Permit (
Ilh .p CITY OF TIGARD ELECTRICAL PERMIT
• j3
COMMUNITY DEVELOPMENT Permit #: ELC2013 00066
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013
Parcel: 2S103BB02600
Jurisdiction: Tigard
Site address: 12480 SW KATHERINE ST
Project: Sweitz Subdivision: BROOKWAY Lot: 26
Project Description: (2) branch circuits for A/C connection and service plug
Contractor: BOB'S ELECTRIC Owner: SWEITZ, TROY J & CHRISTIE A
2700 NE BURTON ROAD STE A 12480 SW KATHERINE
VANCOUVER, WA 98662 TIGARD, OR 97223
PHONE: 360 - 254 -7200 PHONE: 503 - 758 -6979
FAX: 360 - 254 -8219
FEES .
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 01/29/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/29/2013 $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 9 2 -001 -0 90. You may � obttain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or .1
Issued By: (�( /o-t Permittee Signature: OA( #PPtJ - H `vk...t
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 503.638.4175 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. . ,
FROM (SUM) JAN 27 2013 23: 06 /ST. 23: OR /No. 8302026355 P 1
Electrical Permit ApplicatioCE I OI I ICI: t sl: O\L1
III City of Tigard ! 2 8 2013 n Received ( a q 13 permit No.. L QO /3 ODD o
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
1 • inspection Line: 503.6 3 39.4175 59 OFTIGARI� Da� �
Other Permit: p 2 for
l g BUILDING DIVISION Notified/Method: i <o Supplemental Information
/Mallet www.tigard -or. ov
s IT - r < - 1 44 ;1 -- i - — t x•E. a 1: 1 y -7 - TS J,- l h +r -, f "C .
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❑ N ew construction ®Addition/alteration/replacement Please check all that apply (submit a sets of plans whams checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
El Demolition 0 Other
where the available fault current ❑ Marinas and boatyards.
1 s - ' , 2 F ; i"' .r . exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
-• _ _ .. _ ...... _ ._ . 1 _ . ___ _ less to grouts, or exceeds 14,000 ❑Commercial -use agricultural
® 1- and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
--=-=',-; s-? c r ❑ �ncv a'etem larger separately derived system.
' 'e vc -
.. . ,. 1 _ . ... . ' _ ? . t` t "' itw� .� ,' ' uon : ❑ Adrh ()film motor load of ❑ "A "E ", "1 - ", "l - °,
.. s. _ _ • ,. - :�. a- : ors � �.
Job no.: 13 -196 Job site address: 12480 SW Katherine St. 100HPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Ti- aid , OR 97223 ❑ Health-care facilities.
0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
64115" i{v'4' c C .. '-r'::1,:-:, ,:tom t ;- `'+t'''...
Cross street/directions to job site: osrlpttoa Qty. Pm Tail •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. add'l 500 sq. ft or portion 33.92 1 -
Limited energy, residential 67.84
t A d a i -c r r? ' S t t �� iii r "5''''''3 (with above sq. ft.) 2
�., ._ ; . om, . Limited energy, multi- Otmily
r esidential (with above sq. ft.) 67.84 2
A C connection_& Service plug -
Services or feeders Installatlon on, and/or relocation
200 amps or less 100.70 2
r L si _ r 'n'
. ' -7 l 201 amps to 400 amps 133.56 2
Name: Tro & Christie Sweitz �l s s 200.34 2
amps to 1,000 amps 301.04 2
-
Address: 12480 SW Katherine St. Over 1.000 amps or sorts 552.26 2
City / State/ZIP: Temporary services or feeders Installation, alteration, and/or
T _1 , _ d OR ' 223 relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
03 58 - • 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
s s s a xc fee,
rf,, . .. Y c` • r _ _... i;.'... = .- .. ,
above bran circuit ceder 7.42 2
each rant
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 1 7.42 7.42 2
Address: Miscellaneous (service or feeder not included)
City/ StateJZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail
Signal W . ' �` �� r; : `" :'' i - , ''• vs Aar, : :. g 3 zF : l c circuit(s) n limited-energy 67.84 2
Business name: r panel, alteration, or extension. Page 2 2
Bob s Electric Each additional Inspection over allowable in any of the above
Address: 2700 NE Burton Rd. Ste. A Additional inspection (I hr min) 66.25/ hr
Investigation (1 ) 66.25/ hr
+ _ • ' Ind p lan t (I hr tirmin min) 78.18/ hr
Phone: ( 360 ) 254 - 7200 Fax: ( -60 )254 - 8219 Inspections for which no fee is .
90.00/ hr
s tficall listed 'A hr min
Electrical Lic. 7 A Suprv. Lic.: 4322S = -- µ`ms T- =FI. - E- 1 % =' a '
Suprv. Electrician signature, requi
Subtotal: 63.60
Plan review (25% of permit fee):
Print name: Kevin Broselle Date: 1 24 13 State surcharge (12% of permit fee): 7.63
Authorized signature: TOTAL PERMIT FEE: 71.23
This permit application expires If a permit le not obtalaed within 180
Print name: Date: • days after It has been accepted as complete.
Number of inspections allowed per permit.
IABuilding\PermledELC-PamhApp.doc 10/01/09 44046I$T(I1/05 /COMIWEB
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
12480 SW KATHERINE ST, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
02/25/2013 00:00
ELC2013-00066
PASS - No C of O
Violation Summary:
Inspector Contractor