Permit � CITY OF TIGARD ELECTRICAL PERMIT
1 t 4 COMMUNITY DEVELOPMENT Permit# ELC2O11 -00607
Date Issued 10/28/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 1 S125CA11900
Jurisdiction Tigard
Site address 9255 SW 74TH AVE
Project Lawrence Partition Subdivision 2007 -083 PARTITION PLAT Lot 2
Project Description Temporary power
Contractor WHITE LIGHTNING ELECTRIC CO Owner MEECHAN PATRICK & KATHIE
7524 SE 52ND 8603 SW 49TH AVE
PORTLAND, OR 97206 PORTLAND, OR 97219
PHONE 503 - 772 -3009 PHONE 503 - 245 -2931
FAX 503 - 772 -4008
FEES
Quantity Description Date Amount
1 ea Temp Services or Feeders - 10/28/2011 $59 36
Specifics. 200 amps or less
1 ea 12% State Surcharge - 10/28/2011 $7 12
Type of Use SF Electrical
Class of Work OTR
Type of Const
Occupancy Grp
Total $66 48
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 expiie if work is not started within 180 days of issuance, or it 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 th- ru es Or • tract questions to OUNC by calling 503 232 19812_1_890 332 2344
Issued By , , 1 _ 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
Electrical Permit Application a O OFFICE I Ii ONLY
of Tigard C, I ' Ll 4�
• 13125 SW Hall Blvd ,ligard, yy 722 "
= PlanR a
_ Phone 503 718 2439 Fax 5031599"1 O 960 Q. 01 Date/13 Other Pennd w I n (i i t ,
- f I G A R D Inspection Line 503 639 4175 OC T \ Date Ready/By ® See Page 2 for
Internet www tigard-or gov I�Q Notified/Method BM Supplemental Information
TYPE OF WWL)RI' ,ZI:r,:ti \JV3\ ». PLAN REVIEW
r� i �' • Please check all that apply (submit 2 sets of plans w /items checked below)
L9 �' rvew construction ❑ Addition /alterationAilacement
v ❑ Service or feeder 400 amps or more ❑ Building over three stories
❑Demolition ❑ Other where the available fault current
❑ Mannas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings
less to mound, or exceeds 14,000 ID Commercial -use agncultural
131- and 2 -family dwelling ❑ Commercial /Industnal ❑ Accessory budding amps for all other Installations buildings
❑Multi -family ❑ Master builder ❑ Other ❑ Fire pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A" "C". "1 -2 "'•I
Job no Job site address Li 2 S Sw I OOHP or more occupancy
S 7 ❑ Six or more residential units ❑ Recreational 5 elude parks
City/State/ZIP I 0 0. 9 21 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous 'canons 600 volts nominal
Suite /bldg /apt no - Protect name- ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site oesenprion I Qty I Fee- 1 Total I •
New residential single -or multi-family dwelling unit.
Includes attached garage.
-
Subdivision Lot no 1,000 sq R or less 16854 4
Tax map /parcel no. Ea add'I 500 sq R or portion 33 92 1
l imited energy, residential 7500 2
DESCRIPTION OF WORK (with above sy h)
Limited energy multi-family 75 2
ice, . - �T��Gr residential (with above sq R )
'�"_ Services or feeders Installation, alteration, and/or relocation
200 amps or less 100 70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 13356 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
City/State/ZIP
1 emporary services or feeders installation, alteration, and /or
y relocation
Phone ( ) Fax ( ) 200 amps or less 59 36 S 1 AL. 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps a 08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670. and 701 401 amps to 599 amps 168 sa 2
Branch circuits- new, alteration, or extension, • er panel
Owner signature Date A Fee for branch circuits with
El APPLICANT El CONTACT PERSON above service or feeder fee 7 42 2
`
I each branch circuit
Business name 'v - i k-e_ L1 4-tQ nh E. l'e -4-t-(\ _ B Fee for branch circuits without
service or feeder fee, first 56 18 2
Contact name. --I j ,- branch circuit
I 1 Each add'I branch circuit 7 42 2
Address --) S 1 N e, L s' 2_ R,vg Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State /ZIP. 1 r fMrD_ 1 >i21 °( dwelling, semce and/or feeder 67 84 2
Phone: ( col) - 1 '� 1 _ ..� Fax : (�'D --7 7 a_ - 1J ,7$ Reconnect only 67 84 2
Pump or irrigation circle 67 84 2
E - mail. ( k- I 4 . - 1.3. - £ .-,G1, Lit2y Sign or outline lighting 6784 2
CONTRACTOR Signal mrcun(s) or limited-energy
Business name ✓ J , j t'L 1, „', i ' it panel, alteration, or i inspection Page 2 2
^( r' Each additional inspection over allowable in any of the above
Address ' - ) 1 a < 0, S"'ir .2 Additional inspection (I hr min) 66 25/ hr
City /State /ZIP ,P� tk AJ �� 1-7.2_ Investigation plant (I hr mm) 78 18/ hr
25/ hr
1 Industrial plant (1 hr mm) 78 1
Phone (�3) "� -jZ - 107 Fax (Z ") - ) y, - 'T0°3 Inspections for which no lee is 9000 /hr
specifically listed (1/2 hr mm)
CCB Lie ) z - 1 g 4 1 Electncal Lie \- .y 1 c Lie ( -kill J TS ELECTRICAL PERMIT FEES
Supry Electrician signature, required -------------
.--------' Subtotal j� , )(
Plan review (25% of permit fee)
Print name I� 0( frx- Date 2/tr . -- )ci) l State surcharge (12% of permit fee) 7, / )'
i 0 TOTAL PERM' f FEE & /'(r
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.
N um be r of inspections allowed per permit
1 \Bmlding \Permlis\ELC- PermnApp doe 07 /01 /10 440-4615T(11105/COMM'EB