Permit a CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2012 00553
T E GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/24/2012
Parcel: 2S 111 DD04600
Jurisdiction: Tigard
Site address: 15795 SW STRATFORD LP
Project: Geelan Subdivision: STRATFORD Lot: 12
Project Description: (2) branch circuits and (1) 200 amps or less
Contractor: RK ELECTRIC INC Owner: GEELAN, RHEA
24495 NW OAK DR 15795 SW STRATFORD LP
HILLSBORO, OR 97124 TIGARD, OR 97224
PHONE: 503 - 640 -1344 PHONE: 503 - 367 -5607
FAX: 503 - 356 -0513
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/24/2012 $100.70
Specifics: amps or less
2 crt Branch Circuits w /Purchase 09/24/2012 $14.84
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 09/24/2012 $13.86
Electrical
Type of Const:
Occupancy Grp:
Total $129.40
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 0 52- 001 -0090. You may � obtain a copy of the rules or direct questions to OUNC by calling 503..2 19 32.1987 or 1.800.332.2344.
Issued By: �r l�C(� Permittee Signature: Og 'TP_C 1 AN
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.
Sep 24 2012 8:53AM HP LRSERJET FAX 5033560513 p.1
E l e ctrical Permit Aaalica ' w� -�d yob: (.1.11..1,-, u' :r t,N I,
City of Tigard v
2012 Re
p 4 cele4 Q _ g-Lt dal a - 0, s. •
1 . : ' Pecmir N a:
13125 SW Hall Blvd., Tigard, OR 97 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 ,, z- - Date/a : Other Permit ' ! d' - w0 • - Data Re B Judi; 0 Seep 2 for
T I G A R n Inspection Ling 503.639.4I7S k f ady, yt a�
Internet: www,tigard -or. Ili s � t, ^ • ∎ • • , Notified/Method: Sapptementalinformatlon
\ ,. Inft` 1 Y_5�:./ d1 'f271 � } .�'✓ y . M M J �pi�y19 �Y'. AYn L� j
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'°� al��'��t:S m���>t��l' x -!',: �lVC?a2t,�#Sk:: r rt,G d.l s�u.0 �•..arsl4h e�(?.:d�:�:!°kj�� "� 1��:�'k'E • =if
❑ New construction Addition/alteration/replacement please oheak all that apply (sabodt 1 rate of plane whtame checked below):
❑ Semite or Bader 400 amps ormore p8u111114 ova throe stories.
❑ Demolition ❑ Other: �, i where the available thou current 1:1 Marinas and boatyards.
` ?t.� 4 4' t+ '•'
` . r w/rr tit 's : r�'o a t ±'�' IT,trm ','1 .7 ii ,y it,.�,C :1 exceeds 10,000 amps at 150 volts r a Floating buildings.
rc s.h . k . ' M
" °.nx lees w ground, or eaosede 14,000 ❑ CommeloiuFure alyioultural
r; 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other Installations. buildings.
❑ Mu hi-family ❑ Master builder ❑ Other: ❑ Firs pump. ❑ installation of 75 KVA or
x , r u . , " + r r. ,, �.. s ," 1 r' • g , o" }J 1 1 iM1'? 0.... ❑Emergency system. tanner separately derived system. 1` • f'':'r %,'�^:?'i, :K,' 5 !$ e- !,.: k'., , ,�=., yl,5r d! .. ; r l ••dti1FA , °C root 0 ❑" ' " -2 ., "
,; "! ` An,,...; i7 ;,'' ; 1, _ t. v r I;t i r Add oPaaw motor load of
� IOOHP or main, occupancy.
Job no.: J l Job site address: S q s lam! r! t . ❑ Six ar mare residential unite. ❑ Recreational vehicle pules.
City/State/ZIP: I t -Lr O a vi q ❑ Health -oars facilities. ❑ Supply voltage far more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ' ❑Serviceorfeeder600arapsormore.
;e'-iitde _
Vtp.� ` glii: Y
B}i;(r44 i?S ?.y' cl:'t'! � s`�I' vJ :, -
Cross street/directions to Job site: esserlrnsa Qtr. r44. 'h •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or lase 168.54 ! 4
fax map /parcel no.: Ea. add'I 500 eq. f . or portion 33.92 :' 1
Limited energy, residential
'r;): , !: c e "100 , 'fi ` ; �l
'tiy;as •° i...•' y "41 tr above ft.) 75.00 2
L fi 4 1 �' ..: '' i i ' . . ;.. ' : • p ,l : ;' i n \ , vi ,U S FrM'�Aht� .p �u� i., I '� i :i�4;r � .a l : . r j � 1; )' :
1a ,C�.$JW iY�,, °'p'4.� ( with b
all
' In o- Limited energy, multi- family
residential (with shove eq. ft} 75.00 2
�aI1 QA �_ °�' u 5 racks �� Services or feeders inatallationalter'edon, and /or relocation w
200 amps or lass I 100.70 lob MD 2
, I i , , . 1 . , �kt:rlls .. •1 f4"NfTl :"/ . �' ; y'4 •i'• 4,§W 1 j `'� .�l i 7:
1 1 ' r 201 snips to 400 amps - 133.56 2
1 � 401 amps to 600 amps 200.34 2
Name: T,2, V ea. t.e,`fin 601 amps to 1,000 amps 301.04 2
t.
Address: i a •I� SW S ` r ct - T15 d Lbo p Over 1,000 amps or volts , 552.26 2
City/State/ZIP: _�_ Temporary services or feeders Installation, alteration, and /or
Ci
tY `CL sera , ci R Q - X 7 relocation
Phone: (6 '3 al ..... i Fax: ( ) 200 amps or less 59.36 I
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 z
Branch circuits— new, alteration, or eatenslon, r panel
Owner signature: D 1 A. Fee for branch circuits with /� �
'`I :'t°i <1�i'i r J � ai �,va �. '�•YdiY>.3 a . Y i:� above service or feeder fee, ' •/ 7.42 (4, V4 2
.I , ,. .,.. ' a,::y, [ r.- .a.:r:2, �o a;t a; each branch circuit I-'
Business name: e K ate, e fir:L 13. Fee for branch circuits without
service or feeder fee, fin 56,18 2
Contact name: Oa r r I branch circuit
E ach edd'I branch circuit 7.42 2
Address: Oat r Aw oak rM Miscellaneous (service or feeder not included)
CI lState/Z1P: I ( � Each manutkctured or modular
tY ;• 1 5 101 D ♦ 9 '-r dwelling feeder 67,84 2
Reconnect only 67,84 2
Phone: (5 ^ O) Q Fax: ('3J fro - (3 Reconnect
or irrigation circle 67,84 2
E -mail: Sign or outline lighting
67.84
Y'1 K'' t1 :...I. f'% ' ?il°s. 4 1 ry.:; 1. , r..'ji! ?:
r '' :1,..�4 '� ,� ,bi�,•. ':' °�;': z •,• y � �• (,;yM1• Signal ttlrcult(a) or limlted•energy
Business name: RK Electric, Inc, petrel, alteration, or extension. Page 2 2
Each additional inspection over allowable Its any of the above
Address: 24495 NW Oak Drive Additional Inspection (1 hr mitt) 6625/ hr •
City /State/ZIP: Hillsboro, OR 97124 Investigation (1 hr min) 6625/ hr
Industrial plant (I hr min)_ 78.18/ hr 1
Phone: (503) 640 - 1344 Fax: (503) 356 - 0513 Inspections for which no fee is 90,00/ hr
CCD Lic.: 94275 Electrical Lic.: 34 -375C Suprv. Lie.: 4724 -S spec! /cellvliste hr 4 � '
,, 6FE r � ,� ;'i'',Cli. .,•
Jae 1� %V�IdDh{� �
Subtotal: 1 1 5, 54 i
Suprv. Electrician signature, required: quirrd: / /o'>'
/ Pla review (25% of permit fee):
Print name: Ron L. Kurtz Date: q /a- j / f -3, State surcharge (12% of permit fee): b, 9
TOTAL PERMIT FEE: ' all , 140
(p
Authorized signature: r !!!!!! J
g ` j This permit applleadon expires If a pared* is not obtained within IOU
Print name: Ron L. Kurtz Date: q days after It has been accepted as complete,
J ,/ .7- ' Nulnbar of inspections allowed per permit
I.IDuildinsWItwlOELC-PermIUpp.doc 07/01010 440.4615T(I I/05/COMIWEa