Permit CITY OF TIGARD ELECTRICAL PERMIT
I I ' COMMUNITY DEVELOPMENT Permit #: ELC2013 -00308
T (GARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Date Issued: 06/04/2013
Parcel: 1 S133DD09500
Jurisdiction: Tigard
Site address: 12643 SW FALCON RISE DR
Project: Tremblay Subdivision:'ILLAGE AT SUMMER LAKE PARK NO Lot: 132
Project Description: (1) feeder and (3) branch circuits.
Contractor: ENDERS ELECTRIC Owner: TREMBLAY, WILLIAM & MARDY
PO BOX 1661 12643 SW FALCON RISE DR
BEAVERTON, OR 97075 TIGARD, OR 97223
PHONE 503 - 626 -4813 PHONE:
FAX. 503 - 646 -3871
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/04/2013 $100.70
Specifics: amps or less
3 crt Branch Circuits w /Purchase 06/04/2013 $22.26
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 06/04/2013 $14.76
Electrical
Type of Const:
Occupancy Grp:
Total $137 72
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 952- 001 -0090 You may o• - • - • • of the rules or direct questions to OUNC by calling 503.232 1987 or 1 800 332 2344
Issued By /J _ _ 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:
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 ApplicatRECEIVED 1.0k orf I(F.. 1 ONI.1•
Received City of Tigard ��, , h..�� Review nete Receiv : 3 Permit No.: i • `D .- • 13125 SW Hall Blvd., Tigard, OR 942.23 2013 Plan Review
` p • • • Phone: 503.7182439 Fax; 503.598.1960 D Other Permit:
1 - 11 ; :\ It n Inspection Line: 503.639.4175 CITY OF TIGAR Date Ready/By: ® See Page 2 for
Internet: www.tigard - or.gov BU LL , ■ I. t Notified/Method: Supplemental Information
67 i n n g • ky !::r, r' � i: ...__ . - -,F .
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- ,+'}rZ..an d,_.. .... ,ur :�....._.. -. ...a'....... �...:aE}'_itua . t..- ,.._._...r. _ v.:.4,•,fy:.- ,...,.w .rrr,,, .,T:•�r ,.;>„ -_t,• ::
❑ New construction e Addition /alteration/replacement Please cheek all that apply (submit 3 seta of plans w /items checked below).
❑ Service or Redu 400 amps or more ❑ Budding over t aeries.
❑ Demolition 0 Other: where the available fault current ❑ Marinas and boatyards.
' :,_:� ; ,.'ii''':,:,: r - , n t . " i n y ; r. , v . ; ,, ,417,;-...,,,,,,,..:.:,,,!-.1-.-':i ' ":: exceeds 1 0, 000 amps 150 volts or ❑ Floating buildings.
_ 1 - ,- - rit :t: ; "°` ; , . .: -. ek .. .'' :,. ,_ :ta • _ �: 1 4 I 'Li;; 7 . . t, :t n � = ' - - : % 1 :,0. •r a,.. ; ! i : ti . mP g
er = . : :... . ......�_�.> •. •,e:a •,. ,�. E •: -_�- -,, . 1.....a •t y...- - -� less to ground, or exceeds 14,000 ❑ Comm
- '- •`- ' - • Commercial-uso agricultural
® 1- and 2- fan3ily dwelling 0 Commercial /industrial : Accessory building t amps for 211 other installations. buildings.
❑ Multi- family ❑ Master builder Q Other: El Fire pump. ❑ Installation of 75 KVA or
r _- e res f ^_i : -rs x
r11..1 -- _ p.i, t ;: � - , : -K- ;1• s;,74 ❑ E enc system larger separately derived system.
flr.`�?rz .i l ti
l ,:i &11; `fi'h 'a >+k S "�p� s .I : ti pia �, 4y O {)i"r iet : :. ?:,. ;. ( . 4: i : ; ,1� = -ti ::•? + y
ll. �f. 1, 1.,•. �{ �: li: t•:,,'_i�,u1�.:a{s��i''•?��.:• �c.l�;-�..f� i:s- r�:r�:r.�:.. �..;��;:s_': -:::'' tar= ''•-=:�`iws:����'r�':si ❑ Addihoaof new motor load oF ❑ ..A,.<,£„, "1 ..1_3„
Job no.: . Job site address: 12643 SW Falcon Rise Drive + taoF>Pormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks,
City/State/ZIP: Tigard OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
['Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 1 Project name: Tremblay ❑ Service or feeder 600 amps or more.
Cross street/directions :_li,^ _ rt= C(iir a l ill :trAw-; r .• o - ^.. ": y ,,, i;1
, �ii :a k?�__•-.'r c. :w..•r,ti mr.. .tr_. -_ r , '',.`yy; i: � .� )��a.:� u
reet/directions to job site: nasertneon on% Fee. Total
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', 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
r. - Limited energy residential
x L�Tf. 4 `' c fsu�.;: ,, rj .,_ '-'/t = ri•�;s�:c.:.: { : e: '"F i 75.00 2
lQ x ., 1 r. �,ii •:);fib iP G l . P ... t ... a 2 - r.. rif •. (with above sq. R)
1 ti�, 1rd1•: 9.: k 1'. ?; r• �r,. � i' �.. i• ,�11t�: , c , cFI :ra , ff.En•.:.�_.�3 �:,zr'r.:' '.,ta= 'watl:�it�?lf.c ,:('t*��,- ,.r- ,- ... -. •,r
:xr = i�:��.. ka w.. Limited energy, multi-family
Feeder & branch circuits for equipment �p�rreesidential with above ,. R y `T 7 } 5.00 •... { }7 2
d(�kllWAra •i
"yS_6i. g:�f,e
'l'.!iS J_ •. «I 1,I d$ liti p� a4
Services or feeders installation and/or relocation
I • y r. 1$7 '> T
4 5h. -.. • i ; :9F';„-. 6_ :r. -s r , rffI f i •r r- �T
ra�gil -g ff, . ,' .T t''t 20� M less 1 100.70 100 70 2
> j t, �4�
` ,� t e'' :.� � ^'� a` Ir r ,�x� % ::�Ft 'r. r�t:..'�i? y � �•t." amps
, i ,, J,� e .& -ahk 711 ,sL: 4,: wXJ *i4:1,15,:: ?.& il"Pi[�.`r. . � �i - . .:.ir'V .ip. :1.+.4 - i:
Name: Chuck Tremblay Y 201 amps to 400 amps 133.56 _ 2
401 amps to 600 amps 20034 2
Address: 12643 SW Falcon Rise Drive 601 amps to 1,000 amps 301.04 2
City/SC Tigard OR 97223 Over 1,000 amps or volts 55226 2
Temporary services or feeders installation, alteration, and/or
Phone: (503)791 - 3542 I Fax: ( ) relocation
200 amps or less 59.36 i I I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125 08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits - new, alteration, or ex tension, r panel
= a . 7. ,37F ?7- s . i5 Fs :: t i. '�"'r-'tii :ti ti 47.; ;I a7 7 ; ' <4 i= :<�; -4 :�x' H A. Fee for branch circuits with •
,a i= :rrr;rn•.:a. .41:_ L1 :- 74tc:;r 6' : _ lit;:sw.,r_ +'::: _ �x i=t ;, :: ':: ,: •.;.' :t:(•>;w above service or feeder fee, 3 7.42 22.26 2
Business name: Enders Electric Inc each branch circuit
B. Fee for branch circuits without
Contact name: Allen G Robertson service or feeder fee, first 56.18 2
branch circuit
Address: PO Box 1661 Each add'I branch circuit 7 42 2
City / State/ZIP: Beaverton OR 97075 Miscellaneous (service or feeder not included)
Each manufactured or modular 67,84 2
Phone: (503) 626.4813 I Fax: : (503) 6463871 dwelling, service and/or feeder
Reconnect only 67.84 2
E -mail: enderselectric@frontier.com
',FT FF'�'ZG'.Ir.1,'a:¢l{ `i,x •d y e •„r :Y te^•r�-- -.aee rem,F •:a ra, r^:r•., -,., 5 _., - -- _-- --, Ptunporimgation 67.84 2
t '0 :`�} : , y cj} ; Y.-�tii'. .°_ TE : 1 .,_,` 1 : ?•' t- ':: i ;;f-,z;c ;,.•Y - 5148 . i '
1. 1.... .•u'i?i!•�•,il.;':1...:�: ?�!:•. .:A!4.. �. .+ a. al, Ea.. 1. 7._ � �r-..,.: s." d,:: t�!. 5 ..f.:rY.,...,:ti % r �._li{!. �:�.'� Sign or outline lighting 67.84 2
Business name: Enders Electric Inc Signal circuit(s) or limited energy -
panel, alteration, or extension. Page 2 2
Address: PO Box 1661 Each additional inspection over allowable In any of the abov
City / State/ZIP: Beaverton OR 97075 Additional inspection (1 hr min) { 66.25/ hr
investigation (1 hr rain) 66.25/ hr
Phone: (503) 626.4813 I Fax: (503) 6463871 Industrial plant (1 hr min) 78.18/ hr
Inspections for which no fee is 90.00/ hr
CCB Lic.: 26728 Electrical Lic.: 34 -265 Suprv. Lic.: 4685S .. - ifica listed u hr min =Mrr�L •w
7/1)//7 7 �� =r_:_ = _ }u%4:;:': '_ ?; t T '�� ;r . : i: -: . ;,
Suprv. Electrician st ature, required. / �'i :' : • __z " ?� fi _
{ Subtotal: 122.96
Print name: Allen G Robertson Date: 05/3112013 Plan review (25% of permit fee):
i State surcharge (1 of permit fee): 14.76 /
Authorized signature: TOTAL PERMIT FEE: 137.72
Print name: - Date: This p ermit application expires if a permit is not obtained within 180
days after it bas been accepted as complete.
" Number of inspections allowed per permit.
I:taviltrmgi3ertnitstac PermitApp_040913.40e 4-10- 4615r(tI/03 /COM/WEB