Permit q CITY OF TIGARD ELECTRICAL PERMIT
i
' • 2 ,. COMMUNITY DEVELOPMENT Permit #: ELC2012 -00598
,“,
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/17/2012
Parcel: 25101 DCO5700
Jurisdiction: Tigard
Site address: 13495 SW 74TH AVE
Project: Waldron Subdivision: PACIFIC RIDGE Lot: 9
Project Description: (1) branch circuit for new electric vehicle charger
Contractor: IES COMMERCIAL INC Owner: WALDRON, W WAYNE JR
16135 SW 74TH AVE 13495 SW 74TH AVE
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 10/17/2012 $56.18
Specifics: Service 'or Feeder
1 ea 12% State Surcharge - 10/17/2012 $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 952 - 001 -00. You 4 may obtain � a copy of the rules or direct questions to OUNC by calling 503.232 1987 / PP . o a r 1. . 8
4 L4 L r.I f 8000 ..332.2344. Issued By: W � I.it kI.
Permittee Signature: t -i 4- d ,1, 1
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.
10/17/2012 1 1 :49 5036702E EWED IES COMMERCIAL INC
PAGE 01/02
Electrical Permit Applica , FOR OFFICE USE ir.)NILli'
: n '. City of Tigard
13125 SW 1-Tall Blvd., Tigard,OR
' - - Phone: 503,718.2439 Fax: 503.
lig 97223 172Z 1 7 - 2 312
MO? TIGARD Received
Date/Ely: tql, 1 li 1._ sr N 'it No.: &z.t.d.b1.1.-0054V
Plan Review
Date/13y: . Other Permit:
Tr GA RAD inspection Line: 503,639.4175 Date R eady/Br sa See Price r lbr
Internet: www.tigard-or,gov Notified/Method; 1 41 (0 S s upplemental Information
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BUILDING DIVISION
D Now construction El Addition/alteration/replacement Please check an that apply (submit a sets of pl:ms w/itcrns checked below);
CI Service or feeder 400 amps or more 0 Building over three stories,
11 Demolition 0 Other: whore the available fault current CI Marines and hontyards,
.e,V, feddkitigAiNglitittION:::. :;.;„. ... ..-' .:;..; . ,!.;... :; exceeds 10.000 amps at 150 volts or El Floating buildings . • leas to ground, or exceeds 14,000 0 Commercial-use agricultural
0 1- and 2-family dwelling El Commercial/industrial 0 Accessory building amps for all other installations. buildings,
0 Multi-family 0 Master builder 0 Other: 0 Fire pump, CI Installation of 75 KVA or
.. ID Etnergency aystem. lo larger separately derived system,
,..:1 ..:.:!:! ::,:i•iiIttii:tlivi;j6vgketioN4Ritv ::.... - .. :.... . ::...-:
_ .
Job no.: 7t AEG, Job site address: 13ticts st.3 . '71-01.1 Nkie i fintrIP OT MOTC. occupancy,
CI Six or more residential unfts. 0 Recreational vehicle parks,
City/State/ZIP: 1 leite i o , • 4 :0 223 0 Health-care Facilities. 0 Supply voltage for more than
IM Hazardous locitions, 600 volts nominal. .
Suite/bldg./apt. no.: • Project name: ij A 0 ,,, 0 SerVICO Of feeder 600 amps or more,
j l :.: : :. .....:.;.; . :.....: .- i . •i
Cross street/directions to job site: nenrimiaa . i ov. I ref, 1 ma I •
New resident:a single- or multi-family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or Icss 168,54 4
Ea. add'I 500 sq, ft, or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
75,00 2
l t i:.! ' : ' : '':! :q:. ' ' 'I.:■ . ijitActtrenoNI • tit. Aird'atci .;:i !.;:•, !;'. , ;'• • ..., .;-: ..- . - • - .....:. with ab_co__
timitcd energy, multi-family
, • , 75.00 2
flOb 0 ) '10 A CAT A/ n ea e iecAn‘c kreim c-Le residential (with above aq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or Tess 100.70 2
-
.. , •,.... • - - •
• :;.::: ;::•:•::: ... . ,, - • •:-. •-• :12 TENANT. .. : ,...„. 201 imps to 400 amps 133,56 2
N 401 amps to 600 amps 200.34 2
ame:
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or vain 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125,OR 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits – new, alteration, or extension, er panel
Owncr signature: Date: A. Fcc for branch circuits with
c .yi:::.,: :.::•.:::-:....!..; ,:•,.::-;•., :.. -;..; PER . -.... - i above service or feeder foe,
742 2
each branch circuit ,
Business name: B. Fee for branch circuits ivillteto
service or feeder fee, first I 56.18 ci, • 1 g 2
Contact name: branch circuit
Each add'I branch circuit 7,42 2
Address: Miscclianeons (service or feeder not Included)
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Recnnect only
— o 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
Sign or outlinelighting 67,M 2
-:' . :,,''..''. ..'• ••••■• I ;:- . . " :eP li gi t .. 1 .KT I ,A 1. :' : :: : : : ::: 1 1•H' . •; . i:''':'i .. : : :'''''••-; !':: :'••H'.. • r• . :.:. ••::••:. Signal circuit(s) or limited energy
Business name: IES COMMERCIAL, INC and :literati° or extension, . Pa_c 2 2
Each additional inspection over allowable in any of the abov
Address: 16135 SW 74m 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) 670-9572 - Inspections for which no fee Is
90.00/ hr
specifically listed ('4 hr min)
CCI3 Lie.: 182452 Electrical Lic.: C448 Suprv. Lic.: 1 4ti / /5 •?•1 •i .,•:; ....:•:.., L, :EILEpitICALi: rERIVItr; FEES • ' . •. •:' ' •.: . . '.' .;
O ....•-• Subtotal: 51,,„.18 •
Suprv. Electrician signature, required: 0 If Plan review (25% of permit fee):
y . .
k 00„ i
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Print name: fre ate: State surcharge (12% of permit fee): &sfi
TOTAL PERMTT PEE:
Authorized signature:
This permit application expires if a permit is not °bollixit within 1St)
days after it has bccn accepted as complete.
Print name: Date: • Number af inspections allowed per pa mit.
r: \Buildireermitz\ ELC.Porrn itAvp.doo 07/01/10 440.46 i 57(11/05/CW.4/WEB