Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00721
Date Issued: 12/09/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S136DD00900
Jurisdiction: Tigard
Site address: 6830 SW ATLANTA ST 100
Project: Tillamook County Creamery Subdivision: WEST PORTLAND HEIGHTS Lot: 24
Project Description: Electrical for TI: (6) branch circuits for new wall construction
Contractor: DREAMHOUSE ELECTRIC LLC Owner: ATLANTA STREET LLC
221 SW MOONRIDGE PL PO BOX 1727
PORTLAND, OR 97225 LAKE OSWEGO, OR 97035
PHONE: 503 - 519 -6711 PHONE: 503 997 -8478
FAX: 503 - 648 -9723
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 12/09/2013 $93 28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/09/2013 $11 19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104 47
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 obt eepy of the rules or direct questions to OUNC by calling 503.232 1987 or 1 800 332 2344 _
Issued By: / - ✓ 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 Applicatiol>1ECIV' D i l)Iz ot I IC h 1 Sr i1NLl
Cl of Tigard P� R eceived Permit No.: i 3 -
i l l l' 13125 SW Hall Blvd., Tigard, OR 97223 plan Review Other Pecmit: l 3_ v� p...7 Phone: 503.718.2439 Fax: 503.598.196�EC 9 7 \3 I7 naffs• RI see pogo 2 for 1
Inspection Line: 503.639.4175 U Dam Rep
Fit::1' 1' a D Notified/Method: , 7Z Lp • SupplemeatalInformation
Internet wvvw hgard -or gov
t ' " ' i•-• Gat i Please chock all that apply (submit 2 sets of plans wlitzms checked below)
New construction ' Addlrion/altC -' ❑ Service or feeder 400 amps or more ❑ Building over three stories,
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
1 , t :
"',, � ' ; •• - .�...i - 'c. , . .,.:,. .- ,J- less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
D 1- and 2- family dwelling JELSommcreiallindustrial ❑ Accessory building amps for all other installations. ❑ Installation El or
n of 75 KVA Multi family ❑ Masher builder 0 Other ❑ Fire pump.
❑ Fi
larger separately in f 75 KVA o system.
7 t:;' '.. - - ' ' ' ❑ Addition of new motor load of ❑ "A ", "E' "1 -2" "1 -3 ".
I OQIiP or more. occupancy.
Job no.; Job site address: 6630 5 1 , 1 i' • ❑ six or more residential units. ❑Recreational vehicle parks.
❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP; "`t X A .1 Q p_ q 1 � Cl Hazardous locations 600 volts nominal
Suite/bldg./apt. no.: Project nam ❑ Service or feeder 600 amps or more
g Pt a T—
Cross street/directions to job site: Peac Q tr• P. Total
A � . New residential single - or multi - family dwelling unit.
SW ( 1 4-A `Miss}/ d Includes attached garage.
Lot n o.: 1.000 sq. ft. or less 168.54 4
Subdivision: Ea. add'l 500 sq. ft or portion _ 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
n (with above SQ. ft)
�
} .. r T:: -.. �_.. "....; Limited energy, multi-family 75.00
residential (with above sg• ft.)
D' u • • a ' . t ° ' 01 .- Services or feeders inatallation,alteratio1 and/or relocation
to � < <i 200 or less 100.70
I , qr t 1 M . - 4 201 amps to 400 amps 133.56 2
amps
: :rcr. 1.. _.,.. h +,,r.... . •'.'..:n;;;;':,-,, '- :.... 401 at'npsto 600amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State/ZIP: relocation
200 amps or less 59.36 1
Phone: ( ) Fax ( ) 201 amps to 400 amps 125.08 2
Owner installation: This installation is being made On property that l own which is tlOt col amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch Circuits with
above service or feeder fee,
7.42 2
each branch circuit
B. Fee for branch circuits without
Business narltle'. service or feeder fee, first
/to 2
branch circuit I 56.18 5'4.1, $ 2
Contact name: 7 j,
Each add'1 branch Circuit 7.42
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 1
city/State /ZIP: 67,84 2
dwelling, service and/or feeder
-
67, 84 ^
Phone: ( ) I Fax:: ( ) Reconnect only
2
67.84 2
Pump or irrigation circle -
E-mail -
, .,t 7 _ T r 77:77- i -" '.7-r ll ; iii . ' 11 I 7. Sign o r outline lighting 67 .8
ii� .. lf ` . . > . ...I . i . ; : , . ., , 1;1 ..•;t . _ •. > ::.. .. Signal circuit(s) orlimnited- energy
panel, alteration, or extension. Page 2 2
Business name: DreamHouse Electric, LLC Each additional inspection over allowable in any of the above
Address: 221 SW Moonridge Place Additional inspection (1 hr min) 6625/ hr
City /State /ZIP: Portland, OR 97225 Investigation (1 hr min) 66.25/ hr
Phone; ( 503) 519 - 6711 Fax: ( 503) 648 - 9723 Industrial plant (1 hr min) 78.18 / hr
CCB Lic.: 196726 Electrical Lie.. C 8 / /, , , ic.: 4560S , Inspections for which no fee is 90.00/ hr x
� — ,� A s 7- ' '''' hated ' tam
. hr
Suprv. Electrician signature, required: � +" , - � � , i; Ir;i l
_.. Subtotal: a, •Z
Print name; Chris Mahofi /` Date: ` 6 /3 Plan review (25% of jlermit fee): 1-•
Authorized signatureA `� State surcharge (12% of permit fee): I. • ( Q
TOTAL PERMIT FEE: Olt, 41
EM IIPM1.1.111111111111FAINI Date:
L15utldiog \PermifinELC- ParmitApP.doc 07/01/10 440 46157(11 /05/COM /WE)