Permit y q CITY OF TIGARD ELECTRICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00668
T IGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/26/2012
Parcel: 2S103BCO5600
•
Jurisdiction: Tigard
Site address: 12235 SW TIPPITT PL
Project: Depaoli Subdivision: TIPPITT PLACE Lot: 6
Project Description: (1) 200 amps or less to replace 100 amp federal pacific panel in basement and laundry room
Contractor: PRECISION NW ELECTRICAL Owner: DEPAOLI, PETER JAMES & TONI - ANN
12020 SE ANNA CT 12235 SW TIPPITT PL
• DAMASCUS, OR 97009 TIGARD, OR 97223
•
PHONE: 503 - 413 -9870 PHONE:
FAX: 503 - 594 -2873
FEES
Quantity . Description Date Amount
1' ea • or Feeders - 200 11/26/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 11/26/2012 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OA 2 -001- 090. You By: may obtain
Permittee Signature:
ain 1.800.332.2344. ` /
Issued B Wes( (L�f 0AJ A1"T. vd ki
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m, for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
OCT -14 -2008 14:37 From: To:5035981960 Paee:1'2
RECEIVED
NOV26201
Electrical Permit Application FOP. OFFICI, USE ONI,Y' A p
City of Tigard CITY TIGI RD Received ( ..2•(o A_ S Permit No,; EL•C W [d. - DO 6bo
13125 SW Hall Blvd.. Tigard, OR 97B$JILDING DIVIS , Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Datc/B Other Permit
T I G AR D Inspection Line: 503.639.4175 Data Rcady/By: - la Sec Page 2 for
Internet: www.tigard r.gov Natified/Method Supplemental Information
f� ,� . r.9" r.:�'. Z'(' ��:^ jloii� �1;,.r {.�r.s,{ ", .i..= - `? f ^ra F•i".. tA:" t; �
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,; ...., - -� .. ....:.,: :��, �_.,; , �.�` ` I• iii.- - ,i, �;✓- a, ':am�� '7+:- a:��. , ��,sr� �: ,.�,3, y���7r • .�� ; .� ; ; -w,, •, ;::.,:,�... . .,..v
j i 11' ��•: ..a , «� •. .... ..'"�"� �.. y`• :lr ��; 4 �':��-'�: +� ... 4•'���h5'j.- �+tta�'�,_ ;;y , �, ;,,: y >.:.,�t'�el xif^'- `ti +'i %?� ;,:���Ff'•r'Irm�y4�,:••, `a ��
.. __ �_ P lease check all that p a•- -•u <• • - )
l� New eonstruc . �- Addition/alteration/replacement apply (subnut 2 sets of lane w %,tans checked below •
a Service or toiler 400 amps or more ❑ Building over three atorics•
❑ Demolition ❑ Other:
where the available fault current ❑ Marinas and boatyards.
%t `jSr 7tp•F t P' '*,t , 3 7aLe> .Ht t; a e t exceeds 10,000 amps at ISO volis ❑ Floating buildings.
� ' � � """"
lass to ground, or exceeds 14,000 ❑ Commetelsl -use agncultulal
a 1- and 2-family dwelling ■ Commercial /industrial r Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. Li Fire pulp. 0 Inswltalion of 75 KVA or
't ; v 5 r y r qs , v , eney ystem, Iar E aratc
ply m c
.• �Y + J ,, 4 < <- _ 4 . d r . a *y,.w �l . li ...0q ` new mot bad f y
,.... , .,. ... �, i.:: - � ❑ A 'ton of or o � - „ er ., „ « _ .. da 3_ d system-
Job no.: QtiQ401; Job site address: 122-.15 t l T� p i #- p�.•• I00HP m more- occupancy.
-- 0 ❑ Six or more residential units. ❑ Recreational vehtcic parks
City/State/ZIP: I pewO t O lt t �1 �23 ❑ Health-cm facilities. ❑ Supply voltage for more than / 1 ❑Hazardous locations. 600 volts nommei.
Suite/bldg. /apt. no.: ( Project name: Dep4tl\ I ❑ Service or feeder 600 amp r c
so root .
:vs,R
Cross stet et /directions to job site: : 7. :7 , ,� : 1 '.'r; lt*.. + ., r �,t: ?F' 1 . • � �. .Tr. ` `:
Deampt on 3211 - 'cc. Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parccl no.:
Ea. add'I 500 sq. ft. or portion 33.92 1
, �T ,'." Limited energy, residential
'h,r �:6; - �ieS'Nri + iC ,;:;; i 6 «? v: + ;-rt r ,, ! 75 00 2
,':, ` `'- • - r w ,+ '.= . , ,rz -(' ;= _ s. A , Ii... ..( - ;;;A pp ,, . , ;_ (with above sq. fi)
# Limited energy, multi - family
I 100 - . . ■ .• ' 'P A-C/A �l G residential (with above sq. ft,) 75.00 2
t �• 1osJ + V 0 d 200 amps installation r �.y��
�^li
Services orfeeders on s teration, and/or relocation
tt rope or less 1... 100 70 '7 2
.n;; ,:triil('i11 ;4. .i.,' :, ... n;i ,;.aJ ., a ?au' ',,. f c . ? ; rii 201 amps to 400 amps 133.56
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 i 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not —
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 164.54 2
Branch circuits - new, alteration or extension, per panel
Owner signa t Date:_ A. Fee for branch circuits with
?I ''''ii. . 7 . : ;" ;E ° Ar „ , :p ,, ,.7 ;4 .,. `a l r" s ti` ia9y,,,,,, tM,. above actvie or feeder fee,
742
• .
_ . . .. � . .., - „: a. .„ , . _ .:. � �� each branch circuit 2
Business name: B. Fee for branch circuits without
service or feeder fcc, feat
Contact name: branch circuit 56.18 2
Address: — Each add'l branch circu 7 42 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder _
Phone: ( ) 1 Fax: : ( ) Reconnect only 67.84 2
E-mail: — Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
: ; "'iri , „ r y ; - — a:;rr• *. -, s
;:<�, : , , . ' nl �. :• � ;es ,.i • c � ' ; - �.` - -�� .,:�.>w• .� + ,, ;x.;� -�0 ir:,��%r,; Signal cireuit(s
, ) or limited- energy
Business name: -p ' ON G v L r panel, alteration, or extension, Page 2 2
E ach additional ins , ection over allowable in an of the above
Address: ‘2.0 o se " c • Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: b Investigation (1 hr min) 66.25/ hr
wive...0,40.0 t.. eel T1
I Industrial plant (I hr min) 78.18/ hr
Phone: 41 .. ce i 0 Fax: (53) 7 4:7 ,...5 2 Inspections for which no fee is
CCI3 LiC.: . Su Lie: ry , 1 I s • cifca0 listed h hr min
90.00/ hr
Electrical Lic.: •� p, . f , rr�
i �O3 �/ i : `' y `oq' :'r?te r.Y. ikA:' .. S1 .;
Suprv. Electrician signature, required: t Subtotal, tbc, • 1 O
A . • J Plan review (25% of permit fee):
Print name: A . - • ' Date: t”' 1$ ^ ` % L State surcharge (12% of permit fee):
Authorized signature: , TOTAL PERMIT FEE: y (+� �°��
. • +► _ . ••_A �.° This permit application expires if a permit is not obtained within 180 '
Print name: �1 te Q ,s _ 1►O1v Date: `t_ N w ebe r of inspections allowed per permit. days after it has been accepted as complete
1RVf.J 4010 ,4_ ii, ' ..� C, Sr
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