Permit CITY OF TIGARD ELECTRICAL PERMIT
' - COMMUNITY DEVELOPMENT Permit#: ELC2013 00482
T I G ARE) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2013
Parcel: 1 S133CC80102
Jurisdiction: Tigard
Site address: 14180 SW BARROWS RD 2
Project: Cochran Subdivision:SCHOLLS VILLAGE CONDO STAGE 3 Lot: 10-2
Project Description: Electrical reconnect only
Contractor: Owner: COCHRAN, DANIEL C
14180 SW BARROWS RD 10-2
TIGARD,OR 97223
PHONE: PHONE: 770-870-4148
FAX:
FEES •
Quantity Description Date Amount
1 ea Reconnect Only 08/15/2013 $67.84
Specifics:,
1 ea 12%State Surcharge- 08/15/2013 $8.14
Electrical
Type of Use: SFA
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $75.98
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 i - • •-nce 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 •TTENTION: Or-_•n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 001-0010 th ough OAR 9'•-'• -'.90. You may obtain a copy of the rules or direct questions to OUNC by calling 503. 987 or 1.800.332.23
Is ed By: t Permittee Signature: rx
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.
•
Electrical Permit ApplicatiECEIVED ruH OFFICE USE(1N-1_1'
Received 1���
City of Tigard n��(� 1 5 �e,B Permit No.: Pe-{/c9.‘" j g
13125 SW Hall Blvd.,Ttgard,OR 97243 2013 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 Dare/B : Other Permit:
T Inspection Line: 503.639.4175 CITY OF TIGARD Dare Ready/By: ,tins:
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method:
TYPE OF WORK Print name: Dat
❑New construction ❑Addition/alteration/replacement
III Demolition [J�.Ot ier: PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked below):
CATEGORY OF CONSTRUCTION p Service or feeder 400 amps or more ['Building over three stories.
❑1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building where the available fault current ['Marinas and boatyards.
❑Multi-famil exceeds 10,000 amps at 150 volts or ❑Floating buildings.
y ❑Master builder ®Other. less to ground,or exceeds 14,000 ❑Commercial-use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other installations. buildings.
❑Fire pump. ['Installation of 150 KVA or
Job no.: I Job site address: I4(t3p S, yarn ws ❑Emergency system. larger separately derived system.
['Addition of new motor load of ❑°A",°E",`1-2",°l-3",
City/State/ZIP: TtGto►Ct-O r 0 Q g'? Z 2 3 100HP or more. ocamancy.
❑Six or more residential units. ['Recreational vehicle parks.
Suite/bldg./apt.no.: Z I Pro J ect name: ❑
Health-care facilities. ['Supply voltage for more than
Cross street/directions to job site: W0 M1V rr0W S ❑ Hazardous r feeder 600 volts nominal.
❑ Service or feeder 600
amps or more.
FEE SCHEDULE
Subdivision: I Lot no.: Denatmlon I Qtr. I Fee. I Total I•
New residential single-or multi-family dwelling unit.
Tax map/parcel no.: Includes attached garage.
DESCRIPTION OF WORK 1,000 sq.ft.or less 168.54 4
` 1 t Ea.add'l 500 sq.ft.or portion 33.92 1
F� C IIYlk. 1 n S 4..4 1 d G Limited energy,residential
l (with above sq.ft.) 75.00 2
• dr Limited energy,multi-family 75.00 2
X PROPERTY OWNER I ❑ TENANT residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Name: be h ; ,cA cc,GLr ct- Services or feeders installadontaloeration,and/or relocation
200 amps«less 100.70
Address: 141 6 ce. sw S oUs � -A..,-,..1....--,
201 amps to 400 amps 133.56 2 2
City/State/ZIP: iS 2 ewe{la" k 0 Q. q do o-I 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:('T?0)Ti O . y„t Lt$ I Fax:( ) Over 1,000 amps or volts 552.26 2
Owner installation:This installation is being made on property that I own which is not Temporary services or feeders installation,alteration,and/or
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. relocation
Owner signature: Date:ill(1 SI CS 200 amps or less 59.36 1
-❑ APPLICANT I L CONTACT PERSON 201 amps to 400 amps 125.08 2
401 amps to 599 amps 168.54 2
Business name: Branch circuits-new,alteration,or extension,per panel
n --- A.Fee for branch circuits with
y
Contact name: \13 rm.*, above service or feeder fee, 7.42 2
each branch circuit
Address: \l°k 1(e s w c '_.tli (�� it ea ri l 2..Z 7 B.Fee for branch Circuits without
"�'` �' "I service or feeder fee,rust
56.18 2
City/State/ZIP: �n.. v e_ R—(�1 branch circuit
Each add'I branch circuit 7.42 2
Phone:(5.'3) 20O. 1(12 ey-c I Fax: :( ) Miscellaneous(service or feeder not included)
E-mail: QC S1 V[.r est II MO.: 1 _C pM Each manufactured or modular 67.84 2
CO C dwelling,service and/or feeder
Reconnect only 1 67.84 ,eg 7.gy 2
Business name: Pump or irrigation circle 67.84 2
Address: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy See
City/State/ZIP: panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Phone:( ) I Fax:( ) Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
CCB Lic.: I Electrical Lic.: I Suprv.Lic.:
Industrial plant(1 hr min) 78.18/hr _
Suprv.Electrician signature,required: Inspections for which no fee is
specifically listed('4 hr min) 90'�hr
\\s- ELECTRICAL PERMIT FEES
Print name:' 1 1� Date: 8 13
'r G`"^ Subtotal: ?,g`f
Authorized signature )Q 0 J� Plan review(25%of permit fee): �'
State surcharge(12%of permit fee): g•pi
I:tBuildiugtpermns\ELC_PetmitApp_ELR_EREAoc Rev 0521/2013 440-4615T(11/05/COM/WRB
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