Permit CITY OF TIGARD ELECTRICAL PERMIT
i:. COMMUNITY DEVELOPMENT Permit #: ELC2012 -00517
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/04/2012
Parcel: 2S 111 BC04500
Jurisdiction: Tigard
Site address: 14700 SW 103RD AVE
Project: Friswold Subdivision: 1998 -167 PARTITION PLAT Lot: 2
Project Description: (1) 200 amps or less and (1) branch circuits to replace service due to tree impact
Contractor: SQUIRES ELECTRIC Owner: FRISWOLD, JAMES E & DIANA J
1001 SE DIVISION STREET #1 14700 SW 103RD AVE
PORTLAND, OR 97202 TIGARD, OR 97224
PHONE: 503 - 252 -1609 PHONE:
FAX: 503 - 253 -5831
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/04/2012 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 09/04/2012 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 09/04/2012 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
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 OA 9 2- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or ( 1.80 00 0.332.234 ( 4.
Issued By: � ( J+jt�_ tc Permittee Signature: DN A f L M-no1V1
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.
09/04/2012 11:16 5032535831 SQUIRES ELECTRIC #1899 P.001 /002
Electrical Permit A,pplica ' FOR OFFiCE USE ONLY
City of Tigard CP1VED J . Received
Date/13 : 7 I y �' Permit Mee... / 0 190 — �S7 7
13125 SW Hall Blvd., Tigard. 0 _23 Plan Review
e ; Phone: 503.7182439 Fax: 503.598 0 4 2012 oueng : Other Permit:
Inspection Line: 503.639.4175 Date Rea age 2 for
TIGAhD dy/6y Jvris: ®y
Internet: www.tigard -or.gov ® Notified/Method: 11
a t CO Suppkm m
evtalIotoraeon
?`-',*.�`- ..f,,-. ;�;1��;= yr:t °iN •n: n .�i�:�� K � � 4.- Yt :�' •� ':� e <.��e':�2:�:ti��- ... �._... - - -
['New construction t ® Additio al eratton/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
Demolition ❑Other: ❑ Service or feeder 400 amps or more ❑ Building over three xrnries.
:t� . o i �, r � _ where the available fault current ❑ Marinas and boatyards.
<• y .�' • 7i OR'; 7? -�• r_ , - *%::.- 000 amps 150 1 g•
d "rL,- �t "��' exceeds I0, p volts or ❑ Floating buildings.
less to owl Or ex ceeds 14,000
® I - and 2 family dwelling 0 Commercial/industrial Accessory building r Oom" ew ttse agricultural
n' S amps for all other installations. building
❑ Multi family ❑ Master builder ❑ Other. ❑ Eire pump. ❑ Installation of 75 KvA or
`<> 1'�.` i '',, '> _ ` - — ,� T -ir �•. t .�: ❑ Emergency system. larger separate) derived
rK.e�:,, .,., .Si O a' D' n a :4 Y ed system.
,. ,. •.. �-- �.����;Is7: ` - ., ....,......:',.:Z...,.,..,. , � ,.�w 2� # °• ❑ Add i t i on of new motor load of ❑ -q °, »F., "1-2", '1-3",
Job no.: lob site address: 14700 SW 103 Ave, lOOHP or mote. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97224 ❑ Health facilities. ❑ Supply voltage for morn than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ service or feeder 600 amps or more. _
Cross street/directions to job site: SW Murdock St street south is cross scree F' . '" - ' ?" - , ^
Deserlption I Qtr. 1 • Taal l •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: lAt no.: 1,000 sq. ft. or less 168.54 4
— – Ea. add'1500 sq. ft. or portion 33.92 I
Tax map /parcel no.: -
J�",^yh5 °h ;; .... ; ;- .r- _ _ _ Limited energy, residential
rtil. K ': { `y k . 2 Y 'il Ny: 75.00 2
��`:.F:. �`...::t3;r?�:•�`:' - ': l� ..aw�ilx`�S�.. �- ,s.. (with atwve R.)
Limited energy. multi- family
Replace service due to tree impact tesidentlal (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less I 100.70 I I 2
T �? >:_ = .-„�,�ri . � , , ;s : 4 201 amps to 400 amps 133.16 2
Name: Jim & Diana Friswold 401 amps to 600 amp
200.34 2
601 amps to 1,000 amps 301.04 2
Address: 14700 SW 103" Ave Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and /or '
relocation
2
Phone: ( ) Fax: ( ) 200 amps or less 59 i
- 201 amps to 400 amps 125.
Owner installation: This installation is being made on property that 1 own which is not
08
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 168.54 12
Branch circuits— new, alteration, or extension, per panel
Owner Signature: Date:
` `�„ _ A. Fee for branch circuits with
xOy _ „ oz> above service or feeder fee. 1
z:..da - .._... �_ t: ;C�c; 'each branch circuit 7.4. 2
Business name: SQUIRES ELECTRIC, INC. B. Foe for branch circuits without
service or feeder fee, first _ 56.18 I
Contact name: JOE SQUIRES branch circuit 1
Each addl branch circuit 7.42 l 2
Address: 1001 SE DIVISION ST. #I • 14 L'scellaneou jservice or feeder not included)
City /State /ZIP: PORTLAND, OR 97202 Each manufactured or modular 67 ( 2
dwelling, service and/or feeder
Phone: (503)252 - 1609 I Fax: : (503) 253 - 5831 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: JOE@SQUIRESELECTRIC.COM
�z v ��. Signor outline lighting 67.84 2
'::- ' g' � s. • ' � -:�.q Signal ClrCUlt(S) or limited-energy
Business namc: SQUIRES ELECTRIC, INC. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in an/of-the above
Address: 1001 SE DIVISION ST., #1 Additional inspection (1 hr min) 66.25/ hr
City /Slate/ZIP: PORTLAND, OR 9720' Investigation (1 hr min) 66.25/ hr
Industrial plant (I hr min) 78.1 8 / hr
Phone: (503 -) 252 -1609 'ax: (503) 253 -5831 Inspections for which no fee is
- Specifically listed ('1s hr min) 00/ hr
CCI3 Lie.: 135085 Electrical • 1101 A . Suprv. Lic -: 4882S ;.'.: ": p; :[n 7 - ,.: ..' _;'
Suprv. Electrician signature, ...11110.7 Plan 108.12
Plan review (25% of permit fee)`
Print name: JOE SQUIRES Date: 09/04/12 State surcharge (12% arg ( permit fcc): 12.97
Authorized signature:
TOTAL PERMIT FEE: 121,09 /
Tail permit application expires if a permit is not obtained within 180
Print name: JOF, SQUIRES Date: 09/04/12 days after it has been accepted an complete
—
• Number of inspections allowed per permit.
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