Permit • CITY OF TIGARD ELECTRICAL PERMIT
- / 6 g PERMIT #: ELC2006 -00530
r DEVELOPMENT SERVICES / DATE ISSUED: 9/20/2006
° II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 25111 DD - 05800
SITE ADDRESS: 15930 SW STRATFORD LP ZONING: R -4.5
SUBDIVISION: STRATFORD LOT : 055 JURISDICTION: TIG
Project Description: (4) branch circuits. Job # R - 06 - 1037.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
BILL MAHER ABC ELECTRIC
15930 SW STRATFORD LP 135 NE 9TH AVE
TIGARD, OR 97224 PORTLAND, OR 97232
Phone: 503 - 620 -5448 Contact #: PRI 503 - 233 -7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: ELE 161501
[ELPRMT] ELC Permit 9/20/2006 $66.80 LIC 26 -1226C
[TAX] 8% State Surcharge 9/20/2006 $5.34 SUP 5096S
Total $72.14 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: - - Permittee Signature: j _xR, 0
OWNER INSTALLATION ONLY \1
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'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
k. f
Electrical Permit Application FOR OWF10E USE ONI.V Received City of Tigard SEP 2 0 2006 A Date/B . ^ .- I • PemutNo: /0, OD 6
13125 SW Hall Blvd., Tigard. OR 97223 Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
` ' Date/B .
Inspection Line: 503.639.4175 • .. " . .._,... „A : _ Bate Ready/By: ® See Page 2 for
Internet: www.Ci.tigaid Or.uS r .. ... 7 ., i ,, ." Notified/Method: Supplemental Information
' • • TYPE OF WORK , ... PLAN REVIEW '.',;
Please check all that apply:
❑ New construction " Addition/alteration/replacement ❑Service over 225 amps, cnmm'I ❑Hazardous location
❑ Demolition ❑ Other ❑Service over 320 amps -- rating ❑Buildngover 10,000 sq. ft.,
- CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑System ova 600 volts nominal units in one structure
IS) - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑Feeders, 400 amps or more
❑ Building over three stories mP
❑ Multi- family ❑ Muster builder ❑ Other. ❑Occupant load over 99 persons ❑Manufactured structures or
' JOB SITE INFORMATION AND LOCATION .. ❑E plan RV park
Job no.: Job s a jr`
❑Health -car's facility ❑Other:
e .( • 4S Q Q S W fYf l�' ford Submit sets of plans with any of the above.
City/State/ZIP: O-c i D 12. (7� The above are not applicable to temporary construction service.
ti: FEE*. SCHEDULE ' ,
Suite/bldg. /apt. no.: Wroject name: m a lr Description k va• Fee. I Total I •
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage. -
1,000 sq. R. or less 145.15 4
Subdivision: I Lot no.: Ea. odd'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
.'i:. . `; - J ESCit1PTION OP WORK: .. Each manufactured or modular
/ dice r dwelling, service and/or feeder 90.90 2
( /,,� / - /� C (.L I �� S Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
. ..,.
201 amps to 400 amps 106 85
: ❑ TENANT .
�� YRoPERTY OWNER � . ' 401 amps to 600 amps 160.60 2
Name: t b� / /4i h 601 amps to 1.000 amps 240.60 2
Address: 5 g 30 G ,f ford' I p Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
Cily /Statc/Z1P: jel , ar„,/ VIZ q 7e= -DY Temporary services or feeders Installation, alteration, and/or
1 relocation
Phone: ( ) SY (.i V Fax: ( ) 200 amps or less 66.85 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 _ 2
Owner signature: Date: Branch circuits- new, alteration, or extension, per panel
'
E APPUCAN�' ; , l , 0 �CONTACr PERSON : A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: Nbc ��� c .. branch circuit
B. Fee for branch circuits
Contact name: IL Q w -" without service or feeder fee, / 46.85 4/4 2
each branch circuit
Address: Each add'I branch circuit 3 - 6.65 / ft 9 ' 2
City/State/Z1P: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
.:,... , ,.. . ' ' " '-... .. ' ::CONTRACTOB energy panel, alteration. or
extension. Describe: Page 2 2
Business name: I`L'K , k...- 4 Ct f i C
Address: C gut- ( � Each additional inspection over allowable In any of the above
�5 - Q -► 1 ` � ��v - � Per inspection 62.50
�-\ City/State /ZIP: \C>. — c' Q�e7 Investigation per hour (I hr min) 62.50
Phone: Fax
Industrial plant per hour 73.75
• • .: : ELECTRICAL PERMIT FEES'': :: ' '.: ;..
CCB Lic.: /( /3-0 1 I Electrical Lic.Veo _ / I Suprv. Lic..9 6 Subtotal (06 SD
- Suprv. Electrician signature, required: Plan review (25% of permit fee)
State surcharge (8% of permit fee) 6dt
Print nameshU Ih JAD D /1.121 o f Date: 19 l
TOTAL PERMIT FEE - X24
Authorized signature: r• This permit application expires if a permit is not obtained within 1130
•
,'r days after It has been accepted as complete
Pratt name: 11 1 SL1 Q .( ( I Date: /fo�', • Fee methodology set by Tri -County Building Industry Service Board
•• Number of inspections per pem it allowed.
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