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Permit CITY OF TIGARD ELECTRICAL PERMIT 111 .1 COMMUNITY DEVELOPMENT Permit #: ELC2013 -00030 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/16/2013 Parcel: 2S 104CCO2400 Jurisdiction: Tigard Site address: 13951 SW HILLSHIRE DR Project: Minor Family Subdivision: HILLSHIRE ESTATES NO.2 Lot: 130 Project Description: (3) branch circuits Move some can lights fish in some switch legs Contractor: PC ELECTRIC Owner: MINOR FAMILY REVOCABLE TRUST PO BOX 517 13951 NW HILLSHIRE DR NEWBERG, OR 97132 TIGARD, OR 97223 PHONE: 503 - 538 -6033 PHONE: FAX: 503 - 538 -6461 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 01/16/2013 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/16/2013 $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 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- 001 -0090. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: � _f Permittee Signature: okf , -PI 32 Z i rod 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. Jan 15 2013 8 :55AM HP LASERJET FAX p. - Electrical Permit Application 'RECEIVED IYtlz 01.1 11 - F l \l.l City of Tigard JAN 1 i 5 Recoi ,- / • 13125 S W Hall Blvd., Tigard, OR 97223 c � �3 Datr/ i / (O /3 Penn it NO I�� o / 3 ' �U 3oJ Phone: 503.718.2439 Fax: 503.598.1 Date/By: Other Permit: Plan Review rc,,; :r, Inspection Line: 503.639.4175 QFTIGARD Internet: www.tigard- or.gov BUILDING DIVI Data Ready/By: I S See P 2 for SIN Notified/Methad: .� r _._ -_ : -- _ :i;� ;',_,r_ :, _ t 1 0 9nPptemenhl Information - - : ;: _ - - 'ice- :ui �::-r. ,:.: „ . ; ' ' ', _t' _ -' ... . . ❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 3 sets of plans w /items checked below:.: ': :.. El Demol It10n ❑Other: the available fault current ❑ Service or feeder 400 amps or more Buildiq over three stories. :. :_ ts: . l '/ i� 1:.; aI Y _ a -- where ❑ Marinas and f i7Tii3 :'- � -14iii :`._, - f.�... - - , is €_ , i's.: . ` 40.blli' amps at p 1 JO volts or ❑ Floating buildings. exceeds 10,000 am M � >> L' ® 1- and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building less to ground, or exceeds 14,000 ❑ Commercial -use agricultural El Multi ❑ Master builder su . other installations. Installation buildings. lI. . i _ -- �_�- ;'.� -?' ❑Other: ❑ Fire pump. [natal .::_, _,�.= :c_ :�'•� _ _ ` -: '- - • -' la of 75 KVA or ,.: ,--- r - ._ 4 :: ❑ enry system. g separately derived system. . _ .. ' ' ` ❑ Add i tion of new ,.r- -. -.., �- � � T:. ;, -. : -- _ �..: .,.. E nerg m otor load of ❑ .. Job no.: Job site address: 13951 SW Hillsbire Dr. 2" "1 - 3" IODHP or mote, oxupancy. City/State/ZIP: Tigard OR 97223 ❑ Six or more residential units. ❑ Recreational vehicle parks. ❑ Health -care facilities. ❑ Supply voltage for more than Suite/bldg./apt no.: ❑ Hazardous locations. 600 volts nominal. I Project name: ❑ Service Of feeder 600 amps or more. Cross street / directions to job site: - D = iR`E.: " ° .. _ :;. nvkplon °•'•ii is I t , .,it s.,_.. :_rr I QQty. Rea I ' Total ''. New residential single- or multi-family dwelling unit. Includes attached garage. Subdivision; I Lot no.: 1,000 sq. ft. or less 168.54 Tax map /parcel no.: Ea, add'I 500 sq. ft. or portion 33.92 `' _ ; °i' := = K t,:::: - `= t;D1 Limited energy, ,:,:.,:,, _�_ : :..; : �., .� �_ -. - - - - as .�_ -.-- - � •� � ^7' with above � ,� � en Move some can lights fish in some switch legs Limited energy, multi - family residential (with above sq. ft.) 75.00 2 _ _ relocation ;: v -_ Services or feeders installation, alteration, and/or i . _ amps or less 100.70 2 �' .t %r to !th11T 201 amps to 400 amps IIIIII �_ .._.......- �' r.. _' 4 _.r � :. '. ,.: Name: 133.56 II 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation 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 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 turps to 599 amps 168.54 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel �' - u - A. Fee for branch circuits with - �r _" 0 .:Z:.:.117:. - :. �'�}�Op e above service or feeder fee, 7.4: Business name: each branch circuit B. Fee for branch circuits without Contact name: service or feeder fee, first 1 56.18 branch circuit 56.18 2 Address: Each «dd'l branch circuit 2 7.42 14.84 2 Miscellaneous service or feeder not Included City/State/ZIP: Each manufactured or modular ■ dwellin service and/or fender 67,84 © Phone: ( ) I Fax: : ( ) Reconnect only II 67.84 E - mail: Pump or irrigation circle + `� . _ - .... - .. , 67.84 , '. r " ; - :7'. ,. rt:ge lighting :;: �y ;' 4,� : ,.__: = a _ i�' -"�_�j Sin or outlin li g 67.84 • Business name: PC Electric Signal circuits) or litrtited -energy panel, alteration, or extension. Page 2 2 Address: PO Box 517 - Each additional laspectltm over allowable in any of the above Additional inspection (1 hr min) 66.25/ hr City/State/ZIP: Newberg/ Or/ 97132 investigation (1 hr min) 66.251 hr Phone: (503) 538.6033 industrial plant (l hr min) 78.18/ hr I Fax: (503) 538.6461 Inspections for which no fee is hr CCB Lic.: 187490 I Electrical Lic.: 36-11 4c a., Main listed 15 hr min W Suprv. Lic.: 5012s • - . :' - , , . 4%;:- :V3 S S uprv. Electrician signature, required: u tal: 71.02 Print name: Steve P Plan review (25% of permit fee): Peppmeier Date: 1/15/13 State surcharge (12% of permit fee): 8.52 Authorized signature: TOTAL PERMIT FEE 79.54 Tb8 permit application expires if a permit Is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1 : 1 nuitding $PermitAEl,GPermitAppdne 07/01 /10 440.461NT(lI105iCOM / tYEg