Permit ��r 1
CITY OF TIGARD ELECTRICAL PERMIT
. `- COMMUNITY DEVELOPMENT Permit #: ELC2010 -00013
•
T q 0 jy RD 13125 SW Hall Blvd., Tigard OR, 97223 503.639.4171 Date Issued: 01/12/2010
Parcel: 2S 1.15AA00100
Jurisdiction: Tigard
Site address: 16100 SW 108TH AVE 173
Subdivision: DURHAM' PARK APARTMENTS Lot: 36
Project: Brightwaters at Red Hawk
Project Description: Installation of (28) branch circuits for fire alarm panels.
Owner: FEES.
DHP TERRACE LLC & Quantity Description • Date. Amount
DHP ANNEX LLC, BY AKAWIE & LAPIETRA PC,
13 HERON DR 28 crt Branch Circuits 01/12/2010 $256.52
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 01/12/2010 $30.78
Electrical
Contractor:
JARMER ELECTRIC INC
5105 SW 45TH AVE #200
PORTLAND, OR 97221
PHONE: 503- 246 -5381
FAX: 503- 244 -8037
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $287.30
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1
Issued 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' — - • 4 ,# ' 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.
Electrical Fermat Application t i • i- 1 kl a,, 1 t
t l l . 3 1 I I(1 I UiVl.l
City of Tigard JAN Reeav /2, .
1 2 2 1 oaldti �� Pcnnn No.: (,6 Gam �' A X 13
' l
13125 SW lull Blvd., Tigard OR 97223 Plan Review
, • r ;; Phone: 503.639.4171 Pax; Soss98.>96o, OF TIGAR i ' Other Permit:
• , i it Inspection Line; 503.639.4175 a ° Ready/13y; W Scc P 2for
BUI DIVISI / A. dad/Method: ene
.. Interact: WWW.ilgatd -01:gov 1 Supplemental Information
TXP)p Ok. WORK • •• • F' m: Rom* .
❑ New construction gAdditiotl /ttltotation/rcplacement Please check p 1I that apply (submit 3 sets of plans w /items checked below);
❑ Service or feeder 400 maps or morn ❑ Building over three stories,
❑ Demolition Other: where the availablo ihult currant ❑ Marinas and boatyards.
. ". ' ' eA'I`tenoRX O1R cm tt7Cl'ION ' meads 10,000 amps at 150 volts or ❑ Floating buildings. -
• lass to ground. or exceeds 14,000 Q Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for nil other installations. buildings,
Multi - family ❑ Master builder • ❑ Other: 0 Firs pump. ❑ Installation of 75 KVAor
13 E.iner system. let separately derived system.
'' ' ' arm ORMATIIJI'iit , A NIii mIcier erg ene y larger
CI Addition of new motor load of ❑"A", "E ", "1-2", "I -3 ",
Job no.: /Q, Q Job site address: 16,190 j /0 g 100k1Pormom. occupancy.
1:1
Six armor a residential units. ❑ Recreational vehicle packs,
City /Statc/ZIP: • j Curj Ore c / -7- q O Hcetth -care Facilities. ❑ Supply voltage for more ihrm
r � 0 Havinious locations. 6n0 volts nominal,
Suite/bldg./apt no,: Project namc: am y j'a h4. Li) s ./111111›- 0 Service or feeder 600 !nips or more.
]lam 1)E.
Cross street/directions to job site: Deserratiou i QtL::.l Pew 1 rood f •
New,rc identinl single- or multi - family dwelling unit.
— includes attached garage.
Subdivision: I Lot no,: 1,000 sq.;ft. or less 168:54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel'no.: Limited energy, residential
• Ii Esau't1alsf'o ''* m - _ (with above sq. ft.) 67.84 2
1 ` \ �Limhod`cnergy, multi - family 67,84 2
! / ✓ /4 -1-4- rive .) i11 "e residential (with above sq. n.)
i Services or feeders lnstatlation alteration, and/or relocation
200 amps or less 100.70 2
' '.0 •PR RTY'.04ENER • . . ❑ TENANT 20l amps to 400 amps 133.56 2
. Name: • • 401 amps. to 600 amps 1 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 F
City/State/ZIP: Teoipnrary services or feeders Installation, alteration, and/or
relocation _
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation; This installation is befngiTlade 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 amp9ao:599 amps 168.54 2
Branch circuits- new, alterntion, or extension, per panel
Owner signature: Date: A, Fee for branch circuits with
• • • 0 APPLICANT . ' f ' •0 CONTACT' PERSON above service or feeder fee,
Busines name:
cacti brmticltcircuit 7.42 2
S. Fee for branch circuits
—
Contact name:
without service or feeder fcc. ' 56.18 ,5 �p , / g 2
first branch circuit
Address: Each add'Tbranch circuit Ia } 1 7.42 ' .j 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phonc: ( ) l Fax: . (' )
Reconnect ;only 2
67.84
E -mail: Pump or irrigation circle 67.84 - 2
• • • • CONTRACTOR _ Sign or outline lighting 67.84 2
Business name: �'4f sv � EJ C t I N� e circuit(s) al er[United- Or
energy panel, alteration or
Address: 5I Q5 L4-I41 I ODD • extension, Describe: Page 2 2
City/State/ZIP: ' - O1t`?LA 4ID t� ti Each additional inspecdon over allowable in auyr of the abo
D3) ( 91.1(9 • 5.31 Fax: (503) 7 , I t' Per inspection 66.25
Phone:
,±5D3) investigati per hour (l hr min) 66.25
CCB Lic.: co g. Elcctricdl Lic.; ; , • 414 Stl Lic,: 0 lam industrial plant per bow 78.18
• • •. ELECTRICAL PERMIT FEES '
Suprv. Electrician signature, required: e , c..._- < e.....---„..,---, - Subtotal; ,;Z �� S,Z
Print name: • IVA2'r 5 1)'1 +1? . Date :. — i 2, _/ d Pla review (25% of permit fee):
Authorized signature' / % •. r = / State surcharge (1296 of permit fee): 3o, 7
• .,i iw ,�i„ d i �% _ TOTAL PERMIT FEE: 2 l e 7, 3
Print name: t' p � - 1 N G / Datc This Permit apitlieation expires Ira permit in not obtained within 180
J ' / '1 Z �y days after it has been accepted as complete. -
Number of inspections allowed per permit
t;lThdlahlree ,ita\ELC :PcnnitApp.dnc 10/01/09 44n.4615T(11 /n5/COM/WES