Permit O CITY OF TIGARD ELECTRICAL PERMIT
• • • a COMMUNITY DEVELOPMENT
111 Permit #: ELC2013 00105
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 25101 BC00101
Jurisdiction: Tigard
Site address: 8195 SW HUNZIKER RD B
Project: Steelers Inc Subdivision: CROW PARK 217 Lot: 4
Project Description: Connect power to temporary container office in back lot.
Contractor: WILLAMETTE ELECTRIC INC Owner: KNEZ REALTY GROUP LLC
PO BOX 230547 12301 SE HWY 212
TIGARD, OR 97281 CLACKAMAS, OR 97015
PHONE: 503 - 624 -3631 PHONE:
FAX: 503 - 624 -2938
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 02/14/2013 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 02/14/2013 $7.42
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/14/2013 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
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 ••• • - 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. • ' ENTION: Oreg.. law • ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -0.1 -0010 through OAR 95 ' • 1 -009 • You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I-- ued By: 1 _ .' - _ � t • Permittee Signature:
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: a/ LW/ 3
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.
Electrical Permit Applica / CE VFD FOR OFFICE USE ONLY
s
City of Tigard ! � I Received
: / Aram PermitNo.: GLeA0/5--
1111 " 13125 SW Hall Blvd., Tigard, OR 97R 1 4 2013 n
Plan Review
Phone: 503.639.4171 Fax: 503.59! Date/B : Other Permit: l_,, l �, , ,1,3--efere
Inspection Line: 503.639 , v - Date Ready/By: luris: ® See Page 2 for
T I G A RD
Internet: www.tigard- or.gov CITY U f Notified/Method: Supplemental Information
TYPE c r 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 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OE CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
_ less to ground, or exceeds 14,000
❑ 1 - and 2 dwelling Commercial /industrial Accessory building ❑ Commercial -use agricultural
y g � ❑ Y g amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
Emergency system larger separately derived system.
st
em
,YOB SITE INFORMATION AND LOCATION A dd
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
,, N t 100HP or more. occupancy.
Job no.: I Job site address: gie' , Z, 5 (' 0..o.., 1 3 I e• ^
/ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: �,i/ t K„ $'i 5 / 2 2 3 ❑ Health -care facilities. ❑ Supply voltage for more than
/ f ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: 5 it- cc/ ,. ,r ❑ Service or feeder 600 amps or more.
/ L FEE _SCHEDULE .
!
Cross street/directions to job site: R 8 a� 0 r Description I Qty. I Fee. I T otal I •
New residential single- or multi- family dwelling unit.
includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi- family
75.00 2
C. . M r:.4- t o w , I „ S ea residential (with above sq. ft.)
� Services or feeders installation, alteration, and/or relocation
G ^ I C4,/ e7 / 3. ; i r e a / '1 -4 et v4 / ✓ / 200 amps or less 1 100.70 /00.7 2
❑ PROPERTY OWN ER I ❑ TENANT 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: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 1
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 I 0 CONTACT PERSON above service or feeder fee 7.42 7.4(9- 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only /f 67.84 'i'6 2
E - mail: Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
CONRiI:GTOI Signal circuit(s) or limited- 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
City/State /ZIP: Tigard, OR 97281 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 624 - 3631 I Fax: (503) 624 - 2938 Inspections for which no fee is 90.00 / hr
specifically listed (Vs hr min)
CCB Lic.: 75059 Electrical Lic.: 34 -283C ` _ I Suprv. Lic.: 4226 -S ELECTRICAL ; FEES .
Subtotal: . LW
Suprv. Electrician signature, requ' Plan review (25% of permit fee):
Print name: David Fife Date: /"" 1 3' `/1 State surcharge (12% of permit fee): Er..- • ,j f
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Date: days after it has been accepted as complete. q
Print name:
N um b er of inspections allowed per permit. ,12/7A7
1 :\ Building \PermiuELC- PennitApp.doc 07/01/10 440- 4615T(I1 /05 /COM/WEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
8195 SW HUNZIKER RD B, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
02/20/2013 00:00
ELC2013-00105
PASS - No C of O
Violation Summary:
Inspector Contractor