Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00573
Date Issued: 10/14/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 2S 110AD08702
Jurisdiction: TIGARD
Site address: 10795 SW MURDOCK CT 6
Project: Pacific Crest Apartments Subdivision: LANG HILL NO.2 Lot: 77G
Project Description: Replacing damaged panel.
Contractor: STONER ELECTRIC Owner: PACIFIC CREST INVESTORS LLC
1904 SE OCHOCO 900 LARKSPUR LANDING CIRCLE #100
MILWAUKIE, OR 97222 LARKSPUR, CA 94939
PHONE 503 - 462 -6500 PHONE
FAX 503 - 659 -4968
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 10/14/2011 $100.70
S pecifics: amps or less
1 ea 12% State Surcharge - 10/14/2011 $12.08
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 O • r. • :2-001-0090 You ma obta • - .. • re rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344 r1
Issued By: /yi'_.Z� /� -� 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.
Oct.13. 201. 3:13PM Stoner Electric Group No.9992 P. 1
Electrical Pe rmit Apphcation
.,,, FOR Orri
E OFFICE r i i OLOLY B , �1 )
13125 SW Hall Blvd., , Tigard OR 9 2 l� e 1
' I Mono: 503.639,4171 Fax: 503.59 . 960 `, `� DareB Olher retie
71 ARD Inspection Line: 503.639 QC `raw, Drs Ready/3y: RI See Page 2for
Internet: www.tigard - goy . \ oufiodlMelhod: Supplemental information
' Pte: ,,, "-•.=' TYF of : 0 ,;,, •.&=� 1 ' N. g70,;;41:',.=•57-_,-;----!: a PLAN . ,i` I -
❑ Now construction R Addition/alteratio r:'.' _ amen[ Please check all that apply (submit 5 nets or plans Nfitems checked below)
9 Service or feedcr400 amps or more is Building overtbrtestones.
❑ Demolition ❑ S r ter: whcrethe available fault current 0 Marinas and boatyards.
6 ° "d'" ' a e l '1: OR�!
F CATE¢ Q O RvcTION ' ,a ,,` : .'a, exceeds 10,000 amps at 150 rolls or ❑ Montilla Montilla buildings,
r " less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
V f..tvi 1- and 2- family dwelling ❑ Commercial/industrial CI Accessory building
amps for all other installations. buildings.
u[ti- family 0 Master builder ❑ Other: Flea pump. ❑ Installation of 75 KVA or
_ _ ; t ,_, �,. ; . _ ❑ Emergency system. larger sepomtely derived system.
_ °, = T OI�:,fiI7t,I 1311fA O'LOCATION�� «r,a<,3gµ []Adfli iionofnewmororloadof El '`A". "E" "1- 2 ",'1 -3"
Job no.; '7 III 7Z [Job site address: D 1,.. 1''✓1Lv ❑ Six I sor ormr eresidential lal units. ❑ R occupancy.
�� °'�-��✓ `-` tters r Recreational eational vehicle parks.
C i t y / S t a t e / Z I P f ` 7 ~ � e p e e 97 2.2.4' ❑ Health -care redlines. ❑ Supply volute for more than
e d Harardogs locations. 600 volts nominal,
P�U F t t / ,5sj (~ - . 4Pr ❑ Service or f eeder 600 amp: O r ratite.
SuitcPoldg. /apt. no.: Project name: `.rc l t , r .� _ _
" ' TEE SCHED `"> :,3c"-
Cross street/directions to s lob site: :_•: llL� :.,., <,; . _ 5l -
I `
J � Descriprlan I pm � pee. 1 Taal 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. 0, or less 168.54 4
Tax ma / steel no.: En. add'I 500 sq. ft or portion 33.92 I
P P Limited energy, residential
s ._,
i ,w ,� ,_7t - - C1�iPTION OF WORK : 'p ': j. _ (with above s q. ft.) 75. 2
� Limited energy, multi- family 75,00 2
ti t PL4 f R,4p AyEC_ residential (with above sq, ft.)
Services or feeders Installation, alteration, and/or relocation
200 amps or Toss / 100.70 /op , 70 2
' "4 t' 201 amps to 400 amps 133,56 2
401 amps to 600 amps
601 amps to 1,000 amps 200 34
301.04 2
Name:
l ` . 2
Address: (� " t Z Over 1,000 amps or rolls 552.26 2
City/State/ZIP: C �" 1 �C , 1 Temporary services or feeders installation, alteration, and/or
s _,- I relocation �,,,
f 200 amps or less 59.36 1
Phone; ( ) Fax: ( ) �\ 1
L 201 amps to 400 amps 125,08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to OR$ 447, 449, 670, and 701. 401 amps to 599 amps 168 54 2
Branch circuits — new, alteration, or extension, • ar panel
Owner signature: Date: A. Fee for branch circuils with
❑ APPZ,ICAN1`' = ; :.:, _= - I , LI CONTA6t. �?T 1' v • above service or fader fee, 742 2
r each branch circuit
Business name: B Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
- Each add'I branch circuit 7.42 u 2
Address: Miscellaneous (service or feeder not included)
Ci /StatefL[P; Each manufactured or modular 67,84 2
dwellin , service and/or feeder • „�,
Phone: ( ) Fax ; ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: Sign or outline lighting 67.84 2
y°-= •.
: CONTRACTOR Y .zC: "- 5�- 4" .
Signal circuits) or limited- enetgy
INC panel, alteration, or extension. ,_ Paget 2
Business name: STONER ELECTRIC, Each additional inspection over allowable in any of the above
Address: 1904 SE OCHOCO Additional inspection (1 hr min) 6625/
Investigation (1 hr min) 66,25/ hr
City /State/ZIP: M I LWAUKI E, OR 97222 Industrial plant (1 hr min) 78.18 / hr
Phone: ( 503) Fax: ( 503) 659 -4968 Inspections for which no fee is 90.00 / hr
specifically listed ('V in min)
CCn Lie.: 44823 Electrical Lie.: 26 -122C I Suprv. Lie.: 34965 =_ '' - )ELPC'f1 tcA,Ix"TERIWIT,,FEES.
Suprv. Electrician signature, required: mx4 AL,�� a Stitch): 1 Ob. 70
review (25 /o of permit fee): -
Print name: MICHAEL FALCONER Date: /p if by State surcharge (12%of permit fee): iZ ∎ D6
TOTAL PERMIT PEE % I t Z e
Authorized signature: This permit application expires Ira permit is not obtained within 100
Print name: Date: . Number days after It has been accepted as complete.
nberofinspeedons allowed perpermii.
1: 00i1Otng wamirefit,C- PenniiA9Pdoc 07 /01 /10 440 -4615i(11105 /COWW5o
II
„.
Ma
City of Tigard
November 22, 2011
Pacific Crest
Affinity Property Management, LLC
111 SW 5t Ave., #3690
Portland, OR 97204
Re: Permit No. ELC2011 -00573 .
Dear Applicant:
The City of Tigard has received and is returning your payment for the above referenced
permit(s) for the following:
Site Address: 10795 SW Murdock Ct., Unit 6
Project Name: Pacific Credit Apartments
Check: #0059001580 in the amount of $112.78.
Notes: The permit fees for this case have been paid in full by the electrical contractor (see
attached copy of receipt) and the permit has been issued, inspected and closed.
Please contact me at 503.718.2430 if you have any questions.
Sincerely,
te
.1 r ,,f�
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. ® Tigard, Oregon 97223 ® 503.639.4171
TTY Relay: 503.684.2772 ® www.tigard- or.gov
117 CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 184237 - 10/14/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
ELC2011 -00573 Services or Feeders - 200 amps or less 220 - 0000 -43103 $100.70
ELC2011 -00573 12% State Surcharge - Electrical 100- 0000 -24001 $12.08
Total: $112.78
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 020886 BTAGGART 10/14/2011 $112.78
Payor:. Stoner Electric, Inc.
Total Payments: $112.78
Balance Due: $0.00
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