Permit :p CITY OF TIGARD ELECTRICAL PERMIT
! -m ,. COMMUNITY DEVELOPMENT Permit #: ELC2013 00071
T [CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013
Parcel: 1 S136AD04600
Jurisdiction: Tigard
Site address: 6707 SW PINE ST
Project: Hettick Subdivision: VILLA RIDGE Lot: 2
Project Description: (4) branch circuits for garage outlets and misc wiring
Contractor: WEBER ELECTRIC INC Owner: HETTICK, WILLIAM C & JANICE E
7007 SW ROBBINS RD 6707 SW PINE ST
TUALATIN, OR 97062 PORTLAND, OR 97223
PHONE: 503 - 819 -7380 PHONE:
FAX:
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 01/29/2013 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/29/2013 $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 •A 952-00 - 0 090. 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: .A IA l t/t Permittee Signature: • --.5--) '41----
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 503.639.4176 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.
Electrical Permit Application RECEI FOR OFFICE USE ONLY
Cit of Ti and Received q 2 Permit i / ` �N I —
III City g DateB . d' / 3 C�—C,�. 3 D DU 7
° 13125 SW Hall Blvd., Tigard, OR 97223 JAN 2 9 2013 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 DateJB : Other Permit:
Inspection Line: 503.639.4175 /� �/ OF T / � p� Date Ready/By: Juris: El See Page 2 for
T I G AR p
Internet: www.tigard- or.gov CITY i llr I I�ll'tfl(J Notifted/Method: 11 tp Supplemental Information
TYPE OF W LDNNG DIVISION PLAN REVIEW
❑ New construction E Addition/alteration /replacement 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
® 1- 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 ", "l -2 ", "1 -3 ",
Job no.: Job site address: 6707 SW Pine St 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ 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
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 168.54 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 75.00 2
4 circuits for garage outlets and misc wiring residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: Hettick 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
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 circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
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'l branch circuit 3 7.42 22.26 2
Address: Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: Weber Electric, Inc. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 7007 SW Robbins Rd Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Tualatin, OR 97062 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 819 - 7380 Fax: ( ) na Inspections for which no fee is
90.00/ hr
specifically listed (V2 hr min)
CCB Lic.: 44087 Electrical Lic.: 34 - 442C Suprv. Lic.: 4028S ELECTRICAL PERMIT FEES
Subtotal: 78.44
Suprv. Electrician signature, required: '777.
l j./ Plan review (25% of permit fee):
Print name: Matt Weber Date: 1 -29 -13 State surcharge (12% of permit fee): 9.41
TOTAL PERMIT FEE: 87.85
Authorized signature: This permit application 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.
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