Permit ,` • � .. � -.� C I l i OF � .:'; �( ® ELECTRICAL PERMIT
IN
PERMIT #: ELC2008 00190
COMMUNITY DEVELOPMENT DATE ISSUED: 4/212008
TIG n u o 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DA-00200
SITE ADDRESS: 09070 SW 66TH AVE ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: WHALEN •
Project Description: Installing service and (5) branch circuits for garage, greenhouse and shed.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNALJPANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 5 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JOHN & VALERIE WHALEN WEST SIDE ELECTRIC CO INC
9070 SW 66TH AVE 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 736 -0677
PRI 503 - 231 -1548
FEES
Description Date Amount Reg #: ELE 26 - 135c
[ELPRMT] ELC Permit 4/2/2008 $113.55 LIC 13306
[TAX] 12% State Surchar 4/2/2008 $13.63 SUP 4654S
Total $127.18 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: /� _ ' /_J �f —.ii • - rmittee Signature: �� 7 �,a L./
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 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.
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5032319987 22.04:18 04 -01 -20081 2 /4
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City of Tigard Received n
M 't 13125 SW Hall Blvd., Tigard, � L •. ? P atelBy L( o C CJ PermitNo.: � _ ��---• /G
< Phone: 503.639.4171 Fax: 5055.1960 A Plan Rcvicw
i Inspection Line. 503.639.4175 �`'\" " ate/ Jeri:, 'crm t;
:'fiIGARD p �` ^� `� t Re aterh
" ' s Internet: www.tigard or.gov �� Y !Writ: p See mane j for
C� ounet!/prcthod;
1 �+ �1,�`° Supplemental Information
TYPE OF WO'.
�` PLAN REVIEW
❑ New construction VAddition/alterat • .: cement Please check all that apply PP Y (submit 2 sets of plans w /hems checked below):
❑Demolition Other: ID ' El Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current
CONSTRUCTION Marinas and boatyards.
CATEGORY OF
exceeds 10,040 amps at 150 volts or ❑ Floating buildings.
1g
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building less to ground, or exceeds l a,uoo ❑ Commercial•use agricultural
0 Fire pump.
Multi-family ❑Master builder ❑Other: amps for all other installations. buildings
❑ Installation of 75 KVA or
❑ Emergency system, larger separately derived system.
JOB SITE INFORMATION AND LOCATION
❑ Addition of new motor load of
• ❑ °A' g^ 12" "1.3"
Job no.:.cy ( gbS r} Job site address: 1070 $ J iy / `t 4 y i00o somore. occupancy.
� ( � G ' ❑Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ( � C 0 facilities.
^Q l-✓• (' i / Z - L ❑Supply voltage for more than
no.: • Suite /bldg. /a C. L ❑ Hazardous locations. 600 volts nominal.
p Project name: l j _ ) ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: FEE. SCHEDULE '':
Description 1 Qty. 1 Fee. 1 Total 1 • '
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: • Ea. add'! 500 sq. ft. or portion 33.40 1
DESCRIPTION OF WORK Limited energy, residential
(with above sq. 0.) 75.00
(� 1 r 1 Limited energy, multi - family 75,00 2
y. A- L tf ( Lt t .t - f J G ,, q residential (with above sq. 0.)
tS ,,e,..." L.4, ��� Services o,• feeders installation, alteration, and /or relocation
. . X 200 amps or less I 80.30 2
. PROPERTY OWNER :;'0' TENANT 201 amps to 400 amps { 106.85 .. 2
,.s
Name: • .� 401 amps to 600 amps 160.60 2
— t
Address: C 601 amps to 1,000 amps 240.60 2
I Gt v\./\ Q . Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporar services or feeders installation, alteration, and /or
relocation
Phone: (F y 21...1,--)5 4 S I Fax: (. ) 200 amps or less I 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75
Owner signature: Branch circuits - new, alteration, or extension, per panel
Date: A. Fee for branch circuits 1111h
. : ' :, E APPLICANT ,0 CONTACT PERSON • above service or feeder fee,
Business name: WEST SIDE ELECTRIC CO.
each branch circuit 6.65 / 2
B. Fee for branch circuits
Contact name: GLENN GROSSMAN without service or feeder fee,
first branch circuit 46.85 2
Address: 1834 SE 8 AVE. • Each add'l branch circuit 6.65 i 2
City/State /ZIP: PORTLAND, OR 97214 Miscellaneous (service or feeder not included)
Each manufactured or nodular
Phone: (503) 231 - 1548 Fax: : (503) 736 - 0677 _dwelling, service and /or feeder 90.90 12..
Reconnect only 66.85 2
E -mail: GLENNG @WESTSIDEELECTRIC.COM I Pump or irrigation circle 53.40 2
ti . . CONTRACTOR ..
I: , :. `*,,!!!• '. ' Sign or outline lighting 53.40 2
Business name: WEST SIDE ELECTRIC CO. Signal circuit(s) or limited
energy panel, alteration, or
Address: 1834 SE 8" AVE. extension. Describe: Page 2 2
City /State /ZIP: PORTLAND, OR 97214 Each additional inspection over allowable in any of the above
Phone: 503 231 - 1548 Per inspection 62.50
( ) Fax: (503)736 - 0677
Investigation per hour 0 hr min) 62.50
CCB Lic.: 13306 I Electrical Lic.: 26 -135c Suprv. Lic.: 46545 Industrial plant per hour 73.75
Suprv. Electrician signature, required: fJ ELECTRICAL 'PERMIT FEES • •' • • ;
i� `. 0 / L-A-- Subtotal: i 1 5 .4s•
Print name: RANDALL ROBERTS Date: l t� Plan review (25%, of permit fee):
` Z L' State surcharge (12% of permit fee): V
l:
Authorized signature: - P ) j Z 7 L'
TOTAL PERMIT FEE:, 4 , j g
Print flame: I This permit application expires if a permit is not obtained wifhit(I80
Date: days after It has been accopted as complete.
tanuitdingli 'ccmi PemnitApp.doc 05/23/en 7 • - Number of inspections allowed per permit.
4 I /05 /CO.WwEn