Permit CITY OF TIGARD ELECTRICAL PERMIT
�
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00711
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012
TIGARD Parcel: 2S101 DB00103
Jurisdiction: Tigard
Site address: 7360 SW HUNZIKER RD 103
Project: Platinum Lending Subdivision:CONDO SUPPLEMENTAL PLAT NO.4: Lot: 22830 -2
Project Description: (6) branch circuits for TI
Contractor: A C & E ELECTRIC CO Owner: ROBINSON FAMILY TRUST
3535 DEL WEBB AVE NE #100 21360 NW AMBERWOOD DR
SALEM, OR 97303 HILLSBORO, OR 97124
PHONE: 503 - 363 -2301 PHONE: 503-645-8531
FAX: 503 - 363 -2302
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 12/17/2012 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/17/2012 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through 0 52- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _G�� Permittee Signature: eV /970 G -✓ 7-l
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
12/13/2012 09 :48 5034850586 =C &E ELECTRIC PAGE 01/02
Electrical Permit Application RECEIVE FOR OFFICE t1SE ONLY
Cr of Tigard Received
hr DEC 1 3 2012.1 Yd /� / // •f!'r PermitNn•: CLe � -407//
IIII 13125 SW HaII Slvd.. Tigard, OR 97223 Plan Rcvicw
1t Phone: 503,718.2439 Fax: 503.598.1960 CITY T p C� fD Date/By; Other Pmnie /7 *— i 0 y/
Inspection Line: 503.639.4175 � I 1 1 1 I Dsto Rcad /B Iuae:
TfGARD g BU ILDING DIVISI( 1 Y Y- 'l S peerrntallnfsrmatinn
Interact: www.ti -or. ov �,�,t o � uRcd/;vlcthod: �
- ' Y _ ;`i.'' ... : rW :4 :e Y Ceti �• 7K i Y` }06.14 �R1 ` r, '•, *Ts' tv .$ .
�,t �"� r t yµ,"� yy� -
•"� AR~C-� � �. T.�' i n n; •' . I:•�.� t � „.. ._?� � �, re ._ � �, ,�'.r- � A'I�•�1t1�V _ ...� L�h]' 'n��r,
❑ New construction ® Addition/alteration /replacement Please check all that apply (submit 2 acts of plans w /Items chocked below):
0 Service or feeder 4410 nmrs or more ❑ Building over three stories.
Cl Demolition ❑ Other: whom tho available fault current ❑ Marinas and boatyards,
CI Floating buildings,
e. � � r y� . #Y415 � , y` .gy f y' '•"j' „ceeAe 10,000 amps at 150 volts or
, b>s +' iiR?�� ir. Xw�., °3Y� �ti,_. ; . : , r.,r r less to ground, or exceeds Ih,000
❑ 1- and 2- farnily dwelling !El Commercial /industrial ❑ Accesso buildin Q Commercial nest agricultural
�' R amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
u ^ y � ,�, Emergency system. larger separately derived system
1 1 '�, O t 7 ,W t . 7 ' . ” 1 9' .,. i ❑ g Y f p Y
! , 1 r r:y w ar . `+uy ,�..r. , ti ' , 5 tY!i r Addil;nn o f new motor load of ❑ "A ,. ..1 -2 ••1 _3"
Job Ito, . Job site address: 7360 Hanziker 1001-11P or more. occupancy.
❑ Six or more residential unite. ❑ Recreational vehicle perks,
City /Skate /ZIP: Tigard, OR— [i ldenith -care facilities. 0 Supply voltage for more thnn
❑Hazardous local Ions. 600 volts nominal.
Suite/bldg./apt-CO.: 103 Project name: Platinum Lending U Service or feeder 600 amps or more.
,r x " r!'" ' . , r ,, ?",.;, g, St'' net o1 .' rr. y1' T i .i t,:,4T; N'o
Cross street/directions to, job site: noxrlpt+aa O y. res. 1 Tntnl •
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R, or less 168.54 4
Ea. add'] 500 sq. ft. or portion r M 33,92 1
Tax map /parcel t10 : Limited energy, residential
'd VLsI VI . + ' w tK i ti`�t above multi Il) 75 00
t
,.; ,, � y � may :` .may ` �`� µ'if O ,+^�:��� �. >- �.±t�, --(
Hilltop - TI build -out i mt a energy ove 75.00 2
residential (with above sq. ft.) ,
Services or feeders Installation, alteration, and /or relocation
200 amps or less 100,70 2
lEl a � ;, s• ;' " , t 201 amps to 400 amps
{ •°, . �•.,;. mss ;x: ski. hf"`,, -.Iis 133,56 2
401 amps to 600 amps 200.34 2
Name: ,
601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or volts 552.26 _ 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( ) i Fax: ( ) 200 amps or less 59.36 r 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 salt. 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. Fcc for branch circuits with
,.;iPTrttr#u r r .� "''� d t r above service or feeder fee, 5 7.42 37.10 2
.dv , '$1l each branch circuit
Business name: B. Fee fbr branch circuits without
service or feeder fee, first 1 56.1S 56.18 2
Contact name: _ branch circuit
Each add'I branch circuit 7,42 2
Address: Misccllareotissservice or feeder not include
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67,84 2
Phone: ( ) Fax :: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
4 Sign or outline lighting 67.84 2
� 0 ' Signal circuit(a) or limited-energy
Business name: AC&E Electric panel, alteration, or extension. 1 Page 2 _ 2
{ Each additional inspection over allowable in any of the above
Address: 3535 Del Webb Ave Additional inspection (1 hr min) I T 66.25/ hr
City /State /ZIP: 97301 { Investigation (1 hr min} 66,25 / hr
industrial plant (I hr min) 78.18/ hr
P' one: (503) 363 -2301 Fax: (503) 363 -2302 Inspections for which no fee is
90.00/ hr
J'i y/ e� V specifically listed ('14 hr mm t
CCB Lie_: 59 /ft,
' I i 1 Electrical Lie,' /IC .7 i 1 3hprv. Lic.: 5387S 1 , ° { �,r ": s "
ii *`; 'Eloi�`T' .. CA15;,PEVLMrTJf:rtSr . ii r I^ .
Suprv. Electrician signature, required: o� ' Su 1, 93 28
/ �#,��
Plan review (25% of permit it fc fcc);
law" Print name: Carl Duncan Date: 12/13/2012 State surcharge (12% of permit fee): 11.19
••— TOTAL PERMIT FEE: 104.47
Authorized signature: This permit application expires if it permit is list obtained within 150
Print. name: Date: days after it has been accepted as complete.
N um b er o inspections allowed per permit.
11301ding \Pcmtits\ELC- PcrrnitApp.doc 07/01/10 440-4615T( /aS /COM/WEB