Permit •
CITY OF TIGARD ELECTRICAL PERMIT
>s COMMUNITY DEVELOPMENT Permit #: ELC2012 00354
TIGARD A R. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2012
I
Parcel: 1 S125DA01601
Jurisdiction: Tigard
Site address: 6770 SW TAYLORS FERRY RD
Project: Layton Subdivision: KINGS VIEW Lot: 1
Project Description: (4) branch circuits furnace & heat pump connections, plug for EAC, service light & plug
Contractor: BOB'S ELECTRIC Owner: LAYTON, DAVE
2700 NE BURTON ROAD STE A 6770 SW TALORS FERRY RD
VANCOUVER, WA 98662 TIGARD, OR 97223
PHONE: 360 - 254 -7200 PHONE: 503 - 307 -4107
FAX: 360 - 254 -8219
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 06/07/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/07/2012 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OA - 001 -009 . You may ob in a copy of he rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /�
Issued By: Permittee Signature: Oki ' ' {- 1 ► L �i111 •
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
FROM (WED)JUN 8 2012 7: 28 /ST. 7: 27 /Mo. 9302926816 P 2
5
Electrical Permit A t r lilcation ._ � I O IL 01 1-1( 1: I C (IN! . l figimi City of Tigard ' : '', 1 ' �re ; Permit 0/9 A — eV 3S
:: 13125 SW Hall Blvd., Tigard, OR ' 7 a �. .. other Per 5T e a VO.�$ .
Phone 503.639.4171 Fax: 503.598.1 . 2 for
I 1 t l> Internet: www.tigardor.gov 5 0 2012 Date d: Supplemental Information
t
❑ N ew construction l!, t !r ° , V f apply ( & p )
®Addthon/: � 1 � - 4 � 1 Please click all that 1 submit acts of Ions wrtems chocked bebw ;
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition El Other
where the available fault current 0 Marinas and boatyards.
L 't ,> s , ' r ` t exceeds 10,000 apps at 150 volts or 11 Floating buildings.
U _;,1 ;f , it less to ground, or exceeds 14,000 0 Commercial -use agricultural
Q 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for an other installations. buildings.
❑ Multi ❑ Master builder ❑ Other ❑ Fire pump. 0 Installation of 75 KVA or
G? --- ._ � n • F r �, ' :...... ,U ., . . .n'. 1 .. . . 0 Adelman of raw�motor load of 0 A" separately derived _ system.
Job no.: 12 -660 Job site address: 6770 SW Taylors Ferry Rd. 1: occupancy. Six a more residential unite. ❑ Recreational vehicle parks.
City /State/ZIP: Portland, OR 97223 O Health-care facilities. 0 Supply voltage for more than
•iazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: d 17) O Service or feed 600 amps or more
Cross street/directions to job site: F ti«iiatwo " ` cry Yee. Total `
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.M 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
� ia y " r r c.„ t 1S 1 teal 67.84 2
== z-
_ � (w above sq. fl.)
1: 1 ' ` �.. W Limited energy, multi - family
.. � . 67.84 2
Furnace & heat • um
connections, .1u: for EAC, servi.e rtsideotial ( ab°vesq. ft.)
Services or feeders installation on, and/or relocation
l i : h t & .1u: 200 amps or less 100.70 2
1r5c d i ..- t .1.:.:::'4, , , -
i
U ,. n `. r . a _.. - 1■ ' ' , 4 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Dave La ton - 601 amps to 1,000 amps 301.04 2
Address: 6770 SW Ta lors Fer Rd. Over 1,000 amps or volts 552.26 2
City/State/ZIP: Portland OR 97223
Temporary �ceaor feeders installatlon ,alteration, and/or
Phone: ( I ) I — Fax: ( ) 200 amps or less 59.36 I 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 druids — new, alteratlog or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
+} - "S , s x t j c j .� above service or feeder fee,
.. e, r_rT 1 z1; -., t Ir _ 1 . ,1 r -. i x 'T .
...... .,.: n
, . _. ,..:. . - a.,,;: c ,. `::.i each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 3 7.42 22.26 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 - mail
Qi�`� . � _ - _ - ,� r t_ Sign or outline lighting 67.84 2
C-�'is a.. ..-.. -.LJr ___L ._ r_..:_ - ,�y _.. a:_ _ ` -.,_ .. _ .__..' .- _..- _�d�.tu"t . - .. � _ T- _: � si circuit(s) or limite kuergy
panel, alteration, or extension. Page 2 2
Business name: Bob's Electric Each additional inspection over allowable in any of the above
Address: 2700 NE Burton Rd. Ste. A Additional inspection (I hr min) 6625/hr
Investigation (I hr min) 66.25/hr
t Industrial plant (I hr min) 78.18/ hr
Phone: ( 360 ) 254 -7200 Fax: (361 )254 -8219 Inspections for which no fee is 90.00 /hr
• 'fieal listed %r hr min
ectrical Lic.: 3 43 � ' _- a_ > r_
Suprv. Electrician signature, required: A ' Subtotal. 78.44
— Plan review (25% of permit fee):
Print name: Kevin Broselle Date 6 4 12 State surcharge (12% of permit fee): 9.41 /
TOTAL PERMIT FEE: 87.85 t/
Authorized signature: This permit appllcatloo 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-
I:\ Building\PenniulELC- PerrnitApp.doc 10/01/09 440- 4615T(l1/051COMIWEB