Permit CITY OF TIGARD ELECTRICAL PERMIT
111 rr COMMUNITY DEVELOPMENT Permit#: ELC2013-00600
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2013
TIGARD Parcel: 1 S1 34AB03300
Jurisdiction: Tigard
Site address: 10330 SW SCHOLLS FERRY RD
Project: Muslim Educational Trust Subdivision: ENGLEWOOD Lot: 88
Project Description: (1)branch circuit for minerette lighting
Contractor: HEIL ELECTRIC CO Owner: MUSLIM EDUCATIONAL TRUST INC
8425 SE STARK ST PO BOX 283
PORTLAND, OR 97216 PORTLAND, OR 97223
PHONE: 503-255-4074 PHONE:
FAX: 503-255-4139
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 10/09/2013 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/09/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 aw 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 00 0. Y u 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: iZ / //•P G/ /
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 503.639.4176 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.
10/07/2013 14:35 50325541,3 ' 1 HEIL ELECTRIC CO PAGE 02
��Electrical Permit App t: % i C FOR OFFICE USE ONLY
° ° Q\� Received
City of Tigard \ `� C1 `� ® DateBv: AO 7 M;�� PermrNQ.;S-t�/�' — 600
/• 13125 SW Hall Blvd.,Tigard,OR�j1(�_3 Plan Review Other Pcrmir
•
!z Phone; 503.718,2439 Fax: 503,598.196 ��� ���®� Date/B : �/�Oa/0
Inspection Linn; 503.639.4175 ,q- c\\\' Date Ready/By: Juru: r� RI See Page 2 for
I 1 Cr:'F[.1 0 Notified/Method: l'3 Supplemental Information
Internet: www.[igard•ar.gov �j ���
TYPE:O 4�RK _ ,.tPliliN=`:�1k.";) -., .......,....
k New construction ,❑Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked below):
❑Service or feeder 40(1 amps or More ❑Building over three stones,
❑ Demolition ❑Other; where the available fault current ❑Marinas and boatyards.
T rs or ❑Floamt buildin s
��`� CATEGORY:•.OT COINSThtUCTION � '' exceeds 10.000 amps at 150 vol g g.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling 2rCommcrcial/industria1 ❑Accessory buiiding amps for an other insrallalions. buildings.
0 Multi-family Q Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JO B lame
INFO ' "` ❑Emergency system, larger separately derived system.
RMATION A;ND-;LOCATION 1.2' `1
. in of new motor load of ❑°A""L' " 3"
n 100HP or more. occupancy.
Job no.: !r Job site address:�O33a 5%i..)s L.I l 1/s tV/O
Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:lQ&Ar Of q Z� J ❑Health-care facilities. ❑Supply voltage for more than
�J �d' 600 molts nominal.
❑Hazardous loc:uions,
Suite/bldg./apt.no.. I Project name: t . ."f ❑Service or feeder boa amps or more.
,. a '.`FEE`.SCHEDULE;(.•': :.',;, :i., ''. ;
Cross street/directions to job site: f 615 uM E?A�oAr f"L- T -ST �°c`o'tprlon 1 Qu. I mor Total I .
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision; Lot no.; 1,000 sq.Cl,or less 168.54 4
Ea,addl.500 sq.ft,or portion 33.92 I
Tax snap/parcel no.. _ 'Limited energy.residential
.: _ .. (with above sq.ft.) 75.00 2
-. " ' DESCRIPTION OF Vti'Ol(�C ..r, . �,
r Limited energy.(with multi-family 75.00 2
fit✓ residential(with above so,ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration.and/or relocation
200 amps or Icss 100 70 1
Q.;PROPE'— ' '— ' I 0'. iYANT. _.... ;:i, ....
' � 201 amps to 400 amps 133.56 2
Namc: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 30i.04 2
Over 1,000 amps or volts 55226 2
City/State/GIP: 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-newzalteration,or extension.per panel
u A.Fee ibr branch circuits with
® ',A; 1.I ly}'I•, : I .:: •'EOl kkc.:I`E,FRSOl..' r' x above service or ficcdcr fee,
•Business rattle:
each branch circuit 7,42 2
B.Fee for branch circuits without ) kg
Contact name; service or feeder fee,first 1 56.18 IQ 2
branch circuit
Address; Each add')branch circuit 7.42 2—
City/State/ZIP:/State/ZIP Miscellaneous(service or feeder not included)
r? : Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Phone:( ) Fax::( )
Reconnect only 67.84 2
-E-mail: Pump or irrigation circle 67.84 2
' CONTRACTOR „ ,.., Sign or outline lighting 67.84 2
Business name: R tk thvI C-. Signal circuit(s)or littdced-energy See
panel alteration,or extension. Page 2 2
-
Address:Ott 7 3f Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIIIQy' d , 41 24 La> Investigation(1 hr min) 66.25/hr
Phone:0 0 255 40'74 F4 Fax 3)2_5-5 .41,t 31 Industrial plant(1 hr min) 78,1$/hr
VCCS C Inspections for which no fee is gp 00/hr
Lic.: �g Electrical Lic. —(1,490---f Sup .Lie.: SSa2 ✓ specifically listed(V,hi min)
®� jo 1I Jo :„.ELECTRICAL;'PERMIT.`FEE S
Suprv. Electrician signature,required: a( a. v.L..l _ 1 Subtotal: -17 (p
Print name: ok( r U, (
i O' Date: `O/ rl l � Plan review(25%of permit fix): �q
t State surcharge(12%of permit fee): (p
Authorized signature; TOTAL PERMIT FEE: 1,02_ I
YY�1 n a I� /� This permit application expires if a permit is not obtained within 180
Print name: (11 — Date; L 1 / dnyb•tact it has been accepted as complete.
` • Number of inspections allowed per permit.
t:lauildinslPermiul2LC_Permit4pp ELR,ERE.doc Run,05/21/2013 440-46151(11/05/COhfrwas
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10330 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2013-00600
Jeff Grove
Violation Summary:
Inspector Contractor