Permit CITY OF TIGARD ELECTRICAL PERMIT
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-��'• COMMUNITY DEVELOPMENT Permit#: ELC2013-00606
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2013
TIGARD Parcel: 2S109DA13900
Jurisdiction: Tigard
Site address: 12685 SW MOUNT VISTA CT
Project: Armstrong Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 58
Project Description: (5)branch circuits for basement addition
Contractor: GLOBAL ELECTRIC, INC. Owner: ARMSTRONG, BRIAN P
PO BOX 162 12685 SW MOUNT VISTA COURT
NORTH PLAINS, OR 97133 TIGARD, OR 97224
PHONE: 503-647-5650 PHONE:
FAX: 503-647-5649
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 10/10/2013 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/10/2013 $10.30
Type of Use: SF 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-,r•r. 'ob.may•stain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: -r r, - _ Permittee Signature: 0/if e�/4"L/P`,177a/
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.
From:Global Electric, Inc. 503647549 10/09/2013 07:31 #557 P.001/002
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Electrical Permit Applicatio t �. I I( lt 0 1 I r<I «rS l
City of Tigard Q 13 Date/B: /Q�. .. _ (5/ Permit No.EZC o/3 X16,
13125 SW Hall Blvd.,Tigard,OR 97223 Y Plan Review
8 Phone: 503.718.2439 Fax: 503.598.19 r% F 1 Date/By; Other Permit: •
i :1;; Inspection Line: 503.639.4175 � +• e ARIA Date Ready/By: fwu: 65 See Page 2 for
Internet: www.tigard-or.gov BUILD t Notitied/Method: iI/! Supplemental lnformadon
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s 0,44�kcr; y� 'S�i ric.41. 5 xV � 0 41? t4 ^,°''4:41 t L.zs. • q.... '`f�n.}-t �7 yi-k..,s• /-v:VVV 1 A+ sue=
1,315.4'ttaVt34' ie ,r �i_? ,.. V- O a �> N., :.rr: f4..sl`ta :. gar : ':n^4..7,;,, ..e�_` : z11 174.. .4 N"_fr,*, y..,
❑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.
!` ; �,. '; ;ajli• i" is ``' p �'' 3 c+ exceeds 10,000 am s at I50 volts or ❑Floating buildings.
-. less to ground,or exceeds 14,000 ❑Commercial-use agricultural
1/: I-and 2-family dwelling ❑CommerciaL/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family . ❑Master builder ❑Other: p p. ❑Installation of 150 KVA or
°4 key "' C ..3 71 IZ 8 r D rt b s�G 461-" °;! - M.,�2_ ❑FEmergency system. larger separately derived system.
�..mo�ww''
,,,W r ,AVy'r ,4 . 4 y 3� . r ro• ❑Addition of new motor load of ❑"A""F""I. 13 ,
+ rQ , l C�,r�y IOOHP or rrmre occupancy.
Job no.: Job site address: I�10®� W (�pullk VIS�ZI C.1 r ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: ���� / Q 9 ❑Hazlth-oure facilities.
❑Hazardous locations. ❑Supply voltage for more than
600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑Serviceorfeeder600ampsormore
Cross street/directions to job site: neunpiion Qty. Fee Toni
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:
1,000 sq.ft.or less 168.54 4
Tax lna / nice/n0.: Ea.add'I 500 sq.ft.or portion 33.92 I
p p Limited energy,residential i
. w r,
75. 0 2
iw ` . `= i a f f G G 't a,`t"p4.i +ro_, y ✓ (with above sq.ft.)
// w a
Limited energy,multi-family 75.00 2
1StANLP r Pt Q 1 7 0 residential(with above sq.ft.)
i P ;;YRiNriEj'VstiIT'erE024Pra FO �CP.ikegERW-RWaa
�t� 5 Services or feeders installation,alteration,and/or relocation
ems?e ? t_ o ''` it V. '.,,yt 'P '` '-, ,, 1 s f ^ r .yy c 200 amps or less I 100.70 I 12
+` 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:( ) l Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being rnade 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, er panel
p. r'' A- tw 3's .v "t` "y" A.Fee for branch circuits with
above service or feede ec,
Business name: each branch circuit 7'42 2
B.Fee for branch circuits without
Contact name: service or feeder fee,first I 56.18 t I g 2
branch circuit j
Address: Each add'I branch circuit -t 7.42 4c. ,fig 2 l
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67 84
Phone:( ) I Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
P,rx;P ikA Ve=k'e -,w•„,: e , 0,. ,�' '' "~ 14,..„4 'f . ,-,1 Sign or outline lighting 67.84 2
Business name: !0 / / eir/1G C Signal circuit(s)or limited-energy See
^�/ panel,alteration,or extension. Page 2 2
Address: po `� Each additional inspection over allowable in any of the above
ty Qr /Q/ n�/33 lnveslunalinspection(Ihrmin) 66.75/hr 1
Ci /State/ZIP: g. (�/J
Investigation(1 hr min) 66._5/hr
Phone:()3)Co gi ._ SD Fax:5)3) ‘o y7_ W Industrial plant(1 hr min) 78.18/hr
/��cp Inspections for which no fce is 90.00/hr
CCB Lic.: /�� 0 / Electrical Lic.: .Vey(. Suprv.Lic.: ).i specifically listed('/hr min)
Suprv.Electrician,is f �,fequired: � Subtotal Kip
/l/b/ 3 Plan review(25%of permit fee):
Print name: LL Date: (f O
U57! �� State surcharge(12%of permit fee): /Q,3 0
Authorized signature: ...rat- TOTAL PERMIT FEE: 6,
This permit application expires if a permit is not obtd within 180
Print name: TsyL^ in' Date: j0 6�3 days after it has been accepted as complete.
�`//^^ / U ` Number of inspections allowed per permit.
1:1BuildingkPcrmus\ELC I'ermilApp_ELR ERE.doc Rev 05/21/20 0-4615T(I I/05/COM/WEB
C,Ne3 •
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12685 SW MOUNT VISTA CT, TIGARD, OR,
97224
Residential - Electrical
199 Electrical final
2013-12-09 00:00:00
ELC2013-00606
PASS - No C of O
Violation Summary:
Inspector Contractor