Permit CITY OF TIGARD ELECTRICAL PERMIT
•
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00484
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/06/2011
Parcel: 1S134CB10200
Jurisdiction: Tigard
Site address: 12454 SW EDGEWATER CT
Project: VARNUM Subdivision: MILL VIEW Lot: 2
Project Description: Solar photovoltaic system.
Contractor: WEST SIDE ELECTRIC CO INC Owner: VARNUM, STEVEN S
1834 SE 8TH AVE MARTIN, ANNE -MARIE
PORTLAND, OR 97214 12454 SW EDGEWATER CT
TIGARD, OR 97223
PHONE: 503 - 231 -1548 PHONE:
FAX: 503 - 736 -0677
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/06/2011 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 09/06/2011 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 09/06/2011 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through • 952- 001 -0090 You ma • • - co•y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344. r
Issued By: i ��� — PermitteeSignature:
OWNER INSTALLATION ONL
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Date /Bt: g 30 �� Permit No.: ZL!' ��� t
61// -'60 g /
17F
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review I
Phone' 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit
TI GARD Inspection Line: 503.639.4175 Date Ready /By. p�� /a /b Juns See Page 2 for
Internet: www.tigard -or gov Notified/Method: W r � `, /lam -{✓ Supplemental Information
N 11 49, 3 TYRE OF WOR M d' '' x : d kk)/ Dal
❑ New construction ❑ Addition /alteration /replacement _
° ` .Mfii. REVIEW € r .';
❑ Demolition El Other: Solar Install �$
1 Please check all that apply (submit 2. sets of plans w /items checked below):
"y CAeTEGORYO CONSR �+ ❑Service or feeder 400 amps or more ❑ Building over three
❑ 1- and 2- family dwelling IJ Commercial /industrial U Accessory building where the available fault current stories.
❑ Multi - family ❑ Master builder ❑ Other: exceeds 10,000 amps at 150 volts or ❑ Marinas and boatyards
fs, a � ,„,,,„,.; less to ground, or exceeds 14,000 1=1 Floating buildings.
M JOB $ITATI O TION NNIA AT[ON ,tp t amps for all other installations.
❑ Commercial -use
Job no.: Job site address: 12454 SW Edgewater Court Fire pump. agricultural
❑Emergency system. buildings.
City /State /ZIP: Tigard /OR/97223 addition of new motor load of ❑ Installation of 75 KVA
Suite/bldg. /apt. no.: Project name: Varnum toO or more. or
❑Six o or r more residential units. larger separately derived system.
Cross street/directions to ob site: ❑ "A'. "E ",'1-2 " °1 -3",
J ❑ Health-care facilities.
occupancy.
❑ Hazardous locations.
❑ Recreational vehicle
❑ Service or feeder 600 parks
Subdivision: Lot no.: amps or more
_ t ❑ Supply voltage for
more than
Tax map /parcel no.: 600 volts nominal.
_ " " DESCRIP OF WORK 0 1 : . -.4 , c:k0;:int,
3 kW solar electric install on roof i ?,. `" *FEEr SCI-IEDULEv,. ,e & "i ;Z: „g,
Description I Qty. I T. I Total 1*
New residential single- or multi - family dwelling unit.
Includes attached garage.
r
_ f mXapasa a aint¢[ PROPERTtI',,Q'�4NER il _; �4 0 t I TENWAI 1,000 sq. ft. or less 168.54 4
Name: Steve Varnum Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential 75.00 2
Address: 12454 SW Edgewater Court (with above sq. ft.)
Limited energy, multi - family 75.00 2
City /State /ZIP: Tigard /OR/97223 residential (with above sq ft.)
Services or feeders installation, alteration, and /or relocation
Phone: ( ) Fax: ( ) 200 amps or less I 100.70 lam . 70 2
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 133.56 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 200.34 2
Owner signature: Date: 601 amps to 1,000 amps 301.04 2
�B �., a a s Over 1,000 amps or volts 552 26 2
,.t � �„ �AP.PLICQNT2 CONTAMT PERSO a_ Temporary services or feeders installation, alteration, and /or
Business name: Future City Solar relocation ,
200 amps or less 59.36 I
Contact name: Jordan Weisman 201 amps to 400 amps 125.08 2
Address: 1631 NE Broadway #320 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
City /State /ZIP: Portland /OR/97232 A. Fee for branch circuits with /
above service or feeder fee,
Phone: (503) 407 -6820 Fax: : ( ) each branch circuit 7'42 7• 9- 2
Jordan @futurecitysolar com B. Fee for branch feeder fee, without
service or feeder fee, firs[ 56.18 2
,, 4 '� t` `. r s; "i4 i.''^ CONj'Tligg t 41'.7„ ' »= � + ' `"a; , r, s, branch circuit
Business name: Westside Electric Each add'I branch circuit 7 42 2
Miscellaneous (service or feeder not included)
Address: 1834 SE 8th Ave Each manufactured or modular
67.84 2
dwelling, service and /or feeder
City /State /ZIP: Portland, OR 97214 Reconnect only 67.84 2
( 5 03- 231 -1548 (503 )-231 -9987 Pump or irrigation circle 67.84 2
Fax:
Phone:
Sign or outline lighting 67.84 2
CCB Lie.:13306 Electrical Lic.:26 -135C Suprv. Lie,: 4654 -S Signal circuit(s) or limited-energy
panel, alteration, or extension. Page 2 _ 2
Suprv. Electrician signature, required: Rilli77-- Each additional inspection over allowable in any of the above
/� Additional inspection (1 hr min) 66.25/ hr
Print name: Randall F Roberts Date: Sep 02, 2011 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr Dun) 78.18/ hr
Authorized signature: Inspections for which no fee is
specifically listed ('/ hr nun) 90.001 hr
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