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Permit CITY OF TIGARD ELECTRICAL PERMIT • • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00063 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012 Parcel: 1 S134DD00100 Jurisdiction: Tigard Site address: 10551 SW TIGARD ST 61 Project: Windmill Apartments Subdivision: 2004 - 050 PARTITION PLAT Lot: 2 Project Description: (4) branch circuits for ductless heat pumps in units 61, 62, 63 & 64. Contractor: PREMIER ELECTRICAL INC Owner: RICHARDS, JAMES E & SHARON S PO BOX P BY NORRIS & STEVENS CORVALLIS, OR 97339 621 SW MORRISON ST #800 PORTLAND, OR 97205 PHONE: 541 - 758 -4284 PHONE: 503 - 624 -9856 FAX: 541 - 758 -4433 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 01/27/2012 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/27/2012 $9.41 Type of Use: MF Electrical Class of Work: ALT Type of Const: Occupancy Grp: R -2 Total $87.85 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 OAR - '2 -00 d o You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. % e' M - /( /7v "./ 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. Electrical Permit Application Fotz OFFICE USE 0 NL1' • • Re � City of Tigard 'c Re : ��/ Permit N :� /� -00 / o t3!25 SW Hull B1vd., Tigard, " 223 o� ceived _ OthorPermi I. Phonc: 503.7182439 Fax: 501' :1960 p Ns,' cad /°2z 0r 0' °Z g g J PIV .- � O Notified Mel hod! u Y r a w - rrtr P1 ment rmntum ins Line: 503 \V O Ready /By; cage 2 for f[i,Al;ll � Supplemental Interact: www,ti and -or. U v � rM 'r .} e7• , ry ..r ! ;rl �tY.y� } r r t r.r YKrpY M ' /gYKI; err ...rq, I ' fi -. ( , `te gf.r1 y, M 1 ,Yr (Y „r r Q . h, i lly. t' `l ., 1 11.Y r 11, ;},r. 1 � „l i'" (t , „ vr r q . , . a }Y. ,„„,, „,' " A {�t fl li rl! {f lr iril: A ylil a,}f r d ill l� t rlq r" fi r, • y:C11 r,• 2 H q r a t li d ' ir1i1,f5� ) , ' y l l���{ X11 1 r r • l J l i,�u 1;1 [l t i�g fit+ ct�ict rl. �,d�tg �Grt r! .....rrAHL i f. i i i o tier {l l :!l ►f nlrlrtlA' 1 )tl4t7Y.,, ,. . , .Wrrtd,fl�iYetYrtan,rY0. J ..4` A 1w1j �1 � Iliifl�1 ❑ New Construction ® Addition /altcratii;tp 'cmcnl Please check all that apply (submit a sets of plwnx w /items checked below): 00 ❑ Service or feeder 400 amps or more ❑ Building over three sror iOtt. ❑ Demolition ❑ Other ��,, 1� p where the available fault crnrcnr ❑ Marinas and boatyards, - r Y . c, y , • • fA n p r� l tnr rq,", s e11 w e rr y At oct al au n r��p i �ur(' 1'[h`��ilR4k f 2,.eI 1 , 1 1 (3!{�kl liil to( exceeds 10.000 amps at 150 vnIt or ❑ Flooring buildioa:s, jr r.i,k P IR A, t lrlrrrla,LS, 11 ,t}/i 11 1 t% 7'Y �'GYW6 {inrtj , q t A lass to gerund or exceeds 14.000 1:j Commercial-use agricultural ❑ I - and 2- family dwelling ❑ Commercial /industrial © Accessory building amps for all other installotiona, buildings. El Multi family ❑ Master builder CI Other: ❑ Firo pump. 10 Installation of 75 KVA or Y^ r- r i�r q Au ,t!: >, Ip(r' .l M tl l , - ❑ Emergency system, larger separately derived system. t i {fl iirir 1 �rl, ru �p urq �:;p� Iq rrkil R,p mi i f f rt w'.ri cn nr9 rlt it 1 ern i r uY ({ }��� t i 1' lll1 t{ E EEMI E irria fkl kh l' ' nrf i ,bz�irr.,p i . 1 1: 4 a Addition a Kw motor loud of ❑ larger "L", "L el deriv 10014P or more. occupancy Job no.: Job site address: 10551 SW Tigard ST 61 ❑Sir or more residential unii%. 0 Recre:uiorul vehicle pn i, - - 0 Health -cure facilities. ❑ Supply voltage for mom Ilia City/State/ZIP: Tigard, OR 97223 ❑ 7 h a tardous locations, 600 volts nominal, Suite/bldg. /apt. no.: Project name: /4)//\/ l`1 /L[_ ❑ Service or feeder 600 amps or Moro i� Nr ,r� ifj i1{ Air l Nt r Stn 1� l'r ' of 'tl'^ffr rilj l`l�'q�'l'trl PINFER� ! f�,n�� IMF ' f ,S.siP t 4 , l g T ��r�j�{ S Ci r lj 6r ti3ili rwla;. Cross street/directions to job she: /9d97 67175 naernptign lt[tE "� ® " New residential single or multi - family dwelling unit. Includes attached garage. Subdivision: — Lot no,. 1,000 sq. B. or less 168.54 4 - Fa. add'l S00 sq, tt, or portion 33.92 1 Tax map /parcel no.: Limited energy, residential � f 7, r.. 7Rf Y. t t Yn . y, re,r rn;ur tk /f >4a{nr L rrIN rFY,fYa ff Orr ttY v ri, rC `r q Jj j, , it 75,00 2 y { f ii r t cG �H{ , i t i , rs l , r t MI ti l 1 ei yvy ,lxt p 1, pjlr .. j )f { l w eSr { 11 t ir r , t r3 • f 1 (with above N. t1. t +l ��t`l�M '�l:r�A!Aei tlt�tn 1r lJ , r�lad(eiruJ r�ar 1�7�atr lV�)fltlhr�a�{.t�l r���r��a vGir,::N /iI r i fi � ll„ l Limited energy. multi- family (with above sq. ft. 75 2 residential ( K1 ) Electrical for heat pump installations: Units Gl, 62, 63, 64 __ -• Services or feeders installation. alteration. and /or relocation 200 amps or less 100.70 2 1' t nrgr rwu unm yry r,r u7rrcrrgr qr t r 9 r i , r or,r,r m1' t °j lq r l r' /i 20 am t o 400 pm s ] 33.56 2 401 amps ` "� 1TERSI31t�2'r �r�i Vigil i if I a l IN II I II ;• S l� r Abigail p s to 60 p 200,34 2 p 0 amps 200, 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1.000 amps or volts 552,26 2 Temporary services or faders installati —'" "" on, 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 madc on property that I own which is not 401 amps to 594 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or eXtension.`icr panel Owner signature _ Date: A. Fee for branch circuits with { r pm � , YCnrr n ` p�{ above service or feeder fee, 2 � 1 l la. G fei,i i ` r l C t i l lVl4i �ll ! t! 1 i 111dC11, 1 {r > 4 q )v �mmwi r 1 t i r l. rCrlbiFll fJi each branch circuit 7,42 J ex i t eMr4 ,„ Business name: B. Fee for branch circuits without service or feeder fee, first 1 56,18 56,18 2 Contact name: branch circuit Each add'l branch circuit 3 7,42 22.26 2 Address: Miscellaneous service or (ceder not Included — Each manufactured or modular III 67.84 2 City /State/ZIP: dwellin_, service and/or feeder Phone: ( ) Fax: ( ) Reconnect only MIESCIIIIMMI 2 _ Pump or irrigation circle IIII 67.84 2 E -mail, /) k1p y � y �„ �p �y Sign or outline lighting 67.84 2 fell/ '41 ,'Jttl7VY�;Cf �ilHl (�i t1N7171, >I '�:i'wr�' EE trR ll - 1A.,t1��dh nl lf� ,1� rr1'I��{�� li�l�{pr1.� j r'l Signal circuit(s) or 1imited-enery EMI= and alteration or extension. 2 Business name: Premier Electric _ Each additional ills r colon over allowable in an of the above Address: PO Box P Additional inspection (I hr min) 66.25/ he ME Investigation (1 hr min) 66.25/ hr City /Statc/Z1F: Corvallis, OR 97339 Industrial plant (I hr min ) 78.18/ hr Phone: (541) 758 -4284 Fax: (541) 758 -4433 Inspections for which no fee is 90.00 /hr s • .citically listed %: hr min Electrical Lie.: 2 -84C Suprv. Lie.: 4933$ Mee 'Itr;arx.r? 1' t,,.ArI..L'�t'1'+rVh, }hrLR Tf rr M, + Yt' Subtotal: 78,44 Suprv. Electrician signature, required: Plat review (25'/4 of permit fee): Print name: Rob Rloom Date: 1/23/12 State surcharge (12% of permit fee): 9,41 TOTAL PERMIT FEE: 117.85 l Authorized signature: , '- "I'. 'ihia permit application expires if u permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: _. 1--/.,2, • Number of inspections allowed per permit, rlHruilding \Permiu\Y'.i.C.PcrmilApp.aoc 07A01/l0 440 46isT(i tro5/COM)WuU 0200/9T00 l j DI21DTId 2I INtd2Id CCtt9gLTtS XVd Il<d 9: Z ZTOZ /CZ /T0