Permit CITY OF TIGARD ELECTRICAL PERMIT
Per
COMMUNITY DEVELOPMENT
Permit #: ELC2012 -00279
T [ G A Ii l? 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/14/2012
Parcel: 2S104AB01700
Jurisdiction: Tigard
Site address: 12130 SW MORNING HILL DR
Project: Dyer Subdivision: MORNING HILL NO.1 Lot: 23
Project Description: Panel change - grounding electrical system redone
Contractor: BRANDON KING ELECTRIC LLC Owner: DYER, MICHELE K
18400 NE HILLSIDE DRIVE 12130 SW MORNING HILL DR
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -2727 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 05/14/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 05/14/2012 $12.08
Type of Use: SF 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 adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OA -001-00 You may obtain a � coopyy doff the rules or direct questions to OUNC by calling 503.232,1987 or 1.800.3 T-f 32.2344.
Issued By: � .�/L OYLI� Permittee Signature: O� 0.
� f� �� -I ( o ILL
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.
FROM : FAX NO. : Jul. 16 2011 04:59PM P 1
r. I . .
•
_
Electrical Permit ApplicationFIECEIVt - FOR OFFICE (m.: ONLY
III City. of Tigard
, -- . 13125 SW flail Blvd., Tigard, C/R 97223
Phone: 503.718.2439 Fax: Ot
503.598.19 MA /AY 1 4 2012 R r /al I 2■
Plan Review
err)/ OF TIGA9D ilariljY' . i'ennithlo.: eLtaola 049 75
hr Perrnil:
e
i I k; A p r) Inspection I.inc: 503.639.4175 flute Ready/By Avis: RI See Page 2 fur
Internet: wvivi.tigard-or.gov BUILDING DIVISION Nowictumcihm: —1 co Supplemental Information
?FiJ:iit.11:-!! ' !qiill 'Ui l _ ri di1Opilikiiatragelte - t111RS 11 11411:i1914 - 7: 4 1ill1 1 1 1 1 1 ;t 1 19;!.4;iiiii4L1 ;?
-1.dM;r4110R!!!=iiiiM:It011"1,Ft*..4413ilip7;N;11041,1l4:1;11gtS'IllE'lfr"14/tmlii■qt.M5,•ndieleilitflk1441,1'.1.14.,,-,"'"--G,49, ' " . "'"''''' ra ' 7 ''';iZbilZio'Pl . ' . . --- . ----- -----"" ... 4.4,--- ■ . ... ------
0 New construction ZE Add iti on/alteration/replacement Please cheek all t1131 apply (Submit 2 sets of plans yr/ileum; chocked below):
a Service or fer.der 400 amps or more 0 Building over three stories.
C] Demolition 0 Other: . where the available fault current 0 Marinas and boatyards.
iiiiiik,': or e■tittg exceeds 10,000 amps nt 150 volts 0 Floating buildintp.
•,,,,...,...,4-17.,,,,;!iirt.r.2.---• iii
, - , 4Ei:..-.ns.,v4 ,, 9 -, 475-e , FiRi sk WiL 44) ' q ,'' less t moo ot ox000 /4,000 0 COMMC1 cial-uso agricultural
al- and 2-family dwelling ID Commercial/industrial 0 Accessory building amps for all other install:gifts. buildings.
El Multi-family 0 Master builder El Other: . 0 Fire pump. 0 Listallation of 75 KVA or
- ..v 0 Emergency system. larger separately derived system.
il' tibRe!i.%;:ittleir..0,211 .m. 0 Addition of new moior load ut 0 "A", "E", - I .2",
occupancy.
Job 110.: Job site address: il 30 ,51.) r Or/It'll' i• V( 160H1` or mons.
O SP& or more residential units. 0 Reveftlional vehicle whs.
City/StatcfL(P: A 04,. 0 ri... q fl 7_.1.: 0 Health-care facilities.
D Hazardous locations. 0 Supply voltage for more then
600 volts nominal.
Suite/bldg./apt no.: I Project name: El service or lbcdcr 600 WTI ps or ustms. •
-
r77 77 4 .1 1 qP1ITY F t:.Xi i. .igkig0,494i 1 .;.0.1=MV:.1%::.6.gii'4i:
Cross street/directions to job sitc: 5 4.,) k - ..S .s. liAk• Descriodqp I ,..._,
. . ' New residential single- or multi-family dwelling unit.
Includes attached garage.
__..
4
Subdivision: Lot no.: 1.000 sq. R. or less 168.54
--- Ea. addl 500 sq. ft. or portion 33.92 1
'fax map/parcel no.: , . Limited energy, residential 75.00 2
above sq
, =i 11 .4 ., :7 11 0;i'ii6i.7,:', 1 1; ,.: i" (with . ft.)
liV•Ii•iii;":,r'.6";.';.!::',1•,•"1 i uv
W7Fn••••;a::E7 ' '40 ' „ ,... .... thmrsetene■ ,,,c1...sli.e12E. .
■ Limited energy, multi-family
75.00 2
''''. S tWk ' residential (with above .. •
—
l' L41C Serviecs or feeder;installation, ;Iteration and/nrclneation
■ ,----,-_,-
- )4r 4 A 4 A C. . 2t/0 amps or lass 1 100.70 (0010 2
_
a , ...#00CT - T4'i"'.; , :7g08.i;V• n'aiiirii49 • ,. 20 1 POPS 10 40 0 fIFP,,.. ,.. , . . . , 133.56 '2
401 amps to 600 amps • 200.34 2
Name:
601 amps MI.000 amps 301.04 -
Address: over 1,000 amps or VOIM 552.26 2
.,.
Temporary services or feeders installation, alteration,"and/or
City/Shtte/ZIP:
relocation _
_
Phone: ( ) [Fax: ( ) • 200 snips Of less
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not -
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 snips to 599 amps • 168.54
Branch Circuits alteration, o extension, per panel
Owner signature: Date: A. Fee fur brunch circuits with
- -
itiiiit . v. . - i, . 1, ,--.. , 75 1 11i, i ii ! P . At.ii above serviceor feeder fee,
742 2
411 - P. , - ..:iNt;:,.,71,0 ',-, - ..,...,......._1-. . each branch mot
---
Business name: j •
B.
v. • . ° t . . . FCC for branch circuits without
ro ,,,
service or feeder fee. first 56.18 2
. .
Contact name; ilL
' ....1.s A f branch circuit —
--. _ Each add'l branch circuit 7.42 2
Address:
.
g 00 N , :It_ arVoL .., . ,
Miscellaneous (service or feeder not included) • __._
Each manufactured ur modular 67.84 , 2
City/State/ZIP: U Q 0 , 2 _
dwelling, service rincliar feeder L.
Phone: ( 5 ) ) Fa q_ Fax: : ( ) Reconnect only 67.84 2
, Pomp or irrigation circle 67.84 2
E -mail : .
• in. Obo " S I. . 0- I ' .■:■A ika rh . 'hit— Sign or outline lighting 67,114 2
glr .7,1,Z,S.71.•..:.'w goviiiliiili.iii si oirouir(s) or limited-elle/1
Business name: , I r „. ,
. 1..!/• 6 fe..(...4-v..■ , panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above__
Address; i 1 400 P C ih.W S .4.rWC- Additional inspection (I hr min) 66.25/ hr --
investigation (I lir min) 66.25/ hr
'City/Stale/ZIP: 4 9 ' ' 6 1V>1...
Industrial plant (1 hr min) 78.18/ hr
Phone: ( 5 - 03) $ . z... . we. ,.. Fax; ( inspections for which no fee is
90.00/ hr
,....sReeilleal_ ly listed_ SK hr mira t, ___,. . , ,,,.,.....,,,,,,,,,...„ .... ,,,....,...,...,.
XC13 Lic.- Mit gc 4, trical I ALI,: (.3 Z Su Lie.; 5316 3 t i,k, i 1 , 1m.„!;:ipm;t615,1035a4 fo stec
loairsa„,z.„,„:„,,,.::::,..,.?.....::::
.__.. . T „,, ir I
Subtotal: 1 Deo • 1
Suprv. Electrician signature, required: 2.--
Plan review (25% of permit fee):
...._
Print name: (r0,40 K-, ' natc: 0S iSon— State surcharge (1214 of permit fee): % .
TOTAL PERMIT FEF.: i t_7
Authorized signatur. .
This permit application expires if a permit is nut obtained within 180
days atter It has been accepted as complete.
Print name: 0,,,,,,k 1 . 14,,:
Date: 0 S - a.ec2, • Number of inspections allowoi per pcoritt.
1: 07/01/10 J 440.46.,,,1./usicomp..
. .
TRANSMISSION VERIFICATION REPORT
TIME : 05/14/2012 16:45
NAME : CITY OF TIGARD
FAX : 5035981960
TEL : 5037182449
• SER.# : BR0H7J690762
DATE, TIME 05/14 16:44
FAX NO. /NAME 5035382727
DURATION 00:00:21
PAGE(S) 01
RESULT OK
MODE STANDARD
ECM
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permlt #: ELC2012 -00279
T f GAP D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05!1412012
Parcel: 2S104AB01700
Jurisdiction: Tigard
Site address: 12130 SW MORNING HILL DR
Project Dyer Subdivision: MORNING HILL NO.1 Lot: 23
Project Description: Panel change - grounding electrical system redone
Contractor: BRANDON KING ELECTRIC LLC Owner. DYER, MICHELE K
18400 NE HILLSIDE DRIVE 12130 SW MORNING HILL DR
•
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 - 2727 PHONE:
FAX:
FEES
Quantity Description _ Data Amount
1 ea Services or Feeders - 200 0511412012 $100.70
siaeai(ias. amps or less
1 ea 12% State Surcharge - 0511412012 512.08
Type of use: SF Electrical
Class of Work: ALT
Type of Conat:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)