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Permit • CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2012 -00631 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/05/2012 Parcel: 2S 109AB03800 Jurisdiction: Tigard Site address: 13387 SW ALPINE VIEW DR Project: Mesher Subdivision: THREE MOUNTAINS ESTATES Lot: 31 Project Description: (3) branch circuits (2) for solarium and (1) for den Contractor: OWNER Owner: MESHER, BRENT J DIETRICH, EVANGELINE 13387 SW ALPINE VIEW DR TIGARD, OR 97224 PHONE: PHONE: 503 - 329 -8884 FAX: FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 11/05/2012 $71.02 Specifics: Service or Feeder - 1 ea 12% State Surcharge - 11/05/2012 $8.52 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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 iss nce, or if work is suspended for more the 180 • days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi Center. Those rules are s- fort in OAR 952- 001 -0010 through 0 R 2- 001 -0090. You may btain a copy of the rules or direct questions to OUNC by calling 32.1987 or 1.800.3 .2344. - / Issued By: Permittee Signature: wit 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. Electrical Permit A licatiaECEIVED F1P FOR OFFICE USE ONLY City of Tigard NOV 0 5 2012 Received 11 1 Er Date _t'_ _I- I�(I ��u Permit No.: �j , a/f l v0(„ 3/ 13125 Sw Hall Blvd., Tigard, OR 97,�� Plan Review Phone: 503.718.2439 Fax: 503.59 fl `�" I Date/By: Li Other Permit: 7ri TIGARD Inspection Line: 503.639.41 75 BUILDING 1 �I1Y G U1V �{�/ �5�� Date Ready/By: ":77E lyfjsi 0 See Pee 2 for Internet: www.tieard or.gov pV1LU Notified/Method I/30 Supplemental Information TYPE OF WORK Print name: F2 E '1 U New construction Addition /alteration /replacement ❑ Demolition ❑ Other: 00000 PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below) CATEGORY OF CONSTRUCTION ❑Service or feeder 400 amps or more ❑ Building over three X 1- and 2- family dwelling H Commercial /industrial H Accessory building where the available fault current stories exceeds 10,000 amps at 150 volts or ❑ Marinas and boatyards ❑ Multi- family ❑ Master builder ❑ Other: 00000 less toERaund,orexceeds 14,000 ❑ Floating buildings JOB SITE INFORMATION AND LOCATION amps for all other installations ❑ Commercial -use lob no.: 00 000 ,lob site address: 0 ❑ ❑0 0155 ' 7y I IG ?f W ❑ Fire pump agricultural ❑Emergency system. buildings City/State/ZIP: 9.gpi7- 7 (f/W / 0 Q r / /J ❑Addition of new motor load of El of 75 K Vr / /nC cy- IOOFIP or more or Suite /bldg. /apt. no.: ❑ ❑ 0 0 ❑ Project name: ❑ ❑ ❑ 0 ❑ larger separately derived system nix or more residential units. Cross street/directions to job site: 0 0000 ❑ Health -care facilities. ❑ occupancy. 0 ❑ 0 0 ❑ ❑ Hazardous locations. ❑ Recreational vehicle ❑ Service or feeder 600 parks. Subdivision: ❑ ❑ ❑ ❑ ❑ Lot no.: ❑ ❑ ❑ 0 0 amps or more. ❑ Supply voltage for Tax map /parcel no.: ❑ ❑ ❑ 0 ❑ more than 600 volts nominal. A DESCRIPTION OF WORK ❑❑ ❑ � ' /0 �� / "/ C a �`r c 9 / — " S DL/ n V�V/(//7 Description FEE SCHEDULE I ❑ ❑ Fee. I Total l• 00000 New residential single- or multi- family dwelling unit. ,�,/ Includes attached garage. Yg PROPERTY OWNER ❑ TENANT 1.000 sq. ft. or less - 168.54 ' . _ - =1' 4 Name: ❑ 0 ❑ ❑ 0 ' hJ fi / ' / _ f 5 Ea. add 500 sq. ft. or portion r 33.92 : - - ' I / 3 ?c-2 c& l t 6 - I - /fie- 1)/ Limited energy, sq. - 75.00 �r 2 Address: ❑ ❑ 0 ❑ ❑ (with above sq. ft.) Limited energy, multi- family City /State /ZIP: ❑ 0 0 ❑ ❑ T /1 � 0/00 CI ) ? 2 Lf residential (with above sq. f1.) rv, 75,00 " 2 ) _ L — / , Fax: ( ) 20 a Services or feeders installation, alteration, and/or relocation ( Phone: 00000 ❑ ❑ ❑�/} (� Fax: 00000 00000 200 a or less 100 70 � 100 • __ 2 Owner installation: This lnst ation is bring made on property that I own which is not 201 amps to400 amps 133.56 .__ 2 intended for sale, lease ent. • ex an • according to ORS 4=37, 449, 670, an 70 . 401 amps to 600 amps :0 200.34 2 Owner signature: an 601 amps to 1,000 amps 7 301 04 - " ^ - 2 v / Date: / / Z �y Over 1,000 amps or volts C= 552.26 - 2 Ist APPLICANT atONTACT PERSON Temporary services or feeders installation, alteration, and /or Business name: ❑ ❑ ❑ ❑ ❑ relocation Contact name: 000 0 0 QI��'� * 4 - 20 amps to or less 00 59.36 0000 I /i �(l�/ 201 amps to 400 amps ❑ ❑ 1 25.08 G O G,G � 2 Address: 00000 r 3 C7 SlA Or P/ 1416-- LJi�� 401 amps to 599 amps ❑G 168.54 G0r�' = 2 ^ Branch circuits - new, alteration, or extension, per panel City /State /Zl P: ❑ ❑ ❑ ❑ 0 7,---r /T 4 /f 4 8K ' ???1/ A. Fee for branch circuits with above service or feeder fee, 0 G 7 4� "] "7 Phone: (0000❑)❑❑❑ ❑(� Z�� Fax: :(0000❑) ❑0❑❑❑ each branch circuit E-mail: 00000 ( B. Fee for branch circuits without service or feeder fee. first r -'li 56 18 . 2 CONTRACTOR branch circuit • Each add'I branch circuit ",f2. 7 .42 Business name: 0000 0 Miscellaneous (service or feeder not included) Address: ❑ 0 ❑ 0 ❑ Each manufactured or modular LID 67 84 ;1 2 dwelling, service and/or feeder City /State /ZIP: 0 ❑ ❑ ❑ ❑ Reconnect only 0/1 67.84 _ _ 2 Pump or irrigation circle 0 67.84 0717G 2 Phone: ( ❑❑ DOD) ❑0❑❑❑ Fax: ( 00000) 00000 Sign or outline lighting f7❑ 67.84 r 2 CCB Lie.: ❑ ❑ 0 ❑ 0 Electrical Lie.: 7 11 17 Fl ( Suprv. Lie.: ❑ ❑ ❑ 0 ❑ Signal circuit(s) or limited - energy I J 11 1 _ panel, alteration, or extension Page 2 2 Suprv. Electrician signature, required: Each additional inspection over allowable in any of the above x Additional inspection (I hr min) '12 66.25/ hr Grin Print name: , ' -. /` Dat � Investigation (I hr min) 66.25/ hr Authorized sig � ' Lr� i Industrial plant (I hr min) 78.18/hr -'q - Inspections for which no fee is 0000 specifically listed ('h hr min) 0❑ 90.00/ hr 0 ELECTRICAL PERMIT FEES Subtotal: 0f/1�J C" Plan review (25% of permit fee): 00000 State surcharge (12% of permit fee): 0 04199 TOTAL PERMIT FEE: C& L©L5 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. 4 I:\ Building \Permits \ELC•PermitApp.doc 07/01/10 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13387 SW ALPINE VIEW DR, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal 2014-01-27 00:00:00 ELC2012-00631 PASS - No C of O Violation Summary: Inspector Contractor