, first I 56,18 .51). if 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not Included)
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67,84 2
E Pump or irrigation circle 67.84 2
-mail : -
Sign or outlinelighting 67.84 2
i.t. '::t ' !. ' . : ! :. : i i',: , ' '.,"...::.':'..:: :::..!''' ''' - . '.: i : -:: ,i - ',..i' ; - rgil -. .11 eircuit(s) or umitc,d
Business name; IES COMMERCIAL, INC panel, altenation, or extension. Page 2 2
. - Each additional inspection over allowable in any of the above
Address: 16135 SW 74 AVE Additional inspection (1 hr min) ' 66.25/ hr
Investigation (1 hr min) 66,25/ hr
City/State/ZIP: TIGARD, OR 97224
- industrial plant (1 hr min) 78.18/ hr
Phone: (503) 648-1900 Fax: (503) 670 Inspections for which no foe Is
90
specificallylisted (14 hr min) .00/ hr
„,...CCB Lie.: 182452 i51 I it<trical Lic.: C448 54rv. Lic.: 4 1q/f_5
. .:EllECITtICA.L:PXRIWIT,• :. .1 1 11IS , ; :. • .• ; ' ; •
(11 signature, required:
Suprv. Electrician 1rj.71 Subtotal: 6 F
an
Plan review (25% of permit fee):
Print na
.
j
me: Co.rapu 644./5, • Date: g/zi /I 2- State surcharge (12% of permit fee);
Authorized signature: TOTAL. PERMIT FIE; f 6Z, ...."-.
This permit application expires if a permit Is not obtained within 180
cloys After it has been Accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
1:Tuilding1Pcnni5NELC•PorniitApp.doc 07/01/10 "r"6 1 /05/COMIWER
a CITY OF TIGARD ELECTRICAL PERMIT
N I
° COMMUNITY DEVELOPMENT Permit #: ELC2012 -00501
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/27/2012
Parcel: 2S104CD10100
Jurisdiction: Tigard
Site address: 13620 SW TRACY PL
Project: McKinney Subdivision: HILLSHIRE ESTATES NO.2 Lot: 100
Project Description: (1) branch ciircuit for electric vehicle charger in garage
Contractor: IES COMMERCIAL INC Owner: MCKINNEY, FRANK D & LISA M
16135 SW 74TH AVE 13620 SW TRACY PL
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 648 -1900 PHONE:
FAX: 503 - 670 -9572
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/27/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/27/2012 $6.74
Type of Use: SF Electrical
Class of Work: ALT
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 52-001-0090. You � may � obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.
Issued By: � rSW1�i L! Q Permittee Signature: //L..l AP L/ C I'1 T /t'd
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.