Permit V' J-N. CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2015 00959
tDate Issued: 12/07/2015
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S102BC01102
Jurisdiction: TIGARD
Site address: 12772 SW KING PL
Project: Graceland,Lot 4 Subdivision: NORTH TIGARDVILLE ADDITION Lot: 29
Project Description: Reconnect existing house.
Contractor: SUNLIGHT ELECTRIC INC Owner: PACIFIC EVERGREEN HOMES LLC
2800 NE 65TH AVE SUITE B 7410 SW OLESON RD#133
VANCOUVER, WA 98661 PORTLAND, OR 97223
PHONE: 360-772-3877 PHONE:
FAX: 360-694-9728
FEES
Quantity Description Date Amount
1 ea Reconnect Only 12/07/2015 $67.84
Specifics:
1 ea 12%State Surcharge- 12/07/2015 $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. ATTENTIO • egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 ough OA' 952-0 -0090. You may obtain a copy of the rules or direct questions to OUNC by callin 1987 or 1.800.332 2344.
I
Issued :\ : % • Permittee
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.
4 - _ 11OROFFICI IISF ONi V;.%
Electrical Permit Applicat t � .-.
Received ����
City of Tigard 7 2015 Date/!3': �e 11111.i Permit S. ��r„�
a 13125 SW Hall Blvd.,Tigard.OR 972 Plan Review Related Permit N:
Phone: 503.718.2439 Fax: 503,5;281960C
03. c 0 Dateive
L OF TIGARD Ready Date/By: tuns: El See Page 2 for.
Inspection Line: 503.639.4!75 >'
T_IGA'RDInternet: www.tigard-or.gov BUILDING DIVISION lvoLhcd/t5ethod: Supplemental Information
,...,. .
. ...��,:::-..,.. �rG .r.., _ '�;i C[:AI`i�R._.. �''Jr.:,,r-c;s..r..,.a i,.�r�'t:'.:.."r:::.';
117.-,. . .. . I
❑New construction ❑Addition/alteration/replacement
I Please check all that apply(submit 2 sets of plans w/items checked):
1 0 Sen'm;:or ie.eliei 400 amps or more 0 Building over three stories
❑ Demolition ❑Other: whet the,available fault curtest 0 Marinas and boatyards.
:CATEGORY OF CONSTRUCTION•. TT-,,- -._ I c.cee,is 10,000 snips at ISO volts or 0 Floating buildings.
_®l at -- - __________:.___...1less to ground,or exceeds 14,000 0 Commercial-use agricultural
I-and 2-family dwelling ❑Commercial/industrial ❑:Accessory builiting I am;a i01'all other installations. buildings.
j ❑ Multi-family ❑ Master builder ❑Other:- -- - - 1 ❑Cite pump.. 0 Installation of 150 KVA or
t-- - - 1 ❑l at rt:cncy system, late t separately derived
_ .ro. ... _i .r oical'-' :iNu_,elcr�'
0 Addition of 11CN'motor load of system.
.lob fir -- Job site address: j --- _ I IoiJHPof more. ❑":\ F „I t_3
_ -- ..f-- �/ 1 occupancy.
❑Six at more residential units.
I City/Stat.:-/ZIP: 2._ �� _ I lea!tlt-:arc facilities. 0 Recreational vehicle parks.
-- — � t�Z� — 0
-- ❑liazardoas locations. 0 Supply voltage for time than
Suite/bldg./apt.#: Project name: 600 volts nominal.
------------
j 0 Service or feeder 600 amps or more.
Cross street/directions to job site: 1 - , ,a. c y�K'" �`lf''�•�, ' Ii.:'`
•,::v:'r x' ex'aT. a �: •J'� +i ('I�'.I�•.iii, Lt�`�-i;M, vr'a.:; ' ,:
u I/f� / --
iv - - Description i Qty. I Ench 1 Total I
I�//1� New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: 9 Includes attached garage.
��eAl 1,000 sq.ft,or less 168.54 4
Tax map/parcel 1i: Ea.add'I 500 sq.B.or portion 33.92 1
:.r ; ';;:- ;'�{ ,±.. FSGRIPTIQVf, 4:\.OR '.:t`j ,;:..... Limited energy,resential o
1 i .. 'F!:” 1 K - . I id75.00 -
(with above sq.ft.)
- --_-_ I 'Limited energy,multi-family 1 75.0(1 2
--- ---- - --- - - --1 I R: tet,�i1 residential
trav tl�above sq.tt.) ❑ See Page 2
t t CCN: N'
.(��>.PIL I,ERT '` t1 NER - 1_ - At---_._.-- I Services or feeder,;installation,alteration,and/or relocation 1
>I2I�l.'amps()I'less I 1 100.7(] 2
Name: Pacific.Evergreen Homes -------------------__-- - .t.-____-i �
;Address:7410 SW Okvott Rd.Suite 133 itl' ,❑Ips n,400 amus 133.56 2
_ ---.._------ 1 401 :units to COO amps 1 I 200.34 12
City/State/ZIP: Portland,OR.97223 - I Gni amps to 1,000 amps I ' 301.04 1 2
Phone:(503)664-6423 ; Fax:i t I Over 1,000 amps or volts 552.26-- -2
• I 'Fentpurary services or feeders installation,alteration,and/or
Email: ---- '�-'--'-'----- I1—ree'itii)(t _
_-— - .—._-lO_—
Owner installation:This installation is being made on property that I own whicl iJ riot- I i 200 amps or less -- 1 59.36 I ' I
intended for sale. lease.rent,or exchange,according to ORS 447,449.670,and 701. I 201 amps to 400 amps 125.08 2
_ _
(honer signature: Date: 401 amps to 599 amps 1 168,54 2
r„,, -riM1a - , y= •, _ Branch circuits-new,alteration,or extension,per panel
K;� :,, :'t :PR,I_00:'as.?k. :t. . e,•..-.i"•i':;e�titt&PISTt1C:.iii,,. ,1359)..;,,:r r ;.
-.` .:*.�� -': .„ -. "z`" `• A.Fee for branch circuits with
Business name:Same above service or feeder fee,
7.42 2
each branch circuit
Contact name:Alan GoffMoore 13.Foe for branch circuits without
--- -- -' service or feeder fee,first 56.18 2
Address: branch circuit
J - - 1 Each add'I branch circuit 7.42 2
City/State/ZIP: I
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( -) - - . trach manufactured or modular 1 67.84 2
dwell iint.service and/or feeder _
Email aiangoffmoorc :gntaul con --- I p:c,,:mv',,�,iv --- I f I 67,84 2
z; "TMs%<iS*?i+:;zl<t0.` ;'CUN'1'RA 1"UR_ -- _,-_,._---__._.•_,-__.--.-.,.._'1 I Nunn or rrtat:uon circle 67,84 2
I Business name:Sunlight Electric.Inc n ice maim,:hgir.lr.g, I 67.84 ' i
-- --- - - - ct;;u:a(:.mtWit 5:o;iunucd-energy I ❑ Sec Page 2 I
Address:2804 NE 6� Ave.Site I) .I ry ''terturn:.oreetension, 1 1 - 1
" - --- - -- - 1 I E;ielh addititlnat inspection over allowable in any of the above
j City/Staier"ZIP:Vancouver SVA 98661 -_ -- --_ - I '-Additionai inspection(1 hr_nin) 1 j 66.25/hr
Phone:(971)222-5758 Fax:(360)326-966(1 I L!nvcstih.;tion(I itt mini 90.00/hr
I-- -- - ----- -- 1
industrial plant(1 hr min) 78.18/hr
1 Entail:sunlight.incl�rcomcast.net • r------ -
-- -- - _-__-'-- Inspections for which no fee is 90.00/hr
CCB Lie.: 172549 Electrical L-ic.: 11608 1 Suprv. I'ie.: / 79”3 5 specifically listed('r:hi min)
__ lsI GCtT1tIGALaI:__[tltiEXPs;F1 Els :°•x. "' j
, ,
Suprv. Electrician signature,required/ '.� r---- '� r - �`f
p ! �r 4 �_ U'. I _ Subtotal: �'f
rDale.: If)/2{)115 ❑Plan Review Required(25°/of permit fee): �'
Print name: Chester Garrett _--- --- 4/
1 State surcharge(12%of permit fee): V./7
1 TOTAL PERMIT FEE: 75.9 g'
Authorized signature:
This permit application expires if a permit is not obtained within ISO
Print name: Peter Kozarez I Date: 10/20/15 1 days after it has been accepted as complete.
----- I ' 1`iumher of inspections allowed per permit.
I'\Building\Permits\EI.C_'srmitApp-GLIi ERE dos Rev 06/17/2010 a-to-4'15 r;,."i.cOMAk r.ti