Permit Elkip CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00267
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2011
Parcel: 2S102BD02201
Jurisdiction: Tigard
Site address: 9980 SW WALNUT ST 27
Project: Chalet Village Subdivision: NORTH TIGARDVILLE ADDITION Lot: 39
Project Description: Units 27 -32: (1) branch circuit per building for GFCI
Contractor: JARMER ELECTRIC INC Owner: CHALET VILLAGE LLC
5105 SW 45TH AVE #200 BY RANDALL REALTY CORP
PORTLAND, OR 97221 9500 SW BARBUR BLVD, STE 300
PORTLAND, OR 97219
PHONE: 503 - 246 -5381 PHONE:
FAX: 503 - 244 -8037
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 05/24/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/24/2011 $6.74
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 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 O 95 I •'090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
4 ,
Issued By: \ • - Permittee Signature: Q4 � /°/ 0 � ew X1)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. .
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 permit Applicatidi r() is u r i n e t I: 11
City of Tigard i L 1 V r: Received >>i>'�-
13125 SW Hall Blvd., Tigard, OR 972230 y (��
Permit No.: LCaDI /� �C� (� 7
• Phone: 503.639.4171 pax; 503.598.1%04 2 3 2 011 ,,: , Other Permit: -
1 ; ,_ i.. i Inspection Line 503.639.4175 Ave Ready/3y; Sea Page I for
Internet www,tignrd- ot.gov • CITY OF TIGARD Netificd/Methed: VIM r Supplemental information
• ' • 4f ROWING D VISION ;p i ; � ► wi.
• ❑ New construction 'IS-Addition/alteration/replacement Please ch all t hat apply (unbind a sits of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over throe atoricn,
❑ Demolition 0 Other:
whore the available thult currant ❑ Merinos and boatyards.
• G.t GORY to • Cd> g)C:'tiew • • =cods 10,000 amps at 150 volts or O Floating bm0dings.
dwelling ❑ CommcrciaVindustrial lass to ground, or exceeds 14,000 Q Commercial-use agricultural
❑ 1 -and 2- family dwelii
❑ Accessory building amps for all other iostallationa, buildings,
ulti- family ❑ Master builder ❑ Other: D Fire pump. ❑ installation of
• •': • '..30t 81'I'E . A' L TION . . El M y system. larger separately derived system.
_ ❑ Addition °ram motor load of ❑ "A ", "6", "1- 2, "1 -3^,
Job no.: 73 I Job site address: ��f L -
1001dP or more, occupancy.
❑ Six or mote residential unite. ❑ RCEMItionat vehicle parks,
City /State/ZIP: 1 1 7 '' ?� D Health -cue ihcilities. 0 Supply voltage Rte more than
, �.� O Hazardous locations. t61)0 volts nominal.
Suito/bldg. /apt no.: �( r Project namc: 1.� ( i x fir_ A.1,„ f C3 Service or feeder de0 Snips
ps or ore:
2 .` e t
Cross she t/dire ctions to job i ems ` ?t = e ' ^ lung 'B
rt It, ,
n4e _IIIITEIN •
i New residential single- or multi-flintily dwelling unit.
includes attached garage.
Subdivision: • Lot no,: 1,000 sq. R. or less 16834 _ 4
Tax map/parcel no.: Ea. add'1500 sq. R. or portion 33.92 1
Limited energy, residential 67.84 2
D)CBCRIP'1TQ1Y C �k10 (with above eq. it.)
,f ( ..� r. d Limited energy, multi - family 07.84 • 2
k t:.-C, i° "i. � l \-e- 1 .. ;.4' r t,- (° , . , residential (with above eq. a.)
4 d'` e°-y ` `¢• / '/ Service' or feeder; Installation, alteration, and/or relocation
- '.+A ;A:i•; W E.- ) . • .. 200 amps or less 100.70 2
' - 13'PROPERTY R • L . 13 TC'fANT. • • .. 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
•
Address: Over snips to 1,000 amps 301.04 2
Ov1r 1,000 snips or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax ( ) 200 amps or less 59.36 l .
Owner installations This installation is being made 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 amps to 599 amps 168.54 2
Owner signature �� Branch cltemt; � alteration, or extension, per panel
--� d ` . . A. Fcc for blanch rousts with
CI 'CdIVTA+C! P138,gp11i above service or feeder tbc. 7.42 2
Business name' each branch circuit
_
•
B. Fey for branch circuits _
Contact name: wtUrturr service OT fcodor fcc, ' 5618 �� 2
first branch Wrenn _
Address: Each add'l branch circuit 7.42 2
Miscdiasemna (service gr feeder not Included)
City/Statc/ZiP: Each maimiletumd or modular 67.84 2
Phone: ( ) I Fax:: ( ) dwelling, service and/or feeder
Reconnect only 67.84 2
E -mail: Pump or. irrigation circle 67.84 2
1; 41�1'Jl'la<A1'f OR Sign or outline lightin 67.84 2 •
Business name: .?AlZv - E-LEdTT4 & I NC., Signal cpaniel,( limited-
tion. or
Address: 'I D (:1 h. p Opp . extension. Describe: Page 2 2
City/State/Z II , 4 O Each additional Inspection over allowable in any of the above
6,6D3) * • 3g1 Fate: (r �� ``tt 11�
Per inspection 66.25
6 �, �'" t"c'"�� Investigation per hoar (1 hr mini) 66.25
CCB Lie.: , Electrical Lie.: , f S . Lie.: lmduarial Pin Witold 78.18
VV "� Suprv. Electrician Signature, required: i A a' y�,,,�,.„�,.y, CA>E. PEitI I' 1 6"$
_ subtotal; 6 /_,
Print name: fl)Ardl. 5/ tl te_ Date: c> ) l f Plan review (25% of permit fee):
Stec aarchargo ((2% ofpermit fcc): b `7 1 /
Authorized signature: TOTAL PB1MIT FEE: (, "6,' c• Z.,
Print name: Date 'eta Permit aPpikation expires ilia permit le met obtained within 180
-- days after it has been accepted as complete.
t lfidl �-
• Number of inspections allowed per permit
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