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Permit
CITY OF TIGARD ELECTRICAL PERMIT • = COMMUNITY DEVELOPMENT Permit #: ELC2011 -00249 TGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/12/2011 Ii Parcel: 2S103CB03001 Jurisdiction: Tigard Site address: 12285 SW MARION ST Project: Mainlander Properties Subdivision: WILLAMETTE NO.2 Lot: 35 Project Description: (2) branch circuits for A/C and an additional outlet. Contractor: GRF ELECTRIC Owner: MAINLANDER PROPERTIES 15460 S PARADISE LN 12285 SW MARION ST MULINO, OR 97042 TIGARD, OR 97223 PHONE: 503 - 635 -4477 HONE: 503 - 829 -4146 FAX: 503 - 829 -5747 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 05/12/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/12/2011 $7.63 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 0 • R 952- 001 -0090. Yo..may -ebtai :: - or direct questions to OUNC by calling 503 23 .1987 or 1.800.332.2344" 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. 2011 -05 -12 11:03 GRF ELECTRIC 5038295747» 5035981960 P 1/2 Electrical Permit Application ��V9 FOR OFFICE r S4_. O\1 City of Tigard 8Datdeeeiyed ` (` , ,� Bv: S PermitNo.: / G C • I3125 SW Hall alvd., Tigard, OR 97223 1 Plan Review X71 _ f/�11 ��' cod-41/ Phone: 503.639.4171 Fax: 503.598. l9C�O P� R DAM/By: Other Perrot: p In; e ction Line: 503.639.4175 \` Slrl} o ra Rea dy /By; luris S Page 2 for I'[Gn R tt — Internet: www.tigard- or.gov l�� G, Notified/Method. fI i Supplemental Information TYPE OF WO'. a t a _ L PLAN REVIEW III New construction r , �4ddition/alterat : rrepiaCement Plea a check nil that apply (submit 2 sets of plans wntems checked b ❑ Service or feeder 400 amps or more ❑ Building over three stones. Q Demolition • a Other; where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ commercial -use agricultural [51- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other instanations. buildings. ❑ Multi family ❑ Master builder ❑ Other; ❑ Fire pump, ❑ Installation of 75 KvA or • JOB SITE INFORMATION AND LOCATION ❑ Omergency system. larger separately derived syruem. ❑ Addition of new motor load of Job no.; Job site address: Z 00HP or more, occupancy. '] ` t CI Recreational vehicle parks. Y , t[L� ❑ .Six or mor residential units, City/State/ZIP: I I ,•' / c ^ ^ ❑Health -ca a facilities 0 Supply voltage for more than /J7 /YL�- ! f ❑ Hazardous locations. 600 volts nominal Suite/bl /ape no Project name: M r / It L'7 ,1„ ❑ Service or feeder 600 amps us more. Cross street/directions to job site: FEE SCKfF.bULE Nom. e r" /t.; COeycnption Qb. FN, Total 1 New residential single- or multi - family dwelling unit, Includes attached garap. Subdivision; Lot no. - 1,000 sq ft. or less 168.54 4 Tax map /parcel n0.. --. Ea. add'l 500 sq ft. or portion 33 1 '- Limited energy, residential • DESCRIPTION OF WORK (with above so. ft.) 67.84 2 Limited energy, multi- family C- - .C_„.-/ residential (with above sq. ft ) 67.84 2 Services or feeders installation, alteration, and/or relocation 200 amps or less _ 100.70 2 I ROPERTY OWNER _ ❑ TENANT 201 amps to 400 amps _ _ 133,5E 2 Name: _ 401 Amps to 600 amps 200.34 I 601 amps t0 1,000 amps 301.04 2 2 Address: ` 2...-2- Z f ( `} 7 k 5 (r f " rz1 r 0 +?-i • Ov 1,000 amps or volts 552 26 1 2 (ity /State /ZIP: -T - � ' Temporary hervices or feeders installation, alteration, and /Or �� relocation L Phone: ( (rU 5 1 c t 7 ' Fa ( ) 200 amps or less .. I 5936 i ` � 201 amps 10 400 amps 125.08 2 Owner installation: This installation is being made on property that 1 own which is not intended for sale, lease, rent, Or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 I 2 Branch circuits -new, alteration, Or extension, per panel Owner signature: _ ._ Date; _ A. Fee for branch c with © APPLICANT ❑ CONTACT PERSON above Service or feeder fee, each branch circuit 7 42 2 Business name; - 8. Fcc for branch circuits without --_____ service or feeder fee, first Contact name: branch circuit 56.18 i5. _ , �' 2 Address: Each add'1 branch circuit f 7 � _ Miseellaneous(service or feeder not included) City /State /Z1P: Each manufactured or modular _ dwelling, service and/or feeder 67 '$ 1 2 Phone: ( ) I Fax; : ( ) Reconnect only 67 84 2 _E E -_ - - Pump or irrigation circle 67 84 2 L . CONTRACTOR Sign or outline lighting 67.84 2 Signal circuits) or Itmited.energy ' Business name: L - Of • _ . . panel, alteration, or extension. Page 2 2 Each additional inspection over allow in any of thee above C� t.� / Address: `. , j r �f L. n Additional inspection (1 hr min) 66 25/ hr City /State /ZIP: : / '2 — Investigation (1 hr mm) 6625/hr } GG -1 Industrial plant'( I hr min) 78 18/ hr Phone: (193 3 7y - ' ' . - Fax c ( 3 D 7,::1 -- S ; t ,_ Inspections for Zell no fee is Emomm CCB Lit specifically listed (/ hr min) 90.00/ hr If Suprv. Lie.' / s -_5 ELECTRICAL PERMIT FEES ' Suprv. Electrician signature, required: i t� Subtotal: �� "'" " - ♦. \ • `,.. Plan review (25% of permit fee). Print name: 1 A . Date: State surcharge (12 /0 permit tee); Odik Authnrired .ignnti,rc • TOTAL PFRM[T P " ` This permit appticarion expires if a permit Is not obtonted wild( 1st Print name: Date: days after It has been accepted an complet ' Number of inspections allowed per permit.