Permit •
a CITY OF TIGARD ELECTRICAL PERMIT
iill
' a ' COMMUNITY DEVELOPMENT Permit #: ELC2013 00076
TI GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/30/2013
Parcel: 2S103DC01300
Jurisdiction: Tigard
Site address: 11490 SW VIEWMOUNT LN
Project: Hegar Subdivision: VIEWMOUNT Lot: 1
Project Description: (1) reconnect only for duplex 11490 -11492 SW Viewmount Ln .
Contractor: Owner: HEGAR, ROBERT W
12720 SW 60TH CT
PORTLAND, OR 97219
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 01/30/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 01/30/2013 $8.14
Electrical
Type of Use: SF .
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
Total $75.98
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 OAR 9 2- 001 -0090. 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: .2�Y/ J&4! in Permittee Signature: 0IV i rPPL,C/^ 4. 77t2id
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 shalt 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 - 30 -2013 WED 06:34 AM FAX NO. P. 01
Electrical Permit Application I elri•It'1 I i.: t)NI.\
D ECEIVED
City of Tigard Dom t 30 (3 -4 Penh No.: 6L a o i 3- 000
1 1 11 ' a 13125 SW Hall Blvd., Tigard, OR 97223 IA J N 0 �. Pion !review Phone: 503.718.2439 Fax: 503,598.1960 : Date/f1 '. Other Permit:
1 A I. 11 Inspection Line: 503.639,4175 Mau Ready /By: bun C / _ lil See Page 2 for
Internet www.tigard- or.gov CITY OF TIGARD Notified/Method: SupplementalInronnation
TlTE' O . pJtA1V 'REVIEW.
0 Now construction Addition/alteration /replacement P lalsa check all that apply (Submit 2 sets of plans whams checked below):
� ❑ Service or feeder 400 amps or more A Building over three dories.
P
Demolition Other: -• e eci ' tfN where the available fault current ❑ Marinas and boatyards,
exceeds 10,000 amps at I SO volts or ❑ Floating buildings.
CATEGORY. OT/ COiW UCI 1ON ; '.: hew to ground, Of exceed% 14,000 ❑ Commercial -use agricultural
l- and 2- family dwelling 0 Commercial /industrial 0 Accessory building amps for all other installations. buildings,
0 Multi - family 0 Master builder 0 Other: 0 Fire pump, ❑ Inshdlation of 75 ICVA or
1 ■ ❑ Emergency system. larger separately derived system.
• JOB SIiTE • INFORMATION AND ,EOC1%TJON _ ❑ Addiunn of now motor load of ❑ "A ", ,. ..1.2 - I-3",
Job no.: cob site address: I f �g -� UI m0IJ17 -} � I i x or o /rare. occupancy.
❑ Six or more residential un ❑ Recneuional vehicle parks,
City /State/ZIP: 1 i d;; c)._ z'oa ❑Hen1U>care facilities. ❑ Supply volmge ibr more than
` f 13 Hazardous locations. 600 volb nominal.
Su ite/bldg. /apt no.. Project name: ❑ Service or feeder 60o amps or moms,
t.': f F1 IT SCIIG;DUI.1�
Cross street/directions to job site: 4 i + Descrirltlep I ow. I Rea, I TWA! J • .
!! ^, ,' New residential single- or multi- family dwelling unit.
��v -&e- V v `�+ Includes attached garage.
Subdivision: g, i r /r Lot no.; 1,000 sq. R, or Iran _ - 168.54 4
V Eu. add'I 500 sq. ft, or portion 33.92 1
Tax map /parcel no.: Limited energy, residential _
• ; :DESCRWJION' OT':WK OR': •' • ' (with above sq, ft.) 75.00 2 •
OY` �/ C. , Limited anal ( multi -famiq 75.00 2
D. residential (w abo 5 ft.l
CAT, / � Services or feeders installation, alteration . and/or relocation
0 (/ii -{ . Cr ,, t / s �L `-'v ("Ile . Oil 200 amps or I 100.70 ' 2
PROPk STY OWNER , .Q ,TL N, F , . 201 amps to 400 amps 133.56 2
erne• j] /_ / / ft - RAM-C/1 - 401 amps to 600 amps _ 200.34 2
�n 601am�tu1,000amps 301,04 2
Address: -7 S vt) AO � S Al Over 1,000 amps or volts _ 552 26 2
Ci /State/ZIP: Temporary services ur feeders installation, alteration, and /or
ty Q1f 7 t �-/1 V 7 ZZ relocation
Phone: L Fax I 200 amps or less 59.36 _
1
7ig�QS�p3 i ( ) 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that T own which is not 401 amps to 599 amps — 168,54 . 2
intended for sale, le exchange, cord to ORS 447, 449, 670, and 701.
/ � Branch circuits — new, alteration , r extension, per panel .. Th _r signature: Data; A_ Fee for branch circuits with
it IIMi: CJ`trON YA . P1CItS41N' r' above service or feeder fee, 7.42 2
each branch circuit
Business name B. Foe for branch circuits without
service or feeder fee, firer 56.18 2
ContACt name: branch circuit ___
Each add'I branch circuit 7.42 2
Address: _ Miscellaneous (service or feeder not indnded)
C i /State/ZIP: — Each manufactured or modular 6784 2
t3' dwelling. service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 1 67.84 , 2
Pump or irrigation circle 67.84 2
E -mail: Sign or outline lighting 67.84 2
_
C OI!FTIAtL LR . .. Signal circuit(s) or 1 imited- energy
Business name: panel, alteration. or extension. Page 2
- Each additional Inspection over allowable in any of the above ,
Address: Additional impectiun (1 hr min) 66,25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is
specifically listodyh hr min) 90'00 / hr
- CCI3 Lie.: Electrical Lie.: Suprv. Lie.: W 1l '.EIZCTCAL :PERI .FEES _ '
Suprv. Electrician signature, requi -, • Subtotal:
Plan review (25% of permit fee):
_
Print nlune: Date; State surcharge (12% of pcnnit fee):
TOTAL PERMIT FEE; -7 9 F
Authorized signa IM'���-
- This permitapplialiva expires if a permit. obtained ant obtain within 180
V l� , days after it has been accepted as complete.
Print name: ` \ �\ _ Date: 3 k � • Number of inspections allowed per permit.
I:lduldiloPcrmiulELC- PCnnitApp.dae 07101/10 440- 46111'(1I/OS/COM/WED
JAN -30 -2013 WED 06:35 AM FAX NO, P. 02
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIAEN'1C IAL WORK ONLY:
Pee for all residential systems combined ... $75.00
Check Type of Work Involved:
O Audio and Stereo Systems*
❑ Burglar Alarm
0 Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ ' Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY
Fee for each commercial $75.00
system
(SEE OAR 91.8- 309 -0000)
Check Type of Work Involved:
O Audio and Stereo Systems
[� Boiler Controls
❑ Clock Systems
[�
Data Telecommunication Installa: •n
❑ Fire Alarm Installation
❑ FVVAC
[1 Instrumentation
[] Intercom and Paging 5 • - ems
C] Landscape Irrigation r ontrol*
Medical
Ej Nurse (alts -
❑ Outdoor . . cape Lighting*
ii
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
Lesaax,xwrmit+n c- raou„p 07 /01110