Permit •
CITY OF TIGARD ELECTRICAL PERMIT
EI
' ° : COMMUNITY DEVELOPMENT Permit #: ELC2007 -00020
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/09/2007
Parcel: 2S109AA00200
Jurisdiction: TIG
Site address: 14035 SW 125TH AVE
Project: REINHART Subdivision: Lot:
Project Description: (2) branch circuits for furnace & heat pump. 7/11/12, REINSTATED FOR FINAL INSPECTION
Contractor: JACOBS HEATING AND A/C Owner: STEVE REINHART
4474 SE MILWAUKIE 14035 SW 125TH AVE
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 234 -7331 PHONE: 503-780-8057
FAX: 503 - 808 -9108
FEES
Quantity Description Date Amount
1 [ELPRMT] ELC Permit 01/09/2007 $53.50
Specifics: 1 [TAXI 8% State Surcharge 01/09/2007 $4.28
Type of Use: SF 1 hr Hourly Electrical Rate 07/11/2012 $90.00
Class of Work: 1 ea Hourly Electrical 12% 07/11/2012 $10.80
Surcharge
Type of Const:
Occupancy Grp:
Total $158.58
Required Items and Reports (Conditions)
•
This permit is i • : • su •i • • the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in ' ccordance with appr• -d 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. A NTION: Oregon law re , s yo to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 - 4010 throu & h OAR 952 700 `, obtain a copy of / e rules or direct questions to OUNC by calli .2 2.1987 or 1.800.3212344.
Issue. =y: Permittee Signature. �C
• 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.
v
•
• CITY' OF ' TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: E 9/2007 - 00020
DATE ISSUED: 1/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 109AA -00200
SITE ADDRESS: 14035 SW 125TH AVE ZONING: R-4.5
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: (2) branch circuits for furnace & heat pump.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >=4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: • CLASS AREA/SPEC OCC:
Owner: Contractor:
STEVE REINHART JACOBS HEATING AND NC
14035 SW 125TH AVE 4474 SE MILWAUKIE
TIGARD, OR 97223 PORTLAND, OR 97202
Phone: 503 - 780 -8057 Contact #: PRI 503 - 234 -7331
FAX 503 - 808 -9108
FEES
Description Date Amount Reg #: ELE 26- 807CRE
[ELPRMT] ELC Permit 1/9/2007 $53.50 LIC 1441
[TAX] 8% State Surcharge 1/9/2007 $4.28 SUP 704LHR
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 A lic e FOR OFFICE USE ONLY
City of Tigard Dat `� i �/ ��
n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
N C Phone: 503.639.4171 Fax: 503.598.1 9 2UU7 Date/B : Other Permit:
T I G A R D Inspection Line: 503.639 1 Date Ready/By: ® See Page 2 for
Internet: www.tigard or.gov , Notified/Method: Supplemental Information
Utl Y r iivatti� PLAN REVIEW
T 'II ra ;
❑ New construction . . Addit o 7a en tid replacemen 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
.V1- 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 ", "I -2 ", "I -3 ",
Job no.: Job site address: 1 1. 0,:Y"") 5l, i i ; • 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: --\- Ci f ���CO 0 2 6 1 � / El Health-care facilities. ❑ Supply voltage for more than
J ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
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 145.15 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Q
Limited energy, multi-family 75.00 2
' / c J - � ✓ � Cl. 'l
- ti cn (Ly� � ' residential (with th above sq. ft.)
1, n (' ` _ Services or feeders installation, alteration, and/or relocation
Y v2_ pi, ( 200 amps or less 80.30 2
k-PROPEHTY OWNE I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ` — 4Q/ ---g gTh e., ,' hc.r -I- 401 amps to 600 amps • 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: . Temporary services or feeders installation, alteration, and /or
relocation
Phone: (r D 'Q - 6cfl Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps . 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
g A. Fee for branch circuits with
• ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, ' 46.85 ,C) (p� '� 2
first branch circuit
Address: Each add'I branch circuit ( 6.65 (.0.U5 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name.: �(� L j I € _ / • Signal circuit(s) or limited -
}- i C-eVI� energy panel, alteration, or
Address: 44 2.4-_ Ste_ m I I(,� (, .Q 44—Q_ extension. Describe: Page 2 2
City/State/ZIP: 9, cz - 7 aDD Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone; r : ) Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lic.: ' Electrical Lic.: v, Co - IG i iiprv. Lic.:' - '( 0 i . Industrial plant per hour 73.75 _
P 4)Q ) � � ELECTRICAL PERMIT FEES
Suprv. Electrician signature, ature re q uire ,(� � Subtotal: S..3
Print name: F Q p, tit -- T (1 y- Date: 1 ! f t -) Plan review (25% of permit fee):
. State surcharge (8% of permit fee): -f-I.
Authorized signature. `%� / n 1� C- i ,t-- �--1Z TOTAL PERMIT FEE: 5"") . - 1
�M / This permit application expires if a permit is not obtained within 18
Print name: / ' 1 -Q., 1‘,‘ n , .e MC u < Date: l l5 days after it has been accepted as complete.
• Number of inspections allowed per permit.
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