Permit CITY OF TIGARD ELECTRICAL PERMIT
„ 2 COMMUNITY DEVELOPMENT Permit ft ELC2011 -00606
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued 10(28/2011
Parcel 2S110DD12300
Jurisdiction Tigard
Site address 10720 SW HIGHLAND DR
Project WILSON Subdivision SUMMERFIELD NO 13 Lot 693
Project Description (2) circuits for spa tub
Contractor WEBER ELECTRIC INC Owner WILSON, CHARLENE
PO BOX 231154 10720 SW HIGHLAND DR
TIGARD, OR 97281 TIGARD, OR 97224
PHONE 503- 620 -1906 PHONE
FAX 503 - 620 -6819
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 10/28/2011 $63 60
Specifics' Service or Feeder
1 ea 12% State Surcharge - 10/28/2011 $7 63
Type of Use SF Electrical
Class of Work ALT
Type of Const
Occupancy Grp
Total $71 23
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 -001 -0090 You may obtain a co• • - ru es or • questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued Bye' Perm ittee Signature / 7 / /. . CL/\
aria OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale lease or rent
OWNER'S SIGNATURE Date
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR ELEC' Date
LICENSE NO
can 503 639 4175 by 7 00 a m for the next available inspection date
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection
Electrical Permit Application Received FoI OFFICE USE ONEY
• City of Tigard or Date/B /0 46� Permit No E2-C- �l— LX)(n(7(/i
;14 • 13125 SW Hall Blvd, I Igard,OIV j, 9A Plan Review
- Phone 503 718 2439 Fax 503`$ 1960 q `ISO Date/By Other Permit
Inspection l me 5036394175 •t-' r '` y Date Ready/By runs ® See Page 2 for
'T IGARD
Internet www tigard-or gov QV+ IN A O Notified/Method p Supplemental Information
TYPE OF WORKtt U\'4\ PLAN REVIEW
,-0,2,,, Please check all that apply (submit 3 sets of plans whiems checked below)
i /r
El New construction g Addition /alterat
' eplacent ❑ Service or feeder 400 amps or more ❑ Building over three stones
❑ Demolition ❑ Other where the available tault current ❑ Mannas 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
a1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings
CI Multi-family ❑ Master builder ❑ Other ❑ Fire pump ❑ Installation of 75 KVA of
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately denied system
❑ Addition of new motor load of ❑ "A ", E",'-1 2', "I - ",
IOOIIP or more occupancy
Job no Job site address
to Tao Si.) H 15 at4 &'S J , 0 r ❑ Six or more residential units ❑ Recreational vehicle parks
Oily /Stele /ZlP ert 5 ant OR 9 7 2 Z ❑ Health -care facilities
❑Hazardous locations ❑ Supply voltage for more than
600 volts nominal
Suite/bldg /apt no Project name /d bonj ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site ° V
J Description I Q(V ' Fee I Total 1 *
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 R or portion 3392 1
Tax map /parcel no
Limited energy, residential 7500 2
DESCRIPTION OF WORK (with above sq ft )
Limited energy, multifamily 75 00 2
I GSc S Fe,, s T L, residential (with above sq ft )
Services or feeders installation, alteration, and /or relocation
200 amps or less 100 70 2
t PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2
Name 401 amps to 600 amps 20034 2
wt L So r ' 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
relocation
Phone ( ) F ( ) 200 amps or less 59 36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125 oa 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, per panel
Owner signature Date A Fee for branch circuits with 1
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit _
Business name B Fee tor branch circuits without
service or feeder fee, first / �(
5618 o ,($ 2
Contact name branch circuit _
Each add'I branch circuit / 7 42 7,1 a 2
Address Miscellaneous (service or feeder not included) _
City/State/ZIP Fach 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 Signor outline lighting 67 84 2
CONTRACTOR Signal circtut(s) or I muted- energy
Business name W panel, alteration, or extension Page 2 2
6V E tx41t e it C Each additional inspection over allowable in any of the above
Address 7". - , SCJ /2+ 66l n s Ret_ Additional Inspection (I hr mm) 66 25/ hr
City /State /ZIP _ Investigation (I hr mm) 6625/ hr
7 t rc - 1 u.( n , 0/2 9 Industrial plant (I hr min) 7818/ hr
Phone ( 5b j b f cf _ 7 37o Fax ( S5 Inspections for which no fee is 90 00/ hr
specifically listed (h hr mm)
CCB Lic 9 9 087 Electrical Lic s - 442 C Supry Lic 4028 3 ELEC PRICAL PERMIT FEES
Supry Electrician signature, leyutred / Subtotal 43 - d
/ �c Plan review (25% of permit fee)
Punt name /n„ � I 1 Date f o - 2 S, - / / State surcharge (12% of pent fee) 7 , E 3
I L--)'G C r
TorAL PERMIT FEE '1 / I Z 3
Authorized signature
This permit application expires if a permit is not obtained within 180
Print name Date days after it has been accepted as complete-
' Number of inspections allowed per pertain
1 \Bwlding\ Permits \ELC- PermtApp doe 07/01/10 440- 4615TO I /05iCOMAVFB
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*
n B • urglar Alarm
❑ Garage Door Opener*
n I- • Ieating, Ventilation and Aix Conditioning System*
Fl V • acuum Systems*
El Other
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
El Boiler Controls
n Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ I -IVAC
n Instrumentation
Fl Intercom and Paging Systems
n Landscape Irrigation Control*
n 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 ram ldingWermas\EL( -Penn tApp dot. 07/01/ 10