Permit •
4 I CITY OF TIGARD
DEVELOPMENT SERVICES I v (31' ELECTRICAL PERMIT
PERMIT #: ELC2006 -00563
�� DATE ISSUED: 10/4/2006
� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103C 6 - 01700
SITE ADDRESS: 12300 SW JAMES ST ZONING: R - 4.5
SUBDIVISION: WILLAMETTE LOT: 042 JURISDICTION: TIG
Project Description: 2 branch circuits, furnace and heatpump.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JIM HURTT BADGER ELECTRIC INC.
12300 SW JAMES ST PO BOX 55446
TIGARD, OR 97223 PORTLAND, OR 97238 -5446
Phone: 503 - 320 -8111 Contact #: PRI 503 - 288 -4756
FAX 503 -493 -7173
FEES
Description Date Amount Reg #: ELE 3-571C
[ELPRMT] ELC Permit 10/4/2006 $60.15 LIC 156851
[TAX] 8% State Surcharge 10/4/2006 $4.80 SUP 4951S
Total $64.95 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: () - .0k.
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'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
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.
OCT-2,-2006 09:58P FROM: BADGER ELECTRIC, INC 503 - 493 -7173 TO: 5035981960 P.2
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IL rsw•• ar.•Ya a v■ awe a aM•mvYNVY. ,' -'
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City of Tigard Received
DateJB . 10 0(0 $ i 0. - _s
13125 SW Hall Blvd., Tigard, OR 97'223 m 2006 Plan Review Other Permit
Phone: 503.639.4171 Fax: 503.598.1960," I , ' • i Date/By:
inspec Line: tion ne: 503.639.4175 ,x n � ! . !+► _ � _. rte' See Pace i for
Internet: www.ci.tigard.arus Ga OF
no. ; `::'� NatilkdlMel6od 1 ® Supplemental Information
,∎fte.10N
aF •i••r , { W i t PLAN REVIEW
ORK
❑ New construction dition/alteration/replacement Please check all that apply:
['Service over 225 amps, comm•I ❑Ha ardous location
❑ Demolition ❑ Other: - ❑Service over 320 amps — rating ❑Buildng over 10,000 sq. Il.,
CATEGORY OF CONSIRUCIION. of I- and 2- (kmily dwellings 4 or more new residential
['System over 600 volts nominal units in one structure
d 2- family dwelling ❑ Commercial/industrial ❑Accessory building ❑Building over three stories (]Feeders, 400 amps or more
❑ Multi- family ❑ Master builder ❑ Other: DOooupant load over 99 persons ❑RV ufhctwed structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/li8Ming plan p ark
['Health-cam facility ❑Other:
Job no.: I Job she address I, a 30t7 S t/v
Submit .2,_ sets of plans with any of the above.
City/ State/ZIP: The above are not applicable to temporary construction service.
FEE* SCHEDULE
Suite/bldg/apt. no.: I Project name: - Oirrr • 1 Qty. I Pea. ( raw I ..
Cross street/directions to job site: New residential single- or sushi-family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'I 500 sq. it or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: Limited energy, non-residential 75.00 2
, DESCRR'71ON OF WORI<C Each manufactured or modular
dwelling, service and/or tinder , 90.90 2
T Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
PROPERTY OWNER 1 0 7RNAN17 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 4 / ,,r• 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps err volts 454.65 2
Reconnect only 66.85 _ 2
City /State/ZIP: Temporary services or feeders Installation, alteration, and/or
Phone: ( 3) 3 .Q 1 t 1 I Fax: ( ) relocation
200 amps or less
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 66.85
100.30 t
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch drafts — new, alteration, or extension, per panel
0 A P ( P L 1 C A N T I . . " ...0 CO!'1'rACT PERSON A. Fee for branch circuits with
service or Mader fee, each 6.65 2
Business name: branch circuit
D. Fee for branch circuits
Contact name: without service or feeder fee, 1 4615 46e5 2
each branch circuit
Address: Each add'I branch circuit - 6.65 135 ..... 2
City/State/ZIP: Miseellancous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: Signal circuit(s) or limited -
����/�rr���� energy panel, alteration, or
�t.>fr.J�+a'J6 �
L � -
extension. . Describe: Page 2 2
Business name:
Address: 1)-0. 5'544 t4 Each additional Inspection over allowable In any of the above
J J Per Inspection 62.50 ' .
City / State/ZIP: Th rj 41 ' 3 6 Investigation per hour (t In min) 62.50
, Industrial plant per hour 73.75
Phone: (514-9 2 � Fes' (�� > '4 113 ELECTRICAL PERMIT FEES*
CCB Lie.: lane, ' I Electrical Lie.: 3 - 571(, ( Suprv. Lie.: A9s IS Subtotal \'3 ' 4
Suprv. Electrician signature, requited: Plan review (25%ofpermit fee)
ate: State surcharge (8% of permit fee) I
Print name: Cuv/s I(lc
TOTAL PERMIT FEE
Authorized signature: ' This penult application expires it • permit Is not , . tamed w I : 0
days after It has been accepted as complete
Print name: Date: • yea methodology set by Tri -Comfy Building Industry Serniccy Board / f‘il . •• Number ofmsaeetiuwocrpermitallowed. /�„ !✓�
1/ ( a� V-�
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