Permit CITY OF TIGARD ELECTRICAL PERMIT
' 1 COMMUNITY DEVELOPMENT Permit#: ELC2013-00612
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2013
Parcel: 2S102BCO2003
Jurisdiction: Tigard
Site address: 10700 SW FONNER ST
Project: SAKHITAB Subdivision: NORTH TIGARDVILLE ADDITION Lot: 24
Project Description: Electrical reconnect
Contractor: OLIVERS PRECISION ELECTRIC COMPANY Owner: SAKHITAB, HOMA
17035 SW HIGH HILL LN 10700 SW FONNER ST
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BEAVERTON,OR 97007 TIGARD,OR 97223
PHONE: 503-579-7747 PHONE:
FAX: 503-579-5907
FEES
Quantity Description Date Amount
1 ea Reconnect Only 10/14/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 10/14/2013 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
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Occupancy Grp:
Total $75.98
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 a : .ith 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. ATT• 'TION: Oregon .w re. 'es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-1.10 through OAR 952-0;1 .090. Y fi may obtain a copy of the rules or direct questions to OUNC by call' -2.1987 or 1.800.332.2344. _ _
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Issue. By: j Permittee Signat e: s'_ �'� i
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
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SIGNATURE OF SUPR.ELEC' . • 4 • 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.
Oct 11 13 12:42p Oliver's Precision Elect 5035795907 p.2
Electrical Permit A 1 •li '/ FOR OFFICE ESE O
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City of Tigard C''''- 1 : i ty Received /O Permit No.: f/(��f l g- OQ X012
DataBv:
Ill
13125 SW Hall Blvd.,Tigard, R 97223 Plan Review Other Permit:
Phone: 503.718.2439 Fax: 50311021S Daic Br:
Inspection Line: 503.639.4175 d 2013 Date Ready/By: /ure' ® See Paget for
T I GAFD Internet: www.tigard-or.gov t� /t Notified/Method: Supplemental information
T"PCyCn [� i�f°tRD PLAN RE.r[EIV.
• c i J r t t! tfi �t' Please check all that apply(submit 2 sets of plans w/items checked below):
4 ❑New construction ❑Addi�ion�ahe4atran/replace�rtent
❑Service or feeder 400 amps or more CI Building over three stories.
❑Demolition ®Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 15D volts or ❑Floating building.
less to ground,ar 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. 0 Installation of 150 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Additroo of new motor load of
Job no.: Job site address: 10700 SW Fonner Street 1DOHPormore. occup anc y.
❑Six or more residential units. 0 Recreational vehicle parks.
❑Health-care facilities. ❑Supply voltage for more than
CityiState/ZIP:Tigard,OR ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: . Project name: 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: pocripdoa I Qty. I r«. 1 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'l 500 sq.ft.or portion 33.92 l
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK • (with above sq.ft.)
Limited energy,multi-family 75.00 2
electrical reconnect residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 i 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 i
Over 1,000 amps or volts 552.26 2
City./State/ZIP: Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) Fax:( ) 200 amps or less 59 36 l
Owner installation:This installation is being made on property that 1 own which is not 201 ampsto400amps 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
❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name:Oliver's Precision Electric each branch circuit
B.Fee for branch circuits wirhoru
Contact name:Bill Oliver service or feeder fee,first 56.18 2
branch circuit
Address: 17035 SW High Hill Lane s Each add'i branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP:Beaverton,OR 97007 Each manufactured or modular
' dwelling,service and/or feeder 67.84 1 2
Phone:(503)579-7747 Fax::(503)579-5907 Reconnect only t s 67.84 67.84 2
E-mail:ope234@aoLcom Pump or irrigation circle 67.84 2
. CONTRACTOR . Sign or outline lighting 67.84 2
Business name:Oliver's Precision Electric Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: 17035 SW High Hill Lane Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
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City/State/ZIP:Beaverton,OR 97007 Investigation(I hr min) 66.25i hr
Phone:(503)579-7747 Fax:(503)579-5907 Industrial plant(1 hr min) 78.18i hr
_ v{� ' Inspections for which no fee is 90.00/hr
CCB Lie.: 186112 514)°kli Electrical Lie.: 34-521C-11t\t( Suprv.Lic.: 2539S tie, specifically listed(%hr min)
Io1' . ELECTRICAL PERMIT FEES •
Suprv.Electrician signature,required: net /t�j4.44/ _ Subtotal: 67.84
Print name: William Oliver (� `� Date: 10/11/13 _ Plan review(25%of permit fee):
State surcharge(12%of permit fee): 8.14
Authorized signature: TOTAL PERMIT FEE: 75.98
This permit application expires if a permit is net obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
BettitditytlPermitsTLC_Permi1APn_ELR_ERE.doc Ravin/210M 440.4615i(I1/O/COMI/WEB