Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2022-00327
Date Issued: 5/23/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134CB01800
Jurisdiction: Tigard
Site address: 12130 SW SUMMER ST
Project: LAMB Subdivision: SUMMER HILLS PARK Lot: 21
Project Description: 400 amp service upgrade with a 200 amp split pack meter for existing dwelling. ADU will have a 200 amp service
meter.
Contractor: PDX ELECTRIC LLC Owner: LAMB, RICHARD PIERCE & JANNA MAE BOREN
15816 SW UPPER BOONES FERRY 12130 SW SUMMER ST
LAKE OSWEGE, OR 97035 TIGARD, OR 97223
PHONE:
PHONE: 503-997-1989
FAX: 503-200-1362
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/23/2022 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 05/23/2022 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)
This permit is Issued subject to the regulations contained in the Tigard Municipal Code, Stale 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 r if work is suspended for more the
180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification enter. Those rules are set forth in OAR
952-001-0010 throuoh OAR 952-001-0090. You may obtain a f"the rules or direct auestions to OUNC by calling 50 2.1987 a 1.800.332.2344.
Issued By: L9 G. C2F. Permittee Signature:
OWNER INSTALLATION ONL,Y�
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'N 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 FO12 OFFICE USE ONLY
�
City ojTigard RECEIVE �aeeeive ,. V!i✓ Permit 4' ' (. J
tilli d >II 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
111 Phone: 503.718.2439 Date./By: Related Permit n:
TIGAI;D Email: TigardBuildingPerinits@Tigarc-or.gov NAY 1 6 102Z Ready Date/By' buns: QI See Page 2 for
Inspection Line: 503.639.4175 Internet: www.tigard-or.gov NodHedlMethod: -- Supplant:nal Infertile Flow
: .•s. „r#r4•e.\,£ 12 ..;%i'$2'0'fYPg.,.a + SV 4. ;; `i `t?;t '4 <<:e + ..
- lie _ �,;. � �./-�,�1,e,„ _u. �: -� �•,< <,„.,.,:, , 'rpI,AN:Rk31iEW,', �3sv, ,:., ,'.;,
D ew construction ❑Addition/elterzti0l1' eL(�� DIVISION' Please check all that apply(submit g sets of plans wdtems checked):
0 Service or feeder 400 amps or more ❑Building over three stones.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
;i js \s}rte' k 7i`a:i-7.°r''A -?'C4TZGO1tYr,QFj;C,Q $TRIJ„�,'r1Q�N„/#`+ 'r* 'c+}'? l 1*',9.� exceeds 10,000 amps at ISO volts er ❑Floating buildings.
❑ 1 and 2-family dwelling ❑Commercial/industrial iltE ccessory building less to around,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings
❑Multi family 0 Master builder 0 Other: 0 Fire pump. 0 Install/lion of 150 KVA or
:st4n .}fx w;a` 's.,.yayL.98 $1TE,IPIF'l7RMdT1i Nh;+ Y30L",t(TION,y�^ s"a `pa d 4.' 0 emesSeneYo system. larger s-pasalely derived
/^/l L5�C1l1n/V5lsV ❑Addition of new motor load of system.
Job#' Job site address: G�✓f�U 100111'or more. ❑"A "E","1.2","1-3",
City/State/ZIP:TgaCZ�OQ 97.12 Q ❑Stxormore facilities. units. ocapaeoy
/ .LLj/•I'sz/J 0 Health-care facilities. 0 Rees-colonel vehicle parks
Suite/bldg./apt.#: Project name: Qco,42 1��6 �/j�/ ❑Flare:dons locations ❑Supply voltage for mare than
/ e.rij ❑Service or feeder 600 amps or more 600 voila nominal
Cross street/directions to job site: lzi S L Q4 d ((j,) L .mom y. rµ, 1 , 2r. ,,,�,EE:.SCHEDIJLE r
frrax, v. 'T ly7/ cJ1.G
r:�2� S �;t# is1�pC'kli� DncriDtlon I QtY i Each i- Total f�•
--- New residential single-or multi-famlly dwelling unit.
Subd1V1§iOn: 54 V,lw�"%'// �7ipf Lot ii ]J Includes attached garage.
TM map/parcel# g.Z(7 !V //S 3 C2 0/4 e-J E .a sq.50os less 33.92 4
� � � 7 �� Ea.add'1 500 sq.!t.or portion 33.92 I
.._... ¢RK`y-�*�„_� "�& 4s''4. v°' Limbed energy,residential 75.00 2
!�, -� .. G3.- JQ J/ (with above sq.ft.)
' .evv, r S ^_t'T s Limited energy,multi-family 75.00 2
-3„ residential(with above sq.ft.)
G•, PROtfER,`P.t' ¢VYiVE'R°L`s' ,1; + a rr/o X t=.,. Renewable Energy Q See Page 2
. €. wy 4 t'. .: es` *r„'ek.ii9Wi" j „- ,,�,, 6 Services or feeders installation,alteration,and/or relocation
Name: ,(,e1I Z-OF d f �T,-„lii 200 amps or less ,�.1QUW ''j 100.70 I'k, )t-, 2
Address: /Z/3 n r!5-e ' Jr-�' ,',t- e:f 201 amps to 400 empsl p fbs(�1 /"��-t 3_.56 2
_ 401 amps to 600 amps __ 20(.34 2
City/State/ZIP: 7- rd �� 9f Z 601 amps to 1,000 amps 301.04 2
Phone:( ) ) 155 .-s-- ,_ Over 1,000 amps or volts 552.26 2
//,,���� •
Temporary services or feeders Installation,alteration,and/or
gii411 ° ♦ i'�" lt-L' J%a�i 64 ..• i'Ar./ relocation
Owiie„t sdI atlon:This installation is Tf g made on property that I own which is not 200 amps or less 59.36 I t I
intended for sale,lease,rent,or exchange,accordmg to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signatu�ree��/ Date: 401 amps to 599 amps 168.54 2
`^tc,i,!,.+,. + v�(-p10,,titANT`,„fa,✓�, rru ales;,,r A;4E:ij{)NTAO1t''PF,RSON ,^::.,, A.EranehelroulFeeforbranch circuih is-new,a wlteithration or extenslcn, ier panel
Business name: above service or feed• f
each branch circuit . • '42 2
Contact name: k ;h�B 'C1J 'B.Fee for branch circuits without
/ / ��? �-y service or feeder fee.first
1
Address: 74. ff ,,,5l/ su/f1�/ e. branch circuit 56 18 2
City/State/ZIP: �/1 0,e f I zz? Each adel branch circuit t 7 42 2
Miscellaneous(service or feeder not included)
Phone ( .57J/) Q 5�3i Each manufactured or modular 67.84 2
�t dwelling,service and/or feeder
Email: 4rHHG -ow.6At'evf /piGY l co
�f P� ( "II Reconnect only 67.84 2
a._?' " - ./Y6:" ',':r1'CONT O11_2. '1:'".1",'..,'. Pump or irrigation circle 67.84 2
tilB1iSB f� X
1 'rcre(''I,' /���lirlJ'7wV�' PD g/,1 '( k.+1i/ Sign or outline
l lighting I- 67.84 _ii
nal etreuit(s)Or lim
Address: i{r �.y.e, b� y nel alteration or ited-ener4 ❑ See Page 2
Each additional Ins Wien over allowable In 3 nv of the above
City/State/ZIP: p�rlfrK/at974 5Additional inspection(I hr min) 66.25/hr
r/
Phone:(5' ) 63 - ' o
Email: i A. 0 pike)!' at' . OM Inspections
for which no fee is
CCB Lic.: i Electrical Lie,: `Y Suprv. Lie.: , 4 s
i' ELECTRICAL PERMIT FEES
IMEEMI' ` f y Subtotal: ,'i',;
�
�� 7 ❑Plan Review R ,wired 25 oo of ermn fee
Print name: �i U ! �J�/� r a ,.�{ p )-
�'� �I�`//" Stara sutcher�e T %L of remitfee): j ,,i
Authorized signature: y TOTAL PERMIT FEE: J, • 7�
i Thts permit application expires If a permit is not obi allied within 0
' / Date: Lj /3/ Z days after It has been accepted as complete.
[,tm Pr �( EC Pen°ttApp ELRERE•.d a40A61sTf 11rosnbMnvsa oe Rev 10/26/7017 ' Number of inspections allowed per permit.
#r PDX eleGfrt G tr6Q1AiriS -4DUse 0 ) ) AtI4 (s )
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