Permit 5, CITY OF TIGARD ELECTRICAL PERMIT
Per
COMMUNITY DEVELOPMENT
Permit #: ELC2012 -00315
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2012
Parcel: 1S136 DC04400
Jurisdiction: Tigard
Site address: 11945 SW 70TH AVE
Project: Tualatin Valley Fire & Rescue Subdivision: • FRUITLAND ACRES Lot: 31
Project Description: (2) branch circuits for TI
Contractor: E C COMPANY Owner: TUALATIN VALLEY FIRE & RESCUE
PO BOX 10286 11945 SW 70TH AVE
PORTLAND, OR 97296 TIGARD, OR 97223
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 05/24/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/24/2012 $7.63
Type of Use: COM 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 5 - 001 -00 . You may obtain a copy T of the rules or direct questions to OUNC by calling 503.232.1987
r"1 23 � 7 f or 1.800.332.2344.
Issued By: J t Permittee Signature: OM �PLi 6411011/41-
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.
May. 23. 2012 12:29PM _ No. 0573 P. 1 59 /
Electrical Permit Application RFE FOR 01 U G ONL1
City of Tigard `R'ece(ved
�' g S 0141 ta- sr Pemrit x °PLC • 1 _ -0(3.3
i� -- , q 13125 SW Hall Blvd., Tigard, OR 97223 MAY 2 3 20' 'lanit crd ew
I Phone: 503.7182439 Fax: 503.598.1960 Date10 . Omer Permit
r 1 G A R D Inspection Line: 503.639.4175
CITY OF T1GA a Reaey /By See Page Z for
Internet: www,tigard- or.gov v I�Ged/Melhod �� - Supplemenlellnformatioo
BUILDINCI • • TYPE OP WORK • . �' PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacemeni Please cheek all that apply (submit 2 sets of plans wfitems checked below):
CI Service or feeder 400 amps or more ❑ Building over three stories,
❑ Demolition 0 Other:
where The available faull current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps as 150 volts or ❑ Floating buldings-
less to grotmd. or exceeds 14,000 ❑ Commercial - use agricultural
❑ 1- and 2- family dwelling 21 Commercial/industrial ❑ Accessory building amps for all other installation'. bnildiogs.
❑ Multi - family ❑ Master builder ❑ Other: ❑Fire pump. ❑ lnsrallal of 75 KVA or
JOB SITE INFORMATION AND 'LOCATION ❑limergeney larger separately derived system.
•
❑ Addition of new motor load of ❑ "N', "E' "1 - "1 - ",
Job no.: 74258 - 30 I Job site address: 11945 SW 70 Ave I00HP or more. Occupancy.
l ]Six or more residential emirs. ❑ Recreadonal vehicle parts.
City /Slatc/ZIP: Tigard OR 97223 ❑ Heabh-care facilities_ ❑ Supply mirage for more Than
C) Hazardous locations, 600 volts nominal.
Suite/bldg/apt. no.: I Project name: Tualltin Valley Fire & Re ❑ Service or feeder 600 amps or more.
Cross street/directions to job FEE . SCHEDULE" .'
J k'eu I ._ I 7a 1 Tout l
New residential single- or multi- family dwelling unit.
Ineludes attached garage.
Subdivision: I Lot no.: 1,000 sq. R or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. R. or portion 33.92 1
. Limited energy, residential 75.00 2
..: DESCRIPTION OF WORK :. (withabovo sq. R)
-
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Limited energy, multi- family
Tenant Improvement (2) UPS Circuits residential (with above sq. ft.) 75.00 2
Services or feeders Installa alteration, and/or relocation
200 amps or Secs 100.70 2
❑ PROPERTY OWNER ' ' 1' : D TENmr .: 201 amps to 400 amps 133,56 2 •
Name' 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552,26 2
City/State/DP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) [ Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 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 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or ex tension, per panel
Owner signature: Date: A- Pee for branch circuits with •
® APPI:ICANT ❑ . CONTACT. PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: EC Company B. Fee fin branch circuits without
service or feeder fee, first 1 $6.18 56.18 2
Contact name: Kathy Kelley branch circuit
Each add'I branch circuit I 7.42 _ 7.42 2
Address: PO Box 10286 Miscellaneous (service or feeder not Included)
City /State/21P: Portland OR 97296 Each �ctured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 224.3551 I Fax :: (503) 248.6353 Reconnect only 67,84 2
Pump or irrigation circle 67.84 2
E -mail: kathyk@e- e-co.eom Sign or outline lighting 67.84 2
• CONTRACTOR . .. Signal circuit(s) or limited•energy
Business name: EC Company panel, alteration, or mansion. Page 2 , 2
Each additional Inspection over allowable in any of the above
Address: PO Box 10286 _Additional inspection (I hr min) 66.25/ hr
City/Slate/Z1P: Portland OR 97296 investigation (I hr min) 66.25/hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 244.3571 I Fax: (503) 248.6353 Inspections for which no Rae is
hr
specifically listed OS hr min) 90.00i
CCII Lie.: 49737 Electrical I,' • • 6.4 C Suprv. Lie.: 2345 - . ELECTRICAL PERMIT. FEES .
Suprv. Electrician signature, required: N, Subtotal: 63.60
Plan review (25% of permit fee):
Print name: Ron Coffin Date: 5 Slate surcharge (12% of permit fee): 7.63
Authorized signature: '� +�7rV L _ TOTALPERMITFEE: 71.23 t./"" at �L �Lr This permit application explres If a permit is not obtained vriihin 180
Print name: Anna Bell Date: 5 -23 -2072 days SRer it has been accepted as complete.
Number of inspections allowed per permit.
l: tBuadiogtPamiu1ELC.PermitAppdec 07/01/10 44046157(11/05/COM/WEB