Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00092
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2013
Parcel: 1S136CB03900
Jurisdiction: Tigard
Site address: 8340 SW STEVE ST
Project: Kallstrom Subdivision: VILLAGE AT ORENCO Lot: 66
Project Description: (2) branch circuits for furnace and a/c
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Contractor: ENGELMAN ELECTRIC INC Owner: 8340 LLC
PO BOX 451 BY KALLSTROM, MARTA
HUBBARD, OR 97032 3601 SW RIVER PKWY #421
PORTLAND, OR 97239
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PHONE: 503 - 981 -8041 PHONE:
FAX: 503 -981 -4026
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 02/07/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/07/2013 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports (Conditions)
This pe• it is issued su•' t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d• e in accordance with • •ved • ns. This permit will expire if work is not started within 180 da s of issuance, or if work is suspended for more the 180
days ATTENTION: Oregon require •u to follow the rules adopted by the Oregon ity No ter. Those rules are set forth in OAR
952 •01- 0010th •ugh OAR • • • 009i • i •u ' ay obtain a copy of toe rules or direct questions to OU C by calling • '87 or 1.800.33 .2344.
Iss ed By: � � Permittee Signatur =
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' 'i.,, Date:
iu y l:
r
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.
Feb/7/2013 8:40:33 AM Engelman Electric Inc 503 - 981 -4026 2/2
Electrical Permit Application RECEIVE � I. t r It rr r l� I U U 1: S E. O N' I . )
City of Tigard RECEIVE L eiVed �� 2
ate/Bv: 7 t -4- k , ♦ P amitm.: OYo✓- 06199®1
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review O Permit;
Phone: 503.718 2439 Pax: 503.598.1960 FEB ^ Date/: Other HI Page 2 for
.� „ t Inspection Line: 503.639.4175 Z U I. Date Reedy/By ge
Internet: wvvtv.tigard- or.gov Notified/Method: Supplements ormettan
: •'
sr ,••::.:,. :.•..._..,,.,- _.,..,. :..:._ /alt ......' 1NG W1SlON" Please cheek all that apply (submit 1 acts of plena w /8amscheckedbelow):
❑ Neew w construction ® Addition/alura rep�cemen C3 Service or Rader 400 amps or more ❑ Building over three aortas.
❑ Demolition ❑ Other: where the available Ibult current 0 Marinas and boatyards.
. .. :. ..;:; >.,, :. ;.; :...
opAY OlI's . : :; ;:: � ,: :. : ..; • :,: :�• : : : ; � . : : : : . . exceeds 10,000 grape- at 150 volts or Floating
buildings.
: lets to ground, or exceeds 14,000 ❑ Commercial -use egrioultutal
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other inataltatione. buildings.
❑ Multi- flunily ❑ Master builder ❑ Other: P of 75 1KVA o
D Fire pump. D Installation s or
Q &nergenoy system larger separately delved system.
. ';X41)3 :;' Q .. Addition of new motor load of 0 «A ••g« , 1_e-« «1.3
Job no.: 25921 I Job site address: 8340 SW Steve Street i 4pty a ' • 14ee). 0ccupan
❑ Six or mom residential units. ❑ Recreational vehicle Puke-
City/State/ZIP: Tigard OR 97223 D Hoaltb'omre facilities, ❑ Supply voltage for more than
❑ Hazmdoua locations. 600 volts nominal,
Sulte/bldg. /apt. no.: I Project name: Wolfer's/Larry ❑ Service or tboder 600 amps or mare.
Cross street/directions to job site: Description I Qw. I vcc, I Tow I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or loss 166.54 4
Ea. raid'! 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited (with et , residential
:......`. .
.... :..
..: ......... . ...
..,.. ::: :..,....... ...:.:..,. HIV:�: ��i! bRK`: �:::= : :; > :; : : ;• : :.` :.. : : : < ' . FA l
wire for a/c & fltrnace a residential (with above e ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or leas 100.70 2
�II.. ; : R AA ' � . ��sr.�r :fi p'±� "•,,. : : : :.. :; : :. : : 201 amps to 400 amps 13336 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 55226 2
Cl / State/ZdP. Temporary services or feeders Installation, alteration, and/or
tY relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 123.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.64 2
Branch circuits — new, alteration, or extension, r panel
Owner signature: Date: A. Fee fbr branch circuits with
O above service or feeder fee, 742 2
,. .... ,... :� :�1� . ....... . .. . . . . ....��;; :.. . ..�..... ., .. ,, ............ eadtb
Business name: B. Pee fbr branch circuits without
service or feeder fbe, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 1 7.42 7.42 2
Address: Miscellaneous (service or feeder not Included)
City/State/ZIP: Each manufactured or modular 67.84 2
ty dwelling, service and/or fader
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or Irrigation circle 67.84 2
E -mail:
.................. .... :.............,.. :•. :...... • Sign or outline lighting 67,84 2
. ...::..,::•.:•.:::,,•..::•. :• : : : :;; :; :.. :.. :.. : : : ......... .. .... ... :. :., :.. : :: : : :• :: •::.::...'::::.. >' :...•..;:-:..:.:':.: ':.: rt(9)orlitnitad -energy
Signal assail'
Business name: Engelman Electric Inc panel, alteration, or extension Page 2 2
Each additional Inspection over allowable in any of the above
Address: P 0 Box 451 Additional inspection (1 hr min) 66.25 / hr
City/Sffite/ZIP: Hubbard OR 97032 Investigation (1 hr min) 6625/ hr
Industrial plant (1 hr mmn) 78.18 / hr
Phone; (503) 981-8041 I Fax: (503) 981.4026 Inspectio for which no fee le 90.00/ hr
specifically listed hr min)
CCB Lie. 94581 I Electrical 24 - 46C • rv. Lie.: 47398 '
Suprv. Electrician signature, required: a Subtotal: 63.60
Plan review /o of permit fee):
Print name: Ron Thunderbird 11 • State surcharge (12% of permit fee): ..74
Authorized signature: TOTAL PERMIT FEE: X71...3
This permit application expires It a permit Is not obtained within 180
Print name: Aare: days after It has been accepted as complete.
N um b er of Inspections allowed per permit.
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