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Permit CITY OF TIGARD ELECTRICAL PERMIT IN COMMUNITY DEVELOPMENT Permit #: ELC2012 -00058 IIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012 Parcel: 1 S134DD00100 Jurisdiction: Tigard Site address: 10571 SW TIGARD ST 41 Project: Windmill Apartments Subdivision: 2004 -050 PARTITION PLAT Lot: 2 Project Description: (4) branch circuits for ductless heat pumps in units 41, 42, 43 & 44. 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 - Total $87.85 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through 0 • r 95090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 1t �....411V∎af • Permittee Signature: S /9 L /�/� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application FOR OFFICE USE (.7L1' Ti and ' �s Fetrn;, No othervurmi L _ City g / , — 600 G M 13125 SW Hull Blvd.. Tiga OR,�' 223 ��y �J / 4 ' ff , s� .' • �$ E ,m1.. GC ae Phone: 503,718.2439 Fax: 503 9:1960 q Ins 639,4175 \ n JPN k � Date Ready /Sy: lupr'°'' r 9J Sr e Page 2 for '1' C C '� Inspection Line: 503. A 1,1 :> P P""iQ NoliIi d/Method: L Supplemental Information Internet: www,ligard- or,gov _C V.I v � M. r Pinar .. t . I VY. . e,.ta te ._, rrt, •�) "`�, 111 v7ur, 1riY .. t 1 � • TIMER r,'. r, >• e 't rtutzcturear•tr^ tturt umar� .tt ot ,rr h " f u , , fr �� t+ �r .,o, l j 1t•c,• 1 +I'E r, d r ?.,,, t> + 4 , ,Y /u ,.f ,, , S! la r,r, ,. -C C1 ,u 3E {{ ,L 'r'' d.i { a, . �1, f�f y E si3 [ l i t . o ,' r ,. t .. y„� .) . ,1 1 Y l ,,, i, t i. , +' ,,,. , n. t }iii {1� {��lf,ffl zE�ll�I r i if I ri t loO . �r l sl r 1.1, t !Mkt, '"i.l.frdiv �r64okt $ /.. ,, ��i h , lll� . �� r if11 ��,IC � l i lFI�i1I11�,, remile� � i .ta, 0 New construction ® Addition/arterpt t ' , cement Flenre chock 01 that apply (submit I sets of plums w /items checked below), ©© ❑ Service or feeder 400 amps or more © Building over three stones. 0 Demolition rr pp 0 Other: where the available fault current Q Marinas and boatyards. itiP Vi n. rt rr� 19 �r ' l r:' 1 'f I � r"..., 7t 7rl dl an ''j11 rye r,e rrfr & 1 , r N e "(, r , I , r t ❑1'lowin I l { l J d �i, ( R 7 Y �p C,l r f * j / i exceeds 1 0 . 000 amps at t J0 volts or g haildings. r l li W 11df�„ 1fr.,,t M zl t� � itr :o XXIN ro�,l la gokt,tlo-u d n�nht rr7 7 ) 77 7,. ,b1r,[1Cl�.4, A � � Ye less toground,orexceeds 14,000 Q Commercial-use :iricaltural ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for .11 other installations. buildings. S Multi family ❑ Master builder ❑ Other: © Fire pump. ❑ Installation o f 75 KVA or r r .f.. 1r'r'I1 t' di ll ' r !rr.r <rarµ { L dl�`Pil/yauiru ++' re pvrrpn i t f i( : ,.,ea,� ❑Emerge larger separately dcrved system, �) r��' ) { t ry { r e:z rN W 11 ,tt, C ^ SS a, 'tl �rl i 1111, WI$Ct ' Additiono motor load of © ° "E ••t.2" dl.3 ", � 4i ilt'1 :eCE ��dt1 �Y; i ' ' ;fiiy1, d0. Canutrrivllfr 4/'1 i�l'�gi r;bbili dmi iibo I l r 1 40 ❑ „ L , Job no.: Job site address: 10571 SW Tigard ST 41 1001-1P or more, accupttnCy. Recreational veh icle parks. ©Six or more residential units, © P City/StatcIZlP: Tigard, OR 97223 ❑ Health -care facilities. 0 Supply voltapo for more than ❑ Hazardous locations, 600 volts nominal, Suite /bldg, /apt, no,: 0 Service or fee 600 amps or more, r >r t n t `9 l r, l!'r r `E 1i7��Ziii"w"""tp�'U' it I r' rF r[ y r i ��.11��yfri�l #� i : : ,` �, I,. �.,. i �,», is�f�l�� ' r t •��ldi�a��r����1�� Cross street/directibns to job site: A e i i /r '/ Dacr•o, ,r - .t p New residential single- or multi- family dwelling unit. includes attached garage. 1 sq. ft. or less 168.54 4 Subdivision: Lot no.; -" Ett. add'l 500 sq. ft. or portion 33. 1 Tax map /parcel no limiter! energy, residential u. , dt ! Ij I t i r r � t ge0;'+'tal rt ilae , r, R j } i r � 1l" k with above sq, ft, 75,00 2 1 ' E u { R� 't i i3 1 t 1 1 r1 �tl, ?� •" ir+ , , ,I l ' ry Y 7/ 11 ?Mtn� e a d l ,1 1 ''i " ' I ` !ir 1 (with ) df µ, 3..u. , u ti)vl rartrrua sz xr. r Limited energy, multi- family Electrical for heat pump installations: Units 41, 42, 43, 44 residontial,with above sq, ft,) 75,00 2 Services or feeders installation. alteration and /or relocation 200 amps or lass 10.70 l lRli7 ", r i J t 1�vNr, :' , t " fr tIN' l c' r � i t , e �.J1P�` , r, S Ili rltf iE �I�;, r;N1�t f,�Y�?tcltf,e�thr,.l>„ i � l I ,CEMENB .., RE VE N 201 amps to 400 amps 133.56 401 amm to 600 amps 200.34 2 Name: - 601 amps to I ,000 amps 301.04 2 Address: - Over 1.000 umps or volts 552.26 2 - .... Temporary services or feeders installation, alteration, and /or City /State /ZIP: relocation 200 amps or les 59,36 201 amps to 4 amps 1 25.08 Owner installation: This installation is being made on property that I own which is not col amps to 599 amps MI 168.54 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new. alteration, or extension, perpanrl Owner signature: _ ^_ Date: A. hue for branch circuits with S 2 { a p 'ry t M,el ^ { 1 ld r lr I r tAr7 I 741 r,4o q ruu., , �t C rj " { 1 � ,p strove service or feeder tae. 7,42 2 ii R IIt1 t!' flRF J'�p�r7<w srr'dl� i� "tt i q,�u , ,i EI .�� �R, 3 7 yll 7 r r " rE3zu�i. ° , MI sal each branch circuit Business name: B. Fee for branch circuits w/rhow service or feeder foe, first I 56.18 56 2 Contact name: branch circuit Each add'l branch circuit 3 7.42 22,26 2 Address: Miscella (service or feeder not Included) Each manufactured or modular 67.84 2 City /State/ZIP: dwcllin_, service and /or feeder Phone: ( ) ( ' ) Reconnect only 67.84 Fax: : Pump or irfigation circle 67,84 Si o outline light 67,84 r` Cr Rr1Y1 {I Ire. t r n W ,` yry.,x r 1 ! t , 1 t ! enuo'r!! ', i I�rl ►� r o if rltll<lt �'.lC +�' sa �w w, iK' i�ull� '"I"r{ rlf�t 6 mmiari } i'o t�l�'i � ' ~ ; g na t ei„„iiw or timi e.d,ner , ! a 1 ��ll..d d.., tr..11vr„za,n.,rCr"!8. Yr1� : :i1, r , ,. z z e rdl � Sy Business name: Premier Electric panel, ahcratinn OT extension, Pe ,C 2 Each additional inspection over allowable its any of the above Address: PO Box P Additional inspection (1 hr min) 66,25/ hr lnveslisalion hr min) 66.25/br City /State/ZIP: Corvallis, OR 97339 Industrial plant (1 hr min) 7R.18/ hr Phone: (541) 758 Fax: (541) 753 -4433 inspections for which no fee is 90,00 / hr s ificall listed 'h hr min CCB Lie.: 151749 Electrical Lie.: 2 - 84C Suprv. l.,ie,: 49335 ,,; (41s' LYN;�t�(V6l r a ,3 w: LTESB.I.r n !Ai �i t1 E Subtotal: 78.44 Suprv. Electrician signature, required: Plan review (25"/o of permit fee): Print name: Rob Bloom Stale surcharge (12% of permit fee): 9.41 TOTAL PERMIT FEE: 87,85 ' Authorized signature: .. , This p application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: �r, •�� • Number of inspections allowed per permit. I:\ ouildin \1Mrmlu \itLC- PeemitArv.dov.. 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