Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00270
TIGA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05!14/2013
Parcel: 2S 111 BCO2603
Jurisdiction: Tigard
Site address: 10310 SW CANTERBURY LN
Project: Heritage Park Modification Subdivision: TIGARDVILLE HEIGHTS Lot: 7
Project Description: (4) branch circuits and (1) 200 amps or less to wire bathroom
Contractor: INLAND ELECTRIC INC Owner: CITY OF TIGARD
360 SE BASELINE 13125 SW HALL BLVD
HILLSBORO, OR 97123 TIGARD, OR 97223
PHONE: 503 - 681 -4700 PHONE:
FAX: 503 - 681 -4738
FEES
Quantity Description Date Amount
4 crt Branch Circuits w /Purchase 05/14/2013 $29.68
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/14/2013 $15.65
Type of Use: COM Electrical
Class of Work: ALT 1 ea Services or Feeders - 200 05/14/2013 $100.70
amps or less
Type of Const:
Occupancy Grp:
Total $146.03
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 952-101 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
0.
Issued By: J Permittee Signature: ()M APP L.1 d4' 1OL3
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.
05/13/2013 15:29
58359RWEIVED CITY OF TIGARD PAGE 01/01
Electrical Permit Application
City of Tigard MAY 1 4 2013 R-i-a c ( 4 1 7, %*-- Permit No.: 9 3 .ove
1 - ; - - 13125 SW Hall Blvd., Tigard OR 97223 Plan Review rnik `jr 3
r;260/
111"c: 5°31131439 FM: , 5TITI6DFTIGARD Calor Pe
Daleirry:
Inspeetion Line: 503.639.4375 Date Ready/By: lad,: I M See Paw 2 ibr
Notified/Method: '1) (2 1 Suppkmental Informadon
1 i ';::" n : 111rrle 12 vAvw BUILDING DIVISION
.., : . 7 .. 2 . ... ' : ; =- .:::, , ;:i .;.
plesise chei.i all that net ly (Feibmit 2 sets errnns NirAtems e 1;2C lie d beim):
- El Nom construction 0 Addition/alterationheplatcm ent
0 5c! or fccdcr 406 amps pf more IM Minding crvcr tfirce :italics.
0 Demolition 0 Other: - where the ihallable fault =reed 024u nrni boatyard&
. . (m 1,0 1
6 'Imps la 50 volls or Li Floating 17n
.. ...'.:...'".::..., . ,..;,•.', ...tt*tirdjtqtt . ;'Okeilittrtlr ' . . . Nae& 10
•
. . , .. .. . „. . . . ,. „ , ... . - leg , or exceeds 14,000 0 Ceirincreial-use agricultural
0 1- end 2-tinily dwelling 0 Commercial/industrial 0 Acer..ory building amps Ear an Mgr installion& building&
0 Multi-family CI Master builder 0 Other: 0 Fix gnaw 0 Inotoltrition of /5 KvA or
. . 0 Encracncy *mum. larger separately derived ay Oen.
',.:. ,' '.
. • • . • ' DAddition uflew maw teed of El 'A''. 'V, - 1-2", "1-3",
100HP or more. occupancy.
Job no.: „,..5b0) I Job site address: r ; Ca ,,S C-4 C,c "t v.I i , ['Six to MON residentlal units. [3 Recreational vehicle patio.
City/Slate/ZIP: 7 (3 le...- c III, V 0 H facilities. 1:Is voltage for mere guln
13Haeardens locrtrienr. WO ve119 nominal.
Suite/bldg./apt. no.: LProjeet name: I -19, \A i pt IL
' .. L
Cross stmet/dire4tions to job site:SC-I qlra . C...c...7.-. 'b i IN _ °e"Til"k"
I I tsty. troe6 I 'we w T •
New residential single- or molti-fstnily dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,0ce sq. It or Ima 168.54 4
Ea. 26;1'1500 sq. It or portion 3392 1
Tat map/parcel no.:
Limited energy, residential i
75,00 2
. ' . . ' . • ., :: - 1 '''' ' '" ... ilt$4 . . . . .
(with above sq. It)
.
Limited energy, nrnifidtellily
75,00 2
n 0 ,, 6 -c-irv 1.- N...1 I It.• 1 6 C:t`.111 residential (with abOVC Sq. RI ,
Renewable Enervi 1:I See Page 2
Services or feeders Installation,alteration and/or relocation _
:0 T - '. 1
":' .. ' ...::'..... ... : , . : ; : • 0 'min 20 m 0 aru or len f , 100.70 tr -.... 2
201 Amps wane arra; 133.56 2
Null*" C‘ G CA.6-`fL .1 401 amps 1o600 amps 2.0(134 2
,...fr
Address: - -,.1._ 1 ' , Is si,„.; t c ,\,\ 14(4 k 601 amps to 1 . 0 00 =IPS IMAM 2
Over 1,009 amps or volts 55126 2
CitY/StaledZIP: — . 11 .. t 0„-( Q:31.4..,. V\ )..:1-3 Ternporary services or feeders installsMon, atteratioo, and/or
Phone: (S.SS ) (., •e\ Li
Fax: (Sol) (0`6 a ---) relocation
200 amp cr lcsis 5.36I 1
Owner installation: This installation is being made on property Shot J own which is not
201 amps O 400 amps 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. „ .
401 amps to 599 amp 168.54 2
Owner signaturc: Date: Branch circuits- new, alteration, or extension, per panel
. . . • . CIA0111:4iirre :' . - ., ; '-.. ..k. ....;. . EtairtrAcr PERSON .. A. Fee for branch circuits with
.c
above service or feeds.' rte.
7.42 .1.1 2
Elosincss name; each branch circuit
B. Fee For branch circuits without
Contact name: service or feeder fee. first 5618 2
baud circuit
Address: Eneh add'Ibranch circuit 7,42 I 2
Mircelbueous (service or feeder not included)
City/Stateal P!
Esch manufactured ar modular
67.84 2
Phone ( ) I Fax: : ( ) dwelling, service andlut Rader .._
Recomect only 67.84 2
E-mail: Pump or irrigation eireie 67.1 2
67.84 1 2
Business name: — r.,__,„,..\ G ...,._ Il (...\_ T.t (... x tie- (.._._. &gra] circuito) or limited-energy I
panel, altera lion, or as:tension. Page2j„ 2
Address; 3 (., St. il .SA- Each additional inspection over allowable in any of the above
Additional inspection (I lir min) 66.25,116
City/State/ZIP. li\-N\ .c, 4.„ c c 1 -
investigation (thr min) , , 66.2/ hr
Phone: (Sell) ( % 1 L4 0 cz. i Fax: (SQ1) (,,4 . 1 1.--1-)% Industrial plant (1 hr min) 711.18/hr
bisection s far which no fee is
CCI3 Lic.: VS 1 (S_ I EleCtriCel Lie-3 4 Sc C I CI Suprv. Lie.: S, 5 C C specifically lifted f'A hr minL 90.001 hr
Suprv. ElectricizaiW:Aquired:1 VI s t? 5 lill lab. 113 •.:'.t;i:.... : .i: ,-:::.: : • •
.r.b ` Subtotal; il 30 , A
Print rl arke: ' WY - L.-A `2)0,\ c-5 [Date:s 1 )1) II Plan review as% of permit fee):
Stare surcharge (12% of permit fee): ‘ C i
Authorized signatare: TOTAL PERMIT FEE: 4,/ (, 4 (13
- This permit applleaden expires Its peretit IN ant ehtn?nerl widths 18)
Print name; Date:
days miter it nos been accepted as complete.
• :Number of Mapectiona allowed per went.
1:MeikEnnTrenitel.br.e_Ptrmi Opp 040913.doc 4■10.411157 I I /12iCOMIWErfl
L • d 99E0 09E09 'ON' 01H1.0313 CINV1N1 d90:C0 CI. EL /BI/\J
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10310 SW CANTERBURY LN, TIGARD, OR,
97224
Commercial - Electrical
199 Electrical final
2013-12-17 00:00:00
ELC2013-00270
PASS - No C of O
Violation Summary:
Inspector Contractor