Permit y , CITY OF TIGARD ELECTRICAL PERMIT
-! COMMUNITY DEVELOPMENT Permit #: ELC2012 -00340
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
Parcel: 2S 109 DA 15500
Jurisdiction: Tigard
Site address: 15298 SW GREENRIDGE PL
Project: Arlington Heights No. 3, lot 74 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 74
Project Description: (1) branch circuit for installation of solar photovoltaic system
Contractor: MILESTONE ELECTRIC Owner: STONE BRIDGE HOMES
1281 NE 25TH AVE, STE. T 4230 GALEWOOD ST, STE 100
HILLSBORO, OR 97124 LAKE OSWEGO, OR 97035
P
PHONE: 503 - 387 -7577
HONE: 503 - 645 -5323
FAX: 503 - 690 -4843
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 06/04/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/04/2012 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 • 11 - ••0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80 332.2344. ,
��� Permittee Signature:
/ --
Issued By:
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.
,
Electrical Permit Ap_plicati II., ,
• ' • i r ' CENT
D
FOR OFFICE USE ONLY
City of Tigard Received / A ,
Date/By: Co 42... 41?"7 Penult No.: A -- z_6 4 ,207 . 2
5
4 .1 13125 SW Hall Blt Tigar Plan Revie
d, OR 972
I .. . Phone: 503.718.2439 Fax: 503.598.196U 0 4 2012 7 0N ,
Date/By: Other Permit0 ( 200q6
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: luris,r 6... 21 See Page 2 for
TIGARD
Internet: www.tigard-or.gov
BUILDING raistom
ii , , Notified/Method: Supplemental Information
' 4, Ttiptiji wo >„ •, 10 . II*II '1- f . I .;7;,..:.1. ;: .I Ir - I ,:' ., I. ' III I I-,' II ii:''.:',41.:AISI 4, — REVIEW
i za:,i1A,:,,,,,..-. 's, '4, •-;.„.44 , .4,,A,- .40 4.,""t.,.,.., ,....",'„. ,, J•:- -, • •-•,,, , •-L • -, , -• - . ,,,, h: ,.:,..,•,,,,,,. r •,, .4 1 ,
0 New construction 0 Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
111 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
e .%...04 , ,,,,-, t... RucTIoN . - - - , • .. :: - .,,, -;-: ,., . ,.,,,,.;:' .s.., 7, 3 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
; c A ,CATEGoRy coNsT, .,.., ,:: ,,; : , ,, •,,-:,, „
,
less to ground, or exceeds 14,000 0 Commercial-use agricultural
El 1- and 2-family dwelling 0 Commercial/industrial P Accessory building amps for all other installations. buildings.
El Multi-family 0 Master builder El Other: 0 Fire pump. 12 Installation of 75 KVA or
0 Emergency system. larger separately derived system
JOB
'"AV''f - site iNidam ANO' LbtAtioN':' :• -:, ° 7 ' '-,' '' , Add ition o . • ,
,„,;,:,:::;., • ,m''.if(y.„, . :,•',. :0 ., ...., ,,..„ „;..' - f ` r...:7,...., .,,,,1-.°I, itt ',*,, 'i Lj ..-,mi new motor load of
Job no.: t . I t if Job site address: i 5). g 9 6,ce,,,;,1 5 C. r° . 0 100HP or more.
Six or more residential units. 0 occupancy.
Recreational vehicle parks.
City/State/ZIP: t i m ” - rti 0 . e - > 2 q 0 Health-care facilities. 0 Supply voltage for more than
t
4 I (Z l 7 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: c
ac 14,4 e i 0 Service or feeder 600 amps or more.
'... - '2." .;,:. ,.':;'.„1 ••--, kiFEE, SCHEDULE 7.
Cross street/directions to job site: Description I Qty. I Fee. j 'total I
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
. 75.00 2
fg4, DE§c4i7p,tjo..0 . ,,*biiikW;: ,;',..::::,!':;;:':':i:,: i 'I,' ,.' (with above sq. ft.)
Limited energy, multi-family
75.00 2
Stkcte- 3 -,451-4 ll residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less -4----I
TiiiiiiiiiiiViiWi■ikii:V vi5::, , , - ; , c iff TENANT': ':. . . : 201 amps 10 400 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 installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not .
401 amps to 599 amps 168.54 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
0:414Arisitiq. . 411.::Ff-;' Er ONTA`gf'...UROJN. .-`.: -.:. , I above service or feeder fee,
7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first
/ 56.18 .52, ,/, 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E _ Sign or outline lighting 67.84 2
7 &Y. Signal circuit(s) or limited-energy
Business name: Milestone Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 1281 NE 25th Ave. Suite T Additional inspection (1 hr mm) 66.25/ hr
Investigation (1 hr mm) 66.25/ hr
City/State/ZIP: Hillsboro, OR 97124
Industrial plant (1 hr mm) 78.18/ hr
Phone: (503) 645 Fax: (503) 690 Inspections for which no fee is
90.00/ hr
specifically listed ( min)
CCB Lic.: 153480 Electrical Lic.: 34-618C Suprv. Lic.: 5-6,‘ 3 5 wv,4„..„,,-,,,ELF ,TgleAr,..,pmi-ruccsir:
Subtotal: 52, , /i--
Suprv. Electrician signature, required
• plan review (25% of permit fee):
Print name: 64.,-;:- Date: 0V/a State surcharge (12% of permit fee):
TOTAL PERMIT FEE: 6 g p , 7
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
1: \BuildingWermits \ELC-PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB
CITY OF TIGARD ELECTRICAL PERMIT
• - COMMUNITY DEVELOPMENT Permit #: ELC2012 -00340
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
Parcel: 2S109DA15500
Jurisdiction: Tigard
Site address: 15298 SW GREENRIDGE PL
Project: Arlington Heights No. 3, lot 74 Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 74
Project Description: (1) branch circuit for installation of solar photovoltaic system
Contractor: MILESTONE ELECTRIC Owner: STONE BRIDGE HOMES
1281 NE 25TH AVE, STE. T 4230 GALEWOOD ST, STE 100
HILLSBORO, OR 97124 LAKE OSWEGO, OR 97035
PHONE: 503 - 387 -7577
HONE: 503 - 645 -5323
FAX: 503 - 690 -4843
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 06/04/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/04/2012 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 1 -0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80 332.2344.
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 503.639.4176 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.
Electrical Permit ApplicatioRE EI ED FOR OFFICE USE ONLY
City of Tigard S 0 4 2012 Dat T 7 / 02. �r PermitNo.: �Lt 2a/2 -x039'
lig 13125 SW Hall Blvd., Tigard, OR 9722 Plan Revie • to o2Q /a— 0 ,009'6
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permi
T l G A R D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: turi El See Page 2 for
Internet: www.tigard- or.gov BUILDI DIVISION Notified/Method: �C Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: L Job site address: /� / n 100HP or more. occupancy.
1 Z I ' J �� 9 �J f cCn r i Q(G L 1" ❑ Six or more residential units. ❑ Recreational vehicle parks.
Cei
City/State/ZIP: T; C. d / � G ? } 2 '1 d ❑ ❑ Health-care facilities. ❑ Supply voltage for more than
Q ,1 i Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
S•�u a c b r; /�b C A (5. FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
Sol a r i S I 1 I residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less — 1---10 . 2
❑ PROPERTY OWNER - ❑ TENANT 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
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
ty 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
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. Fee for branch circuits with
APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 ,if 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
ty dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited -energy
Business name: Milestone Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 1281 NE 25th Ave. Suite T Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Hillsboro, OR 97124 Investigation (I hr min) 66.25/ hr
Industrial plant (l hr min) 78.18 / hr
Phone: (503) 645 - 5323 Fax: (503) 690 - 4843 Inspections for which no fee is 90.00 / hr
specifically listed (%] hr min)
CCB Lic.: 153480 Electrical Lic.: 34 -618C Suprv. Lic.: 5-6,4 3 5 . "..: ELECTRICAL PERMIT FEES ' -' "'"-"r-t''
Suprv. Electrician signature, required: �/ o Subtotal: '5-6 , /IF
il � /l Plan review (25 /o of permit fee):
Print name: GX,..7 f ,(L Date: 6 /y / State surcharge (12% of permit fee): C , 7
"`� TOTAL PERMIT FEE: 6,2 • 7;2_,
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
N um b er of inspections allowed per permit.
I:\ Building 'Permits\ELC- PennitApp.doc 07/01/10 440- 4615T(I1 /05 /COM/WEB