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Permit CITY OF TIGARD ELECTRICAL PERMIT t; COMMUNITY DEVELOPMENT Permit #: ELC2013 -00400 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013 Parcel: 25109DA15400 Jurisdiction: Tigard Site address: 15272 SW GREENRIDGE PL Project: Hager Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 73 Project Description: (7) branch circuits for lighting upgrades. Contractor: MIKE'S ELECTRIC Owner: HAGER, DWIGHT & CARLA 11070 SW ALLEN BLVD 15272 SW GREENRIDGE PL BEAVERTON, OR 97005 TIGARD, OR 97223 PHONE: 503 - 649 -6991 PHONE: 406 -670 -9904 FAX: 503 - 641 -1902 FEES Quantity Description Date Amount 7 crt Branch Circuits wo /Purchase 07/16/2013 $100.70 Specifics:, Service or Feeder 1 ea 12% State Surcharge - 07/16/2013 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 0 52- 001 -0090. 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: o/ ' ' / /e / 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 503.639.4176 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. 07/12/2013 11:59 � Fl " #1964 P.001/002 Electrical Permit A HIE City of Tigard J L , l 13125 S W Hal] Blvd„ Tigard, O i� TI 2 ___ • P-mit Na.:ELIr�O /3 --0O 4 Phone: 503.718.2439 Fax 503Jyi.t y� N Da n B eview T n s lion Line: 503.639.417 I�LDING DIVISION R inri,, Permit "1'1i;.i ;tD � DU 1 Da tc RcsdYBy� r+„;s: El See Page 2for Internet. www.tigard- vr,gov Noti iod/Method: ,...::.., supplemental Information PLA\ l2EVTivW O New construction t:' Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /news checked below) Demolition �J Other; ❑ Service or feeder 400 amps or more ❑ Building over three stories. where the avxi(abic fault current ❑ Marinas and boatyards. �/ , .: C OF .:CO CTIO\ exceeds 10,000 amps at 150 volts or ❑ Floating building5- L1 1 and 2 dwelling [ Commercial /ind ustrial lcas CO ground. Of exceeds 14,000 ❑ Commercial -use ❑ Accesso building amps for an other installation. buildings. at; tcultumt ❑ Multi - family ❑ Master builder r Other: ❑ lire pomp. d instillation of I SO KVA or `•!''':•:..."•':.: ` . j91,.... S]TE .T FOIL1•L(y &\D LO(ATH)Ai — ❑Emergency system. larger separately derived system. • Addition of new motor load of C3 "A", "u'^ "1 -2 ", "1 -3 J s b no.: 3 J ob site address: a 1►_ 100HP or more. occupancy. +� � ' LE Six Or more residential units. ❑ Reacajenal vehicle parks. 04/City/State/ZIP T % i � 9 ^i j ❑ Health -4,re facilities,. O Supply voltage for more than Wr► p ' ` ❑ H �trdous loca(ions. 600 volts nominal. L Suitc/bldg. /apt, no.: I Project name: El Service or feeder 600 sutps or mote. Cross street/directions to job site: FEE Sfi1kF DL >r Dekcription l Wri ko r_ Total 0 New residential single or multi family dwelling unit. Includes attached garage. - Subdivision: Lot no.: 1,000 sq. ft or less 168.54 Tax Wrap /parcel no.: Ea. add'l 500 sq. IL or portion =N © ;'.DESCRiPT1(?� . N'ORK Limned energy, q. f residential (with above sq. ft.) 75.0 5�, `` • , Limited energy, multi tatnily 75.00 ww i residential (with above s•. ft. 2 II '�- .� l� .LL Imo {. __ Renewable.Ene • El See •c2 ` .. / r e'vals)X t -; > es or feeders installation, alteration, and/or relocation ;`Q OW\ER • I, . t �X l '' 2 0 TE>rA��'��3a. . 00 _ am p' or less 100.70 El Name: �i.� \a to ` - ` i — 0 amps to 400 amps r 133.56 El 401 amps to 600 amps MI 200.34 13 Address: 601 amps to 1,000 amps - 301.04 2 City/State/ZIP: Over 1.000 amps or volts 552.26 2 _ Temporary services or feeders installation, alteration, and /or Phone: ( (670, I Fax: ( ) relocation 200 amps or 1oSS 593 Owner installation: This installation is being made on property that I own which is not II intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 1 68.54 Owner signature: 401 amps to 599 amps 168.54 � Date; Branch circuits - new, alteration, or extension, • er panel u .4.114:C.ANT ^ D CO'_x'T'A(.`T PERSOI • A. Fee for branch circuits with above service or feeder fee, Business name: each branch circuit 7.42 2 B Fcc for branch circuits without Contact name I service or feeder fee. first i 56.18 5( I branch c ircuit Address: • Pack add'1 branch Cirtatit um `�� 7.42 to City/State/ZIP: vliscellaneoua (service or feeder not included Each manufactured or modular Phone: ( ) Fax: - ( ) dwelling, service and/or feeder I 67.84 E Reconnect only 67.84 Pump or irrigation circle 67.84 CO?t T ItA(7TOR Sign or outline lighting 67.84 El Business name: Mollenauer Enterprises, Inc. DR Mike's Electri c Signal circuit(s) or limited - energy I See �© cI, &relation, or =tension_ 1 P• c 2 Address: 11070 SW Allen Blvd. Each additional inspection over allowable in an of the above City/State /ZIP: Beaverton, OR 97(105 Addition] inspection (1 hr min) 6625/ hr r Investigation (1 hr mitt) { 66.25/ hr Phone: (503)649.6991 Fax: (503)641.1902 Industrial plant (1 hr mitt) 78.18/ hr CCB Lie.: 191094 Electrical Lie.: C643 I Suprv. Lie.: 4230S sp. slly listed (F hr min) for which no fee is P spy iftaadly I 90.00/ hr Suprv. Electrician signature, required: s. , ../ t i 4 • J ELECTRICAL • PERMIT FEES. Subtotal: ! ET4MM Print name: Douglas ' e! Plan review (25 %ofptaulit tee); M Date: ( //' State surcharge (12% of permit fro): MIK= Authorized signature: r �, 0 _ TOTAL PERMIT FEE: MIME -�� ca e xpires if a pemit s ot ntae Print name: Darryl Mol lerlhaucr Date: 1 I �1 f 2 Or / J This permit das'x appli aker tion i has berm ;tceep i as co(upobktcind within :0 . 1:113uilaing C_PCrm tApp_ELR F3.aq Rev 05/21/2013 ° Number of inspections allowed per permit. 140.4615T(i 1/0s/CUM/wE8