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Permit CITY OF TIGARD ELECTRICAL PERMIT 1111 ' 11- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00140 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/17/2011 Parcel: 2S111CA02300 Jurisdiction: Tigard Site address: 15461 SW SUMMERFIELD LN Project: Shock Subdivision: Lot: 0 Project Description: Replace panel and ground /bond. Contractor: ALL PRO ELECTRIC INC Owner: SHOCK, ELIZABETH M PO BOX 280 15461 SW SUMMERFIELD LN 6327 -C SW CAPITOL HWY TIGARD, OR 97224 PORTLAND, OR 97239 PHONE: 503 - 246 -0361 PHONE: FAX: 503 - 246 -0406 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 03/17/2011 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 03/17/2011 $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 a - • 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. AT TION: Oregon - • ire •u to follow the rules adopted by the Oregon Utility Not - '•n Center. Those rules are set forth in OAR 952 -001 0010 through OAR 9521 -0090. ou ay obtain a cop of the rules or direct questions to OUNC • y� .232.1987 or 1.800.33 .2344. ' Issu= • By: / " Permittee Sig �� •�� �� � J 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 INSTALL/CRON ONLY SIGNATURE OF SUPR. ELEC' • r � 011,' i 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 16 11 04:14p All Pro Electric 503.246.0406 p.1 Electrical Permit Application ' FOR OFFI( F l SU ON L\ ty of a n �B v G0 / v Perm No.: 74 ■ 1 S Tig W H all Blvd., rd Tigard, OR 97223 Plan Review e Phone: 503.718.2439 Fax: 503.598,196Qi Ci AR 16 2011 ��R Other Permit: T t G A. R Inspection Lute: 503.639.4175 Date Ready/By: cur : M See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition/alteration /replacement Please check all that apply (submit 2 sees of plans w1 items checked below): ['service or feeder 400 amps or more I] Building over three stories. ❑ Demolition ❑ Other. where the available fault current El Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds I4,000 ❑ Commercial -use agricultural ® 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings. ❑ Multi- family El Master builder ❑ Other: ©Fire pump. 0 installation of75KVAor D Addition system. larger separately derived system. 30B SITE INFORMATION AND LOCATION ion of new motor load of ❑ `•A., "E ^, "1 - 2" °! - 3° occupancy. more. no.: 11 -5938 Job site address: 15461 SW . W' Summerfield In 106HP o r i ❑ Six or more residential units. ❑ Recreational vehicle parks. � OR 97224 ❑ Supply voltage for more than City/State/ZIP: Tigard, ID Health-care facilities. 600 volts nominal. Q Hazardous locations. Suite/bldg. /apt. no.: Project name: Shock CI Service or feeder 600 amps or mom. FEE SCHEDULE Cross street/directions to job site: Description I QV?. I ree I Tout I • ' New residential single or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. It or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential • DESCRIPTION OF WORK (with above sq. It) 75.00 2 Limited energy, multi - family 75.00 2 Replacement of Federal Pacific Panel and ground /bond residential (with above sq. 6.) Services or feeders installation, alteration, and/or relocation 200 amps or less 1 100.70 100.70 2 ® PROPERTY OWNER 1 0 TENANT 201 amps to 400 amps 13156 2 Name: Shock ELI to g g_TH 401 amps to 600 amps 200.34 2 f /� 601 amps to 1,000 amps 301.04 12 Address: 15461 SW Summerfield Ln Over 1.000 amps or volts I 552.26 2 City/Stale/ZIP: /StalelZlP: Ti arc, OR 97224 Temporary services or feeders installation, alteration, and/or t7' 8 relocation Phone: ( ) 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 extension, per panel Owner signature: Date: A. Fee for branch circuits - with ' ® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: All Pro Electric, Inc B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: Kevin Poole branch circuit Each add'l branch circuit 7.42 2 Address: 6327 SW Capitol Hwy, Ste C #280 Miscellaneous (service or feeder not included) Ci /StateJZIP: Portland, OR 97239 Each manufactured or modular 67.84 2 ty dwelling, service andt'ot feeder Phone: (503) 246 - 02361 Fax: : (503) 246 - 0406 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: info @all- pro- electric.com Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited - energy Business name: All Pro Electric, Inc panel, alteration, ore tension. • Page 2 2 _._. Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City/State./ZIP: - Investigation (t hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00/ hr specifically listed ('h hr min) CCB Lie.: 14810 1 Electrical Lic.: 26 -1099C Suprv. Lic.: 4630S ELECTRICAL PERMIT FEES Subtotal: 1010 Suprv. Electrician signature, required: ' ,!' , L '- j i G - Plan review (25 %ofpermit fee): Print name: Kevin E. Poole / /I Date: 03/16/2011 State surcharge (12% of permit fee): 12.08 TOTAL PERMIT FEE: 1 12.78 Authorized signature: ( -� /t % % �J � This permit application expires if a permit is not obtained within 180 days after Print name: Sherri G. Poole / Date: 03/16/2011 • Number of inspections ionsithas allowed been per permit. as complete. l :lauldinecnritAELC PcrmitApp doe 07 /01 /10 44(W6151(1 1/05iCOMrWEH