Permit (24) CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELC2023-00345
T I C1 AR I3 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/7/2023
Parcel: 1 S 133AD 10300
Jurisdiction: Tigard
Site address: 10659 SW 127TH CT
Project: French Subdivision: AMART SUMMER LAKE NO.3 Lot: 159
Project Description: Installing 50 amp circuit for EV charger
Contractor: OEG INC Owner: FRENCH, ERIC D&JULIA W
3200 NW YEON AVE 10659 SW 127TH CT
PORTLAND,OR 97210 TIGARD,OR 97223
PHONE: 503-234-9900 PHONE:
FAX: 503-234-1001
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 06/07/2023 $56.18
Specifics:
Service or Feeder
1 ea 12%State Surcharge- 06/07/2023 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 ules are set forth in OAR
952-001-0010 throuah R 952-001-0090. You v obtain a coov of the rules or direct auestions to OUNC by callina 503.232. 1 3 344.
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'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
1111 City of Tigard 1 R DaecteeiBxeyci
Peann �i?G��`1...)
-.113125 SW Hall 131kd. I Isard.OR 97223 �I tan Kex4exx IP
■ Phone- 503 718_2439 (av 5113 598 1960 4 1 ate By Related Permit
Inspection line 503 639 4175 keady Date Its r — tuns RI See Page 2 for
T I G Al D I kk nternet kckv tigard-or aos vottGcd Method 1 �� Supplemental Information
TYPE OF WORK ) PLAN REVIEW
0 Ness construction 0 Addition/alteration-replacement I Please check all that apph Isebniti 2 sets of plans n items checked).
� 0 See ix or feeder 4Pb amps of more Buildingmet three stories
0 Demolition ❑Other:
is here the mailable fault iurtcnt 0 Marinas and boatyard..
CATEGORY OF CONSTRUCTION s eds In 000 amps at I;o k 4ts or 0 Floating buitdtnn,
less to get and in esceed•-14 000 0 Conttnen.ial-use agricultural
7
0 1-and--family dwelling 0 Coll mereiat�industrial 0 Accessory building I
amps for all other tnstallar sits buildings
0 Multi-family ❑Master builder 0 Other: 0I ire pump 0 installation of 1;0 kV A or
JOB SiTE INFORMATION AND LOCATION ❑i irergenex`.}stem target separately dotted
Soh `: l lob site address: :.�, "F / 0 Vdduion of new.motor load of system.
102445-626 j (..,4�` us IPot more 0-k I -I 13-.
CltylStalerZ IP: t ) ❑'ts or more residential l unit, ,x upkncs
' k. ._' -.- t c _ ') 0 Reese ltional xeht le parks
_.._.._,.. ❑Health-care fa•ihOe<
r I 0 11de:trdott location. 0 SuppA i oltage tit more than
Suitubldg.'apt.;x: Project Warne:
i--- ---- ------ -- 0 Sees ice or feeder 600 amps or flute. 600 soles nominal.
Cross streebdirections to job site: FEE SCHEDULE
Description Qtr. l Each [- Total l
-- Sew residential single-or multi-family dwelling unit.
Subdis ision: ) a,,» I ; .t I I of»: Includes attached garage.
1.01$)sq II or less t 168.54 4
Tax map parcel t<:
1.a add'I 500 sq ti or portion 33.92 1
DESCRIPTION OF WORK t.nntied encrgt.residential 75 00
, r m
Ir'I''j .-1 'I�-. `r a"t'.' ,... 1 `. „ . ' i. 3 tb`,, i t- e.
)uithahokcsq tt_I
I tuned elICICs-multi-(amity
residential(with abose sq ft) 75.01 2
Renewable Energy O See Page 2
i PROPERTY OWNER _ 0 TENANT Sers ices or feeders installation,alteration,and/or relocation
Name: t - ) I u_. i" `,-. +- '; 21st amps or less ! 100 70 2
w o 201 amps to 400 amps 133 56 2
Address: y ,. '-r �.,. .
1 ` ) i -- 4n i amps toms)amps 200.34 2
^s �—
Ily'Stata llP: 3 _ �- Lt ,� 8i..,_ 3 s' tot ante.to LtI00amt 301,04 2
Phone:( r ) t e ''-'t Fax: her i Jinn
— x.t 1r 1 (el Temporary
»amps or eolt. 552 2
services or feeders installation,alteration,and/or
[mail: , ` +
Owner installation: This installation is being made on property that I own kohl- : tot I 218i amps or less T <v 36 i
intended for sale lease.rtt or eycp Inge.according to Oki .anP d 7 I 20i amps to 400 amps I's(1s 2
0hkner signature. IL...-.—..--- - A.- Date 4o1 amps to 5v9 amps 168 54 1
( _APPLiCANT Branch circuits—new,alteration,or extension, _r panel
❑ CONTACT PERSON I A I cc for branch circuits t,di:
Business name: OEG,Inc above sersice or l eder tee. 7 42
-- each branch circuit
Contact name: Josh Maier B. I cc for branch circuits t+nhntn I
—
Address: 32f}Q NW Yew'Ave serkice or feeder fee,tirst branch circuit 56 18
_
Cits'State'ZIP:Portland,OR 9721(} Each add'I branch circuit 742 2
Nliscellaneous service or feeder not included)
Phone:1503) 969-3111 Fax: :1 ) I'ach manufactured or modular
6784 -
dxkellmg•set%ice and or feeder
Email: ----
Josh.Maier@oeg.us.com _Reconnect onh 67 84 2
CONTRACTOR _ Pump or irritation circle 67 84—^ 2
Business name. OEG, Sign of Dulling fighting — 6784 2
Signal cueuih s)or limited meet.
O See Pa e 2
Address: _3204 NW cO�TVe panel,alteration,or extension g
City-"Stale/IP: Portland,OR 97210 —._ _____ _Each additional inspection user allowable in any of the above
— (— [ay:I ) �.___-__ In Additional
inspection
hi mint 1 fir mtm l 66_2 fit [ I
Phone. 503 I234-9900t I
tr ' 9olli).fir .
I Mai I: JOSh.Maler@Oe .US.COriZ Industrial plant(f hr min) 78 18 hr
--. lust ecYiortc for sshich no feel., 9(ft)0 hi
203 I ecuical I.ic 26 95C Supra• lie-: 4818s spectiicalh hatedlt_hnnmi
CCt3l.i�.:
jest iT R RP-
ELECTRICAL PERMIT FEES
Supra. I leetrician signature required: Mark Weinbender r "' _ Subtotal
Print name: Mark Weinbender — i Date: 06-07-23 flO Plan Resieks Required t25"0 of permit feet --
State surcharge 112"0 ofperntit feet
Authorized signature: — lO l Al.PLKRII I'[LT:: �
This permit application espires if a permit is not obtained Within 180
Print name: '..� _ �s — Date: .7/'' 5 da}s after it has been accepted as complete.
/ ' \umber of'inspections allcned pet permit
16uddtne Parma-III Pernnt5pp 1'1 11 _ 1 Is Re, l,17201, 44,4,1,1,11,,<(om I Il'it