Permit CITY OF TIGARD ELECTRICAL PERMIT
II
COMMUNITY DEVELOPMENT
Permit#: ELC2014-00347
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/24/2014
Parcel: 2S 102 D D04100
Jurisdiction: Tigard
Site address: 13807 SW FANNO CREEK DR
Project: Blevins Subdivision: BRIDGEPARK Lot: 1
Project Description: Install 200 amp feeder and(4)branch circuits
Contractor: DEKORTE ELECTRIC INC. Owner: BLEVINS,JESSE&CHARMIAN
5331 SW MACADAM AVE#258-113 13807 SW FANNO CREEK DR
PORTLAND, OR 97239 TIGARD,OR 97223
PHONE: 503-288-2211 PHONE: 503-620-1034
FAX: 503-288-2231
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 06/24/2014 $100.70
Specifics: amps or less
4 crt Branch Circuits w/Purchase 06/24/2014 $29.68
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 06/24/2014 $15.65
Electrical
Type of Const:
Occupancy Grp:
Total $146.03
Required Items and Reports(Conditions)
This permi • •-• -• - to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other a••• .ble law. All work will
be d•-- in accordance with =••roved •fans. This permit will expire if work is not started within 180 days of issuance, or if work i suspe'•ed for more the 180
da -. ATTENTION: Oregon la -•uire •u to follow the rules adopted by the Oregon Utility Notificatio enter. Thos- rul are set forth in OAR
9.2-001-0010th gh OAR 952-00 0094 • may obtain a coy of the rules or direct questions to OUNC by calling 7 0 1.800.3 44.
/ ,�
Issued By: / / Permittee Signature: t _
OWNER INSTALLATION ONLY or
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' �,/ j���1i Date: _ ...(.49
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 11111 City of Tigard it - IIH'IFD n«�Y (rj a C� Permit#:I3125 SW Hail Blvd.,Tiglvd,O a 9 't)'. Plan Review
1 C Phone: 503.718.2439 Fax: 503. 9:. •60 Date/By: Related Permit#:
T I GA R D Inspection Line: 503.639.4175 JUN 2 4 2( 1 Ready Date/By: Inns: RI See Page 2 for
. Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TAE Olt {iA�4Jt liW��r�t���U • • • PLAN REVIEW
❑New construction IS Add ition/a',I ERM1 1 r)f Please cheek all that apply(submit 2 sets of plans whtems checked);
❑Service or feeder 400 amps or inure ❑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.
ig 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building loss to ground,or exoeeda 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system, larger separately derived
Job#: Job site address: ❑Addition of new motor load of system.
!3807 5 s 4 i'P1O e,e2 D - IO0HP or more. ❑"A""E""1-2""1-3"
City/State/ZIP: ❑Six or more residential units. occupancy
n — rep b a- q7 27'3 ❑Health-care facilities. ❑Recreational vehicle parks
Suite/bldg./apt#: Project name: Z a.di k)S ❑Hazardous locations, ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site: mitt_ if rAttnt/b ✓K. ,FEE SCHEDULE
neserlution I Ore. I Each I Thal I *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
. DESCRIPTION OF WO10C • Limited energy,residential 75.00 2
/ �e26' AM�44P 1F ,f WCK tFeW/rs (wetnervy, ft.)
�+ Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
PROPERTY OWNER I i ❑ TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: le... ,-✓I $ 200 amps or less / 100.70 2
r 380 7 .� 1-4,0 201 amps to 400 amps 133.56 2
Address: ate ti a (C Nee_ 401 amps to 600 amps 200.34 2
City/State/ZIP: / !(tk d— q 7 7-2-3 601 amps to 1,000 amps 301.04 2
Phone:( ; ) G ZO /0 35 Fax:( ) Over 1,000 amps or volts 552.26 2
.-- G Temporary services or feeders installation,alteration,and/or
Email: �ss�Z. Gd fGJu>�AZ.- et- r relocation
Owner installation:This installation' eing made on property that I own which is not 200 amps or less 59.36 I
intended for sale, ran or exc e,according to ORS 447,449,670, 70 . 201 amps to 400 amps 125.08 2
Owner signatur 4—•-- Date: G /`7 401 amps to 599 amps 168.54 2
Q AP ICANT I ] CON ACT PE Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee, it
each branch circuit 7'42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not Included) •
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67 84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: v,eu'7 .: 6(_ _c%7/-/Ci Signor outline lighting 67,84 2
Address: 5331 SW Macadam Ave Ste 258-113
Signal leer circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Portland,OR 97239 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503 ) 288-2211 Fax:( 503 ) 288-2231 investigation(1 hr min) 66.25/hr
Email: info@dekorteelectric.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
specifically CCB Lic.:159954 Electrical Lie.: 34-541 C Suprv.Lie.:4075S ftcally listed(h hr min) 90.00/hr ___
ELECTRICAL PERMIT' FEES
Suprv.Electrician signature,required:((ems be-Ko 1 Subtotal:
Print name: Ken DeKorte Date: 6/24/2014 ❑Plan Review Required(25%of permit fee): '
State surcharge(12%of permit fee): O
‘..Authorized signature: I'01'AL PERMIT FEE:
This permit application expires If a permit is not obtain within 180
Print name: I Date: days after It has been accepted as complete.
• Number of inspections allowed per permit.
r:muildinalPeretiMELC_PermiWpp_aLR_RRgdoc Rcv 04/21/2014 440-4615T(1 I105/COM/WEB
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