Permit IIICITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00588
T R A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/13/2014
Parcel: 2S 102BC08400
Jurisdiction: Tigard
Site address: 12740 SW WATKINS AVE
Project: Fannie Mae Subdivision: 2001-023 PARTITION PLAT Lot: 2
Project Description: Reconnect Only.
Contractor: NOT REQUIRED Owner: FANNIE MAE C/O REEKIE PROPERTIES LLC
12740 SW WATKINS AVE
TIGARD, OR 97223
PHONE:
PHONE: 503-639-1600
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 10/13/2014 $67.84
Specifics:,
1 ea 12%State Surcharge- 10/13/2014 $8.14
Electrical
Type of Use: SF
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $75.98
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 foil• rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You in ay rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: -e ••. 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 Application i\-C FOR OFFICE USE ONLY
City of Tigard (` w Received f Permit No.: _
1,1
13125 SW Hall Blvd.,Tigard,O ��t Plan Review
I Phone: 503.718.2439 Fax: 503. +a1� Date/B : Other Permit:
IZ I l Inspection Line: 503.639.4175 y D w B See Page 2 for
Internet: www.tigard-or.gov `�� N.C. `" N. Supplemental Information
❑New construction ❑Addition/alteration/ A. ;. -*, Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ®Other:reconnect . �� where the available fault current ❑Marinas and boatyards.
CATEGORY 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 all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A" "E" "1-2" "1-3"
Job no.: Job site address:12740 SW Watkins Ave 100HP or more. 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.: Project name: ❑Service or feeder 600 amps or more.
Cross street/directions to job site:Walnut St to Watkins Description Qty. Fee. Thal •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:2 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 I
Tax map/parcel no.:R2103813
Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
electrical reconnect inspection residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
'' % 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:Fannie Mae C/O Reekie Properties LLC 401 amps to 600 amps 200.34 2
Address:9830 SW McKenzie St 601 amps to 1,000 amps 301.04 2
City/State/ZIP:Tigard,OR 97223 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Phone:(503)639-1600 Fax:(503)213-2013 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, er panel
❑ APPLICANT ® CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name:Reekie Properties LLC each branch circuit
B.Fee for branch circuits without
Contact name:Sue service or feeder fee,first
branch circuit 56.18 2
Address:9830 SW McKenzie St Each add'l branch circuit 7.42 2
City/State/ZIP:Tigard,OR 97223
Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Phone:(503)746-9763 Fax::(503)213-6083 dwelling,service and/or feeder
Reconnect only I 67.84 67.84 2
E-mail:sue.w @reekieproperties.com Pump or irrigation circle 67.84 2
_' Sign or outline fighting 67.84 2
Business name: Signal circuit(s)or limited-energy See
panel,alteration,or extension. _ Page 2 2
Address: Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(1 hr min) 66.25/hr
-
Investigation(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: Electrical Lic.: Suprv.Lic.: s. ificall listed(4 hr min) 90.00/hr
Suprv.Electrician signature,required: Subtotal: 67.84
Print name: Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee): 8.14
Authorized signatur•-,aft_, / TOTAL PERMIT FEE: 75.98
EMMEIWIMAMM This permit application expires K a permit is not obtained within 180
Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Building\Penn s ELC_PemtitApp_ELR_ERE.doc Rev 05212013 440-4615T(11AM/COM/WEB