Permit •
y „ CITY OF TIGARD ELECTRICAL PERMIT
•
F COMMUNITY DEVELOPMENT Permit #: ELC2013 -00104 •
•
• T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 1 S 135CB00600
Jurisdiction: Tigard
Site address: 11530 SW TIEDEMAN AVE
Project: LeafGuard Subdivision: ARBOR ROSES NO.6 Lot: 560
• Project Description: Installation of (1) branch circuit for new baler.
Contractor: PROGRESSIVE ELECTRIC Owner: MCCALL PROPERTIES LLC
16387 S BRADLEY RD BY NED MCCALL
OREGON CITY, OR 97045 5480 NW FRONT AVE
PORTLAND, OR 97210
PHONE: 503 - 407 -5146 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 02/14/2013 $56.18
Specifics: Service or Feeder
1 ea .12% State Surcharge - 02/14/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
•
Type of Const:
Occupancy Grp:
Total $62.92
•
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. ATT ION: Or- •n law • •'res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-1 through OAR 9 : -' • 1 -0090. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.198 1.800.332
Or
Issue. By: �" �i / - Permittee Signature:
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:
C : • CTOR INSTALLATION ONLY
•
SIGNATURE OF SUPR. ELEC' ' AM" r Date: Anirf
LICENSE NO. 6 7 5
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.
Electrical Permit Application F OFF l C E ; O:\ r_
II City of Tigard ® ��' IPtozal No-- E[.e-, 0/5•40/05/
13125 SW Hall Blvd, Tigard, OR 97223 pi Review
8 Phone: 503.7182439 Fax: 503.598.1960 pat .: : i Other Permit ,
T 1 G A R D Inspection Line: 503.639.4175 Date H I D ®Sees rage 2 fair
Internet www_ttgard- or.gov Notified/Method: Sit Ir ati®o
TYPE OF WORK PLAN REVIEW
❑ New construction ( 1 ddit ion /alteration/reepla cement Please cheek a2 °eo apply (sebum' z sets of plans whams `lammed below):
❑ Saviee or few 400 amps or more ❑ Building ova three stories
❑ Demolition ❑ Other: oboe the available fade aurae ❑ Marinas read fad
CATEGORY OF CONSTRUCTION exceeds 10,000 areas at ISO voles or ❑ Flag b®3�gs
El 1 - and 2 dwelling less to ground, or exceeds 14,000 ❑ Co nsercoa4eme agriculararal
y g ®'Commercial mdustrial ❑ Accessory building a n other installations_ .
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ F "A` "erred system
❑ Addition of new mater load of ❑ °A", "E", °I - Z ; °t 3",
Job no.: Job site address: �� l L I00HP or tee. .
/� I 1 ' S W � /� � ln4e>q ! J ❑ Six or more residential �s ❑ Rnaeatnoucil ss t e peals.
City/State/ZIP: - 71 p d n cg 7.2_7S otkahh_care facilities. Hazardous ° � tome tau nominal
SuiteIbldg.lapc no.: I Project name: L E 4 F Au al I'- b ❑ Service or feeder 600 apps or more_
FEE SCHEDULE
Cross street/directions to job site:
J 1 Qrs -I Fa I spa '.
New residential single- or multi- family dwelling snit
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft or less 168.54 4
T a x map /parcel no.: Ea add'1500 sq. ft_ or portion 33.92 1
Limited energy, residential 7500 2
DESCRIPTION OF WORK (with above sq. ft.)
/_ 11 -,/ 1-4c) p Limited energy, multi - family 75.00 2
/ N 3 - 7 PI Lj� 4 f Cr ti2 ( t Y /e- residential (with above sq. R)
Services or feeders installation, alteration, and/or relocation
t-4 W ` 6, L 200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 13356 2
401 amps to 600 amps 20034 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 55226 2
City/State /ZIP: re n Temporary services e or feeders i lion, alteration, andkw
Phone: ( ) I Fax: ( ) 200 amps or less 5936 1
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 far bra circuits with
❑ APPLICANT I ❑ CONTACT PERSON above savice or feeder fee, 7.42 2
each branch circuit Business name: B. Fee far brands throits wig G
service or feeder fee, fast 56.18 3�p a 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: M'iscellaneoas (server or feeder not iaafided)
Ci /State/ZIP: Each manufactured or modular
67_&1 2
ty dwelling, service and/or feeder
Phone: ( )
I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal timings) or limited -energy
Business name: / Q2o (9 e S r V t c � 7 panel, alteration, or extension. Page 2 2
l7`v � - � Each additional inspection over allowable in any of the above
Address: ( 3 - i S ' , (2,A.(00. / £4) Additional inspection (I hr mire) 66.25/ in / Q Investigation (1 hr min) ' 6625/ hr
City/State/ZIP: n � n ) C j 7 , l 70, (r Industrial plant (I hr tee) 78.18/1w
Phone: 4,5) 1 4 D1 - , L / _ I Fax ' J Inspections for which no fees 9D.00/ hr
l lf � �I�! specifically listed (% In min) _
CCB Lic.: 1 q 6 co ' / I Electrical Lic.: e Z c . Suprv. Lic.: � L.1( 5 ELECTRICAL PERMIT FEES
Suprv. Electriciail'SI , ', , required: /DA /, 3 Subtotal: ,.."4 • l7
C/ l Plan rev eon (25%of permit fee): `- - / -
Print name: f t p ax !4 (-A 1.,) Date: a J ( `1 ( ( 3 Stare sine (12% of permit fee): (� •7 e
TOTAL PERMIT FEE: & ( 9,,, 9 2
Authorized signature:
This permit application expires if a permit a not obtained Wilda 1S0
�� days after it has been accepted as complete
Print name: �F/p �Cf,1 fJ ' Y� 4, J i Date. i ii ( • Number of inspections allowed pa permit. •
i1Pa
BEtudd .c- Paseb 07/01/10 App.dor 07/0107/01/10 0 ` � l 440-4615T111/05/COMIWFB
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
11530 SW TIEDEMAN AVE, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
02/25/2013 00:00
ELC2013-00104
PASS - No C of O
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
11530 SW TIEDEMAN AVE, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
02/25/2013 00:00
ELC2013-00104
PASS - No C of O
Violation Summary:
Inspector Contractor