Permit CITY OF TIGARD ELECTRICAL PERMIT
x ' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00164
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/30/2011
Parcel: 2S112BA05900
Jurisdiction: Tigard
Site address: 14058 SW MILTON CT
Project: Transcat Subdivision: Lot: 0
Project Description: Electrical for TI.
Contractor: TIMBERLINE ELECTRICAL CONTRACTORS Owner: GOODHEAD, DAVID & JAN M
PO BOX 918 9846 SW PEPPERTREE LN
LAKE OSWEGO, OR 97034 TIGARD, OR 97224
PHONE: 503 - 459 -4089 PHONE:
FAX: 503 - 254 -4227
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 03/30/2011 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/30/2011 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 -0090. You ma o a copy es or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23447
/
Issued By: Permittee Signature: _ _ 41
dir
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.
, t ��-i r 111
E1ectr) aJ j erm'I PUJicatiod
City of Tigard , n 3 0 2011 R ete i i ved Era _ '� ..
11 fill
,. 13125 SW Hall Blvd., Tigard, OR 97223 Plea Review "
.. I" Phone: 503.639.4171 Fax: 503.598.1960 Date/13 : Ot er Permit. F j /�._
, Inspection Line: 503.639.4175 Date Ready/By: 1 _ -__ 85 See rage 2 for .-
Internet: www.tigerd -0r.gov Noti6ed/Method: Supplemental Information
0 New construction Addition/alteration /replacement Please check all that apply (submit gears o phial writema atiecked1410* ":
0 Service or feeder 400 amps or more ' Q 9wldirig.over throe stories.
0 Demolition Other:
where the available fault current ❑ Marinas and boatyards.
` exceeds 10,000 at-150 volts or _ - Floating buildings.
, amps. (� dings:
less to ground, or exceeds 14,000 0 Commercial -use agricultural
1- and 2- family dwelling 42 Commercial/industrial C] Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: O Fir° pump ❑ Installation of 75 KVA or
['Emergency system. larger ly derived system.
❑ Addition of new motor load of , ❑ A ", "E""1 2 ", "1 -3'•,
Job no.: Job site address: 4{05: L+ 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational veicle parks.
City /State/ZIP: 1 p 4 ._ . 0 Health-care facilities. [(Supply voltage 'formic than
0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: TR I -17 Service or feeder 600 amps or more.
Cross street/directions to job site: ne criptioa Ott. . Bee, Total
— - -- -1New- rcsidentipl- single- or._multi>fau+tlydwelling unit.
Includes attached garage.
Subdivision: Lot no.; 1,000 sq. ft. or less 1 4
Ea. add'( 500 sq. ft or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
2
• g � '��,, Limited energy, multi- family
T ` • # residential (with above sq. 8) '1500 ' 2
Services or feeders installation, alter , and/or relocation
200 amps or less 100:70 2
201 amps to 400 amps 133.56 2
Name 401 amps to 600 amps 200:34 ' ° t- _: 2
601 amps to 1,000 amps 301.04 • 2
Address: Over 1.000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) F ax: ( ) 200 amps or less 59.36 1 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
Branchcircuity - new , alteration -or exteaaion, per- panel
Owner signature :. Date: A. Fee for branch circuits with
;; t above service or feeder fee, 7;42 ' 2
_ i each branch circuit
Business name: B. Fee for branch circuits without r
service or feeder fee, first I 56.18 ' alb, is 2
Contact name: branch circuit
Each add' I branch circuit 1.. . 7.42 j . � , 68 2
Miscellaneous (service or feeder not included)
Each manufactured or modular
67.84 2
dwelling, service and/or feeder '
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail:
Pump or irrigation circle • . 67.84 2
Sign or outline lighting 67.84 2
• Signal circuit(s) or limited - energy
Business name: Ion Cr :7. . 9 a panel, alteration, or extension. Page 2 2
�^ ""` L Each additional inspection over allowable in any. of the abov
Address: P 0 [.�1) • t% Additional inspection (I hr min) 66.25/ hr 1.
City/State/ZIP: 4,1 V �. 916a Investigation (l. 66.25/ hr
� � Industrial plant (t. hr min) 78.18/ hr
Phone: b3) f.� i 0 ., i . IMIMIMETEMIll Inspections for which no fee is
s ifcall listed h rain 90 hr
CCB Lie.: 660 D Electrical .: �� is t � "�
Suprv. Electrician signature, �� FBtr / , a eSubtotal: "„
p gnature, required: / Plan review (25 /o of perm f
Print name: �, r Dat f State surcharge (12% of pe nnit fe 10 - ��
Authorized signature:
TOTAL PERMIT FBE:,_ ( .
This permit application ecpitttytfo perprtt is not 9l71i0,50 within 180
Print name: days after it has 'Nees accepted as eompleie'
Date: + Number of inspections allowed per permit.
I:1 ISuilding \PermtblELC'permitApp.eoc 07/01/10 440- 4615T(11/05/COM/wEB .
Z00 /Z00(2] Xy3 T5 :6T TTOZ /6Z /E0