Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00463
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/17/2011
• Parcel: 2S110AC00400
Jurisdiction: Tigard
Site address: 14799 SW 109TH AVE
Project: Timberline Apartments Subdivision: Lot:
Project Description: Panel replacement for pool heater.
Contractor: WEST SIDE ELECTRIC CO INC Owner: TIMBERLINE APARTMENTS LLC
1834 SE 8TH AVE 5335 SW MEADOWS RD #190
PORTLAND, OR 97214 LAKE OSWEGO, OR 97035
PHONE: 503 - 231 -1548 PHONE:
FAX: 503 - 736 -0677
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 08/17/2011 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 08/17/2011 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through 0' r !r- - 001 -0090. You may obt• a - • • of th .'rect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: ! -�`� :_ �_��� P iffee'Signature:_.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m, for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Rug 18 2011 6:17PM West Side Electric 503 -736 -0656 p. 2
IIEC E - I F I l
Electrical Permit Application AUG 7 2011 l Y)1t u1 Il( 1 q.(0,1.\
City of Tigard °�� q p Reaivea
13125 SW Hall Blvd., Tigard, OR 97223! 1 r 3 @,r„�,+„� P K o7 1 C1 = ��
Phone: 503.639.4171 Fax: 503.59819601 r lit i/-. a�/ of •. Date : Other Permit: Ins cline Line: 503.639.4175 " P l l t � t+ ti Date/8 Daze Ready 6y: B Se Page 2 for
t Internet: www.tigard or.gov Notified/Method: �y �� Supplementt iaf
,. +.` "t. a � . .,e^t:2,1,,,g '' M I N I t-5, a %,,, 3 . ie ' � L +!$:,,0'1 - '- r4T* c. - ni f i iosi .`"� , e y y ;.;r,.: t ;. bp''' S+* 4. ! "y1''"1'.:rJ,41 ■ ❑ New construction ,4 Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /item h ecked below):
0 Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑Other.
,
°I.,-,-... ..• p rr ; - r ?o!Mt.YrOtt':ir ,""in.x4t +; t. k where
e t 16 .000 able taut current Marinas and boatyards.
r
at;;n a- - 0111 4' ..• rt' .,: . i r _ :.i . ..‘,."'-. t'?..` e Kt' �' H. i . ? amps at 150 volts or ❑floating buildings.
❑ 1- and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building l to ground, e exceeds all 14.000 ❑ Commercial - use agricatwral
amps for all other installations. buildings.
Ti Multi- family ❑ Master builder ❑ Other: 0 Fire Pump. ❑ Installation of 75 KVA or
C tt 7 ,s�`�iPii + t+t -!tr fa ,g �. K x n,�uarr u a , _, . t � # _..: ❑ Emergency system larger separately derived system.
ENO ar,'ua:' a uu" s,1 7A .. ,,,haler .gztia n . t. r _„ ; ,ti e . t i El Addition Of new motor load of
❑
Job no.: A 2 , / .lob site address: / e/ 7 9 . j� /6 g-- 100HP or room. occupancy.
`J ['Six or more residential emits. ❑ Recreational vehicle parks.
y r' ❑Hazardous locations, ❑ Supply 0 vo to o go for more than
City/State/ZIP-
( /�; 04, 7 ['Health-cam fecil ons, 600 votes nominal.
Suite/bldg. /apt. no.: ,j/1 " , , r � • � ( I Project name: j 1 h 0 Service or feeder 600 amps or mare
{irErrt`l eye`^ +t i t t �i Y, i ' y,/C"f'r
Cross street/directions to job site: Description �(.tl
� i Qtr. Feeee. . ( I ....y 1. Taut I ; 4
�"' e'`x
' .
New residential single- or multi- family dwelling usit.
Includes attached garage.
Subdivision: Aunah>, Lot no.: : 1,000 sq. ti. or less 168.54 4
�� Ea. add'l 500 sq. It or portion 33.92 1
Tax map/parcel no.: ,s .. ,t �` GO Limited energy, residential
,t*r r� . ,F G " ""ryrt. Sl#` -. r`W*i1�t"G!�. ito , V .. : .'3,Y-" ,,.nt,rsF t' ,t�, @ti.. (with above sq. ft.) 75.00 2
� a Limited energy, multi thmily 75.00 2
� 1�C ( jz 4 / / j, ,0 4 residential (w above sq. ft.) .. r • Services or feeders installation, alteration, and/or relocation
200 amps or less / 100.70 /007.1' 2
e roc W lytr osaa ', TI nnrne O p r � ` a� r 7r am l fi$ n 'A 201 amps to 400 amps 133.56 2
xvx � ...... �f t , L .� ._. ..:��'� f 7 ,r „rte - in..
Name:
401 sups to 600 snaps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts I 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less I 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
for sale, lease, in 40 amps to 599 amps 168.54 `2
intended o as rent, or exchange, rd to ORS 447, 449, l
to d g , act o g 7, 4 , 670, and 701. Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
H -:'� ,�r f S �T ,+)7l q ri above service or feeder fee,
"[3,C r 4..,tysi6 t °„ l.,y @C -,..5 .1,!.14i, ..l'i..x: ,.'au.?r G _��,5...'", ..y�x'/i vft.:� F.�� 7.42 2
d each branch circuit
Business name: B. Fix for branch circuits without
service or feeder fee, first
Contact name: branch circui 56.1 & 2
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax :: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
l''.' a Y f µ � 4t h �'' r Sign or outline lighting 67.84 2
' t .. 't.� ;3}'t iw.r,l� ..' •. :; . za. ? tt, .. 7i x n t ,(Fail p )i i,:kk.. -�:(: Si circttit(s) or limited- energy
Business name anel, alteration, or extension, _ Page 2 2
W est Side Electric Co. C , I nc. I Each additional inspection over allowable in any of the abov
Address: 1834 SE 8th Ave. Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City /State /Z1P: Portland/OR/97214 • Industrial plant (Ihrmin) 78.18/hr
Phone: (5 0 3) 231-1548 Fax: (503) 736-O6 7 7 Inspections for which no fee is 90.00/ hr
s ifreall listed /s hr min
CCB Lic.: 13 3 0 6 Electrical Lic.: 26_135c Suprv. Lic.: 4654_ S .r r .," t ! n 5, 11 ? `7c. Z "'' 0 . ..
Suprv. Electrician signature, required: / Subtotal: 190 O 1 Y_.r
.[ aa✓ Plan review (25% of permit fee):
Print Warne: Randall F Roberts " Date: # r / / State surcharge (12% of permit fee): j cd°
TOTAL PERMIT FEE: / / 2. 2.t-
Authorized Signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
I:\ 5uilding1Permits \ELC- PermitApp.dec 07/01/10 440.4615T(11 S/COM/WI:B