Permit CITY OF TIGARD ELECTRICAL PERMIT
'! .• COMMUNITY DEVELOPMENT Permit #: ELC2011 -00509
TIGARD' 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Date Issued: 09/14/2011
Parcel: 2S102CC01700
Jurisdiction: Tigard
Site address: 10285 SW HILLVIEW ST
Project: BRITTAIN Subdivision: FRELEON HEIGHTS NO.2 Lot: 20
Project Description: (5) branch circuits for remodel.
Contractor: CONDUIT ELECTRIC Owner: BRITTAIN FAMILY TRUST
19461 SW 89TH AVE BY PAUL E /ANITA M BRITTAIN TRS
TUALATIN, OR 97062 1487 PASSED AURORA
SAN DIEGO, CA 92154
PHONE 503 - 692 -1428 PHONE:
FAX 503 - 692 -3652
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 09/14/2011 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 09/14/2011 $10.30
Type of Use: SF 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 may obtain a copy of the - - • 'drrect questions to OUNC by calling 503 232 1987 or 1.800 332 2344,
Issued By: " �� /,•re'_ Permittee Signature: Y13'1
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.
Received: Sep 142011 11:08am
,tea v' ', _
From:CONDUIT ELECTRIC 50`36923 2 09/14/2011 11:04 #907 P.002/002
Electrical Permit Application r .. i. .• rt iOROkFICE L O 1 r
City of Tigard r3 �� M, Rwq�s_
Ill � �` r R c eiB e ^'� Permit No
a 13725 SW Hall Blvd , Tigard, OR 97223
B rm +', 1,, i 4 ` u V+, 't y
_ g ;I �yt..a Plan Review
Date /By Other Permit.
Phone. 503 639 4171 Fax • 503 598 1960
4 GA N D Inspection Line. 503.639.4175 Date Ready/By. .turn 63 See Page 2 for
Internet www.tlgard or.gov 1 Notified/Method: '7 Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition /alteration /replacement Please check all that apply (submit sets of plans whtems checked below)
i El Service or feeder 400 amps or more ❑ Building over three stores
❑ Demolition ❑ 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
1'1 and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other 0 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" "1-2", "1-3",
Job no • 1/ 5 yl yy Job site address' / 02 8S 5i W , / C V, v� 100HP or more occupancy
❑ Six or more residential units ❑ Recreational vehicle parks.
City/Stale /ZIP - '_Q'y¢...t Q C j� .. ? z 3 ❑ Health-care facilities 0 Supply voltage for more than
�� � ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: f' (Li n-6-4-.....i ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: neser men
P 1 at.. 1 Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no : 1,000 sq R or less 168 54 I 4
- Ea add'! 500 sq ft or pornon 33 92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq ft) 67 84 2
A n Cr r i _ / ry ( p� Limited energy, multi - family
3 t? V c ❑ 4 tr`d- 14 t'" -. / id r e ‹hc_ y V residential (with above sq ft) 67 84 2
Services or feeders instaltation and/or relocation y
C lc ( Fete i3A-Tj-r( 01, Z�{ S iNI STA \ t, Z Pr'}- 00 1."e F' '40 amps or less 100.70 2
PROPERTY OWNER /� I ❑ TENANT 201 amps to 400 amps 133 56 2
Name: A Z- i -re- $ (2 + C i L IrT iq is-4 1 401 amps to 600 amps 200 - 34 ' 2
_
C 601 amps to 1,000 amps I 301 2
Address. 1 t-. 2 O ,� S, V\► , , H k <t l,i i--{ v J S 1 , Over 1,000 amps or volts 1 552 26 2' y
CityJState /ZIP t G 2 Z Temporary services or feeders installation, alteration, and /or 1
1 relocation
Phone: (•, _ c — 4 3+ TV/Fax. ( ) E 200 amps or less 1 59 36 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 4 125.08 1 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 � 401 amps to 599 amps I 168.54 i 2
Branch circuits - new, alteration, or extension, per panel
Owner signature. Date: -
A. Fee for branch circuits with
0 APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 7 42 j 2
Business name
B. Fee for branch circuits
Contact name. i without service or feeder fee, _
first branch circuit / �j'
56.18 5 ` . 2
Address: Each add') branch circuit / 7.42 e1 2 1 2 C 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular + I
dwelling, service and/or feeder ! 67 84 2
Phone ( ) Fax:: ( ) I Reconnect only f I 67 84 2
E -mail: _ Pump or irrigation circle 1111 67 84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name Signal circuit(s) or limited -
Conduit Electric energy panel, alteration, or
Address: extension Descnbe. Page 2 2
19461 SW 89th Ave
Each additional inspection over allowable in any of the above
City /State/7_IP: Tualatin, OR 97062
Per inspection 66 25 i
Phone. (5 0 3) 692-1428 Fax: (5 0 3) 692-3652 Investigation pet hour (1 hr min) ` 66.25
CCB Lie.. 109669 Electrical Lie.: 26_ Suprv. Lie.. 450 1 S Industrial plant per hour 78.18 1
ELECTRICAL PERMIT FEES �
Print name:
Suprv. Electrician signature, required. J j Subtotal: 6) t..—
SP-1
, Date: e Y / / "ii/if Plan review (25% of permit fee).
C'har1p Parer State surcharge (12% of permit fee) /45 '3 � ' -
Authorized signature. 92 TOTAL PERMIT FEE. f' ( El E
Print name:
This permit application expires if a permit is not obtained within 180
at � r X Date � � � � C J days after it has been accepted as complete,
* Number of inspections allowed per permit.
1 '.Balldine\Perm,is'LLC -Perms App doe 10 01'09 440.46155T(1 t WEB