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Permit CITY OF TIGARD ELECTRICAL PERMIT j COMMUNITY DEVELOPMENT Permit #: ELC2011 -00421 ?1GrAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/28/2011 Parcel: 2S102DB01600 Jurisdiction: Tigard Site address: 9340 SW HILL ST Project: Stewart Subdivision: BURNHAM PARK Lot: 10 & PT Project Description: (1) service grounding Contractor: WEST SIDE ELECTRIC CO INC Owner: STEWART, RANDY 1834 SE 8TH AVE 9340 SW HILL ST PORTLAND, OR 97214 TIGARD, OR 97223 PHONE: 503 - 231 -1548 PHONE: FAX: 503 - 736 -0677 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 07/28/2011 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 07/28/2011 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 95 -001-04•0. 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: 4 /4 r / . — Permittee Signature: DN /5 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. Jul 26 2011 4:49PM West Side Electric 503 -736 -0656 • p.2 BEC . • Electrical Permit Application �UL %6 2011 rtll� t.►t 1=t1 ,: I '1.O\ 1 But eived far/ail hermit No.: �(..�� t / / —DO City of Tigard ) " 1 3125 SW [-Tall Blvd., Tigard, OR 97223 Oaf u Phone: 503.639.4] 71 Fax: 503.5 O? T1GP►RD � view other Pena[, t1' DatelB , .. , A 1,, I) Inspection Line: 503.639.4175 G DIVISIO Date ReadyBy: WM1 g See Page 2 for Internet: www.tigard or.gov BU1LDIN Notified/Method: Supptemeatal Information ' "i L i" ∎ tom 'n; < it { :4 L . ot h „a4,M , . 4 e .' :e' i 1'"'ti y . .rr . . ) . q { ,; , rc � - vii, y t �� { ueFwwee�� y a :i:�'.^ E .e Y 0 .. r , Y !�M 11.8..4 - 64x, .=t,,. ^ - � - : , .t4rU�r�pl'14,.. -- C✓,%..:.. r� i.:,�aY " � n,i , k..,iz l5' 0. : •'J,: •. I'7 a,R. ''..�. ' -' f1 ,, ''�"�,pp� darar�i�mmu�� I � New construction 1 Addition/alteration/replacement pease check all that apply (submit a sets of plans w /items checked below): ❑ Demolition 0 ❑ Service or feeder 400 amps or more ❑ Building over three stones. { -. where the available fault current ❑ Marinas and boa ards. „ - ,: S '1 1t "Ye 1 7t s:.,;1j.) i .rt w ( ',+ u i t fr • rc a "l'•' i pa, w. �,. exceeds 10,000 am at 15 0 volts or lei' _ '� a� k.. / iiLua .uw� t•`= " k� „�•„'��•,`^„t�.,' � k1 N ia �. P$ ❑ Floating buildings. . rifi less to ground, or exceeds 14,000 ❑ Commercial-use agricultural I- and 2-family dwelling ❑ Commercial industrial ❑ Accessory building I M Multi- family ❑ Master builder ❑Other. amps for all other installations. buildings. ❑ buildi ❑FircP P Installation of 75 KVA or Ei (� �p; '�' ' "'�' �rr�, + R =� "' ',"r c s *;• tt "erz y ., s � • . i : . r ❑ Emergency system. larger separately derived system. l ly .: uv :mi4s 'Pm szs. ,,,LI,>nLI ,4::lv..., ' � y +; 11' ::l 9 Mdtion of cew motor load of ' ob no.: j:c3tii? 7 Job site address: 31/a ,./ 100HPormore. occupancy. I ❑ Six or more residential unit,. ❑ Recreational vehicle parks. tty /$tate/ZIP: 77 9 e?"' D/C 7�� y ❑ Health -care facilities. D Supply voltage for more than p r ❑ Hazardous locations 600 volts nominal. .uite/bldg. /apt no.: Project name: ,, �vhd gi f� {) ❑ Service or feeder ti00 air .L i<�/:, . / h .. } ' , . - � s or more. ri r r te . ,"`�' d. , ih 2 � Nali i e. 3i!yt r {a F.iti::. c 3 f ai:. ..Fi :K 1,. 10 .bF�:• t ' .,,,,. 'ross street/directions to job site: Description Qty. Fes unit! New residential single- or multi - family dwelling unit. includes attached garage, UbdlviSion: ax map/parcel no.: Lot no.: i sq. ft. or less 16834 4 Ea sq. ft portion 33.92 111 Limited ited energy fl residential i - rS,•ss - - 1(en.. X51.. a :Xawar a7ra i ,1 ica 4> ∎ly a '1`0 t4 ... r r a „6,,,,,,.1 ,i. afa ,. of ti. ”' , •,r a ,�l '-''; '.s.. ,, yml +, 004u .i .Al 'i= antis above s.. ft. ?5.00 �� Limited energy, multi - family er�// • ■ i. . /i/ residential whit above .. ft. 1111 75.00 El I i Services or feeders installation alteration and/or relocation 200 amps or less „ 100.70 CO • - L© . f4T ). ? 11 j :' ,,., r .rcu � ,_ 4'',» T.,7112'7, ' � ' ' r r "gj " I 't Y— v4i �y N 3,.:t 201 am e .._ i, Ntlf ie i:IpC Ps to 400 amps III 133.56 = sine: El 401 amps to 600 amps 200.34 601 amps to 1,000 amps 301.04 2 • ddress: Over 1,000 amps or volts 552.26 2 ity/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation 'hone: ( ) Fax: ( ) i 200 amps or less 59.36 1 made on property 201 amps to 400 amps 125. _ © I nor installation: This installation is being p opetty that I own which is not 40t amps to 599 amps 168.54 2 Wended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 1701. Branch circuits - new alteratio , or extensio • , r .. ael • er signature: Date: A. Fee for branch circuits with 1 0114.11g1 u �v' vrt t , a' Y e; :;1' g �r f+V?11 f'.l, oe, t'`v : .^ ICrS .r', sr. {.` :3 d]k' x D .; fix,., s y I, ..m. t r , • ., �� ,:. v ' above feder fee, 7.42 .. ,•.° - eachbtanchnrctut usiness name: B. Fee for branch circuits without service or feeder fee, first 56.18 oniact name: branch circuit Each e4d'l branch circuit 7.42 2 2 • ddress: Miscellaneous service or keder not included) ity /State2lP: Each manufactured or modular fee 67.84 dwelling, service and/or der hone: ( ) Fax: : ( ) only 67.84 2 Pump or irrigation circle 67.84 2 - mail: S' or outlineli lighting in y : 4i w .., �.:,.'a, y » ' fi t•:*"=° `ee tllhr .:`,, =, ,LW:_ >~�.'a t. ,Va (. ' Sign P B 67.84 — © ti �` x 3....,,u •xs -„ "ii�1'I,ttw..f, " us Pt:. a ' `. "''c�inl - x =�< . 1 Signal circuits) or limited. energy usiness West Side Electric Co. Inc. panel, alteration, or extension. Paget 2 Each additional inspection over allowable in env of the above • ddress: 18 3 4 S E 8th Ave. Additional inspection (1 hr min) 66.25/ hr • Investigation (1 hr min) 66.25/ hr ity /State/ZIP: Po land/ OR/ 9 7 2 14 i Industrial plant ft hr min) 78.18/ hr .. ne: (5 0 3) 231-1,8 I F� (5 0 7 3 6 -0677 ; inspections for which no fee is 90.00/ )u ✓ 3) s.ecificall listed 'Vs hr min ' C8Lic.: 13306 i/ Electrical Lic.: - 135C Suprv.Lic. : 4 6 54 - '`42,4..,T:„:fit. ' i "`.�l 4 . 2 . � •�i" ; rs,i;l', s t(s?I1{t • Subtotal: UO '. uprv. Electrician signature, required: ., Plan review (25% of permit foe): f rint name: Randall F Roberts Date: / 2 21/ State surcharge (12% of permit fee): / j — 4 r TOTAL PERMIT FEE: • uthorized signature: . - • . This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete Tint name: Date: + Number of inspections allowed per permit. En uilbnglPemua\ELC PermitApp doc 07 /01 /10 440- 4615T(I I /DS /COM/NED