Permit CITY OF TIGARD ELECTRICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00534
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/13/2012
Parcel: 1 S 125DA03900
Jurisdiction: Tigard
Site address: 6628 SW WALNUT TER
Project: Buhle Subdivision: KINGS VIEW Lot: 24
Project Description: (1) 200 amps or less for panel upgrade
Contractor: SQUIRES ELECTRIC Owner: BUHLE, CHRISTOPHER J
1001 SE DIVISION STREET #1 6628 SW WALNUT TER
PORTLAND, OR 97202 PORTLAND, OR 97223
PHONE: 503 - 252 -1609 PHONE:
FAX: 503 - 253 -5831
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/13/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 09/13/2012 $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 OA 52- 001 -0090. 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: D ~TPO 4ii 0kI
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.
09/13/2012 15:25 5032535831 SQUIRES ELECTRIC #1938 P. 001/002
•
Electrical Permit A licati cENE
D FOR OFHCL: USE ONLY
City of Tigard Received
Date/13 : 4// 12.. u. Permit No.: Ci•Le4D 4„1. ""41
111 , 13125 SW Hall Blvd., Tigard, OR 9727.3 1 3 20 \ 2. Platt Review
• - Phone: 503.718.2439 Fax: 503.598.1960 Datena : Other Permit;
TIGARD
Inspection Linc: 503.639.4175
Internet: www. tigard-orgov Date Ready/By: WI 121 See Page 2 for
SG MID NotifiedNethOd: Supplemental Information
t . ()V $
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,.: .. .in 7 .:• I Z ,4,7 4 4 - 7 .••:• 'ii, C5 - i•• ..• , •-l• . •••*• ,: .::'.:-.5.14`..,,-.:•,-,•-l-T .
Ei New construction Ei Addition/alteiation/replacement Please cheek all that apply (submit 2 sets of plans w/iterca cheeped below):
0 Service or feeder 400 amps or more 0 Building over three gorics.
0 Demolition 0 Other: where the available fault currant 0 Marinas and boatyards,
—.
Etirt*erM .. - • • ".--C• •••,:- • - , .k,, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
lett to ground, or mime& 14.000 El Contritercial•use agriculntral
El 1- and 2 dwelling 0 Commercial/industrial 0 Accessory building amps for all other inaallations. buildin.
0 Multi 0 Master builder U Other: [(Fire pump, 0 InstalLttion of 75 KVA or
•-,- .>,..,. , - • tr--- .-- .• ••,, ••• v-„ ,..:: 0 EmergencY system. larger separately derived iiplem.
-t,.••:it.•1 - ,.• :. , • . ... -,..,, ..::.. .„ .....•i• ...., .:, . .:1.:;' 0 Addition of new motor load of
- '''" AtS i lilt*i ;i krO3 1 KO-Vk 8 OSitgtOIV -, -"q - • - ' • 0 - A","E","1 - 2""i.3',
Job no.: Job site address: 6628 SW Walnut Terrace 100HP or more. occupancy.
0 six or more residential units. 0 Recreational vehicle parks.
City/StateJZIP: Tigard, OR 0 Health-care acuities. 0 Supply voltage for more than
0 Hazardous locations. 600 veils nominal.
Suite/bldg./apt. no.: I Project . name: 0 Service or feeder 600 amps or mom.
Cross street/directions to job site: Descriptive city. tree I Toed I •
New residential single or multi-family dwelling unit.
Includes attached garage.
-
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. addl 500 sq. ft. or portion 33.92 1
lax map/parcel no.:
Limited energy. residential
75.00 2
AR Mtir.g.::"...";:,,i51:#10ATIX:in:raFra&t::::::44.t.V.■r■C (with above sq. ft.) ,
Limited enegy. multi
Panel upgrade residential (with above sq. ft.) _ 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 100.70 2
201 amps to 400 amps 13156 2
401 amps to 600 amps 200.34 2
Name: —
601 amps to 1 000 amps 301.04 1 2
Address: Over 1,000 amps or volts 552.26 d 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amp to 400 amps 125 2
Owner installation: This installation is being made on property that I own which is not 125.
401 amps to 599 amps
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 168.54 2
Branch circuits - new, alteration, or extension, r panel
Owner signature: Date: A. Pee for branch circuits with
1: ,:' ,i25 S' :. I - . ":" :ti: .:::g above service or feeder tee,
742 2
each branch circuit
Business, name: . B. Fee for branch circuits wilhour
service or feeder foc, first
56.18 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
Pump or irrigation circle 67,84 2
E
Sign or outline lighting 67.84 2
. . " ' • ''....-' ' ' '. .... ....... "" . .- '''''..... ''
.. '''' -: • ' • ' • • .
'-,.: .1 •::?:11.1..tr,:L• Signal circurt(s) or limitod-cncrg
panel, alteration, or extension. Page 2 2
Business name: Squires Electric
Each additional inspection over allowable in any of the abov
Address : 1001 SE Division St #1 Additional inspection (1 hr min) 66.25/ hr
—
---- Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Portland, OR 97202
Industrial plant (1 hr min) 78.18/ hr
. -
Phone: (503) 252-1609 Fax: (503) 253 Inspections for which no fee is
90.00/ hr '
s • - hated ',5 hr min
CCD Lie.: 135085 Electrical Ile.: 26-11010 Suprv. Lig.: 4882-S ... 4 7 A.;„7.,' ,"' 7 ! 4 , 4, C 9F t.Fl.`7, 4 :7 7 :7 , i. , :.; , 4„• :i , .; •••.*.
1.. 41E. .... :".Li •Zr 1 . 2 ' 1 4 'L. =" , ' - , •••_'.a' . .t,- - .:', - 4..'' ""..% g.: . .:
Subtotal; 100.70
Suprv. Electrician signature, required:
Plan review (25% of permit fee):
—
Print name; Joe Squires Date: 9/13/12 . State surcharge (1 of permit fee): 12.08
TOTAL PERMIT FEE: 112,78
Authorized signature: 10#,......,,
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
T.113.1.1.14,8%PennithELC-' PennhApp.ilac 07/01/10 440-4415T(i 1/051COWAIE8