Permit • II
CITY OF TIGARD ELECTRICAL PERMIT
I7 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00083
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2012
Parcel: 2S111DD09600
Jurisdiction: Tigard
Site address: 8715 SW STRATFORD CT
Project: DIGGS Subdivision: CHESSMAN DOWNS Lot: 22
Project Description: (2) branch circuits for furnace and A/C unit.
Contractor: A TEMP HEATING & COOLING INC Owner: DIGGS, DONALD W AND
16000 SE EVELYN ST DIANNE E
CLACKAMAS, OR 97015 -9519 8715 SW STRATFORD CT
TIGARD, OR 97224
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 02/07/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/07/2012 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 952- 001 -0090. You may obtain a copy o - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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.
Elec.... ctricai Permit Application t con (* (�s1:: irlNl,}
City of Tigard •
�g Baee;vad a
R.-i Q Permit ' 9 /A.. a^ ►
e 1312 S W Hail Blvd.. Tigard, OR 9?3� /'I i ti t
Phone: 503.639,4171 Fax: 503.54 ijb0 '�� P1ailRmiew
Inspection Line: S03,E39.4175 � Datc OrherP muc ^L I I
t' It: ;il(t) P �� Derr iarliMe13y: See Pa '
Internet: www,ligatd•or.gcv �� - r � •� otifuni/t shod: tin 2 for
,.. 9unpicineutul lorermatisu
TYPE OF WORK t c1F °" w'S \"` PLAN REVIEW
E] New construction ►: Addition/alterattorureZil8 en{3, v' Piazze check all that apply (submi y srts o f hlx w w /items chnoked twlo r); —
�] Demolition Other: a � \ ❑ Service or fonder 400 amps or more ❑ Building ovor three storio;,
3 where the available fault currant El Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 Atop. at 150 volts or ❑ Floating buildings,
11 and 2- family dwelling less to ground, or ex 14,000 ❑ C . c agricult
1 ❑ Commercial/industrial 0 building 0
Multi- family & amps for all other iustalhttions, buildings.
_ ❑ Muster builder ❑ Other: 1:1 Fire pump. ❑ Installariun of 75 KV.q or
1 V
JOB SJ TE INFORMATION
9 Emergency syatotn• larger ea ar
AND LOCATION g p ptely 1.3, d system.
`r ❑ Addition of new motor load of 9 "A" "E••,••1_2' ••
Job no.: 10_4V\ 14 Job site address: I S S S f � - }rp C /'�� I+ lool•IP or more, occupancy.
v t C7ll ❑ Six or mono residential units. ID Roctantional vehicle parks.
t
City /State /21P: , ; � 0 ` /' t 2 Hcelth -n,r0 cilitica. ❑ Supply voltaga for morn than
l� Hazar locatio 600 volts nominal,
Suitt: /bldgiapt• no.: Project name: , 1 s ❑ Servioo or feeder 600 amps or nwra,
Cross street /directions to job site: FEE SCHEDULE
out( tiaa e• Fr Tpp
New residential single- or multi- family dwelling unit.
— Includes attached garage.
Subdivision; Lot no.: 1,000 sq. it or less 168 4
T ax map/parcel no.: Ea. addd'l50c sq. ft. or portion 33,92 I
DESCRIPTION OF WORK Limited energy, rnsidcritial
with above sq. R) 75.00 2
f 1 Limited energy, multi- family
: d I ( !r 1 C 1771 , l e d 5 IA if 1 (I i(9 , i !` S y r gift) p residential (with above s) L 75.00 i 2
Services or feeders lnstallatiou, alteration aud/ur relocation
G
n c' �j 200 amps or less 100.70
2
) 1 PROPERTY OWNER . ❑ TENANT _ 201 amps to 400 amps 133.56 2
Name, ' - 40! amps to 600 amps 200,34 NM
601 amps to 1,000 amps 1111 301.04 r 2
Address: • s vu S 4• r k a 1 over 1,000 amps or volts MI 552.26 NM
City /State /ZIP; I. t, ov, D lq /I �-� Temporary services or feeders installation, alteration, and /or
L� relocation
Phone: ( ) Fax ( ) 200 atnps or less 59,36 l
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 slops to 599 amps 168,x4 2
Owner Signature: Branch circuits – new alteration or extension er . and
Date: A. Fee for branch circuits with
APPLICANT ❑ CONTACT' PERSON above service or feeder fee 7 40 2
" — — each branch circuit
Business name; '" B. Fee for branch circuits without
Evelyn service or fu fee, :line
C
III
ontact name; 16000 l SC. branch anch circuit it 56.18 2
Address: •J �� 11; Each min branch circuit 1 7.42 4
,50 .fS cnti • Miscellaneous service or feeder not included
City /State /Z1P; ""` E ach manufactured or modular 67.ga
�/ dweilin_ service und/or feeder 2
Phone: ( ) 1 Pax: 5 03 ) 5S 4 —ZR L � t Q Reconnect only 67.84
E 1 t pump or irrigation circle MI 67.84 2 2
CONTRACTOR Sign or outline lighting 67.84 2
Signal circuit(s) uriimited- energy
Business name: panel, alteration, or extension. Pa e 2 2
Each additional inspection over allowable in any of the abov
Address: 16000 SE Evelyn St Additional inspection (1 hr min) 66.25/ hr
Cit / Sta te /ZIP: ----- Investigation (1 hr min) 66.25/ hr
]'hone; ( ) Industrial plant(] hr min) 78,18/ hr
Pax: G03 ) rj S A- Zci q O Inspections for which no the is
specifically lilted (h hr min) 90,00/ hr
CCB L ic.:, I E lectrical Lie.: C 4, Suprv. Lie.: Zq Le QS" . ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required; II Subtotal; 7 �J
- Plan review (25% of permit tee):
Print name: _''D_In l � f ' _ _ _ ►at : -- -- -- - - - - -- - - -Slate surcharge (12% emit: Yee
.:,I IA Z 3 g( P ): E z
Authorized 5ignatur .. TOTAL PERMIT FEE: 2
- .. .. This permit application expired if a permit is oat obtained within too
Print rtamc: k Q � L , c _ �� (�! / •
Dare: 2" 3 , days after It hum beep accepted as compicte,
I/ ' N umber of impactions allowed per permit.
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