Permit ■
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y CITY OF TIGARD ELECTRICAL PERMIT
I- 2:- COMMUNITY DEVELOPMENT Permit #: ELC2009 -00512
.T1 GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/02/2009
Parcel: 2S102CCO2800
Jurisdiction: Tigard
Site address: 10330 SW HILLVIEW ST
Subdivision: Lot: 0
Project: Mullins
Project Description: Add /alter (3) branch circuits for a/c tankless water heater and exterior GFCI.
Owner: FEES
MULLINS, MICHAEL Quantity Description Date Amount
10330 SW HILLVIEW
TIGARD, OR 97223 3 crt Branch Circuits 10/02/2009 $60.15
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/02/2009 $7.22
Electrical
Contractor:
WEST SIDE ELECTRIC CO INC
1834 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 231 -1548
FAX: 503- 736 -0677
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $67.37
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 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
...
Issued By: an.( , t- f i„Q n,b Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
1
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' q('
0 leP Date:
LICENSE NO. �'� /
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
Sqpv 2009 5:05PM West S 1 q? t be ric 503-736-0858 p.2
City of Tigard ONLY •
.� ,t R eceived I • .
la 13125 SW Hal] B lvd., Tigard, OR 97223 DatWB J Perm t No.:
Phone: 503.639.4171 Fax: 503.598.1960 SEP P 3 0 2008 Pear' Review Q 6 Z
TIGARU Inspection Line: 503.639.4175 Date/13 : Other Permit;
Internet: www.tigard-or.gov Date Ready/Sy
g CITY OF TIGA n I' Notified/Method: fo
Tk'� .4.'.tN(Q. .i �It :r . . , MN Supplemental See Page 2 I nformatlea
❑ New construction .ql' :`' i;; ; .... .
(g Addi / alteration/replacement '• • Please check all that apply p 'r .: M:' •� an ` -... ..e d ., .w •
❑ Demolition a (sub ni1 sets o f piano w /items chatted below):
' • 0 Service or feeder 400 amps or more ❑ Building over three stories
other
:; 4 L1N 'V " where the available fault cur
s1*41`4)R'Y F M
SlI • ❑ Marinas and boatyards.
In 1 - and 2 dwelling ��` ` " " -• ' exceeds 10,000 amps err 150 volts or ❑Floating buildings,
$ ❑ Commercial/industrial ess to d, or exceeds 14,000
{{--�� Multi- family ld ID building ..` ❑ Cornntercial -use agricultural
E] Fine for groun all other installati ors
❑ Master builder buildings
Other: Q Fire pump_ ❑ Installation of 75 KVA or
J.Q•B;SITE iNvoIt gATIoN Al114. Qekil'KQN; r ❑ Emergency system, larger sepat derived system.
' Job no.: S•$C7c Job site address: r 3 3� S� /T /� ❑ Addition ofttewmotor load of ❑ °n° °" "l „ I.3 ,
( / / DJeW D r• I or more. occupancy.
City /State/ZIP: �y�q `eta, � q ❑ Six ix or or more residential units. ❑ Recreational vehicle parks.
V ` ` I `' f �7 3 ❑ Real rh•care facilities. (] Supply voltage for more than
Suite/bldg./apt. no.: /(//,„).2- ❑ Hazardous locations. 600 volts nominal.
Project name: /nu /6 n ` u � � ` ❑ Service or feeder 600 amps s or more.
Cross street/directions to job site: : _ ;'F 1(!SII,DU
New residential single- or multi -f dwelling Y unit Tat4)
Subdivision: includes attached garage.
I Lot no.: 1,000 sq. fl, or less 145.15
Tax map /parcel no.: . 4
Ea. add'l 500 sq. ft- or portion
flB GAP:O+l , r +`: ; , Limited energy, residential 33.40
Q ;: [� °: , y p ,. . • :'i: t?'.' l i '. if ° e with above s • . ft. 75.00
! K/ '�' � ri:: -
!/ /1 f / OhQ - 4,7/lCS J f ,- r' 7
Limited r id residential (with above sq . y
- G^�r/t (7C h° e residential (with above aq. ft.) 75.00 2
r Services or feeders installation, alteration, and /or relocation
�} /
_;
� x: 200 amps or less
;! +' ' pf 4 '•�•Rf' ,,.•' , �4;' ; 80.30 2
�, " :' ,1- . }aAN.T: ;t ';''r r s 201 amps to 400 amp
Name: 4 ve /!/- s 160.60
t 401 amps to 60 am ps 2
160.60 2
Addre Address: �' � 601 amps to 1,000 amps 240.60 2
ss: ZIP: Orcr 1,000 amps or volts 454,65
Temporary services or feeders Installation, alteration, and/or
2
relocation
Phone: ( )
Fax: (. ) 200 amps or less
Owner installation: This installation is being made on property 201 amps to 400 am s 66.85 1
. intended for sale, lease, rent, or exchange, according cording to ORS 4 7, 449, 670, and 701. not p 1' 2
Owner signature: 401 am ps to 599 amp s 1 33,75 2;.;
Date: Branch circuits- new,alteratloa�or extension,. erearlel •
l¢� A. Fee for branch circuits with • > `t ' NW�!4''IOR90N [ ::_ above service or feeder fee,
6.65 2
Business name: WEST SIDE ELECTRIC CO. each branch circuit
B. Fee for branch circuits •
Contact mate; ?1� (/_ J without service or feeder fee, /
(J f�� ( first branch circuit (
46 y6 2
Address: 1834 SE STH AVE., Each add'l branch circuit
7___ 6.65 /3 7 -=. _ 2
City/State/ZIP: PORTLAND, OR 97214 Miscellaneous (service or feeder not incl uded)
Each manufactured or modular
90 AO
Phone: (503) 231 -1548 I Fax : : (503) 736-0677 dwelling, service and/or feeder Z • W `� Reconnect only 66.85
E-mail; E- :r.: e,1 ... _ -. _ . . - - e • dick 4 '.f ri c�ledrKe.. 'imp orirri irrigation circle . 2
';�l r:n.:..ir'is::. O ^ ;, "'- r.:,i ,r tr 7;::. $ 53.40. 2
.:;::,•..,. , 4 >;' =,, . 31- "n Sign or outline lighting 53.40
Signal circuit(s) or limited -
Business name; WEST SIDE ELECTRIC CO.
Address: 1834 SE 8TH AVE, energy panel, alteration, or •
extension. Describe: page 2 2
City/State/ZIP: PORTLAND, OR 97214
i Each additional Inspection over allowable in any oftbe above .
Phone: (503) 231 -1548 I Fax: (503).736-0677 Per inspection 62.50
Investigation per hour (1 brmin) 62.50
CCB Lie.: 13306 I Electrical Lic.: 26 -135c Suprv. Lic.: 4654S Industrial plant per hour 73.75 75
Supiv. Electrician signature, required: }� IEC.T'I> i L :!I
subtotal: Ej� ;;': F . ? '
;
` 6 2-,-;. to ( a r
- Print name: RA_VDALL ROBERTS Date: /�6ff Q7 Plan review (25% of permit fee)
Authorized signature: State surcharge (12% of permit fee): • "7 r
t TOTAL PERMIT FEE: 6 7
Print Warne; This permit application expires if a permit is not obtained withirf 180
i_—. Date:
„ .. days after it has been accepted u complete.
LABuilhogTcrmitslEt.C_peraihkpa 0 5!23/05 `Number of inspections allowed perpernrit,
440.4615ICt troS/COM/WEB
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