Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
CITY OF TIGARD ELECTRICAL PERMIT '2,. °., COMMUNITY DEVELOPMENT Permit #: ELC2011 -00263 I 3 TIG.Ag D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/19/2011 Parcel: 1S134CD08100 Jurisdiction: Tigard Site address: 11830 SW SUMMER CREST DR Project: MOORE Subdivision: BURLWOOD NO.4 Lot: 10 Project Description: Panel replacement and additional outlet in garage. Contractor: CHEROKEE ELECTRIC CO Owner: MOORE, TIMOTHY M 13211 SW SUMMERWOOD DR 11830 SW SUMMERCREST DR TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503 - 209 -9039 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 05/19/2011 $100.70 Specifics: amps or less 1 crt Branch Circuits w /Purchase 05/19/2011 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 05/19/2011 $12.97 Electrical Type of Const: Occupancy Grp: Total $121.09 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 ules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You m., - _ - - .. of . _ - . ='rest questions to OUNC by calling 503.287 or 1.800.3...2344. Issued By _�1� _ Permittee Signature: f � Ilh 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. Electrical Permit Application FOR OFFICE USE ONLY City of Tigard '+ , / Recei Permi No.: I ` `J g ,; Date/B 'I i 13125 SW Hall Blvd., Tigard, OR 97223" Plan Review 11 4 • : Phone: 503.718.2439 Fax: 503.598.1960 .'s e ~ O�� Date /By: Other Permit: T G A R D Inspection Line: 503.639.4175 �. Date Ready/By: furls: See Page 2 for et Internet: www.tigard - or.gov y Ne N %, Notified/Method: ITC Supplemental Information TYPE OF WOR � C.lk PLAN. REVIEW ❑ New construction g,Addition/alteration/re lacemen t ►" - xt)x" Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition 0 Other: r V\ \�+ ❑ Service or feeder 400 amps or more ❑ Building over three stories. oQ© where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTR TION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ", Job no.: Job site address: ! ` $30 SGT S Eyt -t t r, Six or or more residential R occupancy. Recreational ❑ Six or more residential units. ❑Recreation al vehicle parks. City/State /ZIP: - 1 ; , D r t 77 7---z-3 ❑ Health -care facilities. ❑ Supply voltage for more than /l ❑ Hazardous locations. 600 volts nominal. ' Suite /bldg. /apt. no.: Project name: n rI /t,:ese Gr -�_ ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: � `f o f f (,•_I ' Description I Qty. I Fee. I Total New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'' 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi- family 75.00 2 ReptaCe_ erce n / 4 . 4 1 _ pan Q a cOS residential (with above sq. ft.) !!! Services or feeders installation, alteration, and/or relocation G 60 l " a e__ 200 amps or less / 100.70 /00, 70 2 ❑ PROPERTY OWNER II ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 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 y 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 ja, APPLICANT ❑ CONTACT PERSON above service or feeder fee 1 7.42 7 t ,-(� 2 each branch circuit l B. Fee for branch circuits without Business name: 1 E le r, vie-- service or feeder fee, first Contact name: t branch circuit 56.18 2 S e 1 " er __ nn ,}� Each add'1 branch circuit 7.42 2 Address: /32J ( 5+6J S'u�twterw9a2, IfJ1-, Miscellaneous (service or feeder not included) City/State /ZIP: n q Each manufactured or modular 67.84 2 � Ja i / 7 2._3 dwelling, service and/or feeder Phone: (...03 ) yq _ ga Fax: : ( ) Reconnect only 67.84 2 / Pump or irrigation circle 67.84 2 E-mail: 5cP Vvler'rovL() Qc,, ) , c....0 t Signor outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: Ot ero kee � f . /—rt'� panel, alteration, or extension. Page 2 2 l.wt.le " � Each additional inspection over allowable in any of the above Address: az/ ( 5 w Suv r id , J g �C n � . b Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Q ��' .3 ! 7Z Z Investigation (1 hr min) 66.25/ hr r, , a z%t j Industrial plant (1 hr min) 78.18/ hr Phone: (S ) 297 � 3, Fax: ( ) Inspections for which no fee is 90.00/ hr specifically listed (/ hr min) CCB Lic.: 356 . ( Electrical Lic.:3 — ` g . Suprv. Lic.: 26 i C' ELECTRICAL PERMIT FEES .. / / ' [, 1 / Subtotal: i a I 1 Suprv. Electric'.. st • at re, required: Plan review (25% of permit fee): Print name: p el>-t V lil � — Date: /le� //' State surcharge (12% of permit fee): 1. f 7 TOTAL PERMIT FEE: CI Authorized signature: / I - + `� / u y This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: �� VIL e-e- Date: J>- f * Number of inspections allowed per permit. \ \ 1:\BuildingPermitsELC- PermitApp.doc 07/01/10 4440-4615T(11 /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: ❑ Audio and Stereo Systems n Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC - PermitApp.doc 07/01/10