Permit •
CITY OF TIGARD ELECTRICAL PERMIT
Il i • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00319
T ( GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2013
Parcel: 2S 104CA08100
Jurisdiction: Tigard
Site address: 13266 SW 136TH PL
Project: Mangum Subdivision: HILLSHIRE Lot: 81
Project Description: (2) branch circuits for bathroom remodel
Contractor: EVENT POWER AND LIGHTING Owner: MANGUM, DANIEL K & STACY A
170 LAHTI RD 13266 SW 136TH PL
WOODLAND, WA 98674 TIGARD, OR 97223
PHONE: 360 - 255 -3830 PHONE:
•
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 06/10/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/10/2013 $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 1 -00 0. You may obtain a copy of the rules or direct questions to OUNC by callin r • 3 .1987 or 11:00.332.2344. 4.
Issued By: Permittee Signature: ' !.i — - G
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.
l Permit Application I
Electrical tl ( 1;F ON
a pp anon RECEIVE you l)I I I.1. _;.. _ ONLY
L,l
City of Tigard JUN 10 2013 Received / i t Permit No.: --, 3 _, 03 /
° 13125 SW Hall Blvd., Ti Plan R . l�
Tigard, OR 972.23 Plan Review
C ' - Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGAR 1 Date/B : Other Permit:
TI G A R n Inspection Line: 503.639.4175 V I 1 lrtc Ready /By: M See Page 2 for
Internet www tigard ar.gov BUILDING DIVISI • fied/Method: yta
en, Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ® Addition/alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition 1:1 Other:
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® I - and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" - E ", "I -2" "l -3"
Job no.: Job site address: 13266 SW 136 place 100HP or more_ occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR. ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt- no.: Project name: /7/9-A/ ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: oe eript,on
Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. fR or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK ( with above sq. R.)
Limited energy, multi - family 75.00 2
Bathroom remodel, two circuits residential (with above sq. ft.)
Renewable Energy ❑ See Page 2
Services or feeders Installation, alteration, and/or relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or loss 100.70 2
201 amps to 400 amps 133.56 2
Name: ' /J6 /7
.7)17V/ C L _5 7,7 401 amps to 600 amps 200.34 2
Address: --3'974 601 amps to 1,000 amps 301.04 2
City/State/ZIP: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or less 59.36 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 extension, per panel
APPLICANT A. Fee for branch circuits with
I ❑CONTACT PERSON above service or feeder fee, 2
Business name:. kAtS4ev a `el'vc & gp t � r Art. each branch circuit
B 7.42
` w B. Fee for branch circuits without
Contact name: T service or feeder fee, first I I
C) C ` t branch circuit 56.18 2
Address: ,% 1 L. I 0 10.0 (7 ve Each add'I branch circuit I 7.42 I 2
City/State/"LIP: (,S �, O Miscellaneous (service or feeder not included)
Y�ci.m4 , 0 1 -3 0 Each manufactured or modular
67.84 2
(47 Z2 ( a 0 4 q (s o') e•/( ( _( . 7 ( 3 dwelling, service and/or feeder
Phone: Fax: Reconnect only 67.84 2
E - mail: du5823 @comcast.net Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: vat, --/ �� ¢7C 7 /y Signal circuit(s) or limited -energy See
r y panel, alteration, or extension. Page 2 2
Address: 170 Lahti RD / Each additional inspection over allowable in any of the above
City /State /ZIP: Woodland, WA 98674 Additional inspection (I hr min) 66.25/hr
Investigation (I hr min) 66.25/ hr
Phone: (503) 704 Fax: ( ) gi Industrial plant (I hr min) 78.18/ hr
� Inspections for which no fee is
CCB Lic.: 115114 /2Perfr etrieal Lic.: 34 -473C /�/ Suprv. Lic.: 4325S I6 I f i3 specifically listed (A hr min) 90.00 / hr
J ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: � ‘‘,1.4-A7 Subtotal: 63.60
Print name: Dan Dunn Date: 6/7/2013 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 7.64
Authorized signature: TOTAL PERMIT FEE: J.24
This permit application expires if a permit is not obtained within 180
Print name: Date:
days after it has been accepted as complete.
• Number of inspections allowed per permit. .2/, ?3
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13266 SW 136TH PL, TIGARD, OR, 97223
Residential - Electrical
120 Electrical rough-in
06/12/2013 00:00
ELC2013-00319
FAIL
Outlets not wired for 20 A w. # 12 wire
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13266 SW 136TH PL, TIGARD, OR, 97223
Residential - Electrical
120 Electrical rough-in
06/12/2013 00:00
ELC2013-00319
FAIL
Outlets not wired for 20 A w. # 12 wire
Violation Summary:
Inspector Contractor