Permit (160) CITY OF TIGARD ELECTRICAL PERMIT
111‘ ■ COMMUNITY DEVELOPMENT Permit#: ELC2018-00814
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/18/2018
T r C I<.Cs g Parcel: 2S101 CB00200
Jurisdiction: Tigard
Site address: 8200 SW HUNZIKER RD
Project: Brent Enterprises Subdivision: None Lot: None
Project Description: Reconnect only.
Contractor: Owner: BRENT ENTERPRISES
PO BOX 23096
TIGARD, OR 97281
PHONE: PHONE: 503-324-6011
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 12/18/2018 $67.84
Specifics:
1 ea 12%State Surcharge- 12/18/2018 $8.14
Electrical
Type of Use: COM
Class of Work: ALT
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 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. % may obtain a•.py of the rules direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/2� 1/4
Issued By: ..-C4 �"� GGl _G/ A 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 603.639.4175 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.
Dec 12 18 02:12p Bent Enterprises, Inc, 503-324-7042 p.1
Electrical Permit Application t �,y
City of Tigard E E'\i E DDate�e/Bi_d: _ "---x3....,..itgf_z._e2.0(F- Ert I
Ili n 13125 SW Hall Blvd.,Tigard OR 972 Plan Review
.
Phone: 503.718.2439 Fax: 503.598.1960 pEc, 12 2018 DataBy: Related Permit 4:
T I G I R D Inspection Line: 503.639.4175 U fir Ready Date/8v: gods' E See Page 2 for
Internet: www.tigard.or.gov (wr + �� AF't Notified/Method: Supplemental lnoorination
• TYPE OF WOHKL ` K L.
❑ mi QIV1S1°� • PLAN REVIEW .
New construction �‹Addition/alter nt Please check all that apply(submit 2 sets of plans w;rnems checI cd):
❑Service or feeder 400 naps or more ❑Building over dace stories.
❑Demolition 11]Other:
where the available fault current 0 Marinas and boatyards. i
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling fCommercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use apiculture]
amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑ Other:
ID Fire pump. ❑Installation of 150(VA or
JOB SITE LVFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Lt>C-C-0 Job site address: ✓ i.,U.,Zi ifiJ“- 100EiP or more. ❑ A'_E ._Z: -1-3"
City/State/ZIP: I cy'in. C. (L. (.• q .,(-7-i--7:2'i t„ji7 X ❑Six or more residential units. occupancy.
►at � '/�"I' 7t 0 Flealth-care facilities. 0 Recreational✓Thiel:parks.
. Suitc/bldg./apt.#: Project name: t,? A--(2 0.L,y.,c 0 Hazardous locations.
--
0Supply voltage for here than
t ❑Service or feeder 600 amps or more. 6"volts nominal.
Cross street/directions to job/] site: -r- FEE SCHEDULE
(S)kV/ 74r : , r ,/2 jc J • New
I Oty. i Each I Total
v rJ' New residential stetter-or multi-family dwelling unit,
Subdivision: /A ic"� �[1/,-./� 4unfvolt[ Lot#: Includes attached garage.
1,000 sq.R.or less 168.54 ' 4
Fax map/parcel#: i _
DESCRIPTION OF WORK ,� •add'I sq. or portion 33.92 1
Limited energy,residential 75.00 2
rr. „y;' 3�,� (with above sq.ft.)
) +'I,c3:J't i i ( r C.- c �Alrle(/'` t Limited energy,multi-family
�L �Lil C'�1 C t 4(,y� residential(with above sq.ft) j 75.00 2
, PROPERTY�E Renewable Energy ❑ Sex Page 2
R ��7 ENANT Services or feeders installation,alteration,and/or relocation
Name: 1 t" .,,y e.,4rsyzS • y:,,,i-IL,. 200 amps or less I 100.70 2
Address: cJ "Y`'�.. Z 7Ct. 20I amps to 400 amps 133.56 2
O 401 amps to 600 amps 200.34 2
' City/State/ZIP: ('y gt,t.) C1(L Ct7- ` \
` � 601 amps to I,000 amps 301.04 2 i
F,, Phare:f ) -;' 4. 61( Fax:(3)) �'l /I"t-c Over 1,000 amps or volts ( 552.26 2
v ` Temporary services or feeders installation,alteration,Ind/ar
i Email: �L ?L 1 C1�, � hl,�L � t 4^'1 relocation
A Owner installation: installation is being made on props that I own which is not 200 turps or less 59.36 • 1
'Je intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps ~ 125.08 1 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
N APPLICANT N'CONTACT PERSON Branch circuits—new,alteration,or extension,per par el
4\ v A.Fee for branch circuits with
. ` Business name: b,t_ I.l,l 3c&pc s,j 9 �. .`�- above service or feeder fee,
7.42 2
' l L `'-� each branch circuit
Contact name: - ,r �^ �_ -
�iC'tv�.,l/1 C SQ 6CIA1/ B.Fee for branch circuits without
Address: ?(-) -'70.1, v ) i !j seniceorfeeclerfee,first
56.18 2
14
_ branch circuit
..,.4 City/State/ZIP: '� 1 V• c1`_ 9-7 ci ) Each add'I branch circuit 7.42
C � f 2
t Miscellaneous(service or feeder not included)
APhone:(`i71 ) (I4,—7•y Fax::( ,) S).0 �,{_,0 Each manufactured or modular
/�+ r 'N.41 dwelli service and/or feeder 67.84
P q Email: �..), dl ,Li :-'v��L'✓7,.'j i .�:l\ ' v �.N: 1 Reconnect only / 67.84 �'7 IL/
CONTRACTOR Pump or irritation circle 67.84 t 2
Business name: fee Signor outline lighting 67.84 2
Address: Signal circuits)or limited-energy ❑ See Page 2 i 2
panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the shove
Additional inspection(1 hr min) 66.251 hr
Phone:( ) Fax:
( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78,18/hr
Inspections for which no fee is ,
CCB Lie.: Electrical Lie,: Suprv. Lie.: specifically listed(1A hr min) I 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 6-ii
Print name: i Date: ❑Plan Review Required(25%of permit fee): �—
, State surcharge(12%ofpermit fee): r , tit
Authorized signatur¢r.^7
: le,4/ ct,L�t�"\/ TOTAL PERMIT FEE: '2 5_
i \ 5y
\ /1„7
This permit application expires if a permit is not obtained with a 180
Print name: ,� �Ir - Date: r)f ///A, /ir> days after it has been accepted as complete.
l ' Number of allowed per permit
1:lRuiddinglPerreits\ELC_PcncitApp ELR_ERE.dec Rev 0617/2015 1 440-4615T(1 WS/COM/WEB