Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
. ... I COMMUN DEVELOPMENT Permit #: ELC2012 -00066
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012
Parcel: 2S112AB00800
Jurisdiction: Tigard
Site address: 14255 SW 72ND AVE
Project: Fought & Company Subdivision: 1992 -007 PARTITION PLAT Lot: 2
Project Description: TI
Contractor: CHRISTENSON ELECTRIC INC Owner: FOUGHT COMPANY INC
111 SW COLUMBIA ST, STE 480 PO BOX 23759
PORTLAND, OR 97201 TIGARD, OR 97223
PHONE: 503 - 419 -3300 PHONE:
FAX: 503 - 419 -3695
FEES
Quantity Description Date Amount
33 crt Branch Circuits wo /Purchase 01/27/2012 $293.62
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/27/2012 $35.23
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $328.85
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:: 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ,
f
Issued By: � ....--- — 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.
__ JAN-26-2012 THU 02: , 58 PM CHRI — '.-• Mi - C
'II • ' ',' '' f -s FAX NO. 95034193695 P. 01/02
" 'L
, , A , c •
Electrical Permit Application ' ' -- ' — . FoR orrwE IISP: ONLY
- JAN 2 6 2012 ' Received iew ji u m /WHIMM I lia'' p . 11\To . • --
1 30113 : fiffir=&.1"/ _ *. 1 . 7 't,( - - A Old■ —000(6)
1 1,1_, -- . 11 •• C13 i i tY 25 S H Tigard, OR 97223 Pl 4 an Rev
' • Phone; 501639.4171 Fax: 503 OF TIGAFID D.wiav, 0 , 1 ,„ p.m,:
1 I 6 A Ri) Inspection Line: 503.639.4175 BULGING DIVISION D N e o t t e lf R ic e d n im rly e / od: y; : Jana: 10 See Page 2 for
Internet: www.tigard-or.gov rr....", .s.,,,A...onlinfor,mition
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El New construction &".1 Addition/alteration/replacement Pima check all that apply (submit 2 seta of plans w/iteme checked below):
1:3 Service or feeder 400 amps or more ID Building over Ihree stories,
1:1 Demolition I=1 *tiler: whom the trttnilahle fault current D Mnrina:: and boatyards,
ii .•:.,'...,:•,,,,'.' ... • .. •. ...: . , • . ::'... ckni*oRl', '.0rIsTige1 ION .;.,....::::•. ... • ::.:E.! ;., exceeds 10000 amps at 150 volts or 13 Floating buildings,
less to ground, or exceeds 14,000 0 Commercial-asc a
D 1- and 2-ramily dwelling ommercial/industrial 0 Accessory building amps for all other installations. bundin..
D Multi-family • 'Master builder 0 Other: ID Fire pump, 0 Installation of 75 KVA or
. . .. , . .... . • • , •r'. . ; ; . El.....gency system. larger scparalely derived SyStem.
:..30,1, SITE INFORMATION -
" .. ::.: '::::.. ,:,
0 Additieak anew Mnlor lead of ID
1001-IP or more. occupancy,
lob no.: 01) 1/111 Job site address: 1 . ' VI 1 li •
El Six or more rcajciuntial units, 0 RCCTC:itianal vehicle parks.
City/State/ZIP: --T` Supply vol
k_c 0 O C I '';'..-' o•--7 Health-care
1._. El are facilities.
El Hazardous loonlions. 1:1 voltage for more than
600 volts nominal,
-
Suite/bldg./apt. no.: Project name; -filGd e t 0/0 0 &wig. 1 or feeder 600 nmps or more.
— 7 71. 7 .7 11 7 7 ;.: ..,■ . . FFIT, StIIED11.314,., ,,' ' ' . ' :: . • —
Cross street/directions to job site: t - ... A . A • . , / ik 0 Description ' Mil Etc. I Tad
-
.. A. A
• - New residential single- or multi-family dwelling unit.
•,--wit _. _ / / Includes attached garage.
1,000 sq. 11: or less 168.54 4
Subdivision: Lot no.: -. —
• Ea. addl 500 NI, ft, or portion 3 1
Tax map/parcel no.: -
ener2y, residential __,
Limited 67,84
•
. . .. • . ' I ,$Cla op,•wpRic • , .. . , . ,. .. • ....,.,,,, i:;, y , viiiill -)
. . nq
3_) Cl ' ' t ' Arl 4 , ' 44 n 1 /1 .— Ei r
! •
.1 — Limited energy. multi-fnmily 67.84
residential (with above so. (1.) 2
. -
Services or feeders installation, alteration,, and/or relocation
200 amps or less 100,70 2
2. PROPER TX, OWNER • . ' ... ; • .. ' :::1:1; US.INT . • . :: . .., .i:..:,.., 20 amPs 4 amps 133.56 2
401 amps tP 600 aMPS 200.34 2
Notrne: _____----. 601 amps to 1,000 arnps 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 ...._
01 amps to 599 snips 168.54 2
intended for snle, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits- new, alteration or extension, p panel _
Owner signature! , „ Date: . A. Fee for branch circuits with
, -
. . . above service or feeder rod,
. • 0 PLIcANT. • _ . . ', . 1...''ALS ' ..''': cach branch circuit 7.42 2
•. .
Business nal •
ne. .,,,
V '
A . ' O . ,ii\ Av _ - E. Fee for branch circuits without
j
service or feeder fee, first I
. —
56.18 OW i i o 2
Contact name: branch circuit
„_,__- . - Each addl branch Circuit L j ..3 4- 3, 1 A 4
; .
Address: Miscellaneous (service or feeder not in .
..
_ Each manufactured or modular
City/State/ZIP: dwelling. eervicc uncl/nr fcecler 67.84
Phone: ( ) Fax; ; ( ) ,. Iteconnfrot only — 67,84
- 2
. - Pimp or irrigation circle 67.84 2
E-mail;
Sign or outline lighting 67,84 2
• A ..
CONTRACTOR , CTOIt . , . . . . • ' • . ..• . .. ! Signal , :ircuit(s) or limited-energy -
panel, alteration, or extension,, Page 2
BusineSS name: alrommis.,, A . ,,,,,,_
Each additional insucciion over allowable in Any of the niboY 2
Address: \\A ' ... A . ' ...e AD Additional inspection (I hr min) 66,25/ 1
— .1 .1 66.25/ hr
—..-
g / Investigation (I hr min)
Ci ..- ty/State/ZIP: .... am ikt 01 . o ' 1 Indusninl :plant (I hr min) - ....
78.18/ hr
Phone (A.,7-.. Agra I V L,. /pOi j c" Inspections for which nu lee is
speiifically listed (1/2 hr mm) _
90,00/ hr
,-,
CCB Lic.: 4 imi Electrical Lie ' // tiT 'v. Lie.; 5 s..,• - :. • ..: . .,.:. :. : ..ELF:e1111CA ,F.Et ...,. ,.
06 _ Subtotal: .11gtiffi
4.
Soprv. ,Electrician signature, required; ifiL .r . , - -
P 1 a n review (25% of permit fee):
- ..
Print name! /If -... 1)./1\ _ Date: ( 9 . 10 h 9..._, State surcharge (12% of permit fee): ---
-
TOTAL, PERMIT FEE; , ,,t
Authorized signature: -
This permit application expires ir a permit is not oiltained wit sin - MO
, ..
— da after it has been accepted as comnieie.
Print Elaine: Dote! * NIIMb r ins
er u peciiona Minoan per peril.
'
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