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Permit CITY OF TIGARD ELECTRICAL PERMIT :' �.- .° . COMMUNITY DEVELOPMENT Permit #: ELC2011 -00270 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2011 Parcel: 2S 102BD02201 Jurisdiction: Tigard Site address: 9986 SW WALNUT ST 3 Project: Chalet Village Subdivision: NORTH TIGARDVILLE ADDITION Lot: 39 Project Description: Units 3 -10: (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 wolPurchase 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 R 95'1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: � ` i Permittee Signature: Del /'P/ / C'77DA/ / 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 603.639.4175 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 A, nlicatio F . l it— _ ,j I c]l: rfrrTr h t�sr; ct���la City of Tigard " - p a g h Reee;oed 13125 SW Hall Blvd., Ti baI10B t `� "2Y (/ �� PctmtNo,- Z / , ZD/ _, i,"17, Tigard, OR 9722 RA 2 3 2011 ' Phone: 503.639.4171 Pam 503.598.1960 w/41 OtherPemat: 1 ; , , s ,• 1 , Inspection Lino: 503.639.417S Duo ReadyBy; raj �/ to See Page 2 for Internet: www.tigctd or.gov CITY OF TIGARD Notiiied/Melhod: f7 Sopplemrntalinformation typE oF w onicli IN.)•DiVISION it x:l w ❑ New construction ', Addition /ttltcratioTi/repiacement r lmm cheek a0 il,at apply (submit a sets of plane w/ltems checked below); ❑ Demolition ©Other ❑ Service or feeder 490 amps or more ❑ Building over Puce stories, where tits available i tult currant 0 Marione and boatyards. • ' .. iwA'1tCORY OP . CO til't"'!T ON • exceeds ]0,000 amps at iSO volts or 0 Floating buildings. • El 1 -and 2 dwelling ❑ Commercial/industrial him to ground. or exceeds 14.000 0 Commercial-use agricultural ❑ Accessory building amps for all other installations. buildings. I'Multi- family ❑ Master builder ❑ Other, O Fite pump. 0 Installation of 75 KVA or <._• ...NM Si E E .JRPOR>i `mi LOC4101,4 CI Emergency nc tam. larger separately derived system. �, ❑ Addition of new motor toad of 0"A", "Er. "1-2","1-3". Job no.: ) 7 / i Job site address: ) t f- i i , f I9OHpormore, occupancy. 0 Six or mans residential units. 0 Recreational vehicle corks, City /Statc/ZIP: I 1 c _. C ` j W 0 Health-care facilities. ❑ Supply voltage Ow more, '� " Q Hazardous locations. NO volts nominal. Suite/bldg. /apt no.: Project name: � i� Service or thole 600 Amp; or more. Cross street/directions to job site , °p �" • i s ,aa�t 7 ,i' , , D . 1 ate. I J ToMI New residential single- or meltf- family dwelling unit. _ includes attached garage. Subdivision: I Lot no.- 1,000 sq. R or less 168.54 4 Tax map/parcel no. Ea. ndd'l 500 s . R or portion_ 33.92 1 --- Limited energy, rmsidartt� 67.84 2 DBSCR1Yli ON CJir llQRtlfi (with above sq. R.) } - Limited energy, multi-family i E 1 c I i ` s° �a .. residential (with above sq. n.) I I 67 2 r g - ; r , ` 7 y Services or feeders Installation, alteration, and/or nelocatiob t f i 36. ,{ t C,C. Pi - ) F 1 ; f'/ 4 7. t P �' t ` ... 200 amps or less 100.70 2 r :D - rte'. R •„ . .I . . C TENANT' 201 amps to 400 amps ) 33.56 2 Name: 401 amps to 600 amps 20034 2 Addtbss: 601 amps to 1,000 amps 301.04 2 • Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less I 39.36 II 1 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 saie, lease, rent, or exchange, according to ORS 447.449.670, and 701. 401 amps to 599 amps 168.54 2 Owner s { e• Date Branch eheaifs new, alteration, or extension, per panel A, Pee for branch circuits with ' • 0 APPLICANT' •0 'CONTACT PERSON above service or feeder fire. Business names each branch circuit 7.42 2 B. Fey for branch citeults �� Contact name: without service or feeder fcc. I 96.18 .5.--6, 2 first branch circuit — Address: • Each addi branch circuit 7.42 _ 2 City/Stttec/ZiP: Miscelleecons (serelce or feeder ■ notinelud Each manufacture or modular 67.84 2 • dwelling, service and/or feeder Phone: ( ) Fax:: ( ) Reconnect only - 67.84 - 2 &mail: _ Pump or irrigation circle 67.84 2 ' COI1BACtOlt - Sign ar outline lighting 67.84 2 • Business name: .. •(L �LaTg./ C i NC-. Signal cheuit(s) to limited - magy panel, alteration, or Address: 5 05 a%) yam" , kP extension. Describe: Page 2 - 2 City/State/ZiP: '>Oe? 1 NIp O / _ as Each additional Inspection over allowable in ■ of above Phone:603) _ • . 53Si Fox: (503 - --DSO urv 66.25 gallon per hour (1 hr rain) 66.25 VCCB Lie.: a 110=1M1= S . Lic. :4 0y industrial plant perhour - 78.18 U " ^� : ,_ ,' EC ICAL PE1t1,U7` irgro Suprv. Electrician signature, required: ■ -- _ Subtotal; 57, Print name; � r - VAt2 - r .Tt'lt1tL- / 1 Date_ otedI ) l 1/ Plan review (25% of pe mdt fie): Siete surcharge (12% of permit fee) � `7 1 1 Authorized signature: TOTAL PERMIT FEE: _ Z. _ of Z Print name: I Date: - This permit applrcnnt expire Ua p ermit to net dais after obtained within 180 rt e b hiate accepte as template. tennitatrig icknOtC.Permithpp.dec mom aeo.eatsiltl/DJ/COM M Nnmtrcrofinepc6ciaflAallOwaetperpermiL