Permit CITY OF TIGARD ELECTRICAL PERMIT
11111 " o COMMUNITY DEVELOPMENT Permit #: ELC2010 00479
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/07/2010
Parcel: 2S112BB04400
Jurisdiction: Tigard
Site address: 8115 SW BONITA RD
Subdivision: Lot: 0
Project: Minger
Project Description: Temporary service.
Owner: FEES
MINGER, STACY & JARROD Quantity Description Date Amount
8115 SW BONITA RD
TIGARD, OR 97224 1 ea Temp Services or Feeders - 09/07/2010 $59.36
200 amps or less
PHONE: 1 ea 12% State Surcharge - 09/07/2010 $7.12
Electrical
Contractor:
SQUIRES ELECTRIC
PO BOX 16851
PORTLAND, OR 97292
PHONE: 503 - 252 -1609
FAX: 503 - 253 -5831
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $66.48
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 OAR 952 - 001 -0100. You .. - • • u a e rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: _Law-
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 an inspection that business day.
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.
03/07/2010 12:23 5032535831 4 \UIRES ELECTRIC #6232 P.002/002
Electrical Permit Application ` 0\ 13 '(3 ; ' FOR OFFICE ; :SE OL\
�J Received
III City of Tigard ♦`• `� � 0 � natdB . I tV� riallail
13125 SW Hall Blvd., Tigard, OR 97223 ,
Phone: 503.639.4171 Fax 503.598.1960 l:' Vic Other Permit i lc, A R D Inspection Line: 503.639.4175 Sec Page 2 for
Internet www.trgard-or.gov o i ` .Z; • . Supplemental 7nfOr mAppn
❑ New construction 1.4 Addition/alteration/rep : •, t, - , ` * 0 Please check an that apply (submit 2 sets of plans wrgems checked below
3 Cj 0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition Other: where the available fault current 0 Marinas and boatyards.
d k r :, execoda 10.000 amps at 150 volts a 13 Flowing Flong buildings, .. — - �' reset ro grotnld or cxeoe4s 14,000 ❑ Cemmissial -use a�cicultma!
1- and 2 -family dwelling ID Commercial/industlial El Accessory b j ` amps for all other instillations. aiions. buildin
0 Muhi - family ❑ Master builder 0 Other , 0 Fire pw p. 0 Installation of 75 KVA or
l ❑ Emdgency system- larger separately derived system,
/+ddidon o£ new meter toad of
Job no.: Job site address: 0J /6 — — 100HP or more. oc y.
ry � • O— ' 0 six or more residential units. ❑ Recreational `Chicle parks.
City /StateJZ R JY d a g 1c
Of' 4 ❑ Hw ardou a futilities. . 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldgJapt no.: • f Project name: 0 Service or feeder 600 amps or more.
T•, x"7
Cross street/directions to job sire: Description Qty. 1 ice, 1 Total 1 •
New residential single- or multi- family dwelling unit.
Included attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
E
Tax map /parcel no.: a. 3414'1500 sq. ft . or portion 33.92 1
Limited energy, residential
^; 75.00 2
' :,.� • _ � _ _ ( a sq. R.)
— — -- Limited energy, multi family 75.00 2
J4 _ / 1 • .• residential (with above sq. R)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
Try 201 t0 400
133.56 2
amp �
401 amps to 600 amps 200.34 2
Nltme. 601 amps to 1.000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary serviced or feeders installation, alteration, and/or
City / State/ZIP: relocation _
- Phone:( ) I Fax: ( )
200 amps or less 5936 - l�j ( e
^
Owner installation: This installation is being made on property that 1 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. 601 amps to 599 amps 168.54 2
Branch
Owner signature: Date: Fee for branch circuits with alteration, or extension. per panel
above service or feeder fee. 7.42 2
each branch circuit
Business name: B. Fee for branch circuits withoru
Ravice or feeder fee, fast 56.18 2
Contact name: branch circui
Each add'I branch circuit i 7.42 ( 2
Address: Miscellaneous (service or feeder not included)
—
Each manufacted or modular
City /State/ZIP: dwelling. service and/or feeder 67.84 2
Phone: ( ) J Fax : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E f T - Sign or outline lighting 67.84 2
Business name: l -i Y r F panel, alteration, or extension. Page 2 2
t Q-S l Y i r^ .. Each additional inspection over allowable in any of the abov
Address: Z) It icx. (45 / Additional inspection (1 hr min) 6625/ hr
City / State/ZIP: ) r ( 40 b k. 9 7. g. investi ( i hr min) 66.25 / hr
Industrial plain (i hr min) 78.18/hr
Phone: 603 6, - I ( 0 C l Fax: (6o 5 ,0., 5 e / l inspections for which no fee is 90.00 / la
-. call listed A hr mm
CCB Lic.: 0£ 6 - Electrical Lie..: , -, Ia l Suprv. Lic.: - r- . r i� .._ ?: .._.� j _ , ,� • , oai4p
. ° "
Suprv. Electrician signature, req
Subtotal:
Plan review (25% of permit fee):
Print name: e... s us; re S Date: L /) State surcharge (12% of permit fee): 7 '.-
'
Authorized signature: TOTAL PERMIT FEE: tQ to
j
This permit application expires if a permit is not obtained witbia 180
Print name: Date: days after it has been accepted as complete.
` Niunber of im9oetiong allOwtd per 1»
1; 12undingTormit :UILC- PormnApp.doc 07 /01/10 440 4615T(11 /05/COMIWEB