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HomeMy WebLinkAboutPermit CITY OF TIGARD ELECTRICAL PERMIT NI 2. COMMUNITY DEVELOPMENT Permit#: ELC2013-00535 T I GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2013 Parcel: 2S 102AC00202 Jurisdiction: Tigard Site address: 9110 SW BURNHAM ST Project: Ferguson Enterprises Subdivision: BURNHAM TRACT Lot: 3 Project Description: (11)branch circuits for TI Contractor: WILLAMETTE ELECTRIC INC Owner: MILLER, PRUDENCE M TRUST PO BOX 230547 BY PRUDENCE M MILLER TR TIGARD, OR 97281 4220 SW GREENLEAF DR PORTLAND, OR 97221 PHONE: 503-624-3631 PHONE: FAX: 503-624-2938 FEES Quantity Description Date Amount 11 crt Branch Circuits wo/Purchase 09/10/2013 $130.38 Specifics: Service or Feeder 1 ea 12%State Surcharge- 09/10/2013 $15.65 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $146.03 Required Items and Reports(Conditions) This permit is i - .•ect 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• accordance with =•proved 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. ENTION: Oregon la es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through OAR 952-0s -0090. Y•u ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80 . 2.2 44. / Issu=• By: � � ���-� Permittee Signature: 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' � �. �• ati°, <<�fe Date: LICENSE NO. eil l s 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 ApplicatiooEQEl V ED FOR OFFICE USE ONLY City of Tigard 9 Date/B : /(4 , Permit No.: ESC do/5-,4053s- - 13125 SW Hall Blvd.,Tigard,OR 97221': 1 0 "13 Plan Review C, • Phone: 503.718.2439 Fax: 503.598.1960 Date/13 Other Permit: / u / -6,o/ TI GARD Inspection Line: 503.639.4175 Date Ready/By: Juris: RI See Page 2 for Internet: www.tigard-or.gov CITY OI'TIGARD Notified/Method: Supplemental Information GDW.Iy S IO,. N. ; '7 `l' ,'v 4�FU hfi .•__' � � � a:°.:•k d' Yh w faa„: drijar r ❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. / "' ' Y�'4-".` oli'V' oi,C S;1 �.r. .',CATE , ;-- ORUCTIOr..;.:::r t t •':,,4'• ==r-% , exceeds 10,000 amps at 150 volts or 0 Floating buildings.s. $ less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ 1-and 2-family dwelling g Commercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or x -..," <q, ;r.rte«!.M, F^�-�•. - i •.. •„,,-_ • s; ,. - , ❑Emergency system. larger separately derived system. ''';•! 11 .•'dS1T i I FO MATZO AND LOCATION; ''',.',- '3 � N - ., 0 Addition of new motor load of ❑ 100HP or more. occupancy. Job no.: g �}Job site address: /// S Gu irr,A. ,4 m �� ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: �` I / lJ ,l ❑Health-care facilities. ❑Supply voltage for more than /f 2 ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: TProject name: ❑Service or feeder 600 amps or more. Cross street/directions to job site: Description Qty. Fee. Total • - 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'I 500 sq.ft.or portion 33.92 1 Tax map/parcel no.. Limited ' energy,residential 75.00 2 2. r"" ^lIA IDS o ,it5W.;OFW01ZK' ' 0 ,;:rO ,;. (with above sq.ft.) Limited energy,multi-family 75.00 2 7—e ex.e , �M Pro t/ e,�Yrl r-- residential(with above sq.ft.) Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation ❑•PROPERT,Y•,--O+WNE%l^ sy; ,.I •❑�:T,EN1,6it;t'--.a ,._. ,t'? 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 Over 1,000 amps or volts 552.26 2 City/State/ZIP: 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 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits-new,alteration,or extension,per panel ^'`• .,•F ' '': ' A.Fee for branch circuits with 6 `Y:;[IPP1CA1 0•CO1V>�GP PFRSOIVr +^ � *� �'"' � :". , '. ' ,��, . --. • ���' above service or feeder fee, Business name: each branch circuit 7'42 2 B.Fee for branch circuits without Contact name: service or feeder fee,first / 56.18 SG '- 2 branch circuit Address: Each add'I branch circuit /p 7.42 77 1,--- 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( ) Fax: :( ) dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 ?,. ;nt, :.h�^��p�, ,�--p.��,•Met.f�>l �r,a�.. >'.r..,. ,_.i:--'. ., . _ :�'.';. Y;:.'44...0 '� ;. .%77 -r.' xi's".�€��^ :k0,p.,�JCTO �.?:..,�, y.;:,;,, ii Sle.s.,-�� .�.. F.:_;�„.ni��,r,,�• Sign or outline lighting 67.84 2 Business name: ( /(/ /� ,%7/ Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address: ,Q c /J-0 s-e7 Each additional inspection over allowable in any of the above .�f� [�L Additional inspection(1 hr min) 66.25/hr City/State/ZIP: l i'f .( } ©� c/c / .ems ..1,30. // Investigation(1 hr min) 66.25/hr Phone:( z Fax:( 6 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.:'7�,5-r ? El ctrical Lic3����! Suprv.Lic.r sr cificall listed 'A hrr min �j 90.00/hr r b�(�1/5 ". t`'rrira' t:' ,Jq,-j "�`V-ra.� lt)��/1 'i sit r�. .r' 4.. Suprv.Electrician signature,required: Subtotal: /3 p 3 Print name' k . �k-�-f, Date: Plan review(25%of permit fee): ��� / State surcharge(12%of permit fee): 1 S -oj Authorized signature: TOTAL PERMIT FEE: /Wes 0 3 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440.4615T(11/05/COM/WEB