Permit U CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2013 -00394
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013
Parcel: 1 S133CD03800
Jurisdiction: Tigard
Site address: 11704 SW SWENDON LP
Project: Werner Subdivision: COTSWALD MEADOWS Lot: 36
Project Description: (2) branch circuits for heat pump and service outlet.
Contractor: NICE ELECTRIC CO Owner: OLSON, LINDSEY
PO BOX 636 WERNER, GEORGE
MCMINNVILLE, OR 97128 11704 SW SWENDON LOOP
TIGARD, OR 97223
PHONE: 503 - 434 -5802 PHONE:
FAX: 503 - 472 -1628
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 07/11/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/11 /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: Ore on law requires
y you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 throu AR - 001 -0 . V may obtain a copy of the rules or direct questions to OUNC by calling 5. . 32.1987 or 1.800.332.234' .
Issued By: P erm itt ee Si gnature: /, / �
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' 4 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.
2013/JUL/10 /WED 15:41 Nice Electric FAX No, 503 472 1628 P. 002/003 i✓
Electrical Permit Applicat'(l - - FOR OI ■lICIi 1)SIC ONLY -
City o Tigard • r EIVED Received 7 �mitNo.: f 4' -
1),„€03: // s 39
13125 SW HaII Blvd., Tigard, OR 97221, , Plan a Review Other . Permit
_ . Phone: 503.718.2439 Fax 503.598.10U L 1 0 2 0 � 3 patina.
i t r : n i;I. Inspection Line: 503.639,4175. Date Ready /By.. brig M See, Page 2 for
• -. Internet www.tigard- or.gov CI OFTIGARD Nodfed/Method. Supplemental Information
rty ,'Y ].
' t e s , ✓4. z t1 vfh X 2 11 t 1 :1, Jt 0 n - ` ,r � `It � J r �,: i.: ar . "i 1 i, _ 1 Y h' t l l .i u i .: .4. 1 4 4 .
•'Q S e d7 '++r�•'x t l r , : r � , ' ,, ,
..�`r,.� t.[ � 3 h r � ' !' �..L��r1:���;:�.�Lzi� ; ' , �I.. �..r�.:.ata _ _': .._t .. i � { t " �tua?.:, A „ 1.., 1 �tr.,. Su] L+ 1 i ur. ` �icJ'_•...: a<. .t ,cat.�f�rd., r �� i. uS� . �.'`...t-.�' - 'a,'&- ..,�.,�;
CI New construction ® Addition/alteration/replacement y y Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Bm7diu8 over Ante stories,
❑ Demolition ❑ Other:
t ' a where the available fault current D Marinas and boatyards.
r . . .'.r a.z l t .. lit; :i -g; 4 1tI e i1.d ",at a. e Ms,f, i . 4 , . eV 9 r!' l r1 0i 1 f J �.i3. �. 1 ..::: Jd T :_'.:,. � c 1 • exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
�
' - '1'•. _; " less to ground, or exceeds 14,000 ❑ Coi_mercial-use 08ricuhural
El 1- and 2- family dwelling d Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi -family LI Master builder 0 Other D Fire pump. ❑ Installation of 150 KVA or
❑ Emergency system. larger separately derived s
l 1 k7r � :� T fi - 1 r i r i t t li eYsYB �' eP Y stem.
Y
,;is U,'; , , ...... I . i ,p, !, n `,Clans ;14, 6 L':,4f 15 � i'''A i o e '47 t ics „ . ^-;�, ❑ Addition of new motor load of ❑ "A° "B ", "12 ", "1.3 «,
Job no.: I Job site address: 11704 SW Swendon Loop 10011P or awry occupancy.
O Six or more residential units. 0 Recreational vehicle parka.
City /State/ZIP: Tigard OR 97223 ❑Heahh - care theilities. D Supply voltage for more than
rI Hasaodous locations. 600 volts nominal
Suite/bldg. /apt. no.: I Project name: OHAC - Werner l7 Service or feeder 600 amps or more. • et '4 :401, It: , .:7x51. . lit ,. �4.r i _.t0 E' vr x Fg. i t� ( " °J"•r: ttl.ii,.
Cross street/directions to job site: neserintion 1 oa. I Fir. Total •
"" New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Cotswald Meadows I Lot no.: 36 1,000 sq. R or less 168.54 4
Ea add'1500 sq. R or portion 33.92 1
Tax map/parcel no.: 81376512 Limited energy, residential
• '! t. •t,2`' , r �t . tti . 1 fr .;�!. tl :6.1'; i' fit, O.liie' Y. t� 1 1 � r rh: 1 1 7 ', _ (with above sq. It.)
75.00 2
'��,.. 1 m��:,'1 ....l..c::tuti:u'!t � ..'tt . � .1., aaw `1a.r a r .iz:l:W.... �:.r::.atmt.:� °v:l�',..'u«i:i2t:!:F:' ,'
Limited energy, multi-family 75.00 2
HP, Convenience GPI • residential (with above sq. ft)
1111ini54dbi lain ::?„:;?M T:'t.; igon :SeeiPslt�211~. :,.':li:;;: •Brig ;d'
Services or feeders installation, alteration and /or relocation
ii' r s .,li. ! da . Oa lagig : ? � i' ,i'Aiiiiiir. i b ii; :' .k /ta t j t n r 4144 41 Iti f i i i :IL,. i }xi ; 200 amps or less 100.70 2
Name: George & Lindsey Werner 201 amps to 400 amps 133.56 2
6 r
401 anus to 600 amps 20034 2 •
Address: 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: ( ) I Fax: ( ) relocation
200 amps or less 59.36 1
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 - alteration, or extension, per panel
..ItC, L, r , ;.,:;r 1 r-1 hi,' r n'. ,snit .L ..r.� iitte u.- I`lgl'L 7 1L � x�. g. ' ( " 1 1:1•.! 1 iii: O �:Is i t,1 1 i,v A. Fee far branch circuits with
above service or feeder N. 742 2
Business name: each branch circuit
B. Pee for branch circuits without
Contact name: service or feeder fee, first 1 5618 56.18 2
branch circuit
Address: Each add'l branch circuit 1 7.42 7.42 2 •
Giry /State /Z]P: Miscellaneous (service or feeder not included)
Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) I Fax: ( ) d Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
it h "A .„ t l k.) Y Y r F ;6,y, f t" fi •I t' t1 't et ' 1„ 1 r v (g l i , a r iI _,. 2
!:;/ s.. ,... , .. ,. , px. a' ft t, >r:� . t :�� Sign or outline lighting 67.84
Business name: Nice Electric Co Signal circuit(s) or limited -energy See
panel. alteration, or extension. Page 2 2
Address: PO Box 636 Each additional inspection over allowable in any of the above
Additional inspection (1 hr min) 66,25/ hr
City / State/ZIP: McMinnville OR 97128 investigation (1 hr min) 6625 / hr
Phone: (503) 434 -5802 a, Fax: (503) 472-162S 4 , industrial plant (1 hr min) 78.18/1n
\k \,' Inspections for which no fee is ■ CCB Lic.: 2061 T - Electrical Lic.: 36 -9C %�` Suprv. Lic.: 4829S `�` cifically listed (% hr min) 90.00 / hr J, F t t ^,
t lga'. .
Suprv. Electrician signature, required: Subtotal: 63.60
Print name: Mervin L Zook Date: 7/10/2013 Plan review (25% of permit fee): 7.63
State surcharge (12% of permit fee):
Authorized signature: TOTAL PERMIT FEE: 71.23 1, J
This permit application e+rpires lie permit is not obtained within 180 dl�/
Print name: Date: days after it has been accepted as complete.
° Number of inspections allowed per permit.
rABuilding/p ennittslE ,t.CJ'ennitApp_5LR Rev OS/2112013 440.4615T(t t/OS /COMIWRa
2013/JUL/10 /WED 15:41 Nice Electric FAX No,503 472 1628 P. 001 /003
NICE ELECTRIC COMPANY
CBS #2061 • Company Lic. #36-90
Commercial ^ Industrial — Residential Wiring
Facsimile Transmittal Sheet
•
Address DATE: JULY 1 0, 2013
•
1605 NE Riverside Dr
PO Box 636 To: Electrical Permits
McMinnville OR 97128
COMPANY: City of Tigard
Contact
Phone 503.434.5802 . FAX #: 503.698.1960
Fax 503.472.1628
Email niceelectric( integra.net PHONE #: 503.718.2439 •
FROM: Jennifer Stocks PAGES (INCLUDING COVER SHEET): 3
Notes /Comments
Please fax me the permit number AS SOON AS POSSIBLE.
Thank You,
•
•
Jennifer
No HARD COPY TO FOLLOW UNLESS REQUESTED
"Ease the Day — The Electrical Way"