Permit p CITY OF TIGARD ELECTRICAL PERMIT
= COMMUNITY DEVELOPMENT Permit#: ELC2014-00210
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2014
Parcel: 25101 CA00500
Jurisdiction: TIGARD
Site address: 7960 SW HUNZIKER RD
Project: Potso Dog Park Subdivision: 2007-064 PARTITION PLAT Lot: 2
Project Description: Installation of(1)service and(1)branch circuit for irrigation control
Contractor: ELECTRIC WORKS INC Owner: TIGARD, CITY OF
9122 SE 67TH AVE ATTN: CITY MANAGER
PORTLAND,OR 97206 13325 SW HALL BLVD
TIGARD, OR 97223
PHONE: 503-774-6444 PHONE:
FAX: 503-775-6541
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/01/2014 $100.70
Specifics: amps or less
1 crt Branch Circuits w/Purchase 05/01/2014 $7.42
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 05/01/2014 $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 - -. -= ,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. NTION: Oregon aw re you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are et forth in OAR
952-1.1-0010 through OAR 952-66 90. Yo m y obtain a copy of the rules or direct questions to OUNC by calling 03.232.19 1.800.332.23
I .ued By: Permittee Signature:
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' /I A 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received �i /! / Permit No. �/ 5�/�
Date/By:
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
1-i G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: 67 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
®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.
CATEGORY OF CONSTRUCTION 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 150 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑`A",`E","1-2","1-3",
Job no.:5112 Job site address: �'7 eO \ � I OOHP or more. occupancy.
t/-/ ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 r' ` ❑Health-care facilities. ❑Supply voltage for more than
/47 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Potso Dog Park d ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. l 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'1500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
New 100 amp service. �1 ft(i 3 �,,� 0,7(4-7,...)) residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER J ❑ TENANT 200 amps or less 1 100.70 100.70 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
Over 1,000 amps or volts 552.26 2
City/State/ZIP: 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—new,alteration,or extension,per panel
❑ APPLICANT ® CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 1 7.42 7.42 2
Business name: Electric Works Inc. each branch circuit
B.Fee for branch circuits without
Contact name:Jeremy C.Loraas service or feeder fee,first
branch circuit 56.18 2
Address:9122 SE 67th Ave. Each add'1 branch circuit 7.42 2
City/State/ZIP:Portalnd,OR 97206 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)774-6444 Fax::(503)775-6541 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:EWI @EWI-PDX.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Electric Works Inc. Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 _ 2
Address:9122 SE 67th Ave. Each additional inspection over allowable in any of the above
City/State/ZIP:Portland,OR 97206 Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(503)774-6444 Fax:(503)775-6541 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 48251 Electrical Lie.: 26-484C Suprv.Lie.: 5240s specifically listed(CVs hr min)
If,A,
Suprv.Electrician signature,required: vet oe=. ELECTRICAL PERMIT FEES Subtotal: 108.12 '
Print name: Jeremy C.Loraas Date: 5-1-2014 Plan review(25%of permit fee):
State surcharge(12%of permit fee): 12.9d`f 7
Authorized signature: TOTAL PERMIT FEE: 121.9709
This permit application expires if a permit is not obtained within 180 I
Print name: Date: days after It has been accepted as complete. ,,,L/ 1
* Number of inspections allowed per permit. / i/zit)1:\Build ng\Permits ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB / ;`1
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
7960 SW HUNZIKER RD, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00210
Herb Stabenow
Violation Summary:
Inspector Contractor