Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00459
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/19/2014
TIGARD Parcel: 1 S125DA02700
Jurisdiction: Tigard
Site address: 6617 SW WALNUT TER
Project: Walnut Subdivision: KINGS VIEW Lot: 12
Project Description: Reconnect only.
Contractor: OWNER Owner: BULLDOG CAPITAL PARTNERS LLC
4550 KRUSE WAY SUITE 125
LAKE OSWEGO, OR 97035
PHONE
503-344-4352
E:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 08/19/2014 $67.84
Specifics:
1 ea 12%State Surcharge- 08/19/2014 $8.14
Electrical
Type of Use: SF
Class of Work: OTR
Type of Const:
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 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 OA 852-•^ 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �/ ' r� Permittee Signature: Q'Q' /e,y--gip
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.
• •
. RECEIVFD .
Electrical Permit Application AUG 19 20' I.()1:(>l, ,c ,: 1 S, c,.,
City of Tigard CITY Of 1i{iANU RCe1vCd /9/y Permit N°'.67-C,210/4/-'61 p ys9
• 13125 SW Hall l31vd.,Tigard,O ^ ^ Da acv •
�I' !}. D teBy: Other Permit' Phone: 503.718.2439 Fax: 503. _Date/By:
1.1(,A�, inspection Line: 503.639.4175 Date Ready/By: rnls: ®See Pege 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(submitl sets of plans wiltetm checked below):
❑Demolition " Other: ❑Service or feeder 400 amps or more El Building over three stories.
1'° 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
►: : d 2•family dwelling ❑Commercial/industrial ❑:ccessory building amps for all other installations. Ixrildings.
a Multi-family ❑Master builder :ris r er; ❑Fite pump. ❑Installation of 150 KVA or
JOB SITE INPOIllMAT10N AND LOCATION ' ❑Emergency system, larger separately derived system.
. ❑Addition of new motor load of ❑"A","E^ °1.2. "1-3"
Job no. Job site address: r loon?or more. oetxrpaoey.
I\ l i .,„ 'A A. A [”• 4 ❑Six or more residential units. ❑Rocrratonal vehicle parks.
City/State/ZIP: 1S • I‘rot l 1 (f' ..')'3 ❑Health-care facilities.
El Supply voltage for more than
Y `f lJt (.-1�J 1 J Hazardous locations. 600 volts nominal.
Suite/bldgJapt no_: .• • - Project name: ` .4 4 0 Semi.or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 1. 1.1 . `M di• Description I Qty. 1 Fee. I Tam I
�- New residential single-or multi-family dwelling unit.
fI .r4 t Includes attached garage.
Subdivision: Lot no.: 1,000.sq.ft.or less 168_54 4
— Ea.add'I 500 sq•ft,or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
.DESCRIPTIO •OF WORK • (with above sq.ft.)
Limited energy,multi-family 75.00 2
=MI • r~ ♦. �, '� residential,...th above sq.ft.) :
M' �/� Renewable Enemy 0 See Page 2
�. ',6 V/ V b ervices or feeders installation,alteration,and/or relocation
Ps PROPERTY OW R ❑ TENANT 200 amps or less 100.70 2
�r 201 amps to 400 amps 133.56 2
Name' ` OA C-t` i I i •l i L _ 401 amps to 600 amps 200.34 2
Address: .a r /y r
~601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 55226 2
City/State/ZIP: �I .� l r / Temporary services or feeders installation,alteration,and/or
Phone:( 'v )- tb ( v , . ill relocation
r 200 amps or less 59.36 1
Owner installation:This in ation is being made on property that I own which is not 201 amps to 400 amps 12548 2
intended for sale,lease,r'. xchange,according to ORS 447,449,670,:s d 701,. 401 amps to 599 amps 168.54 z
Owner signature. Date: i1 '0 . Branch circuits-new,alteration,or extension,per panel
N App; PERSON A.Fee for branch circuits with 1
0
3 ` above service or feeder fee,
Business name: ' , silk f'` 11r. I� C `i ►, each branch circuit 7.42 2
Contact name: 1 I �� B.Fee for branch circuits without
, rljn ► I E�'/Isi<riipJlr, seniee or feeder fee,first 56.18 2
branch circuit
Address: I ,r t J M _ Each add'i branch circuit 7.42 2
City/State/ZIP: i Miscellaneous(service or feeder not included)
�i '� .• i�� �l Each manufactured or modular
Phone: v.) � .r Fax:; dwelling.service and/or feeder 67'84 2
#'_ (�� ) < Reconnect only 67.84 Co 7.14 2
ilr iP ,. . rr M Pump or irrigation circle ' 67.84 2
• . CONTRACT a Sign or outline lighting 67.84 2
Business name:.f° r..../..' - signal circuit(s)or limited-energy See ' —panel,alteration,or extension. Page 2 2
t€S4- -' o3 (>y K 48 Each additional inspection over allowable in any of the above
. _ >
Additions)inspection(1 hr min) 66.25/hr
City/State/ZIP lnveatigation(1 hr min) 66/5/hr
Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: Electrical-Lic: Suprv.Lie.: Specitmcaily listed min) 90.00/hr
ELECTRICAL PERMIT,FEES
Suprv.Electrician signature,required; Subtotal;
Print name: Date; A 0 Plan review(25%of permit fee):
Ar •_.�__- i • State surcharge(12%of permit fee); ^" -
Authorized signature: TOTAL PERMIT FEE: -75.9 r ,
Print name: Date: 03 1
i 0 This permit application expires it a permit is not obtained within 180
days after it has been accepted as complete.
I'\8vil4ine\FcEm sslELe irArm FIR Nap Ann a.,w ncnt nnra „•,,,,,,•-„�� ,.w- • Number of inspections allowed per permit.