Permit CITY OF TIGARD 0 5 ELECTRICAL PERMIT
a ' '
PERMIT ISSUED ELC2006-00672
COMMUNITY DEVELOPMENT
DATE ISSUED: 11/27/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 DC - 12500
SITE ADDRESS: 15940 SW OAK MEADOW LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.11 LOT : 621 JURISDICTION: TIG
Project Description: Panel change. Job # 8545.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 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:
RICHARD DUNN WILLAMETTE ELECTRIC INC
15940 SW OAK MEADOW LN PO BOX 230547
TIGARD, OR 97224 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 11/27/200( $80.30 LIC 75059
[TAX] 8% State Surcharge 1I/27/200( $6.42 SUP 1965S
Total $86.72 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: r T'.. Ca
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'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.
III NOV 27 2006 8:01AM WILLAMETTE ELECTRIC 5036242938 p.2
LA- ctrLcal Permit A t, . ,, :,u! Iv FOR (1FFICE l!SE ONLY
.
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1 Received /! i /�
City Tigard Date/B ' _ - l e 4 Permit N o . C.LC. CiaO(J I - o6 k Z-
1 3125 SW W Flail Blvd., Tigard, OR 97223 200 ' Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 %' N e w /Br ,.�, 'IIIrIP, Date/By: Other Permit:
Inspection Line: 503.639.4175 1 f1G� r "i, Date Rcady /By: Jura la See Page 2 far
Internet: www.ci.tigard.or.us Q t N `` Notified/Method: Supplemental Information
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❑ New construction ', i Addition/alteration/replacement Please check all that apply:
['Service over 225 El Demolition El Other:
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_ ,, _ .- _ : . ii -. .,. �,,.....,..�.._ Service over 320 amps c rabng l ❑Bui dng over 10,000 sq. ft.,
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,. - _ _ 1� - _ __ - _ of 1 - end 2 family dwellings 4 or more new residential
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p ...1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building OSystem over 600 volts nominal units in one structure
❑ Multi - family El Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
_,_ si ; . -=1 l �aeean mrn a - =a ❑Occupant load over 99 persons ❑Manufactured structures or
.iii. ........2: :: "7:lia;'' , : . : `` . �3 t t 1'�1i ` �gt4 Fk :-- �l!s2.1- 4!P ! ❑E Egress/ htin Plan RV park
SJ :� : .� },.If�- �� a,,.,n .a: -- -1--1 _ -__ -�_ � - -_ � 8 8 P ■ 614d01.17 � -U Health -care facility ['Other: Job no.: Sys Job site address: /6 -- dip / -1 , ubmit 2 sets of plans with any of the above.
City /State /ZIP: 7 A ar/ / ye 9/14Z/1 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: 7141,,,,.,-‘1 ,[4,,,,,k, ,.
Description 1 Qry. -. Fee. .. - ' I . .. Tomb I .. : ••
Cross strcet/directions to job site: New residential single- or multi - family dwelling unit.
locludea attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.:
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_ • • ,----.-•---,-, :j _ Limited energy, non - residential 75.00 2
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1) / • ,/ dwelling, service and/or feeder 90.90 I T 2
i'� C► Services or feeders installation, alteration, and/or relocation
. 200 amps or less / 80.30 O o 39 2
I° atc`atl ;' . -_ 20 I a mps t o 400 amps 106.8 5 2
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� ` ; „ n ._...___ _ '' - - <_ - ` 401 amps to 600 amps 160.60 2
Name: -� ,k__,. 601 amps to 1,000 amps 240.60 2
Address: _A� Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders Installation, alteration, and/or
Phone: ( ) 1i\ /() I Fax ( ) 200 c 2 amps -
` 0 or less 66.85 _ I
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
:1 - 1 11• , y : _ta;.ig : ;' i ^.: �. %.: ti .. : . __Q =,..: • a; ; _ - 0 ,, tn ; A Fa fo branch circuits with
:;r. i _ : . _ : , -! �f^ - service or feeder fee, each 6.65 2
Business name: branch circuit _
13. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 46.85 2
Address:
Each ad el branch circuit 6.65 2
City /State/ZfP: Miscellaneous (service or feeder not Included)
-
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
+
E -mail: . Signal circuit(s) or limited-
energy anel altetion
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'" �' ",' "' -" extension. Describe: Page 2 2
Business name: L;'I Ia,4h eat't L /ec tryc r..
Address: P Q fit plc s• 9 Each additional Inspection over allowable In any of the above
Per inspection 62.50
City/State /ZIP: Ti' g of ci O e 9 7 Z 8) Investigation per hour (1 hr min) 62.50
Phone: (5q3 ) 6 2 `/ 3 63/ Fax: (51a ) ‘Z Ni - Z 9 e Industrial plant per hour 73.75
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CCB Lie.: 750S e l Electrical Lic. : .3y'Z 7.3 4 Suprv. Lic.: V2 Z if -,S' Subtotal gQ, 3,0
Suprv. Electrician signature, required. - _______ •- --'" ' ---- • ' - - "•. Plan review (25% of permit fee)
-
Print name: Date: State surcharge (8% of permit fee) , , i
v �� TOTAL PERMIT FEE t r 7-L-
A uthorized signature: This permit application expires If a permit la not obtained within 180
days after It has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
s• Number of inspections per permit allowed.
i:\ Bu, idingtPem,itstELC•PennitAsp.doc 12/03 440.4615T(10/02/COtt' SB