Permit 1
q CITY OF TIGARD EL PERMIT
I
'1 ° • COMMUNITY DEVELOPMENT I Permit #: ELC2012 -00590
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 10/11/2012
Parcel: 1 S 136CA02206
Jurisdiction: Tigard
Site address: 7945 SW THORN ST
Project: Yechley Subdivision: MARL TERRACE Lot: 6
Project Description: Installation of ground rods due to water service replacement.
Contractor: WEBER ELECTRIC INC Owner: YECHLEY, SEAN & MANDY
PO BOX 231154 7945 SW THORN ST
TIGARD, OR 97281 TIGARD, OR 97223
PHONE 503 - 620 -1906 PHONE
FAX
FEES
Quantity Description Date Amount 1
1 ea Reconnect Only 10/11/2012 $67.84
Specifics: 1 ea 12% State Surcharge - 10/11/2012 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
I I
Total $75.98
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 acc• - - • 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 A P , TION Oregon la equire ou to follow the rules adopted by the Oregon Utility ■ c; - • • Center Those rules are set forth in OAR
952 -0 • -0010 throug OAR 952-001-01'0. You obtain a copy of the rules or direct questions to OUNC by c - , •t r - . 1987 or 1.800.332.23. _
Is ed By: / Pe rmittee Signatu ! w , , /
/
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'
�'. /A—gm Date:
m f./i c
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.
Electrical Permit Application I( 012 01 I i( l• I I (1 \ I 1
City Tigard Received : o���� E g /o?- 59
Ci of Ti and Permit l.0 o 4aa
i 13125 SW Hall Blvd, Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date' : Other Permit
IL , i 1 Inspection Line: 503.639.4175 Date y +mss• Ei Supplemental for
f �
Internet: www.tigard -or.gov Notified/Method:
. ' TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wktems chocked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
. 'CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fue pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system• f new motor load of ❑ " A"". E", "1- 2 ", " 1 - 3", system.
❑ Addition of ", "E , "1 -", "1 -3 ",
Job no.: I Job site address: 7945 SW Thorn St 100RP or more. occupancy. rea
❑ Six or more residential nits. ❑ Recreational vehicle parks
City/State/ZIP: Tigard, OR ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldgJapt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Desolation I Qty. I Fee I Total I • .
New residential single- or multi -family dwelling unit
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. R or less 168.54 4
Tax map /parcel no.: Ea. ad l'l 500 sq. ft. or portion 33.92 1 Limited energy' residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Add ground rods to service due to water main replacement Limited residential l( (with above Y ft) 75.00 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 1 100.70 100.70 2
❑ PROPEITTY OWNER I ' ❑ 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 552.26 2
City/ State/ZIP:
Temporary services or feeders Installation, alteration, and/or
Phone: ( ) I Fax: ( ) 200 amps or less 59 36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 125.08 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
❑ APPLICANT I 0 CONTACT PERSON above service or feeder fee, each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'1 branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 4
City/ State/ZIP: dwelling, service and/or feeds 67.84 2
Fax: ( ) Reconnect only / 67.84 67, 4 %I 2
Phone: ( ) Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
Business name: Weber Electric, Inc. panel, alteration, or extension. Page 2 . 2
Each additional inspection over allowable in any of the above
Address: 7007 SW Robbins Rd Additional inspection (1 hr min) 66.25/ hr
City/ State/ZIP: Tualatin, OR 97062 Investigation (t In min) 66 25/ hr
Industrial plaid (1 hr min) 78.18/ Iv
Phone: (503) 819 - 7380 Fax: (0) Inspections for which no fee is
specifically listed (14 hr min) 90.00 / hr
CCB Lic.: 44087 Electrical Lic.: 34 -442C S . Lic.: 4028S ELECTRICAL PERMIT FEES 6'/
Suprv. Electrician signature, required.
Subtotal: 1BC 70' �� 0 7
�� ..4.1,77'N., Plan review (25% of permit fee).
Print name: Matt Weber Date: 10 - - State surcharge (12% of permit fee): 40108 1
Authorized signature: PERMIT FEE: 13,238 — " (�
This permit application expires u a permit is not obtained width' 180 / C U
J %
days after it has been accepted as complete. ( J
Print name: I Date: • Number of inspections allowed per permit
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