Permit CITY OF TIGARD ELECTRICAL PERMIT
1114
COMMUNITY DEVELOPMENT Permit#: ELC2013-00556
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2013
Parcel: 1S134BC00300
Jurisdiction: Tigard •
Site address: 12220 SW SCHOLLS FERRY RD
Project: Greenway Town Center Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Temporary power
Contractor: WHISKEY HILL ELECTRIC INC Owner: FW OR-GREENWAY TOWN CENTER LLC
PO BOX 206 PO BOX 790830
HUBBARD, OR 97032 SAN ANTONIO,TX 78279
•
PHONE 503-981-4640 PHONE:
FAX: 503-981-4643
FEES
Quantity Description Date Amount
1 ea Temp Services or Feeders- 09/19/2013 $59.36
Specifics: 200 amps or less
4 crt Branch Circuits w/Purchase 09/19/2013 $29 68
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 09/19/2013 $10 68 •
Electncal
Type of Const:
Occupancy Grp:
Total $99 72
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 obtain a copy of the rules or direct questions to OUNC by calling 03 232.1987 or 1 800.332 2344
Issued By: '-— � Permittee Signature:
OWNER INSTALLATION ONLY �N U
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.
1
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received Permit No..
•J g �� Date/B I :ii �`G i ( _.00 SS q 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503 639 4171 Fax: 50 ..4:, •0, Date/By Other Permit
T I G A R D Inspection Line: 503 639.417 1I �3 Date Ready/By Juris 65 See Page 2 for
Internet www tigard-or.gov ' 1 9 to Notified/Method j�62 Supplemental Information
TYPE OF YY M� K 1 INGOioNA PLAN REVIEW
rkew construction ❑Addition/alteraiti~ 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: Q�,�`1l �� where the available fault current ❑Marinas and boatyards
CATEGORY OF C(11NS UCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling [ Commercial/industrial ❑Accessory building amps for all other installations buildings
❑ Multi-family ❑Master builder ❑Other: ❑Fire pump ❑Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived system
❑Addition of new motor load of ❑"A","E","I-2","I-3",
Job no.: //- Job site address: n /�nh Q/') IOOHP or more occupancy
p0C C/ /P'�Q/v gil- �a//5 ," ❑Recreational vehicle parks
� 0 or more residential units P
City/State/ZIP: / aid j' q%ate ❑Health-care facilities ❑Supply voltage for more than
❑Hazardous locations 600 volts nominal
Suite/bldg./apt.no.: ) I Project name:6-f eel,t v/�TC ❑Service or feeder 600 amps or more
J FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. 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'1 500 sq ft.or portion 33 92 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.R) 75 00 2
Limited energy,multi-family 75 00 2
TtM? PAR POtt -zoo Afrt j residential(with above sq ft)
1 Services or feeders installation,alteration,and/or relocation
200 amps or less 100 70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2
401 amps to 600 amps 200 34 2
Name:
601 amps to 1,000 amps 301 04 2
Address: Over 1,000 amps or volts 552 26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP: relocation
Phone:( ) Fax:( )
200 amps or less 1 59 36 6v:36 1
201 amps to 400 amps 125 08 2
Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168 54 2
intended for sale, lease,rent,or exchange.according to ORS 447,449.670.and 701.
Branch circuits—new,alteration,or extension, er panel
Owner signature: Date: A Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 4 7 42 �+"'/„�( 2
each branch circuit a
Business name: B Fee for branch circuits without
service or feeder fee,first 56 18 2
Contact name: branch circuit
Each add'I branch circuit 7 42 2
Address: Miscellaneous(service or feeder not included)
City/State/ZIP: Each manufactured or modular 67 84 2
Y dwelling,service and/or feeder
Phone:( ) ' Fax: :( ) Reconnect only 67 84 2
Pump or irrigation circle 67 84 2
E-mail: Sign or outline lighting 67 84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name: ex t l r) �' panel,alteration,or extension Page 2 2
p �� x5 t / [ Each additional inspection over allowable in any of the above
Address: D a/'� Additional inspection(1 hr min) 66.25/hr
City/Stale/ZIP:gubiO�`�'�y r 9 f21 a Investigation(1 hr min) 78 18/hr
98/_. viv/cio I Industrial plant for w whhr ich no 78 18/hr
Phone: Fax:( � /- �� 3 Inspections for which no fee is
specifically listed(V2 hr min) 90 00/hr
CCB Lic./ % 5 I Electrical Lic.: 3(P I Suprv. Lie.: �� Q/s ELECTRICAL PERMIT FEES
Suprv. Electrici signature,required: o Subtotal: of
Plan review(25/o of permit fee).
Print nam : 41,70/,i,g, ,',vs Date: 9//8//3 State surcharge(12%of permit fee): / 43 /
TOTAL PERMIT FEE: q�e 9,A ✓/
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit
I U3uddingTermns\ELC-PermtApp doc 07/01/10 440-4615T(1 I/05/COM/WEB