Permit CITY OF TIGARD ELECTRICAL PERMIT
_ COMMUNITY DEVELOPMENT Permit: ELC2013 -00368
13125 SW Hall B lvd., Tigard OR 97223 503 Date Issued: 07/02/2013
TIGARD Parcel: 2S101AC01600
Jurisdiction: Tigard
Site address: 7100 SW HAMPTON ST 130
Project: Mainlander Subdivision: BEVELAND NO.2 Lot: 18 -19, P
Project Description: (1) 200 amp service and (7) branch circuits for new sub -panel and kitchen exhaust hood.
Contractor: TIMBERLINE ELECTRICAL CONTRACTORS Owner. NEIMEYER, JOHN
9414 SW BARBUR BLVD, #100 15 82ND DR STE 210
PORTLAND, OR 97219 GLADSTONE, OR 97027
PHONE: 503 - 459 -4089 PHONE:
FAX: 503 - 254 -4227
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 07/02/2013 $100.70
Specifics: amps or less
7 crt Branch Circuits w /Purchase 07/02/2013 $51.94
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 07/02/2013 $18.32
Electrical
Type of Const:
Occupancy Grp:
Total $170.96
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 -001- 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: b ' / L� /e/A 0
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 603.639.4176 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 licatio • Eiu'l—. f\IFI Foil OF'1 T. lSF. ONI.1
City of Tigard
___. - ' •
..---_, _..,, Received
Date/B . '7 .2 AIWA' P erm itN° r1C.20/ 3 —De -5 ti
, 13 1 25 SW run Blvd, Tigard, OR 97223 JUL 0 it 2013 Review
' Il Phone: 503.718.2439 Fax: 503.598.1960 Revi
DazeiB: Other Permit:
Inspection Line: 503.639.4175 Date Ready/13y: Mal El See Page 2 for
Internet: www.ligard CITY OF TIGARD OF Supplemental Information
El New construction ISI Addition/alteration/replacement Please check all that apply (submit a sets of plans whtems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition 0 Other where the available fault current 0 Marinas and boatyards.
.,..jekiiikiiii ...': -- : :: . ' --.' : - exceeds 10,000 amps at 150 volts or 0P/outing buildings .
less to ground, or exceeds 14,000 0 Commercial-use agricultural
0 1- and 2-family dwelling Eg Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Matti-family 0 Master builder 0 Other. 0 Fire pump. 1:11nstallaticn of 150 KVA or
- - --, . ' 0 Emergency system larger separately derived system
tift A14 . Lbeiiiti5S'
' -s- • . .' - - ••
Job no.: Job site address: 7100 SW Hampton #130 100HP or morc. occupancy.
0 Six or more emitters:is' units. 0 Recreational vehicle parks.
City/S'tatet7JP: Tigard, Or 97223 0 Health-care facilities 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominaL
17 no.: /3 o Project name: Mainlander 0 Service or feeder 600 amps or more.
FEE ; SE*DIJI,,E.:
Cross street/directions to job site: Desesiutton I Qw. I Fes, ( TOLal I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. addl 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
75.00 2
DESCRIPTION - - 1 ' •', I :- ..- - ::-.: : (with above sq. ft.)
Limited energy, multi-Esmily
New Sub yank with circuits for new Lichen exhaust hood residential (with above sq,..ft.) 75.00 2
-21 , '; ' ,•...:-.:,,...--..-:'.-;,.-,,---,
Services or feeders Installation, alteration, and/or relocation
''' , ::, H .1 - ... ‘, -.'-..::-.: . -.: ' - 1 - .: t1.%0414147i.: - . --.,: : :-t- . - ":--... ----- :. 200 amps or less 1 10030 10030 2
, . .• . .. ., . .
201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 - 2
Address: 601 amps to 1,000 amps 301.04 2
City/State/Z1P:
Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 to 400 a 125.0S 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 599 amps 16834 2
Owner signature: Date: Branch ciratits - new, alteration, or extension, per panel
- '-'-::- -^ .:. , i ', ■ ± , • . : :, ' tj Atit ;:.': ,. --. :::: .:-.: I , ....•-•,-. E l :aii : . .-, :-: . A Fee for branch circuits with
above service or feeder fee, 7 51.94
742 2
Business name: See Below each branch circuit
13. Fee for branch circuits without
Contact name: service or feeder fee, first
56.18 2
branch circuit .,
Address: Each addl branch circuit 7.42 2
City/State/ZIP Miscellaneous (service or feeder not included)
:
Each manufactured or modular
67.84 2
Drone ( ) I Fax: : ( ) dwelling, service and/or feeder
Reconnect only 67.84 2
E - Prunp or irrigation circle 67.84 2
67.84 2
—
Business name: Timberline Electrical Contractors Signal circuit(s) or limited-energy See
panel, alteration, or extension. Page 2 2
Address: 9414 aw Barbur Blvd #100 Each additional inspection over allowable in any of the above
Additional inspection (1 hr min) 66.25/ hr
CitylStexe/LIP-. Pertteatd., Ore 97219
Investigation (1 hr min) 66.251 hr
Phone: (503) 459 Fax: (503) 254 Industrial plant (1 hr min) 78.18/ hr
ON Inspections for which no fee is
CCB Lic.: 160037 3/2 L c : GO uprv. Lic.: 4957
i specifically listed (Y2 fir min)
/ 7 / 1 / 111 i il i i 1 19. ''' ''''':-.::'''';'. ' ''''F"'Crill'e44. 90.00/ hr
:'7"jsirr Eslf:':
Suprv. Electrician signature, required )( 1
Print name: Patrick • 'et:. e : Date: 7.1.2013 Plan review (25% of permit fee):
11 I
Authorized signature: , ALL__. State surcharge (12% of permit fee): TOTAL PERMIT FEE: 18.32
0 170.96
Print name: 11 5 1.41 Date: '7/1 I g This permit application expires If a permit is not obtained w1tbM 180
days after it has beat accepted as complete.
* Number of inspections allowed per permit.
BEtaiLding1Pennits \ELC PermitApp_ELR_ERE.doo Rev 05/21/2013 440-4515TO U0S/C01WWEB
Z0O/Z00121 IVA 9t:OZ ETOZ/0E/90