Permit CITY OF TIGARD ELECTRICAL PERMIT
111
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00075
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012
Parcel: 1 S 135CA00307
Jurisdiction: Tigard
Site address: 9655 SW NORTH DAKOTA ST 18
Project: Tamaryn Apartments Subdivision: MEADOW VIEW Lot: 8
Project Description: Panel replacement.
Contractor: STONER ELECTRIC Owner: KOLS KILROY CANYON LP
1904 SE OCHOCO PEZ FUERTE LLC
MILWAUKIE, OR 97222 DIVA PROPERTIES LLC ET AL
111 SW 5TH AVE STE 3690
PORTLAND, OR 97204
PHONE: 503 - 462 -6500 PHONE:
FAX: 503 - 659 -4968
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 02/02/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 02/02/2012 $12.08
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 ad..• • • 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• of the rules •r direct • uestions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .ASE -a - , _ Permittee Signature:
s'� 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.
F e b . 1 . 2 0 1 2 3 : 3 9 P M S t o n e r E l e c t r i c Group No. 1265 P. 1
Electrical Permit Applicatio4(4 Fol; (oiler usr ON 1 X
City of Tigard c c\'\1\' Received ; N iiim 3 NI. cosem
Date/6 : . '..11.0/1•1 ea' ,_.
114 — • 13125 SW Hall BlVd., TiA6 Other Pemiit:
TI 0 W223 \
' Phone: 503.639.4171 Fax Q15598.1960 (..,,•: ‘ Cy Date/13 :
inspection Line: 503.639V75t ..,<R) 4,‘ Date Ready/By: Fa Sea Page 2 for
CAlt.1) •e,
Internet: www.tigard-or.gov 'S‹ \'' 6 , cr . Notifted/Method; Air" - Supislementoll Inrormotion
5 .1 : , C el :.!!!!'i'VMP::!7i, • _VIVA)131. :.,,' : :"; AI: :?Vi:1, :" .:''.!.::':.. .:: ': •,: • :. -., 4,..
El New construction .XT4dditionia1terakfirelilacement Please cheek all that apply (submit a acts of plans watems checked below):
.2)j 0 Service or feeder 400 amps or more 0 Building over three stories,
ID Demolition 0 Other: where the availably flair current 0 Marinas and boatyards.
.-- -.--.
''''.'217 ..-". ,"' . 1, PA - Vr - • ..` ' 3 '7':' . i .Y ',..; '..! ". , 1 :' exceeds 10.000 amps at 150 volts or 0 Floating buildings.
'''' :' : : . : !n'AI, Ii .oif.P. J :E:C. - !Aitliknigg elv,F ,:' -
, ... - .. ground. or exceeds 14.000 0 Commercial-use agricultural
D 1- and 2-family dwelling I71 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
FI, Multi-family I=1 Master builder 0 Other: n Fire puma. D Installation of 75 KVA or
larger separately derived system.
!k ! .1 = 7 -k3i- - zi"i'''' LlAcklition of new motor load of El A "1-3",
100HP or more. occupancy.
Job no.: 65 Job site address: 94,55' .5 --- LL ) ACD1-
(1 Six or more residential units. 0 Recreational vehicle parks.
City/Slate/ZIArljer,AAD OR El Hest th facilities, D Supply voltage for more than
D Hazardous locations- 600 volts nominal.
Suite/b1 /alca....)no.: /8 I Project natneriZid 0 Service or feeder 600 amps or room
SM344 ; 'OE
CrOSS Street/directions to job site: Description 1 0I,'. I F. I Tow •
_
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq. ft. or less 168.54 4
Es. add'I 500 sq. ft. or portion 33.92 I
Tax map/parcel no.: Limited energy, residential
75.00 2
W " • . . ‘: : : ::: ::': : :::.. PE FifilliMAIMPAPV (with above 3° ' fl
Limited energy, multi•family
75.00 2
; ,/V residential (with above sq. I) _
Set-vices or feeders installation, alteration, and/or relocation
200 amps or less / 100.70 /IV, Ip 2
zu : ,.. s pi .;:: : :;)71wS,'..74r Eg igikitikiikaptire 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1.000 amps 301.04 2
Address: Over 1,000 amps or volts 552,26 2
-
Temporary services or feeders InstanotIon, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax; ( ) 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 125.08 2
54
401 amps to 599 amps 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits- new, alteration, or extension, per panel
Owner signature; Date: A. Fee for branch circuits with
;..,,.. , ''.5.k,_ ,-,,,, '''=:rA. ..gi:VS=i,:,,ES: above service or feeder fco
' '
'''•'''. ' ' 0 'APPIAtANt • ' ' : . :' , ' • ' .- ',., 0 , ctem t ochn t • k i..:..t.,:„. e .„ 5 .- . . , 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first
56.15 . 2 •
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not - Included)
— Each manufactured or modular
67.M
City/State/ZIP: dwelling, service and/or feeder 2
Phone: ( ) Fax! : ( ) nly Reconnect o
67.84 2
E-mail: Pump or irrigation circle 67.84 2
6
Sign or outline lighting 2
. :.: :. .,,: :.. Signal circuit(s) or limited-energy
Business name: STONER ELECTRIC, INC. panel. alteration. or extension.
Rad; additional inspeetion over allowable in any of the above
Address: 1904 SE OCHOCO Additional inspection (1 hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State/ZIP: MI LWAUK1E, OR 97222 Industrial plant ( hr min) 78.18/hr
Phone: ( 50a, Fax: ( 503) 6594968 Inspections for which no fee is
9000/h
specilicall listed 'A hr min)
CCB Lic.: 44823 Electrical Lie.: 26-122C suprv. Lie.; 3496s ZaMlyili.V
-- - - - - •
, Subtotal: /4/Pt 70
Suprv. Electrician signature, required: y4 Ah-..„......, Plan review (25% of permit fee): e_
Print name: MICHAEL FALCONER Date: Lb ) / z, State surcharge (12% of permit fee); 1 Z • 68
. TOTAL PERMIT FEE: i /. 2
Authorized signature:
This permit application expires ir a permit Is not obtained within 180
days after II has been accepted as complete.
Print name: Dale: • Ntunber of inspections allowed per permits
Mail dingTerrnitsT LC•PermitApp.doc 07/01110 440-16151(11/05/COMPNE8