Permit p / CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 00073
T'GARD: 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/30/2013
Parcel: 2S114BB13900
Jurisdiction: Tigard
Site address: 10396 SW KENT ST
Project: McDonald Subdivision: SWANSON'S GLEN NO.2 Lot: 80
Project Description: (2) branch circuits to wire for A/C and furnace
•
Contractor: ENGELMAN ELECTRIC INC Owner: MCDONALD, TIMOTHY P/MINDI L
PO BOX 451' 10396 SW KENT ST
HUBBARD, OR 97032 TIGARD, OR 97224
PHONE: 503 - 981 -8041 PHONE:
FAX: 503 - 981 -4026
FEES
Quantity Description • Date Amount
2 crt Branch Circuits wo /Purchase 01/30/2013 $63.60
Specifics: Service or'Feeder
1 ea 12% State Surcharge - 01/30/2013 $7.63
Type of Use: SF Electrical
Class'of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 01- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 11 800.332.2344.
/
Issued By: N/(.�Cf Permittee Signature: O/V A PP ti Al
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.
01/29/2013 03:09PM 5039815NE IV METPOSITE LLC PAGE 02/02
Electrical Permit Application JA N 2 9 2013 FOR OFFICE INF. ONLY
City of Tigalyd L � p R ,Ved Permit No.C� ,,,,/0/3 — X73
'
13125 SW Hall Blvd., Tigard, OR 9O¢ OF TIGARD Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503. I�®ING DIVISION nat '
T I C A Rt) Inspection Line: 503.639.4175 Date Ready/By: NM ®See regc z for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information ' • • ... ','1 $'E':;OV. :WORK.' . . . .tPLAN• . .
❑ New construction ® Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps Or more C1 Building over three storiea.
El Demolition
❑ Other: where the available fault current ❑ Marinas and boatyards. • ... " �, QN$ T RI7G�01 !1`:- ':::, <''; ; ' " : � � exceeds 10 amps at 150 volts or ❑ Floatin buildings
• =. �' � ': : � : � : : ��; FtTEC�r' k) Yt�; �7F;'. : .•:; _ `
less to ground, or exceeds 14,000 El Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder 0 Other: 0 Fire pump. ❑ Installation of 75 KVA or
T ❑ £mergenry system. larger separately derived system.
• ` JOB S •OFQRIVI tION ' LOC}1TI`ON` . ?• :...• �: ° ❑Addition of new motor load of ❑ "A , "1"s > "l separately
Job no.: 25892 f Job site address: 10396 SW Kent Street 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parka.
City/State/ZIP: Tigard OR 97224 CI facilities. ❑ Supply voltage for more than 1
- ['Hazardous locations. 600 wits nominal. 1
Suite /bldg. /apt. no.: Project name: litiMeDonald ❑ Service or feeder 600 amps or more, —
•FEE SC1AlJI:E
Cross street/directions to job site: Description I Qty. I Fee. I rout
New residential single- or multi- family dwelling unit.
. Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. it or portion 33.92 1
Tax map /parcel no.:
Limited energy, residential 75.00
: .. ,. 1 ESCRJYrI014... . ...• . * .. . . (with above sq. R) 2
Limited energy, multi - family 75.00 2
wire for a/c & furnace residential (with above sq. R)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 00.70 2
.
p:?itorl.xr�t.riwca : - rEro;�JVx <:
[� :: .... 201 amps to 400 amps 133.56 2
Name: Tim McDonald 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 10396 SW Kent Street Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard OR 97224 Temporary services or feeders installation, alteration, and /or
tY g relocation
Phone: (503)598 -8075 Pax: ( ) 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 amps to 599 amps 168.54 2
Branch circuits— new, alteration or extension, ear panel
Owner signature: _ Date: A. Fee for branch circuits with
®APPLIC <' , '.' f'cor'i k.cept11K90N• above service or feeder 18e, 7.42 2
D: each branch circuit
Business name; B. Fez for branch circuits without
service or feeder fee, first I 56.18 56.1 8 2
Contact name: branch circuit
Each add'l branch circuit 1 7.42 7.42 2
Address: Miscellaneous (service or feeder not included)
Each City /State/ZIP: dwelling, seervicce nd/or feeder 67.84 2
Phone: ( ) 1 Fax: : ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
i 67.84 2
e lighting
•.,...ri ?:
; ; >)... . . •. CCSl�'171t �IL'.;4'`.r' %.
;�, . $i tc(s) orlimted- energy
,�_ OfOU 1
• .._. 1 I circv•
Business name: Engelman Electric Inc panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: P 0 Box 451 Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: Hubbard OR 97032 Investigation (I hr min) 66.25/ hr
—
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 9814041 Fax: (514451 inspections for which no fee is 90.00/ hr
— specifically listed (y4 hr min)
CCB Lie.: 94581 Electrical . 24 •.. Suprv. 4739 ; •': ••: • •.. • :ELECTRICAL • PERMIT. FEES '.
Suprv. Electrician signature, required: Subtotal: 63,60
Plan review (25% of permit fee):
Print name: Ron Thunderbird r : 1/29/ State surcharge (12% of permit fee): 7.64
TOTAL PERMIT FEE: 71.24
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: I Date: days after it has been accepted as complete.
_ Number of inspections allowed per permit.
1: 1Building■t 'ermlte\ET,GPermitApp.doe 07/01 /10 440-46157(11 /05/COM,WE 1 1 a3 ST
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
10396 SW KENT ST, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
2014-01-06 00:00:00
ELC2013-00073
PASS - No C of O
Violation Summary:
Inspector Contractor