Permit (2) N CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00437
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2014
Parcel: 2S103DD00700
Jurisdiction: Tigard
Site address: 13775 SW PACIFIC HWY
Project: Colony Properties Subdivision: MELROSE Lot: 7-8
Project Description: Grounding due to new water service.
Contractor: LOVETT EXCAVATING Owner: COLONY PROPERTIES
PO BOX 86280 4817 SW STEPHENSON ST
PORTLAND, OR 97286 PORTLAND,OR 97219
PHONE: 503-737-8423 PHONE:
FAX: 503-288-1630
FEES
Quantity Description Date Amount
1 ea Reconnect Only 08/06/2014 $67.84
Specifics:
1 ea 12%State Surcharge- 08/06/2014 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
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: e on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 ugh OAR 2-001-0090.`You may obtain a copy of the rules or direct questions to OUNC by calling 503.2a4.1987 or 1.800.332.2344.
Issued By: ( —� i�'✓t��! Permittee Signature: -ze d
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, 4. 2014 3:03PM LRita-Wt>CL,D No, 1651 P. 1
Electrical _Pern11t AupliCatlon i•UR,(11.0 R r: I St 01I,Y.
City of Tigard Received M��� „
111 13125 SW Hall Blvd.,'f'Tigard,OR 9/223 G 201 Date
Plan Review Other Permir
Phone: 503.7182439 Fax: 503.5Q Dare/B •
f t�,\a t? Inspection Line: 503.639.4175 CM'°OF TIGARD Date Ready/By; Ws: l�See Page 2 for
Internet www.tigard-or.gov 1 i i , k Notified/Method: Supplemental Information
C J ✓ f IN �.:yc1,< tff�.11T'µ 7."4 1 ^ '; f,s ty.T.
t}y 4 RW „},E .qi.7 �� �q v 'L 1 K;. 1, k ryLr 7 .TSB, r,P 4, ., ff";! tq, is
L:':tkm,e ."rb,i.•Al-.a,.. :ltd,�*y ..,:,.ar �`.1't..cs. .�t�., :n 4x t.Ed „: )4.i�e ! 1 •. cif A 0,t r , a r ,:v.:.
0 New construction Addition/alteratiott/replaccmcnt Please check all that apply(submit 2 at of plans w/items ehe iced below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other where the available faulr current ❑Marinas and boatyards.
` i" . tT W 47171:7-44. f It -Z t ' lr4 f f:1�" ',, i : exceeds 10.000 sat ISO volts or ❑Floating buildings,
. ' sa.: c . ";"" 2''1"- i ; '6i''''''
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
El 1-and 2-family dwelling i:'Commercial/industrial ❑Accessory building amps for all other installations. buildings,
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
ai i 1i" 7 dio larger ar ly derived system.s kt r i . Y 11 a , 4 i i'! C Emergency
di n of new motor load of ❑ t 2
Job no.: Job site address: I 7c P4-c l Ps l i.or more e rest Rec reaiion
�7tJ�' ❑Svt or more residential units. ❑Rcercational vehicle parks,
City/State/ZIP: `' 4"14-4) 9.7 Cl Health-Dare facilites.
❑Hazardous locations. L Supply voltage for more than
600 volts nominal.
Suite/bldg./apt.no.: l Project name: (./44..I�N y Qj2pA/l0E5 0 SrviCS or feeder 600 noipa or more.
Cross street/directions to job site: Descrtptt°a I •
QTY. I Fee I Teed
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: l Lot no.: 1,000 sq.ft,or less 168.54 4
Tax map/parcel no.: Ea.add'I 500 sq,ft,or portion 33.92 1
g� uG r , , �^ �1 y� ', p K _,.•� Limited energy,residential 75,00 2
t Y^i li,` ,N,',. :: ,�'.. .leer r.•il:4. t rd. p�. .r;" u tab.i .ki'i n a�:.�l R v y (with above sq.ft.)
Limited energy,multi-family 75.00 2
( �d()� /..)C7-- residential(with above sq.ft.) 75. _
Renewable Enemy _ ❑ Sec Page 2
Services or feeders installation,alteration,and/or relocation
r `» . a t " ? 200 amps or leas allli 100.70 2
Name: C[} 0 /V Li /0R,�Z�r� S 201 amps to 400 amps 133.56 2
L
401 amps to 600 amps 200.34 2
Address: 1.--.fg(1 S CA..l 4t r(,Jr,]CJ. J 5"r- 601 amps to 1,000 amps 301.04 2
� �n Over 1,000 amps or volts t 552.26 2
City/State/ZIP: p(1�tLA Ml q 7? 1 5 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,perpanel
*A : i �+ s ,,,p,,,,, ,, e ,.-� 97,; N y { 4..t�,:'3 A.Fee for branch circuits wirh
above service or feeder fee,
7.42 2
Business name: LO u k 7--' each branch circuit
B.Fee for branch circuits without
Contact name: "DA. A j 6 iLt 0/1414-A..J service or feeder fee,first
56.18 2
branch circuit
Address: Bach add'I branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each mantrfacnlred or modular
Phone: {{ )7 L f 0 u-7 ? Fax: :(2_4W I 3 (. dwelling,service and/or feeder 67.84 z
l-mail;U-,Q"K , .O, ( e $t.it o(CIE 5 C-614^ Pump orir irrigation / 67.84 �7. 2
�'` Pump or irrigation circle 67.84 2
21i?r ,,t., td af' ,K;.i,:ate : Sign or outline lighting 67.84 2
Business name: C_ IJ V z. rT- Signal circuits)or limited-energy Sec
panel.alteration,or extension. Page 2 2
Address: p,0 . b L y 8-"0 Each additional inspection over allowable in tiny of the above
City/State/ZIP: PO L rLdi- 9 7 2_(5-1.. f Investigation inspection( hr min)()hr mm) 66.25/hr
Investigation(1 hr min) 66.251 hr
Phone;(95) 1 3 7 r-g-tiZ 3 7 Fax:( )) 2 Fr 6--J C 3 U Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 9000/hr
CCB Lic.:(Z�"() 7 Electrical Lie.: - Suprv.Lie.:S 1195 S specifically listed Di hr,tnin)
tc, ,
S i1pA14;t;Y3�ft.Hl 1*Ct 14 I K. *i3'i'.tit��?
Suprv,Electrician signature,required:At � l� ', subtotal: I kio �
O , 0-Cl,
Print name: l LnUL- L-4(-4110S �' Date: t-f ( Plan review(2S%ofpermit fee); !�
State surcharge(12%of permit fee): t -
Authorized signature: TOTAL PERMIT FEE: 94
�y This permit application expires if a permit is not obtained within 1811 76d
Print na4� Date: alt-+ J/ days after it has been accepted as complete.
r / • Number of inspections allowed per permit.
Lklauildinal canittV3l,C_PermliADp_ClVB2.doc Rev 05/212013 4404515T(t1/OS/COM/WE9