Loading...
Permit II CITY OF TIGARD ELECTRICAL PERMIT R . COMMUNITY DEVELOPMENT Permit #: ELC2013 00201 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/02/2013 Parcel: 1S125DB06700 Jurisdiction: Tigard Site address: 7095 SW SHADY CT Project: Ulmer Subdivision: SHADY DELL N0.2 Lot: 40 Project Description: New grounding due to repipe. Contractor: PRO CIRCUIT ELECTRIC LLC Owner: ULMER, SCOTT W PO BOX 3948 7095 SW SHADY CT WILSONVILLE, OR 97070 TIGARD, OR 97223 PHONE: 971- 563 -8211 PHONE: FAX: 503 - 266 -1349 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 04/02/2013 $56 18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/02/2013 $6.74 Type of Use: SF 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. ATTENTI • on law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952- 001 -001 rough OAR 9 -001-•! : You may obtain a copy of the rules or direct questions to OUNC by call' 1987 or 1.800.332.2344. Issued Ey` / Permittee Signatur r �4 • < < �� 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 OLJLY 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. Electrical Permit A heat] E City of 'Tigard EIVED FOR OFFICE USE ONLY R !3125 S�1' ('all 131vd, Tigard, 1312 Plume: W 503.639.417 g d OR 9� 2 2013 Da►B . VI, 1 Fax: 503,598 8 0 #110, Permit No.: Ez_edl3 -t��/ T1(3.\ ]; D inspection l J lc: 503.639A 175 Plan Review Internet: Date ' Other Pcrrail: C vw. rr.l igard- or.gov CITY OF TIGARD N Notified/Method: � , � 1 . ?0 - oo� _ — Please dreck all that a TYPE • � ) S') See Pane 2 for N ❑ NCW construction ._ ' , Supplemental Informa6 gAddition /altcration/replaccment AN REVIEW ❑ Demolition apply 2 acts of plans ❑ Other. O sery pp sr/items checked belly CA T O Other: service or fecdcr 400 amps or more OF CONSTRUCTION' where the available fault current Bui Iding over three stories. J -and 2 - family dwel ling ❑Comm exceeds l avail a, 0 Mantras and boatyards. Commercial/industrial D Accessory ups at 150 volts or 1:1 Floating takings. Multi- family ssory building less to ground, or meals 14,000 ❑ Commereia CI __ ❑ Maser builder am for al thv 4useag cuttra doll SITE INFO Outer: p o installations_ buildings. RMA,TION AND ❑ Fite pump. Job no.: lI OCATION OEaer Installation of75 KVA Or Job s address: gencysystem. _ 7, Q� �� ❑Addn imofnewm krgerseparately derived sys City /Stde/ZIP: f //t 1 C ]OOHP or mart. war load of Q A" W£,• •I_2 , �1 -3' occupancy. __ ❑Six or 'note resident is 1 units. y SuitC/bldgJapt_ no.: ❑Nrrllh ante facilities_ 0 Recreational vehicle parks. _ Project name: Service locations. Q Supply voltage /Of more than Cross street/directions to • ❑ Scrviec or feederGQO 600 volts nominal. J sate: �._ amps or more FEE SCHEDULE N n e v residential si�� Subdivision: gls~ or rnulli �family dwelling Includes attached garage. u aiL 100.70 Tax map/parcel no.: Lot no.: 1,000 sq. R. or less 111111111 i 168.54 – DESCRIPTION add'1 500 sq. it or portion 4 N, ; __ OF WORK Limited n-gy. residential 33.92 � '�D r �r f , > 67.84 2 Limited energy, tnulti- . R �� �" res id entia (w a II! ' ROP,ERTY OVr :YER Services or feeders installation, alteration, and/or relocation 2 Name: ❑ I ENANT 200 amps or leas V ( :( lil7�Z�_ 201 amps to 400 amps 2 Address: 401 amps to 600 amps = 2 �� 2 601 amps to 1,000 amps 301 City/Staic/ZIP: 3 � © Over 1,000 amps or volts Phone: ( re mporary services or feeders installation, alteration, and/or Owner installation. This insli ion is being elocation intended for sale, I rent, to g made on 200 amps or less e. exchange, according to ORS 449 6 which is not 201 amps to 400 amps i25'a8 59.36 1111111111 Owner signature: and 701. 401 amps to 599 amps �© • ❑ APPWC,�NI Date: Branch circuits – new, alteration, or extension, . Cr . and Business ❑CONTACT PERSON A. Fee for branch circuits with above service feeder fee, each b branch circuit it Contact name: h rcui B. Fce for branch circuits Address: without service or feeder fee, J first branch circuit 56.18 r ((� Ciiy /Sta[C/11P: Each add't branch circuit Miscellaneous service or feeder not included 2 E manufactured or modal Phone: ( Each manufactured E-mail: llin_ 11111:311111111 11111:311111111 for f ee d er Reco dwe Hol service Business n CONTRACTOR S 67.84 al nine: ' � O I` 1 Pump or irrigation circle L (� _ Sign or outline lighting 67.84 �m Address: _ .-L.. Sigenergy panel, circuits) or limited- 67.E i ii, C C eel, alteration, or Address: City/State/ZIP: extension. Descrihc: W� l�orti�ll P age 2 Phase: ate /ZI * �•7 _ 5 tom: s)-2,,!. r Each additional ins colon over allowable in an of the above CCB Lie.: Fay ( `J�3) Z(p(p (34 C' Per inspection • II ELECTRICAL -f ^� fnvc inspe io nperhotr(t hr mi tt ) 6625 �� Suprv- Electrician signature, required: b Suprv. Lic.: 57 O' {• 5 Industrial plant per hour 1 Subtotal Print name: Q • i `�--- ELE � ' ✓� _ ! f'1 � CTRICAL PERMIT FEES - Auth orizedsignalun: !V~ Date: : MEM y•. Plan review � (25% of permit fee): (25/0 Print name: – '�' 3 Slate surcharge (12% of permit fcc): Bill rcr,. Date: TOTAL PEl2Jv1! "!' ');: MOM Sa'amirsV:LGpermir.t This permit appJkiGon expires if n 1 PP.dac In/alAa9 permit a obtained within lRO /�/ 44O-46t5T(r r/oS/COM/Wrn • Number of i n after it has been accepted as complete. �'V" / ...r - . - _ . . Z'd 61?£699Z£09 014383 1! ad COL LO £L ZO add