Permit 7 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00126
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/08/2011
Parcel: 2S102CA00917
Jurisdiction: Tigard
Site address: 13415 SW VILLAGE GLENN DR
Project: WILTON Subdivision: VILLAGE GLENN Lot: 17
Project Description: Panel replacement.
Contractor: MCCOY ELECTRIC CO INC Owner: WILTON, JOHN W & POMONA L
2014 SE 9TH AVE 13415 SW VILLAGE GLENN DR
PORTLAND, OR 97214 TIGARD, OR 97223
PHONE: 503 - 234 -7521 PHONE:
FAX: 503 - 234 -9473
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 03/08/2011 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 03/08/2011 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 ' if work is not started within 180 days of issuance, or if wor is s, ..ended for more the 180
days. ATTENTION: Oregon law requires you to follow ted by the Oregon Utility Notification C er. T••seles are set forth in OAR
952- 001 -0010 throu• • 952- 001 -0090. You may obtain a c of te• �'
•irect questions to OUNC by calling 50 or 1 • r0, 344.
Ii
Issued By: - - /� Permittee Signature: ,
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.
Mar, 8. 2011 7:40AM McCoy Electric Co, No. 3781 P. 1/1
Permit Application . - - FOR OF ICE, tine, ONLY
ccAe-'nectrical
i lstoei�
City of Tigard Ratery ea 'mac Permit No.: i 1 - (X) 1)1
Ni ) 7 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi ,
` 1 L Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit;
T i C ;\ R Tr Inspection Line: 503.639.4175 Date Ready/By: Turin: El See Page 2 for
Internet' www.tigard Nolificd/Mcthod: T Supplemental Information
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)!
El Service or feeder 400 amps or more 0 Building over three stories.
❑ DemO11ti017 111 Other:
where the available fault current El .Marinas and boatyards.
* �''' r li 8 P 8 J 1 1 11 1 , 1. I t itsti I4 � Q{�y3 �y � ° i � ' aaceeds 10,000 amps at 150 volts or El Floating buildings.
+ `� TT re 1 lees to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2 -famil y dwelling Commercial/industrial ❑ Accessory building amps for all other installations. buildings. •
❑ Multi- family [] Master builder El Other: El Fire pump. ❑ Installation of 73 KVA or
E , : i = - = x , 1 g 17� el ry Emergency system. larger separately derived system.
y� � g ,
1 i3 =.E j -s 1 # r',N 4� €��i4` 9 .N 11. L ❑ Addition of new motor load or ❑"A:, "E","1.-2",“1-3",.
Job no.: D5177 Job site address: 13415 SW VILLAGE GLENN DRIVE 100HP or more. occupancy,
Cl Six or more residential units. El Recreational vehicle parks.
City /State/ZIP: TIGARD, OR 97223 Oilcan-care facilities. El Supply voltage for more than
❑ 1laxardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: OLSON ❑ Service or feeder 600 amps or more.
tl 1. I U 1 :!,,, k./ :.'i(I lr t � , ,,C II DIJLF its (t ,Zta.;:i 'l ?
Cross street/directions to job site: pacripiion
J Qb. I [Rea I Tow I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. It. or less _ 168.54 4
Ea. add'l 500 sq. It. or portion I= 33.98 1
Tax map /parcel no.: tt ( j h € Limited energy, residential
E :, d 1, 4' :! 'l . 'd w r. y f �l ', : ` "�_ t > 1.1'1, tr a l �Ty�tlil 1 1 ''3E t 3 I 1 Fi ll 1 ili , , r� i with above si. ft. ■ 75.00 2 • L energy, multi - family ■ 75,00 2
REPLACE FEDERAL PACIFIC PANEL residential with above - ,. It,)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 100.70 2
E" 1 E Pl � e ii l t i 8 t
i q tl l � ;. ,! si t � I g�l 9��� il nl l° " l l 1 1® ' '' I tl '; lil lEsy .5�� .4i 201 ampo to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address; Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State/ZIP; relocation
r
Phone: ( ) I Fax: ( ) 200 amps or less 59,36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits new, alteration, or exten panel
Owner signature: Date: A. Fee for branch circuits with
1i ur I pp�� 99 �( r a ,i
R g ';rF m:i4 � : ,Ef � - Mill I' R�I� A eIt g l ' i . li] O 4 , i> P E RSt] q x C • #� ' ,;; above service orEBeder 7.42 2
0 m i ar, each branch c
Business name: B. Fee for branch cilcuits
service or feeder fee, first 56.18 2
Contact name_ branch circuit
Each add'] branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or m 67.84 2
dwelling, service and/or feeder
Phone; ( ) Pax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2.
E - mail --
t' « ` 19 ' 1 ' I t "fiT�R`t l' iii ah,�d 1 . . ,l i . i Signor outline lighting 67.84 2
i
:. >. .., , u. ..:. ; . ,' ' 11fr ifs ; rl Signal circuit(s) or limited - energy
Business name: McCoy Electric Co. Inc. pane[, alteration, or extension. Page 2 2
--- Each additional inspection over allowable in any of the abov
Address: 2014 SE 9 Thr AVENUE Additional inspection (1 hr min) 66.25/hr
- Investigation (1 hr min) 66.25/hr
City /State/ZIP: PORTLAND, OR 97214 Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 234 -7521 Fax: (503) 2349473 Inspections for which no fee is 90.00/hr
specifically listed (%r hr min) �
CCB !a
Lie.: 8277 Electrical ic.: 26 - 82C Supry - Lie.: 21755 , EI,E > J; T� >~1 in. _ lam n ,,;
Suprv. Electrician signature, required: r /� ` ')-Arre( Subtotal:
Plan review (25% of permit fee)) : 100.70
Print name: JIM HALL Date: 03 -08 -2011 State surcharge (12% of permit fee): 12.08
TOTAL PERMIT FEE: 112.78
Authorized signature; This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
t:\ eeitdineersits\ELC- PuroitApp.doc 07/01 /10 440 4615Ttlt/ 5/COMnvbe