Permit CITY OF TIGARD ELECTRICAL PERMIT
r • . COMMUNITY DEVELOPMENT Permit #: ELC2010 -00363
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 501639.4171 Date Issued: 07/16/2010
Parcel: 2S109AA00800
Jurisdiction: Tigard
Site address: 14335 SW 125TH AVE
Subdivision: Lot: 0
Project: Oelke
Project Description: Temporary service
Owner: FEES
OELKE, CHRISTIAN & APRIL Quantity Description Date Amount
14335 SW 125TH AVE
TIGARD, OR 97224 1 ea Temp Services or Feeders - 07/16/2010 $59.36
200 amps or less
PHONE: 1 ea 12% State Surcharge - 07/16/2010 $7.12
Electrical
Contractor:
LIGHTHOUSE ELECTRIC LLC
25599 SW 95TH AVE, STE. E
WILSONVILLE, OR 97070
PHONE: 503 - 582 -9600
FAX: 503 - 582 -8484
Type of Use: SF
Class of Work: NEW Type of Const:
Occupancy Grp:
Total $66.48
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 1.800.332.2344.
1.800.332.2344. ,k1
Issued By: - �"�'_ Permittee Signature: G gr/9 -2---,) L1 6-4 �
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
07/15/2010 12:2 50.S5981960 CITY OF TIGARD
PAGE 03q4
- —
RECEIVED . .
1,01; ()11.( .1.i 1 :„.1... "NI 1
1 . (cal Permit A • 'Potion
im„ 1 5 2 (/; i tO geccived -7 - ,
. •• City of Tirprd De : / , .0 f ; 1 11 Al
Other Pere ST I 0 - 1 i ikir
N.,.. , 3125 SW Soil Blvd., Tigard, Oft 9726
l i.TY OF TIGARD ,,,, , in to. no 2 foe
• • ; Plum: 503,6:450A 17 i FEOC. 503,59$. Supplemetsrpi leferniatiell
, - IrrSPeCtiOn VAC 503-*39 .4175 e crUNT ad:
il
intern& wwvellgod-or.gov • - .. .I:. ; ^hr,i; 4 el!,79.t 6 ..... ,
BUILDING DIVISION DeadwiyiBetyi
' " ' '' ' . - • "Illfot er Waft '..*: • • • ' • , , , ' , . .,., . .. • p iave , &to. •kot„Fii4edthia,t'isop4'01:•)iyantps(ot.iibtorTimortilaeis ,:Ffctilnistediringitr,vottrus thccockecismectibtlaw.);
• "4 New construction 0 Addition/alteration/replacement
t 1 the svaitehic emit diluent 0 Nistritex and boatyards,
• DetnOlition
• • - • ... . • kilt are:014:0*.OPDXIOr .. ' .- ...' . .1 • ..
. . . excc eag :0,000 omps nt 1S0 volts or 0 Floi tii.adiscinR510- atoll,
Tom to ground. or coo& 1400 1:1 Co
' •
, 1 - and 2-family dwelling 1:1 Comtnercial/industrial 0 Aocessory building rz o in l e
mp f al ther trentitinari. beildiTIP.,
0 a of 75 KVA
or
Millti-filinity i21 MEOW 'builder 12 Other: El FAtersatley mum. k , derived systcm.
. . . . .
. .
. . . . .,
'-: . C• .• • • • ••'; : :,i00101#111#11iider TPOONDI i ' • ' - •• . . •• • • • C3,6104t1Hpidonoromfnattew. motor lend
0 Itcorentionel vehicle parks,
A ,
no.: Job site addtess: • ."--- rj Supply vatiapo for mem than
-ir A
lob ma A, CovSimesoltolm.coorcitraft:iidlitimenilinl mita.
KO volt: nominal,
City/State/ZW: -----'' ey di . 7 d omwdo I pion6
0 Sorvine or Netter KO • 4 or mom, .
. . . . •
Suite/bldg./apt, iv.. ..:t .. .
• .. ' ." . ' • `,111Pri"..1111=1101 '
MEM Ilan
Cross streeticlirections to job silo: — New residential !Ogle of talllti-lamilY dwelling nail:
Inclatoe tacited garage.
',--.----..--------.--- 1,000 sq. ft or les IM LI
O 168 mon
Subdivision: 0a, re141,500 ge. R, or portion Ili 33.97.
Lot no.:
Tax rnap/parecl no.: . . Lirlited allora• YSIdentilll III 75.00
m
INII
• .. . • . • ,. with above - ft.
..••• . .. . ., • .. . , - - • ' :.'iljattlfrlititlgit;tiletVoitit: :.''' " : ' •• ' . - ' '''' ' ' v- ' Limited energy, multi.ihrnily 111 75.06
P r ' ' eders Io
• rentla with Above .. ft,
Services or fe' 4tallatinn niters 0 n. stutter rdocation
200 0 41 elleas 100.70 1.11.111
• . .' ' 201 arnps to 400 vrAir 11150111111111111111EI
. : ,.., otta,, rsittrowsnot. ..........•", .. ..."., ...•..„0:txxorr.: ,... ... 401 amps to 60 rims 200,34 11111111111
2
M • G amps to 1,001) orn.. 91.04 11111E13
111111
Name:
ders
Address: Al TempoeitrY --t• ' nir Ite installation, alteration. /1111101r
City/StatC/ZrP: 1 .0 e
200 01111:1S Or less rimmIMEnria
Fax: ( ) 201 amps to 40o am g
Owner installation: This Installation is being ramie on property that 1. own which is not 401 to 599 , . OM." 2
intended foe sole leaxe, rent, ar exchange, according to ORS 447, 449, 670. and 701. Brunch eircuitn- new, altered , 1 , or cateren , er , . el
A Fee for branch circuits sedlh
777--- ----a— . bove servi or feeder fee,
• .. '. • " ''''• 0 .AStitiort - ' • .''.. , , - , , • -cualtittlimttarir ... - .. ' 4 • c' 7,42 2
each bran. circuit
Busittcsa name: Es. Fee for branch circui t; r Arno
service or 'eder tea, lirSt 16 IR 11111 2
Contact mane: 7 ,42 ch circuit
Address: 11=11:=1222.11111' . 7 . ,42 2.
Mhee nIUICOUS service or feeder not included
-------- .. ------
City/State/ZIP: Eseh manufactured or modular ' 67,84 2
dwell .2 gef e fICC nridiar fondr
e
Phone: ( ) Fax : ( ) Recenrect 71y 67.84 ;
E-mail: rump or Origation circle 67.84 =
, Sign or outline itiriti al Mill 47.114 .
. '''',.'.., : '''.'. ':,.... • . : ' ' :'.' ' ' CORIOACTO '‘ :. , ' . . - ' ' ' ' ..' • ' '.''', ' Signal circult(s) Or limited-energy Oril
,
art / / i el alteration OT Intc091011.
Business name: .
ei - i r d y 9'. z roxiirMAIII*Mra' L - • " '. (Orl Pith ndditional Ins .ectIon over allorrY , hie ilt n , of the above
Addresa: - Ai NW .,
de as -,,
• ..e.-kri Alf Adeline:sod inspection (I IT min) 111.1=1111.111
City/State/VP: -
I - a- 20, ii=1:11=11 66 . 25 thr
----.--. Industrial plont (1 Im min)
Phone; -we' ,7,. to 0 1=63=111111.
4°
Electrical Lic.: 2 2, - F ; C ) 51?-2- SIV-V. Lc. t 7 1157.17C:111-111 nroir'
CCB 1...:cd -i lir
I f
r
„lectricion r attir
si), e, equired: A itlIMMITMITIMI
• SuhtetO I: 0
Suprv. F , 56
' Date:
31aITM' - / , / ' ._(5-,...rD Pion review 25% of .ffnin f� Print ;
AtItIV1r170 ftioin , tine; — state. mrahnrse (12% of permit f 1 2-
ee): .. v
TOTAL. PERMIT FEE: Fir .
Print orate: ,* • •
Thin permit application expires if o pennirininTainiacti within larl
Mite: dims niter It Ms been accepted ne oarsmen%
1:1111111dIneermto 4.1,.0.PernItApp,Ove 07/111(10 . 0 Nam bcr meinvreatiarep allrnmegl pr. permit,
440,1615T(11R1.5/17.010/WV1