Permit 11111 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC201300521
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/03/2013
Parcel: 2S 110AA00600
Jurisdiction: Tigard
Site address: 10650 SW MCDONALD ST
Project: 7-11 Subdivision: KING CITY TERRACE CONDO Lot: 3-6
Project Description: TI for counter appliances.
Contractor: ADVANTAGE ELECTRIC INC Owner: TEXLAND PROPERTIES CORP
814 SE 46TH AVE TAX DEPT#16394
PORTLAND, OR 97215 PO BOX 711
DALLAS,TX 75221
PHONE: 503-235-5854 PHONE:
FAX:
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 09/03/2013 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/03/2013 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 952-001-0090. You may ob: :copy of =irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. . +
Issued By: Permittee Signature:
%r
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.
Aug 29 13 02:24p Advantage Electric CC°It 5032363913 p.1
Electrical Permit Application ` FOR OFFICE USE ONLY •
Received
71 City of Tigard ��� Datc!Bv: / / Permit No. 'L C�i -,
13125 SW Hall Blvd.,Tigard,OR 9 `\ ® _glan Review. 3
Phone 501718.2439 Fax: 503.598. 960 QU� !�Vse.\1tV,�r/gv;
Other Permit:
'TI GA R D Inspection Line: 503.639.4175 �ryr e�\�Cj Date Ready/By: H sec Page 2 for
Internet: www.tigard-or.gov �J� ®\v Nohfiet Method: B1 Supplemental Information
TYPE OF WORK \v.
e� -
PLAN REVIEW
❑New construction ""Addition/alterationtr::acement Please check all that apply(submit 2 sets of Flans whtems checked below):
❑Demolition III �(j��; ❑Service or feeder 400 amps or more ❑Building over duce stories.
where the avaitable fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
�/ Icas to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ 1-and 2-family dw•oiling `ommercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system, larger separately derived system,
❑Addition of new motor load of ❑'A ,"E","1.2","l-3
+ /) C, 01G ,n�I 1 )00HP or more. occupancy.
Job no.: Job site address:l v JI/�f 1� �j
ter- / V ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: ) , rd ` 6Z, C 22 L4 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Projcct name: .7_ II ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
Docrf Pclon I Qty. I Yee. I Total 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.add'l 500 sq.11.or portion 33 92 1
Tax map/parcel no.
Limited energy,residential
DESCRIPTION OF WORK (with above sq.1L) 75.00 2
„r. Limited energy,multi-family
�V OI i i t rt�ril {�. a ( l rCC.i i't residential(with above sq.tL) 75.00 2
,� l
Renewable Energy ❑ Sec Page 2
LQ r�df( �C r cram-r= r7/)i r C4ei .e� 4-Ad e d r� Services or feeders installation,alteration,and/or relocation
❑ PROP OWNER _{J��J ❑ TENANT i-i .e - 200 amps or less 100.70 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/ZIP: Over 1,000 snips 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 properly that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,ront,or cxchanee,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Brunch circuifa-new,alteration,or exlcnsiort, or panel
,APPLICANT .0 CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
Business name: each branch circuit 7.42 2
A aut-4 n a�e_ r�c-t rr c.�
B.Fee for branch circuits without
Contact name: t� f--p er;, r fey"i service or feeder fee,first 1
1C 1 branch circuit 56 18 s6-,-t3 2
Address: �J Each arld'I branch circuit 4r '. 7.422f-/,6R 2
Miscellaneous(service or feeder not included)
City/Slate/ZIP: Each menulbczured or modular
67.84 2
Phone:cs-c,.Z} 7. ,g-z?7 Fax::( ) dwelling,service and/or feeder .
Reconnect only 67.84 2
E-mail:
CONTRACTOR Pump or irrigation circle , 67.84 2
Signor outline lighting , 67.84 2
Business name: l �1 QC.r�-:e� Signal circuit(s)or limited-energy Se
panel.alteration,or extension. I Page 2 2
Address: 63 i t s'), /'fLv (e Each additional inspection over allowable in any of the above
U Additional inspection(11tr min) 66.25/hr
City/StatcfZIP. 1 6G,(.4, 0 62_ ' 7 ZIc-- Investigation(1 hr min) 66,25/hr
i Phone: v ,) •2 g� '.1 Li Fax:( ) ' Industrial plant(1 hr ruin) 78.18/lnr
r� . r spections for which no tee is
CCB Lic.:%lam �'° t2 lectrical Lic.��2 Suprv.Lic.:�—j�/�S specifically listed('t4 in mine 90.00/
Suprv.Electrician sign ature,required 7/i (��I '/3 ELECTRICAL PERMIT FEES
Subtotal: 85 r 86
Print name.., , ` r Date:Q 26,7 ' l•? Plan review(25%of permit fee):
sr C� J State surcharge(12%of permit fee): j O. 3c) 7,-'
Authorized signature: . ',.-.,.-- -_' TO'I'AI-PERMIT FEE: ' -;16-
mi.permit application expires if permit is not obtained within 180
Print name: �{ r G. Date: 2 days after it has been accepted as complete.
" Number ofiaspections allowed per permit.
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