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Permit CITY OF TIGARD ELECTRICAL PERMIT 11 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00506 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/28/2012 Parcel: 2S 111 DC09500 Jurisdiction: Tigard Site address: 15730 SW OAKHILL LN Project: Miller Subdivision: SUMMERFIELD NO.10 Lot: 562 Project Description: (1) 200 amps new panel Contractor: SQUARE 1 ELECTRIC INC Owner: MILLER, DEAN H 10117 SE SUNNYSIDE RD., STE. F -216 12223 SW 131ST AVE CLACKAMAS, OR 97015 TIGARD, OR 97223 PHONE: 503 - 867 -2423 PHONE: 503 - 813 -7080 FAX: 503 - 914 -0432 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 08/28/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 08/28/2012 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 9 2 -001 -0 0. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.19877 or 1. Issued By: Permittee Signature: 44 i ( _ 4-T" / t Li 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. Aug 28 12 06:55a Square 1 ELectri 5038553516 p.2 Electrical Permit Applicati + IV r FOR OFFICE t sl: ON1.1 City of Tigard p Received 13125 SW Hall Blvd., Tigard OR 97228►UG 2 8 2012 l�s : • '1 [uNe.: CLG��a — 0050 14 a Phone: 503.7182439 Fax: 503.598.1960 Plan review T 1 G KID Inspection Line: 503.639.4175 C1TY Da R ' Other. Permit [nternet: www.ligard or gov , / T C Date Ready/By: ei See Page 2 for Notified/Method: Addition/alterati � 6 - Supplemental Iafonaaoioo • TYPE OF w (tCla PLAN REVIEW ❑ New construction Iacement O1 /reP P lease check as that apply (submit1 sets of plans w/itans checked below): ❑ Demolition ❑ Other: ❑ Service or reeds 400 amps or more 0 Building over three stories. CATEGORY OF CONSTRUCTION where the available fault cares ❑ Marinas and boatyards. buildings. I exceeds 10,000 amps at 150 volts or 0 l less to or Y dwelling ❑ Commercial/industrial ❑ Accessory building e> 14,000 ❑ Co d irg e . l o:<agr x,dtunl TX 1 -told 2 -Ear ❑ Multi-family amps for ml other ir�taltadont bugd Y Q Master builder 0 Oth ❑ Fire pwnp. ❑ Iastafatim of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ t �y system. larger separately derived system Cl Addition of new motorbadof ❑"A - E", - I-2", "1 -3 Job no.: I Job site address: j S SO -e-4) � 1114 t00HPortnore. occu ''1 I ❑ Six or more residual units. ❑ Recreational vehicle parks. City/State/ZIP , (7 .2_ Z 0 locations. 0 Supply voltage far more than _ I O Eiazerdora locatimxs. 600 volts nomiaaL Suite/bl tig./apt no.: 1 Project name: ❑ Service or feeder 600 amps or more Cross street/directions to job site: FEE SCHEDULE Description I OM I Pe` I Tana I • New residential single- or multi- family dwelling unit Includes attached garage. Subdivision: I Lot no.: 1.000 sq. ft or less 16854 4 Tax map /parcel no.: Ea add? 500 sq. ft. or portion 33.92 I I DESCRIPTION Of WORD ited energy, residential (with above sq. It) 75.00 2 l) r Limited energy, multi - family ej residential (with above sq. R.) 75.00 2 - Services or feeders installation alteration, and/or relocation 200 amps or less (, PROPERTY OWNER o � 1 ❑ TENANT 201 amps to 400 amps 133.56 / 7U 2 2 Name: s��lr- AP‘ •r 1 t \ e_4`.. 401 amps to 600 amps 20034 2 Address: P r L 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City /State/ZIP; Temporary services or feeders installation, alteration, and/or relocation Phone: ( E1-3- • c...,(6-0 i Fax: ( ) 200 amps or less 59.36 I 1 Owner installation: This installation is being made on property that I own which is not 20] amps to 400 amps 125.08 2 intended for sale, lease, rend or exchange, according to ORS 447, 449, 670, and 701. 401 as to 599 amps 168.54 2 Owner Signature: Branch circuits— new, alteration, or extension, per panel Date: A. Fee for branch circuits WM ❑ APPLICANT I 0 CONTACT PERSON each branch ah, ircsm 7.42 2 Business name: B. Fee for branch circuits without service or feeder fee, first Contact name: branch circuit 56.18 2 Address Each add't branch circuit 7.42 2 Miscellaneous (service or feeder not included) City/State/ZIP: er Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) I Fax: : ( ) Reconnect only 67 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67,84 2 Signal circuit(s) or limited-energy S t(4 . e 7 n C . r C - s c J G panel. a dditi o nal inspection spec i Page 2 2 Business name: t�-��f K Each additional inspection over allowable in any of the above Address: 1 O j (--t 36 tJ(.c.,Yl n Sl(�l..f2 Rd. rs r F -2i GI Additional inspection (1 hr mm) 6625/ In City /Stater ZIP: e o r t-la r o e / "I Ti Di 5 Inv f on (I Ivmin) 66.25/hr industrial plant (1 br ain) 78.18/ hr Phone: ( 5 0 3 ) Sao I — 2y •2 3 f Fax: (503) q i y - O(.4 32 Inspections for which no fee is 90.001 hr C C.: specifically listed (4 hr min) C - CI 5 Ppg E ical Lic.: c, 82 ( S.pprg. Lic.: 53 7 S ELECTRICAL PERMIT FEES Suprv. Electrician signature, requited: . Subtotal: ) CO r �) 0 f - / Plan review (25% of permit fee): Print name: k 4 v + ?R , t 1 I Date. State surcharge (12% of permit fee): ` .2 • Ds Authorized signature: l�l `C" TOTAL PERMIT FEE: i I •Z , 1 g' j This permit application expires ifs permit is not obtained within 180 Print name: I Dale: dais after it has been accepted as complete • umber of inspections allowed per permit 1 : 11 h'ld neV iu wPvmnApp.doc 07A V I0 440•+16r5r(1 tiDS/CblNflYEB CITY OF TIGARD ELECTRICAL PERMIT 11 • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00506 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/28/2012 Parcel: 2S 111 DC09500 Jurisdiction: Tigard Site address: 15730 SW OAKHILL LN Project: Miller Subdivision: SUMMERFIELD NO.10 Lot: 562 Project Description: (1) 200 amps new panel Contractor: SQUARE 1 ELECTRIC INC Owner: MILLER, DEAN H 10117 SE SUNNYSIDE RD., STE. F -216 12223 SW 131ST AVE CLACKAMAS, OR 97015 TIGARD, OR 97223 PHONE: 503 - 867 -2423 PHONE: 503 - 813 -7080 FAX: 503 - 914 -0432 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 08/28/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 08/28/2012 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 9 2 -001 -0 0. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.19877 or 1. Issued By: Permittee Signature: 44 i ( _ 4-T" / t Li 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. Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 15730 SW OAKHILL LN, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal 2014-03-21 00:00:00 ELC2012-00506 PASS - No C of O Violation Summary: Inspector Contractor