Permit (72) CITY OF TIGARD i • ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT4/6p� Permit#: ELC2016-00357
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 r`�^ Date Issued: 05/02/2016
Parcel: 1 S 136AA02201
Jurisdiction: Tigard
Site address: 6501 SW OAK ST
Project: Peterson Subdivision: None Lot: None
Project Description: -Install new 400 amp service to the garage/shop
-Upgrade to new 200 amp service to the home. 8/3/16,REPRINTED to add(1)branch circuit.
Contractor: MULTIPHASE ELECTRIC Owner: PETERSON,THOMAS C
20701 S. MONPANO OVERLOOK DR. PO BOX 80954
OREGON CITY, OR 97045 PORTLAND, OR 97280
PHONE: 503-631-4649 PHONE:
FAX: 503-631-4659
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/02/2016 $100.70
Specifics: amps or less
1 ea Services or Feeders-201 to 05/02/2016 $133.56
Type of Use: SF 400 amps
Class of Work: ALT 1 ea 12%State Surcharge- 05/02/2016 $28.11
Electrical
Type of Const: 1 crt Branch Circuits w/Purchase 08/04/2016 $7.42
Occupancy Grp: Service or Feeder
45 Misc Administration Fee 08/04/2016 $45.00
0 ea 12%State Surcharge- 08/04/2016 $0.89
Electrical
Total $315.68
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTIO • regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 rough OA 52-00090. You may obtain a copy of the rules or direct questions to OUNC by Galli I.. 32.1987 oF1.800.332.2344.
Issued B lL Permittee Signatur.
_ V
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Aug 02 2016 11:40AM Multiphase Electric, LLC 503-908-1628 page 1
Electrical Permit ApplicatioRECEIVEft FOR OFF I( L I SE ON L1
City of Tigard Received n
Dale/By: (l , / , 4 Pem4$t��i o/I! - a`� /
41 6
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review W
N . Phone: 503.718 2439 Fax: 503.598.1940 C 2 2016 Date/By: Related Permit 8:
Inspection Line: 503.639.4175
I.1 G�\R D CITY Ready Date/By. Lurie H See Page 2 for
w,tigard-or.gov OF TIG�AR NotifiedlMethad: Supplemental Information
Internet: ww
TYPE t i i I DING DIVISION' PLAN REVIEW
❑New construction ®Addition/a teration/rep acement Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more ❑Building over three stones.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings,
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
Multi-familyamps for all other installations buildings.
0 Master builder 0 Other: 0 Fire pump 0 Installation of 150 KVAor
JOB SITE INFORMATION AND LOCATION ❑Emergency system. lar
Job#: Job site address:6501 SW Oak St0 larger separately derived
Addition of new motor load of system.
100IrPormore. 0"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
❑Healthcare facilities. 0 Recreational vehicle parks.
0 Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.4: Project name:
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
FEE SCHEDULE
Detcripties I Qty. 1 Each [ Total i
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: Includes attached garage.
Tax map/parcel 4: 1,000 sq.ft.or less 168 54 4
DESCRIPTION OF WORK energy,
Ea.add' sq.ft.or portion 33 92 1
Limited enerresidential
Add one(1)additional circuit to current permit#2016-00357 for A/C unit. (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 7500 2
0 PROPERTY OWNER TENANT _Renewable Energy p See Page 2
Services or feeders installation,alteration,and/or relocation
Name:
200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
CitylStatelZIP: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 1
Email: Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701.
201 amps to 400 amps 125.08 2
Owner signature: ___ Date: 401 amps to 599 amps 168,54 2
® APPLICANT I ® CONTACT PERSON Branch circuits—new,alteration,or extension, er panel
Business name:Multiphase Electric A.Fee for branch circuits with
above service or feeder fee, 1 7.42 Z
Contact name:Dave Gackle
each branch circuit 7.42
B.Fee for branch circuits without
Address:PO Box 1416 service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP:Oregon City,OR 97045 Each add'1 branch circuit 7.42 2
Phone:(503)408-1593 I Fax::(503)905-1628 Miscellaneous(service or feeder not included)
Each manufactured or modular
Email:info@multiphaseelectric.coin dwelling,service and/or feeder 67.84
CONTRACTOR Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name:Multiphase Electric Sign or outline lighting 67.84
2
Address:PO Box 1416 Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/state/ZIP:Oregon City,OR 97045
Additional inspection(1 hrmin) 66.25,'hr
Phone:(503)908-1593 I Fax:(503)908-1628 Investigation(1 hr min) 90-00/hr
Email:info@multiphaseelectric.com Industrial plant(I hrmin) 78.18/hr
Inspections for which no fee is
CCB Lic.: 162827 Electrical Lic.- Suprv. .: 5122S specifically listed(6 hrmin)
90.00/hr ��
Suprv.Electrician signature,required: �' ELECTRICAL PERMIT FEES
Subtotal: 7.42
Print name: Dave Geckle Date: 8/2/16 0 Plan Review Required(25%of permit fee): yS`,UO
ir
2.0
State surcharge(12%of permit 1 e): ,e69
Authorized signature: _ TOTAL PERMIT FEE: 53.3 f
Print name: Dave Gaek a This permh application expires it a permit is not obtained within 190
ate: 8/2/16 days atter it has been accepted as complete.
* Number of inspections allowed per permit
I\Building\Permits\ELc_PermitApp ELR_ERE.doc Rev 06/17/2015 440.4615r(t1/OS/COM/WEB