Permit CITY OF TOGARD
n ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELC2013 00254
'T WARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued: 05/06/2013
Parcel: 2S111 B601500
Jurisdiction: Tigard
. Site address: 10362 SW MCDONALD ST
-. Project: CODA Subdivision: TIGARDVILLE HEIGHTS Lot: 1
Project Description: (1) branch circuit to install new room lights & fixtures in kitchen and dining room •
Contractor: ATLAS ELECTRICAL CONTRACTORS Owner: WASHINGTON COUNTY
4403 SE ROETHE RD SUPPORT SERVICES- FACILITIES
' MILWAUKIE, OR 96267 ATTN: TERESA WILSON
169 N FIRST AVE
HILLSBORO, OR 97124
PHONE 503 - 659 -2212 PHONE:
FAX: 503 - 659 -4944
FEES
Quantity Description Date Amount
. 1 crt Branch Circuits wo /Purchase 05/06/2013 $56 18
Specifics: Service or Feeder
. 1 ea 12% State Surcharge - 05/06/2013 $6 74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62 92
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 OAR 9 2- 001 -0090 Yo�u / m�ayy o btain a copy of the rules or direct questions to OUNC by calling 503 OM 232 1987 or 1 800 332 2344
Issued By: "� "�- Permittee Signature: 01/ ?4l C# n /
ak/
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.
ATLAS ELECTRICAL Fax:5036594944 May 3 2013 7:22 P . 0 2
Electrical Permit Application
RECEIVE 0 FOR OFFICE USE ONLY'
. .
City of Tigard O,^1, Received Pennit No.:
MAY 0 6 ,. ' 3 5 I ' I .4.--
. , Date/By.
III ' 13125 SW Hall Blvd., Tigard, OR 97223
F
lan Reviw
e
. ■2 . Phone: 503.718.2439 Fax 503.598 191eini oF Tin A Dn Dato/ • Other Permit: '
TI G ARD Inspection Line: 503.639.4175 ‘'irini" Date Ready/By. -rmi , El Set Page 2 for
Internet www.tigard-or.gov BUILDING DIVISIO r ofif 4 m.hod' .i• t (0 , SuPple tog ormatioa
,: '• • . , - ••••=,,-,- ," 1 ■••.%;:. •:.i t• ,, , ' si VRIK •114 -" • • . , -';,' p'11,SI• , ; • ''' , r- IV ' ••-,, 2.• - •■ 4!!'''To,'" ' Il 'tx491 , it'■';!...prAT ,. ''',;•' t
0 New construction P Addition/alteration/replacernent Please .1..4 all that apply (subm.t a sets of plans uthtetos checked below).
0 Service or feeder 400 amps or more 0 Building over three stones
0 Demolition 0 Other: where the available fault current El Marinas and boarYards.
,,: '.;":',.■,' 4 ;;.1:) ^I■Zi- 004tOtr . ,... .01,:,;',„:::' . ..':' , .L':,. -,,.;.. ,.1 exceeds 10,000 amps at 150 volts or 0 Floating buildingis.
less to ground, Or exceeds 14,000 0 Commercial-use agncukural
0 I- and 2-family dwelling ii-7.1 Commercial/industrial El Accessory building amps for all other installations, buildings,
0 Multi-farni ly • Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
403 !M:e1Slki*Mik ‘. il - _.4 ;,,, -: ,] e t , - 0 &wEe ncY "ern' larger separately derived syste
. , ,.,. , „.q., ,...,,, . , , . t,i,,. . t, ' ( El Addition of new motor load of 0
loop or more. occupancy.
JO no.: ,2 a z a Job site address: &)T a &P . p • 0 Six or room residential units 0 Recteational vehitle parks
0 Health-cam facilities M Supply voltage for more than
0 Hazardous locations, 600 volts nominal
Suite/bldg./apt, no.: Project name: 2,224, _ co jp , i 4 0 Service or feeder 600 amps or more
• AiPi 19o41 iii;isAgg
Cross street/directions to job site: nuortanoti I Qty. I re. I Total
New residential single or multi dwelling unit.
•
Includes attached garage.
-
SubdiviSiOn: • Lot no.: 1,000 sq It or less 168 54
Ea add'l 500 sq. ft. or portion 33.92
Tax map/parcel no.: .
' Limited energy, residential
: ':' ,..:" . ' '' ' :' :''":-.7 (with above Sq. ft.) 75.00
Limited energy, multi-family
75.00
- :Sir residential (with above sq. ft.)
. Xtinvaljle Energy:: ,'
Services or feeders installation, alteration, and/or relocation
„',,0 'i ,,, ft74' 0#4X ,; , I ': :', ; 0 : ,., '-;`;.,:,:., .. 200 amps or le" 100.70
' 201 amps to 400 amps 133.56
Name 401 amps to 600 amps 200.34
Address: 601 amps to 1,000 amps 301.04 ,,..
Over 1,000 amps or volts 552.26
e
City/State/ZIP; . . .. ... .. . -
Tmporary services or feeders installation, alteration, and/or
relocation
Phone: ( )
200 amps or less 59 36
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125 08
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 599 amps 168.54
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
. -
,1 a ",V,412kkt.''( "'' , ' li ."" , F.: ' '". Iv colyrAe*Osilso0'1''' :=i, k Fee for branch circuits with
„ , - , i . . • t , . . . , , , ' . . , E , i t . , , . 0 .: . - "Iv! ..:. '0 t i .. , „ ., : • ,,,V. above service or feeder fee,
742
each branch circuit
B Fee for branch circuits without
Contact name:
CA /./ SDI,' service or feeder fee, first
branch circuit I 56 18 56
Address: Each add'l branch circuit 7.42
Miscellaneous (service or feeder not included)
City/State/ZIP: Each inanutIctured or modular
Phone: ( ) Fax; : ( ) dwelling, service and/or feeder 67.84
Reconnect only 67.84
11=1 1 ,..MII,M ) .. , I VAISPRIMP I II II MIIIIIIM/ ' ' itump or irrigation circle
,., Li. ... .., ...‘ .0. .• .._..6_. A - ... -.- -, . •,-, 67 84
;;L• 't.7i'' • p.rf,;i45,:r..:':..:i.;.,,.,',:..;17!,::,, ',-.t.,: Sign or outline lighting 67.84
Signal circuit(s) or limited-energy
Business name: A_ , - -go* AL . 0 1 - - - b ; - r0 A -) panel, alteration, or extension Page 2
A ddress: 1 1■0 - 5 P-06 P---D Each additional inspection over allowable in any of die above
Additional inspection (1 hr mm) 66 25/ hr
City/State/ZIP: /IA i tz4,44 (6 g AP 9 7ZZ Invesugation (1 hr mm) 66.25/ h
Phone: (5/13 ) ( „lg. ... Fax: ( ) 4, A. p_ ... Industrial plant (1 hr min) _ 78,18/ hr
IEEENBEMIZEMIEEMI uprv. Lic.' 52)tci-5 Inspections for which no fee is
specifically listed (1/4 lis min)
,,Ao:N1/4c . ,:i ICAUPEVAI- ft
Suprv. Electrician signature, required.
. ../ ,. ,,I ifflImEmi. .
Subtotal: _542_, /
Plan review (25% of permit fee).
Print name: ---/- 1 4 5 #Ep g . .‘ SSC/10MM State surcharge (12% of permit fee):
' Authorized signature: MEIRMIIIMIEMIE TOTAL PERMIT FEE" 12, 92_
CEMETILT PgliMME Date: 5-.. -2-0 This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per pormit,
I \1Buildiag\Perrnits\ELC_PtttnhApp .040913.doc , ...„ . - . 440-4615TO OS/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
10362 SW MCDONALD ST, TIGARD, OR, 97224
Commercial - Electrical
130 Ceiling cover
05/15/2013 00:00
ELC2013-00254
FAIL
Wrong inspection called in. Need to call for final.
Violation Summary:
Inspector Contractor