Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2013-00599
Date Issued: 10/09/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S102DD01100
Jurisdiction: Tigard
Site address: 13635 SW HALL BLVD
Project: Tanaka Subdivision: EDGEWOOD Lot: 7
Project Description: (1)200 amp subpanel and(1)branch circuit for GFCI
Contractor: D&L ELECTRIC INC Owner: TANAKA,TORU& FUSAE
PO BOX 367 PO BOX 19403
WEST LINN, OR 97068 PORTLAND, OR 97280
PHONE: 503-656-5623
PHONE: 503-780-7102
FAX: 503-650-1918
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/09/2013 $100.70
Specifics: amps or less
1 crt Branch Circuits w/Purchase 10/09/2013 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 10/09/2013 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
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: Ore o requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 952-00 -009 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: Oi/ e/ %ouei-T De./
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 603.639.4175 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.
Oct 06 13 11:58a D&L Electric Inc. 5036501918 p.2
Electrical Permit Application FOR Oil R E IS( OL\\ %.
Recei ed p I� //!-��t n�j
City of Tigard .� Date/B :ld 7 to Permit Np��p�/3 ry/0�99
• 13125 SW Ilall Blvd._Tigard,OR 9 .• t 01�
B pq 1. Plan Revic Other Permit:
II Phone: 503.718.2439 Fax: 503.598,19 1 ( C a DateBy:
Inspection Line: 503.639,4175 v\ ®��\rs aQ®bate Ready/By: Lois: . // H See Page 2 fur .
71Ci.1K17 p O v l?
otifiedn''Tethad: Supplemental Information
Internet: wwtiv.tigard-or.gov ���`
' TYPE OF WORKCJ�`e ��' • PLAN REVIEW
❑New construction ®Addition/alteratiori9 r�ment 'I Please check all that apply(submit 2 sets of plans w/items checked below):
D Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: where the available(suit current ❑Marinas and boatyards.
CATEGO'Y OF CONSTRUCTION exceeds 10,000 amps at 150 vehs or 0 Floating buildings.
less to ground,er exceeds 14 000 ❑Commercial-use agricultural
1-and 2-family dwcllin :7:1 Commercialiindustrial 0 Accessory building amps far all other instillations. buildings
Multi-family W Master builder 0 Other: ❑Fire plane. ❑Installation of 1501CVA or
P-4,4( c �,,y( ❑Emergency system. larr separately derived system.
01 S I NIMI IATION AND LOCATION ❑Addition of new motor load of ❑"A","E'."I-2","1-3",
Job no.: Job site address: 13635 SW HALL BLVD. I00HP or more. occupancy.
['Six or more residential units. 0 Recreational vehicle parks.
City:StateiZIP: TIGARD,OREGON 97223 ❑Health-care facilities. 0 Supply voltage For store than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: 7-7,9709--ell- ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Dereriptton I Qn. I Fm. 1 Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage. _
Subdivision: Lot no.: 1.000sq.fi or less 168.54 4
Ea.add'1 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: -
Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft) 75'00
Limited energy.multi-family 75.00 2
SUB PANEL ONE GFCI RECEPTACLE residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration.and/or relocation
® PROPERTY OWNER I ❑ TENANT 200 amps or less 1 100.70 100.70 2
201 amps to 400 amps 133.56 _ 2
Name:TORO TANAKA 401 amps to 600 amps 200.14 2
Address: 13635 SW HALL BLVD 601 amps to 1,000 amps 301.04 , 2
Over 1,000 amps or volts 552.26 2
City'State:ZIP:TIGARD ORE.97223 Temporary services or feeders installation,alteration,and/or
Phone:(503)780-7102 Fax:( ) relocation _I-I-!200 amps or less 59.36
Owner installation:This installation is being made on property that I own which is not 201 an to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
4.01 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits-new.alteration.or crtension,per panel
❑ APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 1 7.
7.42 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
branch circuit .
Address: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not induded)
City!State,ZIP: Each manufactured or modular
dwelling,service andlor feeder 67.84 2
Phone:( ) Fax: ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
•
CONTRACTOR Sian or outline lighting 67.84 2
Business name: D&L ELECTRIC INC, Signal circuit(s)or limited-energy See
panel.alteration,or extension. Page 2 2
Address: PO BOX 367 Each additional inspection over allowable in any of the above
Additional inspection(1 hr lain) 66.251 hr
City/State/ZIP:WEST LINN,ORE.97068 Investigation(1 hr min) 66 25/hr
Phone:(503)656-5623 Fax:(503) 50-1918 Industrial plant(1 In min) 78.18.1 hr
Inspections for which no fee is 90 001 hr
C('li Lie.: 88069 /1 '/ Ylectrical Lic.: 3-161C 111 r uprv. Lic.: 2662S specificallylisted(Y:hrmml _. .
f ��Ir/alb ELECTRICAL PERMIT FEES
Y Supre.Electrician 5ignahlre,rtxluircd:: y/f Subtotal: 108.12
Print name: DONALD H.LETTENMAIER Date: 10-3-2013 Plan review(25%el-penult fee): •
State surcharge(12%of permit fec): I 12.97 /
Authorized signature: TOTAL PERMIT FEE: 121.09 r/
Tbls permit application expires ifs permit is not obtained within 180
Print name: Date: days after it has been accepted as complete-
• Number of inspections allowed per permit,
I uilding'Pernns\ELC PernitApp ELR_ERE.mkm Rev 05x2 1 72011 4.10-0615T(I I`O5ICOM/WM