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Permit Mk le,,v04_,/ , ,e ,, , v1- 7 dvt>-Ze-e__. 6 j -rcz,<-&-.-Ls !j- (0) c;t-e-64 it ' - CITY OF TIGARD ELECTRICAL PERMIT . 114 ` :"-. COMMUNITY DEVELOPMENT Permit #: ELC2011 00604 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/27/2011 Parcel: 2S101 BC00500 Jurisdiction: Tigard Site address: 12300 SW KNOLL DR Project: Stolt Subdivision: KNOLL ACRES Lot: 10 Project Description: Service replacement and (6) branch circuits for basement wiring. 11/08/11, reprinted permit to include (2) feeders and (6) branch circuits. Contractor: CRAINIC ELECTRIC CO Owner: STOLT, FRED 15812 SE BROOKLYN ST 12300 SW KNOLL DR PORTLAND, OR 97236 TIGARD, OR 97223 PHONE: 503 - 913 -8005 PHONE: FAX: 503 - 760 -1787 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 10/27/2011 $100.70 Specifics: amps or less 6 crt Branch Circuits w /Purchase 10/27/2011 $44.52 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 10/27/2011 $17.43 Electrical Type of Const: 2 ea Services or Feeders - 200 11/08/2011 $201.40 Occupancy Grp: amps or less 6 crt Branch Circuits w /Purchase 11/08/2011 $44.52 Service or Feeder 30 12% State Surcharge - 11/08/2011 $29.51 Electrical Total $438.08 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 oth-r 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 wo /is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi atio Center. / ose Pules are set forth in OAR 952- 001 -0010 through 0.R 952- 001 -0090. You ma • - -. :: - = the ruffs or direct questions to OUNC by callin .1987 or , .00.332.2t - 44. O Issued By _✓ �L :� _ _l. Permittee Signature: / C 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. CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT 9 COMMUNITY DEVELOPMENT Permit# ELC2011 -00604 Date Issued 10/27/2011 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 23101 BC00500 Jurisdiction Tigard Site address 12300 SW KNOLL DR Project Stoll Subdivision KNOLL ACRES Lot 10 Project Description Service replacement and (6) branch circuits for basement wiring Contractor CRAINIC ELECTRIC CO Owner STOLT, FRED 15812 SE BROOKLYN ST 12300 SW KNOLL DR PORTLAND, OR 97236 TIGARD, OR 97223 PHONE 503- 913 -8005 PHONE FAX 503 - 760 -1787 FEES Description Date Amount Specifics Services or Feeders - 200 amps or less 10/27/2011 $100 70 Branch Circuits w /Purchase Service or 10/27/2011 $44 52 Feeder Type of Use SF 12% State Surcharge - Electrical 10/27/2011 $17 43 Class of Work ALT Total Number of Systems Audio & Stereo N Security Alarm N Garage Door Opener N HVAC N Vacuum System N Other N Other Desc Total $162 65 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 Ce. - Those rules re set forth in OAR 952 -001 -0010 through OAR 952 -001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 • 1 or 1 332 2 Issued c - ■`� �y �_ _ Permittee Signature ( Y i \ C 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 Received Date/By. Permit No.: pL ,Ggrx 1 / l u __CtiGo'y 13125 SW Hall Blvd., Tigard, OR 97223saa Plan Review / 1 .. Phone: 503.718.2439 Fax: 503.598f 9t0 0 K , r Date /By: Other Permit: T i G A R D Inspection Line: 503.639.4175 "ty Date Ready/By: Juris H See Page 2 for Internet: www.tigard or.gov 'O %t ^® Notified/Method: Supplemental Information TYPE OF WOR \, 11 ��� '-,C%\.3 '��y PLAN REVIEW CI New construction Addition/alteration �" Iacenfe ❑ Demolition ❑Other: c A Please check all that apply (submit 2 sets of plans w /items checked below): �� l ❑ Service or feeder 400 amps or more ❑ Building over three stories. \�\� where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONST 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 ", "l - ", "l - ", Job no.: Job site address: I OOHP or more. occupancy. pa3� t�// eV . ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: 3 8... ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I * 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'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) 6) l Limited energy, multi - family 75.00 2 -(i {a �-J a (6 ) ,j /l residential (with above sq. ft.) /� s) Services or feeders installation, alteration, and/or relocation v te. .J Tn yl / 200 amps or less t ., 100.70 , Lit 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 Name: - 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City/State /ZIP: 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 intended for salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit llvv 1 Business name: B. Fee for branch circuits without 'service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'l branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 67.84 2 dwelling, 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 CONTRACTOR Signal circuit(s) or limited- energy Business name: panel, alteration, or extension. Page 2 2 Chi , L I-P �� 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is specifically listed (% hr min) 90.00 / hr CCB Lie.: Electrical Lie.: Suprv. Lie.: ELECTRICAL PERMIT FEES Subtotal: ?147; 1 2, Suprv. Electrician signature, required: Plan review (25% of permit fee): Print name: Date: State surcharge (12% of permit fee): , Authorized sign. t TOTAL PERMIT FEE: )-7 y - This permit application expires if a permit is not obtained within 1S0 days after it has been accepted as complete. Print name ( / , Date: / / rrT /f • Number of inspections allowed per permit. C1BuildingWer its 1ELC- PermitApp.doc 07/01/10 IU( V[, (1 440- 4615T( I 1/05/COM/WEB Electrical Permit Application FOR OFFICE USE ONLY City of Tigard 'j� Date /B /o j j Permit No 1 _� ° 13125 SW Hall Blvd, Tigard, OR 97223 c r , ' P lan Review 1 7 Phone 503 718 2439 Fax 503 598 �y Other Permit � TI CA RD Inspection Line 503 639 4175 q q 1, Q'\, Date /By Date Ready/By runs See Page 2 for r Internet www tigard - goy p O Nohfied/Method s iZ`O Supplemental Information ON TYPE OF WORK o��S - \S PLAN REVIEW ❑ New construction Addition / alteration /r p q;gEb� Please check all that apply (submit 2 sets of plans Weems checked below) `` ❑ Service or feeder 400 amps or more ❑ Building over three stories ❑ Demolition Other ( �``l \ where the available fault current ❑ Manias 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 - and 2- family dwelling ❑ Commercial /industnal ❑ Accessory building amps for all other installations buildings Muth- family ❑Master builder El Other less pump ❑ Installation of 75 KVA or JOQ SITE INFORMATION AND LOCATION ❑ Emergency system larger separately denved system ❑ Addition of new motor load of ❑ "A" "E" `I 2" "I 3" �j /�qq //� r , ' Fl V or more occupancy Job no Job site address 2l 3 O V SF /L i V 1 / �L ❑ Six IOOHP or more residential units ❑ Recreational sehicle parks City/State/ZIP n El Health-care facilities 0 Supply voltage for more than © 1 - 19 (N\ ID Hazardous locations 600 sorts nominal Suite/61dg /apt no Protect name [� [ L(f ❑ Sersice or feeder 600 amps or more FEE SCHEDULE Cross street/directions to Job site J ne,en neen I Qtr I Fee I mint I' / , �/ ! r New residential single - or multi -family dwelling unit. t - { mi l/ - L Cr) �p.e /` ( L t Includes attached garage Subdivision Lot no 1,000 sq ft or less 16854 4 Tax map/parcel no Ea add'I 500 sq ft or portion 3392 I Limited energy, residential DESCRIPTION OF WQRK (with above sq ft) 75 00 2 ( �� Limited energy, multi family 75 00 2 (L• Q-c,_ r - t tr art Le- r residential (with above sq R ) 9 � 1 Services or feeders installation, alteration, and /or relocation U 4,R5 p\-* (AAI rk g �5 rn',PJW - 200 amps or leas I 10070 fD, 2 ❑ OPERTY OWNER l ❑ TENAN 201 amps to400 amps 13356 2 Name e --- I 401 amps to 600 amps 200 34 2 -is v�Z- - ...-. - 601 amps to 1 000 amps 301 04 2 Address I - 4.2 , r _ ' Over 1,000 amps or volts 552 26 2 I /State /ZIP / �) /' Temporary services or feeders installation, alteration, and /or Cil y 1 1 , i,/ Q t f/ZA L( /� 7 relocation Phone ( ) - P r 1 / Fax ( ) 200 amps or less 5936 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125 08 2 intended for sale, lease, rent, or exchange according to ORS 447. 449, 670, and 701 401 amps to 599 amps 168 54 2 Branch circuits - new, alteration, or extension, _er panel Owner signature Date A Fee for branch circuits w h ❑ APPLICANT 0 CONTACT PERSON above service or feeder fee, 742 ✓ -f S)' 2 each branch circuit e Business name B Fee for branch circuits without service or feeder fee, first 5618 2 Contact name branch circuit Each add'I branch circuit 742 2 Address Miscellaneous (service or feeder not included) City /Blatt /ZIP Each manufactured or modular 6784 2 dwelling, service and/or feeder Phone ( ) Fax ( ) Reconnect only 67 84 2 Pump or irrigation circle 67 84 2 E -mail Signor outline lighting 67 84 2 CONTRACTOR Signal circml(s) or limited- energy Business name 6 C 0 a N C C y �„ c b C C C Q panel, alteration, or extension Page 2 2 ( /r Each additional inspection over allowable in any of the above Address 1610 2- s � 4 x G f t tit--- p Additional inspection (1 hr mm) 66 25/ hr City /State /ZIP �0. 1{ d ( }. f Z36 Investigation (I hn m) 66 25/ hr �/ Industrial plant (I hr mm) 78 I 8/ hr Phone (5 ( 7 � CI Fax (j 3 3 /'0 / Thy � Inspections for which no fee is 90 00/ hr q 1s Q 1 ,/ O specifically listed (Yh hr mm) CCB Lie (s „ Electrical Lie C 6/ Q Supry Lie 3 7 q ELECTRICAL PERMIT FEES ` � 1:172/77,---r Subtotal �l 7 a -J - Sup Su v Electrician signature, required yyy � Plan review (25% of permit fee) - Print name �� ' — Date /d - Z�, , State surcharge (12% of permit fee) /'"), y3 AAA��� /// � , S. TOTAL PERMIT PEE , ( a ) 6 Authorized Authorized signgn i• f ������ y signature �1 1 C .� , r C t This permit application expires if a permit is not obtained within ISO Print name (�+i — (/' & . e_ e A I ! days after it has been accepted as complete i/J � �( r V ■ C Dat / 7 ( 1 / / r Number of mspcdions allowed per permit i taudding\Permits5ELC- Perm,sApp dac 07 /0010 440 4615T(l i /05 /COM/WUn 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: n Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: n A • udio and Stereo Systems ❑ Boiler Controls n Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n H VAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* I n Protective Signaling in O ther Total number of commercial systems *No licenses are required. Licenses are required for all other installations I \Pmlding\Permils \ELGPermnApp doc 07 /01 /10