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Permit CITY OF TIGARD ELECTRICAL PERMIT 111111 a COMMUNITY DEVELOPMENT Permit#: ELC2013 00558 I G A R L� 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2013 -r Parcel: 1 S134DC09400 Jurisdiction: Tigard Site address: 11536 SW TWIN PARK PL Project: JONES Subdivision: TIGARD PARK Lot: 10 Project Description: Panel change and grounding Contractor: DO RIGHT ELECTRIC INC Owner: JONES,CHARLES B JR/CATHYANN 11852 NE CHATEAU DR 11536 SW TWIN PARK PL WOODBURN,OR 97071 TIGARD,OR 97223 PHONE 971-570-8103 PHONE: FAX. 503-982-0042 _ FEES _ Quantity Description Date Amount 1 ea Services or Feeders-200 09/19/2013 $100 70 Specifics: amps or less 1 crt Branch Circuits w/Purchase 09/19/2013 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 09/19/2013 $12.97 Electrical Type of Const: Occupancy Grp: Total $121 09 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You a copy of t rect questions to OUNC by calling 503 232 1987 or 1.800 332 2344 Issued By:ice. - _ Permittee Signature: III OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept In a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each Inspection. Electrical Permit ADnIicati III F 'JEO Mk OFFICE Il'l', I. Sr.(l\1 1 IIICity of Tigard SEP 2013 Removed �■ Petmitivn.: _._. .ss$ 13725 SW Hall Blvd.,Tigard,OR 97223 plan Review Phone: 503.718.2439 Fax: 503.598. y Rid Remov OthtrPertort- II,i \1:1 l Inspection Lute: 503.639.4175 u tl ' ® ���At t 6J Date Ready/By. El See Page 2 for Internet www.tigard-or.gov BUILD\G DIVISION Na66ediMethod- WM Supplemental Information • - TYPE OF WORK PLAN REVIEW ❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below): ❑Service or feeder 400 crops or more ❑Building over three stories: ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTitUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14.000 ❑Commercial-use agricultural ® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for another installations. bulldtngs. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or ' JOB SITE INFORMATION AND LOCATION ❑Addition of new System. larger E",separately derived system. ❑Addition of new motor load of ©"A","E","1-2","1.3", Job no.: Job site address: i c[ Co {� ?1 100o>P or more. occupancy ! ✓3 C S To tq I C.f`� I 1 ❑Six or more residential units. ❑Recreational vehicle parks City/State/ZIP: 7 o� 9-712.a-3 ❑Health-care ocatio s. ❑Supply voltage for more than t ❑Hazardous locations. 600 valor nominal. Suite/bldg./apt no.: Project name: � � ❑service or feeder 600 amps or more _ • FEE SCHEDULE Cross street/directions to job site: Dratcuu 211 T otv- I zee. I Med I • ' New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no,: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: L;mited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 r Limited energy,multi-family 75.00 2 �AP I n4 rn C [°Jf J resident's'(with above sq.ft.) _ Renewable Energy Q See Pge 2 Servicra or feeders installation,alteration,and/or relocation 200 amps or less 100.70 O,7b 2 ❑ PROPERTY OWNER 1 ❑ TENANT - •1 J� _ ----- 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 Address: 601 maps to 1,000 amps 301.04 2 - Over 1,000 amps or volts 552 26 2 City/State/ZIP: 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–new,alteration,or extension,per panel _ El APPLICANT I 0 CONTACT PERSON A.Fee for branch circuits wtrh above service or feeder fee, 7.42 2 Business name: each branch circuit B.Fee for branch circuits without Contact name: service or feeder fee.fast 56 18 2 branch circuit Address: Each add'l branch circuit 1 7.42 7 1'4_ 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( ) Fax::( ) dwelling,service and/or feeder 67.84 2 Reconnect only T E-mail: Pump or irrigation circle 67.84 2 . CONTRACTOR • , Sign or outline l;ghtinn 67.84 2 Business name:300 R Ilf C1 e Jf,' T Signal cireuit(s 2or limited-energy See 3. t. nt� panel,attetation or extension. Page 2 2 Address: ',g5 a E Gj,f9,,� p,� Each additional inspection over allowable in any of the above Additional inspection(I hr corn) 66.25/hr City/State/ZIP: tApa) OR J 7 0 3 1 Investigation(1 hr min) 66.25/hr Phone:(97/)5)0 '7O3 ax:(5te)7 OS t3 7 Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.:(7' / j S Electrical Lic.: _ C) Suprv. ie.: • c specifically listed 04 hi min) I 110,1,5%-fall , /0 I / ELECTRICAL PERMIT FEES P) Suprv.Electrician 1 , �•t�, cquircd: �C am/ Subtotal: _.. }Q Lam=� a Print ntuno:� 1 Date: 9 I • _�3 Plan review(25%of permit fee): _w � �/ ��e r T �.c-cwirs I ` i State surcharge(12%ofpermit fee): e Authorized signature: TOTAL PERMIT FEE:— - ibis permit application expires if n permit is not obtained within 180 Print name: Date; days after it has been accepted as complete. / • Number of inspections allowed per permit al-09 v t.l9uildmg\Pamits\ELCYamnApp_ELR_EREdoe Rev 05/21/20 IS 4404615T/II/05/COM/WFB