Permit CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: ELC2013 -00086
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/05/2013
Parcel: 2S103CB04300
Jurisdiction: Tigard
Site address: 12250 SW MARION ST
Project: Funderhide Subdivision: WILLAMETTE N0.2 Lot: 22
Project Description: (2) branch circuits to wire for A/C and furnace
Contractor: ENGELMAN ELECTRIC INC Owner FUNDERHIDE, RACHEL A & DANIEL R
PO BOX 451 12250 SW MARION ST
HUBBARD, OR 97032 TIGARD, OR 97223
PHONE: 503 - 981 -8041 PHONE:
FAX: 503 -981 -4026
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 02/05/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/05/2013 $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 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 952-001-00 You may obtain obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. � ,(
Issued By: t�J/� L U�/ Permittee Signature: o r AI 1 . • e 4' 1 2'"
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.
02/05/2013 11:42AM 5039815901 METPOSITE LLC PAGE 02/02
Electrical Permit An lic:6 i EIVED FOR OFFICE USE (.)NI.Y •
City of Tigard Date/13 v . -! l3 S $ PennitNo.: EL_'� e, /3 DC/Pao
1 11 11
■ u 13125 $W Hall Blvd., Tigard, OR 5 2013 Plan Review
• Phone: 503.718.2439 Fax: 503. . 60 Date/15 ; Other Permit:
T I G A R D ms pec d on Lin ° - 5 03 .6 39.4175 CITY OF - 1'1GARD Date Ready/By: brie El See Page 2 for • I www.tigatd or.go ' : " Notified/Method: T% (o Supplemental Information
�I (� N WiS .- . .
1 r1VOtUQ'';= <' . ' . . , PLAN ' REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below);
• ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: _ where the available fault current CI Marinas and boatyards.
`.. �A,. 1tCs Ottt 'U1YCOIVS'PItUenbN' ..........:•••
; ••• • .,..
exceeds 10,000 amps at ISO volts or ❑ Floating buildings.
leas to pound, or exceeds 14,000 ❑ Commercial -use agricultural
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building as fbr all other installations. buildings,
Q Multi family 0 M builder 0 Other: 0 Fire pump. ❑ installation of 75 KVA or
❑ Emergency system. larger separately derived system. •
}; .JO$ 8 III, 'i;, OEN #0 ..;?(13!1) .jtiO.GA;T'•XO ;:':. ❑ Addition of new motor load of ❑ "A ", "E', "1 -2 ", "1-3 ".
•
Job no.: 25913 Job Site address: 12250 SW Marion Street 100HP or more. R occupancy. nation
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard OR 97223 O Health -care facilities. ❑ Supply voltage for more than
0 Hazardovs locations. 600 volts nominal.
Suite/bldg. /apt no.: I Project name: W olfer's/Funderhide ❑ Service or feeder 600 amps or mom.
b'EE'SCHEDULE • ..
Cross street/directions to job site: Description 1 Oa'. 1 t=ee. 1 Total 1
New residential single- or multi- family dwelling twit
Includes attached garage. -
Subdivision: I Lot no.: 1,000 sq. it or Tess 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
• Tax map /parcel no.: Limited energy. residential
,: 3 :r . 1P hey WO ;,. ::•.' < :,` ^ (with above sq• ft.) 75.00 2
:: >'' ?` ' :ti ^ �' ° ;' . Limited energy, multi- family
wire for a/c & furnace . residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 1 00.70 2 •
.:f ;PROPEItTY<;O-W . , I , : _ :' • TEPfAN'r 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
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 1 own which is not -
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
tJ : ) 3G'APL>C:i . 5 •:q ;,CO 4C :. 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'I branch circuit 1 7.42 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: /State /ZIP: Each manufactured or modular 67.84 2
ty dwelling, service and/or feeder
Reconnect Only 67.84 2
Phone: ( ) I Fax: ( ) Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
.. 'i '• :.`; CX`OXt: :':.:.. ''.'... - Signal circuit(s)orlimited - energy •
Business name: Engelman Electric Ina 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) ` 6625/ hr
City/State/ZIP: Hubbard OR 97032 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503 ) 981 I Fax: (503) 981 - 4026 Inspections for which no fee is 90.00 / hr
specifically listed ('A hr min) _
CCB Lic.: 94581 I Electric: 24-46C Suprv. i • - ' ` : :ELECTRICAL •PERMIT. FEES . • • .
Su rv. Electrician si ature r uired: Subtotal 63.60
p �° ` Plan review (25% of permit fee): _-
Print name: Ron Thunderbird e a e: 02/05/13 State surcharge (12% of permit fee): 7.64
TOTAL PERMIT FEE: 71.24
Authorized signature: This permit application espires If a permit is not obtained within 180
Print name: I Date: • n days after it has been accepted as complete
Number of inspections allowed per permit. - ( a3
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