Permit •
•
a , CITY OF TIGARD ELECTRICAL PERMIT
1. • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00648
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11113/2012
Parcel: 1 S127DD00100
Jurisdiction: Tigard
• Site address: 9730 SW CASCADE AVE 100
Project: Shane Company Subdivision: CORAL COMMONS CONDO Lot: 14
Project Description: (5) branch circuits to wire signs, track lights and receptacles
•
Contractor: WILLAMETTE ELECTRIC INC Owner: GM SHANE LLC
PO BOX 230,547 MAX R BROWN LLC ET AL
TIGARD, OR 97281 PO BOX 3552
ENGLEWOOD, CO 80155
PHONE: 503 - 6243631 PHONE:
FAX: 503 -624 -2938
FEES
Quantity Description Date Amount
5 crt. Brahch.Circuits wo /Purchase 11/13/2012 $85.86
Specifics: Service or_Feeder
1 ea 12% State Surcharge - 11/13/2012 $10.30
Type of Use: COM . Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
Total $96.16
•
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 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: tbi Permittee Signature: OFJ ' -/c4 i 1z4
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.
11/09/2012 FRI 16:17 FAX 5036242938 Willamette Electric LJ002 /002 _
Electrical Permit Applicat < ; rot orricE use ONL\
City of Tigard • C IV p 0 ( 13 S S T P erm i tNo.: Eu 0 /� 4E 004. •
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
: g Phone: 503.639.4171 Fax: 503.598. Date/By: Other Permit:
112,70601' o
t 1 GARD Inspection Line: 503.639.4175 _ �� O Date ReadyB 7uris: ®
CITY OF TIGARD � See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
' Sp eplac meat P lease check all that apply (submit 2 sets of
❑ New construction [Addition /alteration /replacement plans wfitems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
;:.: . ' , (.`AT� - ii,... � :. `O , .(�, • . ,
, :
�....:�.: -'•.- :...., 1D :.:;_. :::::'.: exceeds OOOOempsatlSOvo
I volts 0 twildings
o
less to ground, or exceeds 14,000 ❑ Commercial -use
❑ 1- and 2- family dwelling 'Commercial /industrial ❑ Accessory building amps for all other installations. buildings. & aural
B
❑ Multi- family ❑ Master builder ❑ Other: ❑ Installation of 75 KVA or
: io.'
.:. • larger • Jt" S l° 41F1 I101�klxaSnr'#�TVb;_ " ; .. motor 1, :_ ., Emergency system
,:. ...... ' _...; ' ;: .- :::,:...,. .....,._ .,.. ,.. .. Addition � 1
E acparately derived system.
,., - 0 ❑.. �,... _
100HP or more. occupancy.
Job no.: j (Job site address: 4 7 73 0 fc,/ C as 6 a 4<„,,,,, ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: T; y -
h. ❑ Health -care thcitities. ❑ Supply voltage for more than
/ / 13 Hazardous locations, 600 volts nominal,
Suite/bldg. /apt. no.: I Project name: .S 4 DA e, C , .. ✓ C4 7 ❑ Service or feeder 600 amps or more.
job site: or tripuon
Cross street/directions to .....•
J ... 1 Qty. I Fee I Totil ` •
New residential single- or multi- family dwelling unit.
Includes attached garage.
•
Subdivision: I Lot no.: 1,000 sq. R. 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
.. DESCRIPTION =O WORK • . (with above sq. ft.)
Limited energy, multi - family 75.00 2
(/■• / e t ,r) S <.t t _ f r 'e /v /e t . e/ / 1 e t. e d./ 4 . .1 c residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERfY. 1 • • :1, NANT 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
Temporary services or feeders installation, alteration, and /or
City/State /ZIP:
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 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 extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
Q. APPLICANT::... ❑, 'e tli fiA�`,PERSON 7.42 2
each branch circuit
Business name: B. Fee for branch circuit withou
service or feeder fee, first J 5618 s/ - 2
Contact name: branch circuit
Each add'I branch circuit CI 7.42 2 $ 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: ( ) I Fax: : ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
. ...... . ..... ... ._, _ .:.: . .:.: Sign
or outline lighting
67.84
i)j'1?tai1;C'1'$R...,_; . - Signal clrcuit(s)orlimited-energy
Business name: Willamette Electric Inc. panel, alteration, or extension. Page 2 _ _ 2
Each additional inspection over allowable in any of the above
Address: P.O. Box 230547 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Tigard, OR 97281 Industrial plant (I hr min) 78.18 / hr
Phone: (503) 624 - 3631 { Fax: (503) 624 - 2938 Inspections for which no fee is 90.00 / hr
specifically listed (:S hr min)
CCB Lic.: 75059 Electrical Lic.: 34 -283C _ I Suprv. Lic.: 4226-S "+ .. ' 2yf PEI IT • • : • .- iii `.'•. `' • '.
c— Subtotal: '.r
Suprv. Electrician signature, requ'
Plan review (25% of permit fee):
Print name: David Fife l Date: // - 9 -16 State surcharge (12%ofpermit fee): / (..) 3 i
Authorized signature:
TOTAL PERMIT FEE: ` / 6 J.....
This permit application expires if a permit is not obtained within 180
Print name: I Date: days after it has been accepted as complete.
Num of inspections allowed per permit.
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