Permit " CITY OF TIGARD ELECTRICAL PERMIT
• " . COMMUNITY DEVELOPMENT Permit #: ELC2012 -00297
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2012
Parcel: 2S108AB05000
Jurisdiction: Tigard
Site address: 14051 SW 155TH TER
Project: Smart Subdivision: BRENTWOOD ESTATES Lot: 12
Project Description: (2) branch circuits without service or feeder
Contractor: PRECISION NW ELECTRICAL Owner: SMART, DAVID E & JERI L
12020 SE ANNA CT 14051 SW 155TH TERRACE
DAMASCUS, OR 97009 TIGARD, OR 97224
PHONE: 503 -413 -9870 PHONE:
FAX: 503 - 594 -2873
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 05/21/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/21/2012 $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 0 • - • ) 091. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/ ,o
Issued By: ��_:`�0 / / %l•� P er m ittee Signature: /�/ ! /7 P
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.
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05/18/2012 00:11 FAX 50359428� EC / I SION NW la003 /003 Ctittd/'
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Electrical Permit Application MAY 18 2012 1,(w(.)1.1.1( l' 1 0\1.1
City of Tigard w 1 a„ sr Permit Not WI .. DO 1
13125 SW Hall Rlvd.,'Tigard, OR 97 OF TiGARD Review Other permit: S [ o�ol _ pop() '_ t. Phone: 503.7182439 Fax: 503.5 0 /� 1 178trB :
ins
cctionl.ine: 5 03.639.4175 -DIN D Ek k p ady/gy: g See Paso 2for
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Internet: www.tig8td- or,gov Nuti nod/Method: Supplemental Information
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0 New conslruCtiOn ® Addition/alteration/replacement Please check all that apply (submit 2 seta of plans w /items checked below):
❑ Service Or feeder 400 amps or more D 17uilding over three stories.
❑ Demolition ❑ Other: fa
,r r " ; C s a dy. et' 1 , . . �tnOk p u:.f ; Glli' r• rnlr +rm;e quaxl,irnnuk;'ntrl�'utstnlj i ''t�� '`'.1 ` ; ?I! amps al
c tt''1� Wh ere the availab t cement Marinas and
f - + ' + t ' ; s:, l ,t . 4 . „ its i, n i i j ; Y `7 �kl it E 1 + � iii I i t exceeds 10,000 150 volts or D Floating buildings.
, iY . •'i l ,t1 hf:., .1.. { enkhhatiln. r z ... { , ewdllr_�3� , . . , , , I .,. f.. Cr ru . 14,61. ,I ■1.L:5 • , lees to (gonad, or exceeds 14,000 ❑ Commercial - use agricultural
El 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other inatnllarimu. buildings.
❑ Multi - family ❑ Master builder ❑ Other 1 CI Fire pump. ❑ Installation of 75 KVA or
rIto Yll ,tp.,. r !(r, �,,r , u .$ r 1 � ` 1,9111 I 71. 9 ,i ,W I ' D Emergency system. larger separately derived system.
� r r,.t. ;., 11 y m ! {M
I'•'I• ° ?Sl �, iY1 n, e.• Lt ,i:. .u.l },iL1111 .�t ri .dnn )A,Il ,if � f rl . 1 11i2;;;;..8 , 61 , 6:.4 �7{4i ❑ Addition anew ,no lo Of ❑ °A °, "r."1
100HP Cr mmx occupancy.
Job no.: Job site address: 14051 SW 155 Terr o Recreational more residential units. ❑ R,ecteiunal vehicle parks.
El Health-care facilities. O Supply voltage for more than
City/sutte/zlP: Tigard, OR In Hazardous toeatiens, 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name: ❑ service or feeder 600 amps or more.
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Cross street/directions to job site: • 1Scrlo6a rte® •n"at N residential single - or mold -tamny dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or le 168.54 4
Ea. WW1 500 sq. or portion 33.92 1
Tax map/parcel no.: Limited energy. residential 2
■ t.v.: . >; 1 ; , f 'al 1 T 9 7771;1 (` Y'1 1h '•' 1' 70rl } 11, (with above sa, iii 75.00
i r., . 1 vegni K;( 14,!,h aidliiiiliini,;.,,.. .. :Ivlr :g) :: :., : .._..!!4∎1∎l, ,;'.)ei(i1.1,ii
Limited multi - family 75.00 2
2 Circuits for Exteior outlets residential with above sq. t)
Services or feeders installation, alteration, and/or relocation -
, �,� �( �y �1 200 amps or lase I 100.70 2
r { r „r4r ''ll' I>;ja 1' �il!` 1 : �. 0 41! "`' 61 ` ,171 11 k } 1 .' rp " r ,t k r I Ptl 201 amps 10 400 amps 133.56 2
: �R � a„WWiiIF,,, V lr l . r a , h is..: 5. i ,.. .I :.(1 1 o ii I.I. .i ; ', 'f ) ::,. 1 / m . . .. 1 , .
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 Installation, alteration, and/or
City/Slate/ZIP: relocation _
200 amps or less 59.36 + 1
Phone: ( ) I Fax: ( ) 201 amps to 000 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not -
599 166.54 _ 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circula - new, alteration, or extension, r panel
Owner signature Date A. Fee for branch circuits with
,ID ��yyI,,,, r „ ,��� : r l emit I kV I r r iMillfi above service or feeder tee, 7.42 2
wi"IRz< r ' .11 M I 1. 4& :4, h , , 1 ):011∎ nm . } .. tl . l l „ , i;I,
1 ei , Vi, l� ,.,?:1.,41... ; �a ,r,r i✓rt i) kA � I+; ! �9 i .�. y l . l,a�rl„�.,,,Ihmllha.r., -... I J i. . rylA). Li. ,? ,,I JILn ;(. each branch circuit
B. Fee for brunch circuits without
Business name: service or feeder fee. first 1 56.18
branch circuit 56.18 2
Contact name:
Each add'l branch circuit 1 7.42 7.42 2
Address: Miscellaneous (service or feeder not included) -
hula manufactured or modular 67.84 2
City/State./ZIP: dwelling, service and/or feeder
_ 67.84 2
Reconnect only 2
Phone: ( ) I Fax:: ( ) pump ur irrigation cinch 67.84 -
E Sign or outline lighting 67.84 _ 2
nl, I ' 74 . n ? 4I�y' y 1 I j � r`. . l i �t i .. 2 +fC {{ It i�LM� lfl11,11,.1;l f l ''lII;I Lif : 1 l ei ii:.',.',. ?' { .'1� I) I rl Signal circuit(s) or limited energy
2
��. . ., , ;/ '' MI' 1itEa,l t ,� A J , c l ,
1L �
panel, alteration. or extension. Page 2
Business name: Precision NW Electrical Contractors Each additional inspection over allowable in any of the above
Address: 12020 SE Anna Ct Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State /ZIP: Damascus OR 97089 industrial plant (1 hr mot) 78.18/ hr
Phone: (503) 413 s Fax: (503) 594 - 2873 lh ` ' ' Inspections for which no fee is 90.00/ hr
_ meal bated 'A hr min
913 Lic.: 163318 Electrical Lie.: C47 .1 i �prv. L ie.: 50369 - , ,ir;,r,{i1t ,..),,,„1;w:!;-
' , �i � • „ , , � 4 aA .' r - , . 'r , ii ( iLi ' ' ' ' 7. Subtotal: 63.60
Suprv. Electrician signature, required: !y1,j1( Plan review (25% of permit fee):
Print name: Mike McDonald Date: 05/18/2012 State surcharge (12% of permit fee): 7.63
TOTAI. PERMIT PEE: 71.23 /
Authorized signature: •Etta permit application expires If a permit is not obtained within 180
- days after it has been accepted as complete.
Print name: Date: • N of inspections allowed per permit.
l\ DuildhlglPermitAEt .(:-PCn"uApp.da; 07/01(10 440461S1(11/0S/COMIWP3t
05/18/2012 00:11 FAX 5035942873 PRECISION NW fj001 /003
PRECISION NW ELECTRICAL
CONTRACTORS
12020 SE Anna court
Damascus, Oregon 97089
Cell (503)413 -9870
Fax (503)594 -2873
Precisionnwelectrica1C yahoo.com
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