Loading...
Permit t CITY OF TIGARD ELECTRICAL PERMIT ` °I COMMUNITY DEVELOPMENT Permit #: ELC2011 -00197 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/14/2011 Parcel: 1S136DB00501 Jurisdiction: Tigard Site address: 11611 SW PACIFIC HWY Project: Union Gospel Mission Subdivision: Lot: 0 Project Description: (4) branch circuits to upgrade facility. Contractor: CAPITOL ELECTRIC CO INC Owner: FRANCESCHI, JEROME R /GENEVIEVE R 11401 NE MARX STREET INTER VIVOS TRUST AGREEMENT DATE PORTLAND, OR 97220 MA FRANCESCHI, KENNETH A/BARBARA A 602 THIRD ST STE #9 SAN FRANCISCO, CA 94107 PHONE: 503 - 255 -9488 PHONE: FAX: 503 - 257 -7121 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 04/14/2011 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/14/2011 $9.41 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 Required Items and Reports (Conditions) This pe . . . . . . . .s u b j e c t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be d• e in accordance • 'th appro - • plans. This permit will expire if work is not started within 180 days of iss - ce, or if work is suspended for more the 180 day -. ATTENTION: Oregon la req ir- you to follow the rules adopted by the Oregon Utility • " -tion Center. Those rules are set forth in OAR 9 •- 001 -0010 t rough OAR 9501 -009•• �' i '" may obtain a cop of the rules or direct questions to • • ' b . 1 87 or 1.800 .3.2344. / 4 , sued By: � / i /L !� Permittee • ature: - ' ' " i' � ' Jeri ■ 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' — T _ � 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. Electrical Permit Application ecerve 1 a City of Tigard 6)\ ,� Date/By: 4 IV ermit no.: ei�C d! /— 09/9 • 13125 SW HaII Blvd., Tigard, OR 972 Q1 Plan Review Phone: 503.639.4171 Fax: 503.598.19 1 Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 PQ� G0 Date Ready /By: Juris: ❑ See Page 2 for Internet: www.tigard- or.gov rk �l N AS% Notified/Method: Supplemental Information • Q ❑ New construction ❑� Ad dition /alteration /replacement $ Plea check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories f I ) 1 )4:11)4,lslettltr4auy where the available fault current ❑ Marinas and boatyards ❑ 1 and 2 family dwelling I Commercial /industrial ❑ Accessory building exceeds 10,000 amps at 150 volts or Floating buildings ❑ Multi family ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial -use agricultural ' 4 .613- 11'aFbRlakrlO eslb LOCATION' } VAIMti ; amps for all other installations. ❑ buildings Job no.: 110665 ' Job site address: 11611 SW pacific Hwy ❑ Fire Pump ❑ Installation of 75 KVA or ❑ Emergency system larger separately derived system. City /State /ZIP: Tigard, Oregon 97223 ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", 100HP or more. ❑ occupancy • Suite/bldg. /apt. no.: 'Project name: Union Gospel Mission Ltg ❑ Six or more residential units ❑ Recreational vehicle parks. ❑ Health -care facilities ❑ Supply voltage for more than Cross Street/Directions to job site: ❑ Hazardous locations ❑ 600 volts nominal. ❑ Service or feeder 600 amps or more Subdivision: Lot no.: FEE SCHEDULE Description I Qty. I Fee. I Total I " Tax map /parcel no.: New residential - single or multi - family dwelling unit. r`. %- - ii'I . . I., JP OP'WORK o7" U, : : 1 : .iiiogiatigiki. Includes attached garage. Lighting upgrade at the facility 1000 sq. ft. or less $ 168.54 4 Ea. Add'I 500 sq. ft or portion $ 33.92 1 ❑ PROPERTY OWNER _:, 1= �e • U MINANT,.. .:e 4, o- Limited energy residential Name: (with above sq. ft.) $ 75. 2 Limited energy, multi - family Address: residential (with above sq. ft.) $ 75.00 2 Service or feeders installation, alteration, and /or relocation City/State /ZIP: 200 amps or less $ 100.70 2 201 amps to 400 amps $ 133.56 2 Phone: Fax: 401 amps to 600 amps $ 200.34 2 601 amps to 1000 amps $ 301.04 2 Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 552.26 2 intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and /or Owner signature: Date: relocation 200 amps or less 5 59.36 1 ❑ APPLICANT +" r : � : I - .1 U • ..CONTACT PERSON - 201 amps to 400 amps $ 125.08 2 Business Name: 401 amps to 599 amps $ 168.54 _ 2 Branch circuits - new, alteration, or extension, per panel Contact name: A. Fee for branch circuits with service or feeder fee, each Address: branch circuit 5 7.42 2 B. Fee for branch circuits City/State/ZIP: without service or feeder fee, first branch circuit 1 $ 56.18 56.18 2 Phone: Fax: Each additional branch circuit: 3 $ 7.42 22.26 2 Miscellaneous (service or feeder not included) E -mail: Each manufactured or modular ;t ^L'- 9NTRACTOl R::r * !, 1 ' 6 .3.4"' -! ' dwelling, service and or feeder $ 67.84 2 Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 67.84 2 Pump or irrigation circle $ 67.84 2 Contact name: Gary Steiert Sign or outline lighting 5 67.84 2 Signal circuit(s) or limited - Address: 11401 NE MARX ST. energy panel, alterations, or extension. Describe: Fire Alarm $ 75.00 2 City/State /ZIP: PORTLAND, OR 97220 -1041 Page 2 Each additional inspection over allowable in any of the above Phone: 503- 255 -9488 Fax: 503- 257 -7121 Per inspection $ 66.25 Investigation per hour (1 hr min) $ 66.25 CCB Lic.: 48748 'Electrical 2 26 6 - 4960 ISuprv. Lic.: 3132 Industrial plant per hour $ 78.18 _ Suprv. Electrician signature, required / �!� !' , `° ELECTRICAL PERMIT FEES* Subtotal $ 78.44 Print Name: DARRELL MCN L Date: 04/12/11 Plan review (25% of permit fee) Authorized signature: State surcharge ( 12% of permit fee) $ 9.41 ��� i TOTAL PERMIT FEE $ 87.85 Print Name: DARRELL MCNE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections per permit allowed. I II .4 CITY OF TIGARD ELECTRICAL PERMIT ' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00197 Date Issued: 04/14/2011 TtGAR.t 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S136DB00501 Jurisdiction: Tigard Site address: 11611 SW PACIFIC HWY Project: Union Gospel Mission Subdivision: Lot: 0 Project Description: (4) branch circuits to upgrade facility. Contractor: CAPITOL ELECTRIC CO INC Owner: FRANCESCHI, JEROME R /GENEVIEVE R 11401 NE MARX STREET INTER VIVOS TRUST AGREEMENT DATE PORTLAND, OR 97220 MA FRANCESCHI, KENNETH A/BARBARA A 602 THIRD ST STE #9 SAN FRANCISCO, CA 94107 PHONE: 503 - 255 -9488 PHONE: FAX: 503 -257 -7121 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 04/14/2011 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/14/2011 $9.41 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 Required Items and Reports (Conditions) I This per . -• subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be d• e in accordance , 'th appro -d plans. This permit will expire if work is not started within 180 days of iss - ce, or if work is suspended for more the 180 day -. ATTENTION: Oregon la req ire you to follow the rules adopted by the Oregon Utility • ' ation Center. Those rules are set forth in OAR ii 9 •- 001 -0010 t rough OAR 9501 -0090 may obtain a cop of the rules or direct questions to •. ' by 'g i . 1087 or 1.800.3 .2344. sued By: / . iI !-_!....._ Permitt i .ture: =�% / ice. '/ / V� % !/--- --- 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 INSTALLNTION ONLY SIGNATURE OF SUPR. ELEC' T -. ., - 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.