Permit CITY OF TIGARD ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELC2009 -00339
T [ GAR]J 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/13/2009
Parcel: 2S 111 AD07200
Jurisdiction: Tigard
Site address: 8835 SW SCHECKLA DR
Subdivision: Lot: 0
Project: Aldridge
Project Description: Install /alter (2) branch circuits for a/c add on.
Owner: FEES
ALDRIDGE, CARINA Quantity Description Date Amount
8835 SW SCHECKLA DR
TIGARD, OR 97224 2 crt Branch Circuits 07/13/2009 $53.50
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 07/13/2009 $6.42
Electrical
Contractor:
PACIFIC NORTHWEST ELECTRIC INC
PO BOX 310
OREGON CITY, OR 97045
PHONE: 503 - 657 -1188
FAX: 503- 722 -9058
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59.92
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 wit 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 0 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 01►riS \Q W./L ,)\ Permittee Signature: -PP
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 an inspection that business day.
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.
FrrrPacrficNorth West Electric, Inc. (15035981960) 17:57 07 /08 /09GMT -07 Pg 02 -03
Electrical Permit Application _ FOR ()I-r-i(.:E. USE ONLY
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I ' — S upplementallnforma t ion
TYPE OF.W O `IGARD _ _ PLAN REVIEW E
Ne\\ construction - :1ililitl011i311 IIDt,` 1� - _._. __� Pleam: check all dial apply (submit 2 su.ufpltms;ritruu checked below) --I
0 Service Or Iceder amps of nu m,: .
I )enu,illiult 4 [Iliu
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ill ❑ Other: j ,w here the available iaull current ❑ Marinas and b„alcaids
C;ATEGORY'OF f ONSFRUCTJON • : �t: 10,00i , c H s6 �uh> or ❑ r Ic �I,ne buildings , _: to g an ,r c, ,, ■ t. 1110 ID C , 1 ,rcrnal ucc .IenculUU &I
I- and 2- itimily (I\\elIing ❑ rim incrclal%industlial ❑ . \ccess(tr\ huilding -_.__ up. all other' ,n.IIH,,nuu< buildings
1 ❑ Multi -fdrni l) [ Master builder ❑ Other: ❑ lire pulp ® h,.aallanon 01' !iVA o1
j - ❑ i me ell) l rparatr.l de iced SvSt C•m
JOl3 SITE INFORMATION.: AND 'LOCATION
rION
❑ Atldin. ul un, 1110101 load ai ID - q ,- • -1-2' 1
■ 11)0 no i( - Job Site address: � �Vti .( k -C [� ( +-1 ,
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_ i ____ - __.__�.... 0 I •lararduln In(anurrs i3O0 , utts nirnuu•il
Su ite hIdg ,pl, no.: I Project name: 0 Service or seeder 60C a Inps or Marc
(. rts„trcet;dinciio s a µ1h site:
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FEESCHEAULE
�ic�uon i I p_
4_ f rc Total 1
- ----- 1 New residential single- or inulti-family multi—family dwelling unit.
Includes attached garage.
Solidiv iSion 1 tit no. 1 1.000 sy iI cx )us I 14 15 •a
- - . _ - - -- I i idd'1 50 o sl ti. or portion > .lo __ ..._
fax mapparcel nu.: {
- —_ Limited energy, residential 7, 00 2
DESCRIPTION OF •'WORT:: l„'cd, :,hose . li 1
�- C. I ene gx multi 1 o ast\
= � \ I C cti ,,, ._ �{. '' GE - t Iesidential t+cilb abt e y it } 7;_011 i 2
Services or feeders installation, altera ion and /ur relocation
.. 00 amps or less 80 30 f ' ?
0
PROPERTY OWNS - R . ' I { 2
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- 'TENANT IiNT I U I amps to i0(.) amp, 106.83
�` t11C: C` 113 amps to lief) u n , I h0 bU
lam_
{ — f UI amps to I Ot }U amps 240,60
Address:
Oyer 1.000 amps or e'ulls 15-1.65 - >
Stat%II
Temporary services Or feeders installation, alteration, and /or
t it\ : e . !
_...... .._. , -.. _ relocation
- _
}'hone 41} J) ej (° f: F ( ) 200 amps or less i 6a 8t. I t
� _. :� i .lt amps to !O(l amps --
2111 (.. I r
Owner installation: I his installation is being made im property that 1 (rwn schlep 1, 11(11 1 � t -
intended lur sale, k t- rent, or exchange. a 'e:C)I' In 0 ) ) :j <' ( CO. 1 amps to i�)9 amps _ -- - 1 37 1; { 2
k i ( tg to (1(S 1 , - 149, C ) and 7111. i -
amps s -_-
Braneh circuits - new, alteration, or extenson, per
t )\cner signalur'tr Date. ... -- ranch ti i
. panel 1
brat. I i
A lcciir r0huriul suns
Q APPLICANT 1 0 CONTACT PERSON above service or feeder fee,
— - - -_ - - ash branch circuit 6 6; 1 1
7. Business name: i) ( k
CA c 1 .\ L. , D t lviv 3 -t -' 1 ; , Q C'` jj
Y M C- It Fee for branch circuits
J ) branch x va ur hcdct'tec. fp
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untae( lk urtC � .L•, tus circuit
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Address: 1 ) I ` cc) l I h add I branch circuit 1 1 ti 6 6
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( its:5laic• /12 C)Y ( s }: c-,, t l f ash man urinnd nut intlude(t1 r , -
{ S2 v. -._ � ..,_.. - . -- _ deer lit service ar U 40 f
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Phone: t ) Pay ( t } ) q D 1� � ` Reconnect only 66.8 T y '
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EO,N • Sign or outline lighting z,.10 et
Address. !y - - .@ .. - . _. . .- .
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neSS Hain,
t SS f limited
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panel.
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leach ad ditional inspection over allowable in an\ of the who re
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Per r inspection 2 5t) {
Phone: 1 1 -as ( l
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ELECTRICAL
S 111 .PERMIT TEES
Suprs 1 Ieculc signature, required: / ' 2
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(� J V I days after it has been accepted as complete.
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