Permit _--ti
A .m CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
Permit #: ELC2009 -00330
Date Issued: 07/01/2009
.T.IG`ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S 136AA02201
Jurisdiction:
Site address: 11153 SW 65TH AVE
Subdivision: Lot: 0
Project: KESSLER
Project Description: 125 amp sub panel and 16 add. branch circuits
Owner: FEES
KESSLER, JULES Quantity Description Date Amount
8700 SW 26TH STE H
PORTLAND, OR 97219 1 ea Services or Feeders - 200 07/01/2009 $80.30
amps or less
PHONE: 16 crt Branch Circuits w /Purchase 07/01/2009 $106.40
Service or Feeder
1 ea 12% State Surcharge - 07/01/2009 $22.40
Contractor: Electrical
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 $209.10
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 9 2 -' • -0 10. You may ob copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
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' 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.
Forth West Electric, Inc. To:permit a .1:, • 09:12 07101109GMT-07 Pg 02-03
% - Err
W
,..ctrical rermit Applicatio , ED
FOR OFFII.T: USE ()NIA'
. . •
.., •
. ... Citv of Tigard Receised
\A ta 131+ )_,
III t „JUL 0 1 2009
Plan R., ,.., 4 Penult No CL 4 2.A. 9 - 0 0 3319
, - ---
. . 2.•,, 11 S ll 4.1 Hd OR 7,,..,
Phone 50 3.639 4 !71 F:i 503. 598.1960 f /a 0,1,, p. m
te 13 \
r . 1 GAR b Inspection Line 503 .639 :1175 CITY OF TIGARD .. „„ -
, !,, _ – — J„. 0, 0 See Page 2 for -----
• . /1tem& NvveNN.liganl-or gov
BUILDING DIVISION '''''''eftmc"'"d — __ I suppk,nent.1 Infornnitiors
•
, lyg; 0.F.•WORK • • ... .
. PtAnrikEviEw ” ' . •
0 New construction PV:\ dd it ionillerationireplaceino it , Please check all thai apply /submit 2 sets of plans w:iteta checked below)
I
i 0 Service or fia./der kth) amps oi more 0 lictIchng o‘ ea three stones
• 0 Demolition 0 other: • 1 ,,,here the MallabIC latill carrom 0 Marmot, and boat v.-ch.
. . ,
b eNceeds 10,00o amm ai 150 ‘olts oi 0 Flontini! building5.
. CATEGORY 'OF . CONSTRUOION
' .. . .. „ .. .. .. • .
_
L.Ns lc, promkt, ,,r c.c.cedN 1.1.000 0 Commercial /112r I cuitt.,I
--- rqT- -- tind 2 k (R el I i ng n Commercial/industrial 0 Acceoriv uilding-- amps lin all mile/ autallations turildmus
;
i 0 muiti-rathth [1 Master builder 0 Other: 0 Fire poinn 0 Installation of 75 KVA or
1 JOB :INFORMATION, AND •:LOCArION• .
..
. • 0 EineFgeitcy system
0 Addition of 1161k nloror load 01. latTet , eparnIc1) tienved system
___.____
I 00111 or mo 0 re ocuip/inc
i .10b 110.: / .101) /ate addres: 1 0 (,, ; I n CT \--'•
I -.) „2 11/1 0 Six or mere le-side/lad units Recreaonal whicle parks
I Lit,N /State /ill': '
T _4'1 TA, 0 ii, , 0 I/cairn laciline, 0 Suppis koitalte for more than
_ _i D Hazardous location,: 6no xolur. 1511111M71)
..
,
I
1 El Service or feeder 600 am 5 or in - /re
slliteihIdgianl. Ito ____ i _Project name:
Cross streetrIdireettons 0) Icli) /ate:
Descr
: ipliun
Dir,77- Fer.._ T
1-- otal_ 21_
-
---- --
— ---- — 1 Nevi' residential sinale- or multi-lmily dwelling unit.
j includes attached garage.
I ?MOO sq. ft. or less 145.15 [ 4
St/hi/Vision;
i
1 1/ a. add'I 500 sq. II. or portion [
r map'parcel no.
___ 1.irnite'd energy, residential
- I -
: 75.00 2
: WORK -. . . i. \, lib ,,, ,,, i• il.)
•
--- ' Limited energy. multi-family 1
„..) ...-
(71 1 ,-, •,,
L ‘ z , - (---, - - I , - ii—S Pck-rti Ctic•NLA. 1 4 aaft ..k) C1" i rcsideltlial twilit sq . 11 ) ...] l_ .
0 •25.,•U(1
C _
Services or feeders installation, alteration, and/or relocation
k2.,k ( , -..k.- tS
200 amps or less r __.
•
I 0 PitOl'Ellil*.- • ' .1 . : ' - ' , . 0 TENANT .. .
.
• 201 amps to 400 amps 106415 r •->
Nome, _
_ .
4014..unps to 600 amps 160 60
i 2
-•
Address: 601 timps to IMO allipS 240 60
. i ...,
t )Nrer 1.000 aMps or cell:, 1 - / 454 65 - y
Ci t■iStia e .
'temporary serves or feeders installation, alteration, and/or
//11'.
_,F _ _. .
Pi I [Fax:( ) 2a0 amps or e 7, - — I - 66.85 f 1
...
Owner installation: this itstallation is being made on property that I Olin 10111.111 IS 1101 201 amp; to 4011 aMpti
„ _ ____ i 001.30 )
amp!: tO 599 ampS 1 y
intended tbr sale. lease. rem. or exchatigc, according to ORS 447. 44», 671) 401
, and 701. _ r _
Branch circuits - new, alterat or ex tens eta 31111el_
Owner signature- Date:
A Fee li. branch cal T (6
irits ivrth
—
)r
0 APPLICANT 0 CONTACT PERSOICI abo\C service or keder C.
1‘ 1). I '
- 4
— each branch circuit
4
•
Busith,s, nam,: *, 1-3 Fee for branch circuits _
o nittatr set vice or reeder fee_
tfontaet name,
first branch circuit 4(13/15
_,.
1 latch addi branch circuit 6 65 -
r Address:
u ;
1----
ifiseeitan (serNrice or feede not in
.\k 7
..
Cits
I - 4.4
_ I 1 manufactur 01 nit;dulat —I T
---- - - ---- I ,bsellino servicc andlot f 1 eeder : 90 90 i
s
,
Reconnect only • o� 8 )
I .
-----
_
. .
. . .
[-Mail i$VOF Ci cifiChti\j'e , k ) Chr ( - Wiry gunap or irrigation circle 53.40 I -
. .
•1 • • .
Sien ta outline lighting i 53.40 _
______________
lnal circtiii(s) or limited 1 I
Business nallle• .p ....i... N - 0 ii.-1 v._)-{ ., 1
licrg5 panel, :flu...ration. or /
- .
eNiension Desenbe 1 Page 7 2
Address: IDO 6 r,,,k,r 2 ,
,
. _ kiA , i D
___...
L --1-
rCit■ /State.
Etitil additiOnni inspection twer allowable in ;toy of the above
, ..., .
... . , Pei inspection T.— 62 50 r 7
»ho ,0
ne: L C11 2
1"t t I c r i l•ax. k9),,.) ) ) 2, .. (, y• _
Investigation per hour i I iii mini ii)
I-- -i
I - 6
____ ____________.
Industrial plant E per hour I I 73.7i i
( (I - I( .. II I . t (-9 4 1 . : 1.:$.. 1. _ I , .1 'I I' I 'I II} II IIL , . (12 .. - -I- r - . • ---- r - . LECTRCAL.PERMIT,FEES•'', •
, ......____„_______________________ •
oi I I ab
- -
etrician signat/PACItiired• I
L StibtOlal. 1 ifSlp , - 7 0 .... ]
, :ijc,.i ---_% ___
Print intinL. 3 b,l/ \- tA ,Ai, i ' Ll e 6. - _ ' .-.. Dim' - 1-'09 Plan rev im. 12:0,0 ol prima Ice): 1 1 1 . .._
State storehatge t12`14, 01 permit tea ._. c ,Z...). Li 0
,, ,„,
.
Aulhorized signature: / ' _ C: /-11-2-/-).111 loAl.PFR
Pr nt name
. -- - --
, ...,,F . 7 t ---) l'his aPplic i:1 if 31 permit 16 not obtain ed within mit
i: ,f) ,--r CI f 4A--' 40 1' th,y, a fter it ass been accepted as compietc.
- Ntimbel id' in.;peo ion.: allow )II permit
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