Permit •
CITY OF TIGARD ELECTRICAL PERMIT
n
• ''1 a • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00083
T t GARD 13125'SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2013
Parcel: 1 S136DD07001
Jurisdiction: Tigard
Site address: 6960 SW CLINTON ST
Project: Johnson Subdivision: WEST PORTLAND HEIGHTS Lot: 1 -4, 9 -1(
Project Description: (1) 201 amps to 400 amps to replace electrical service with 320 meter base and new panels
• Contractor: DREAMHOUSE ELECTRIC LLC Owner: JOHNSON, MARK
• 221 SW MOONRIDGE PL 6960 SW CLINTON ST
PORTLAND, OR 97225 TIGARD, OR 97223
PHONE: 503 - 519 -6711 PHONE:
FAX: 5 9'17 .)3
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 201 to 02/04/2013 $133.56
Specifics: 400 amps
1 ea 12% State Surcharge - 02/04/2013 $16.03
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $149.59
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 95 001 - 000.. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19987 or 1.800.332.2344.
Issued By: I M Ate
Permittee Signature: D l() APP I C�`"'1 �
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.
Ele Permit A i_ CEWED
City Of Tigard Received v J 1 3 • I ---
i 13125 SW Hall Blvd., Tigard, OR 9 • 'e ; 4 2013 Plan Review Other Permit:
67 Phone; 503.718.2439 Fax: 503.59. • • • Date/By: -
Inspection Line: 503.639.4175 Date Ready/By: rails H See Page 2 for.
A 're. 11 CIT OF TIG Notified/Method - 1(mo Suppteesental Information
tnternel WWW h -or g -,R I ,I
r 1 t[ 1 1 i . 11 it P161 ;1 I, �,:;`
Alh! .' 1 + i *r� - ' n W , - ,. i k l ti ; l *.a. .. n1 '; ;,Is . . ,..'. . - b , ... ,'r.r .. ; i u_ .r :,r! l J. ! rl_1 - ,.
.. _..,,; . _ , , _ :, _ . - ....._ . _ ..- - -.r ,. .- ..,.... , submit 2 Sete of plains wfitems chocked below):
.. t , .. � - Please ,. check ell . that app . ly
❑ New construction
►� ddition/elteratio p lacement O Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 0 Other where the available fault current ❑ Marinas and boatyards.
t " , a Y 1 tI + i ` 1 exceeds 10,000 amps at 150 volts OT ❑ Floating buildings.
t r h ` L .. f r v e 7 * ...� - -- ` ' ••. k m . ti : - s-- 1 . , . . 5 . r ' . — ,•4.,�,: I t, l • . -,.•: .t '1it'i F . °',✓ •.., !. less to groaand or exceeds 14,000 0 commercial-use agricultural
T - and 2- family dwelling ❑ Commerciial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Installation of 75 KVA or
❑
Master builder ❑ Othei Fire pump. system. larger separately 1Vlulh fefnily ❑ i ,, q ❑ Ern oy derived
t a . , 1 i '' 1 ' 'l t i , ,, h,.',:,:,:.. ❑ pddr pn anew motor load of ❑ "A "E . Y ay em.
t-3
111i i . : - . ; ' i t 1� tl i1 . ") i' �' ` 1,{ [ 1. ' - ''' '''..-2;:6 - T.._... � 1 ...ter,.. �.
.. ,., ,. ; _ ..... occupsacy.
100HP a more
Job no.: Job site address: 6 q60 Sw 1✓1 at-, ❑ Six or more residential [nits. ❑ Recreational vehicle parks,
❑ Health -care facilities. ❑ Supply voltage for more than
City/State /ZIP: rl te a, 0 ' • DO-3 ❑ Hazardous locations. 600 volts nominal.
❑ Semax or feeder 600 aau s or more
Suite/bldg. /apt. no.: Project name: AA 4 ,So 11r - tr r. r 7 1 �1 a ,I ,1 y ' r ' lltlin
Cross street/directions to job site: o. a *ipe �' I
New residential single- or multi-family dwelling unit.
b 6 ei I t Willi"' lneludes attached garage.
1,000 sq. ft. or less 168.54 4
Subdivision: LOt no.. Ea. add'l 500 sq. ft. or portion 33.92 ` 1 —
Tax reap /parcel no.: Limited energy, , residential
• ft tial 75.00
r, ,,� 6'tr . f Y i - v ' I,. la . �� n r i , 'Jjt , , i�1r .n ., 1 (w sq' ) 2
1 i ,i,�!. 1. �.,fi . c„ - .. _. 1. :, ,.. ... „.._ i . ...4 �.'.,,r:,:L . c . Limited energy,multl°faxt'UY
_,a;. 75.00 2
11/ t t _ g v 1/.21, 3 * residential (with above sq. ft) _
", ! ¢.f�2Qitrt 1,, Services or feeders installation, alteration, and/or relocation
L _ _ a a 3 , , r ►8. S 200 amps or less l 100.70 L 2
k % r 1 1 "r _ 6 1 r + * } { t 1 N � I , ' 1 amps to 400 amps 1 /33
- "1 1 '1'... ,1, , r -1'4 ' u �,i 1 ; 1 1 a . r 1, ., , ", ,. .:_ 133.56 2
20 133
a e' - - 401 amps o 60 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
•
Address: Over 1,000 amps or volts 552.26 I I 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: rel
200 amps or less 59.36 I 1
Phone: ( ) Fax: ( ) 201 amps to 400 amps 1 2
Owner installation: This installation is being made on property that I own which is not ' 401 amps to 599 amps 1168.54 12 •
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits new, alteration, or eYtensiom, per panel
Owner signature 41 -!�t Dais 71 T i x i above service or fee, 7.42 2
.,10, : i.I
f r . .. .i,.r i1 i �„ •: 1 , , l .. ,l i. _ . . : ; . .
� f ..�,, iorrl �t 1 at:1 1 .411 i
1 i_ c . , ' . I:Ia ..z, : .:.. , . ,. .- : .., .. , r, each branch crteaut
B. Fee for branch c without
Business name: service or feeder fee. first 56,18 2
branch circuit
Contact name: Each add'1 branch circuit 7.42 2
Address: miscellaneous (service or feeder not Included)
Each manufactured or modular ' 67,84 2
City /State/ZIP: dwelling, service and/or feeder
Reconnect only r 67.84 2
Phone: ( )
• per' ' ( ) Pump or irrigation circle 67.84 2
E—mail Sign or outline lighting 67.84 2
r t,:,r „4. _. .:.` a..__..: Signal trrcutt(s) or limited -energy
'i, �l: ],t E.. F.:.l.,.1, v,. {,I} n, . L t ..., (..... r, ....t 3c;.. '' 2 2
Business name: DreamBouse Electric, LLC panel. alteration, or extension Page
Eech additional inspection over allowable in say of the above
Address_ 221 SW Moonridge Place Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Portland, OR 97225 investigation (l hr min) 66.25/ la
Phone; ( 503) 519 -6711 Fax: ( 503) 648 -9723 industrial plant (1 hr min) 78.18/ hr
CCB Lic.: 196726 Electrical L� 848 prv. Lic.: 45605 Inspections for which no fee is 90.00 hr
s ficall listed V+ihrmin ,:
Suprv. Electrician signature, requ /�/ r,L.., ._._ .., T '....,;,.. =:, ` ;!,?,. " ., _ ' � `z _l.,... ; ..,...
/ice ,,,_: ..._
Subtotal.
Print name: Chris Mahoney 'Date: 2v11 // Plan review (25% of permit fee):
Authorized•signaturc: State surcharge (12 %of permit fee):
TOTAL PERMIT FEE: / --9
Print name: Date:
r:l Building tPermifsl6l.C- ParmitApp.doe 07/01/10 440 - 461[[(11/05 /COM/WE8
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
6960 SW CLINTON ST, TIGARD, OR, 97223
Residential - Electrical
115 Electrical service
02/25/2013 00:00
ELC2013-00083
PASS
Violation Summary:
Inspector Contractor
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
6960 SW CLINTON ST, TIGARD, OR, 97223
Residential - Electrical
115 Electrical service
02/25/2013 00:00
ELC2013-00083
PASS
Violation Summary:
Inspector Contractor