Permit ,, CITY OF TIGARD ELECTRICAL PERMIT
Il COMMUNITY DEVELOPMENT Permit #: ELC2012 -00045
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/27/2012
Parcel: 2S109AB10400
Jurisdiction: Tigard
Site address: 13113 SW WILMINGTON LN
Project: PHILPOTT Subdivision: RAVEN RIDGE Lot: 33
Project Description: (1) branch circuit for kiln.
Contractor: WEST SIDE ELECTRIC CO INC Owner: PHILPOTT, CLAIRE
1834 SE 8TH AVE 13113 SW WILMINGTON LN
PORTLAND, OR 97214 TIGARD, OR 97224
PHONE: 503 - 231 -1548 PHONE:
FAX: 503 - 736 -0677
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 01/27/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/27/2012 $6.74
Type of Use: SF 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 1 the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -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: Permittee Signature: _� j /. .
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.
2012 -01 -24 15 :44 WEST SIDE ELECTRIC 15037360677 » 5035981960 P 2/2
Electrical Permit Application I r 1; (I l . l' I(1 1 1 .1. (>.I.1
City of Ti JAN 2 4 2012 bads 'r1 „ S
13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review
Phone: 503,639.4171 Fax: 503.598.1960 Date/13 : Other Permit;
1 11,..11.!/
Intentet ww Inspection Line: 503- 639.4175 I�ITYOFTI � ate y�Y � ' 8 " p ' t � 2tor
v.tigard- or.gov BUR.,DI r-� /s h Noti N Supptetmnmlhaformadoa
"^r 'k'j i n r ,. V :i„ y 4' „pt It �+.. fi re r 57, - ,
r 1� ufs � .� �' ., ; 'si •e +,'(' ; � r 7 �, "� Z• +yc�'.C-?I)y }V � f'l+i . `V�% :'•y'' r , ... -. � ar�"�?�i�y��`�y;<�: �? ri
] k1, � "5 � .. � ��h .9v � C 1 r � 1u r� V. gJ� <•
0 New construction I'+ Addition/alteration/replacement Please check all that apply (submit y uts of plans winems checked below):
0 Service or feeder 400 amps Or mon ❑ Building over three stories.
❑ Demolition • Other: where the available Fault nurtent ['Marinas and boatyards.
nF.,AF: t: ti:ik x, ,M', .', . , ` 'e 5: '' ::..„" s , p`;; .tA'N 4 � 1K4: , 1444 4,i g ,,, ass to ground, 91" wrwed� 14 000 or ❑ Commerc uses S&iCUlnual
al- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. 0 Fire pump. 0 Installation of 75 KVA or
" " . d 1 r „x ❑ rg Y ear. larger separately derived system -
ta '-i f t r tr : c I � . : ` I r ,; 7 `"` 7 i'' 1; l i N • ' 1 4. ) �! ❑Additi o f now motor load of ❑ " •'E ", "I -2 ", "1-3 - ,
Job no.: ,r, - 7 tI 0 Job site address: / 3 / /3 ski k, to jn5,h ft 100HP or more. occupancy.
❑
❑ Six or m ere residential unite. Recreational vehicle parka.
City /State /ZIP: / r rc / b,' 7 7 2 L Health facilities. ❑Supply voltage for more than
/ ❑ Hazardous locations- 600 volts nominal.
Suite/bldg. /apt. no.: Project name: / // G�� C /` O le a ❑ Service 0/r ,or_ `, e " ' ?A :
feeder 600: , , s or more.
5� :r,.t :,gs�'1k� ... x4�;a��'lm�'3...,f -�. fi P., •
Cross street/directions to job site: !rawhides I Qtr. I Pm I T I *
New residential singla- or multi - family dwelling unit.
Includes attached garage. '
Subdivision: I Lot no.: 1,000 sq. ft. or less 168,54 4
Ea add'I 500 sq. ft. or portion 33.92 1
Tax map/parcel no Limited energy, residential
( «i. , �ttiW 0, J,r"tuf { ;
'' �,ac :•'a " 'ir Ilk,: :'. 'i„'ro'',2ri.n . (with above 75.00 2
.. Limited energy, multi- family 75.00 2
f,ro l 1
f/ Or -') • _ residential (with above sq. ft.) _
Services or feeders Instaliatiou, alteration, and/or relocation
200 amps or less 100.70 2
.r0/ ±, r "' Y ;.' t. t( `T T ,f:r,i: :., w..,,, 1� e; z .
l�`iSn�t lk9f ,i c n s '"�i {�' rxr ;;qti ' ''!'I 1 `rv'1ti4 ;^ 201 amps r0400 . 133.36 2
Name: 1 J )� r 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552,26' 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 4 01 a to 599 amps 16854 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701.
Branch circuits- new, alteration, or extension, r panel
Owner sigitattlre Date: A. Fee for branch circuits wuh
ft ! ' ' 1'°3 ,, r' f'-x.� 17.erg^ ' , ' , . ' ^ r i „w :� �J5��. u : . 1''i ' '.77 " . i�c " '7? r r 0/ ' "'"�4•, i each branch feeder fee, 7 ., 2
�\ R � , rr ,. r�. qVi A M ,.w1A ? � N:V. : - v5'e4. i J
Business name: B. Fee for branch circuits wallow
. . service or feeder fee, first / 56.18 C / 2
Contact name: branch circuit / ,? ,
Each add'I branch circuit 7,42 2
Address: Miscellaneous (service or feeder not included]
City /State /ZIP: Each manufactured or modular 67.84 2
I - dwelling, service and/or feeder
1 Fax:: ( ) Reconnect only 67.84 2
Phone: ( ) JJJ
Pump or irrigation circle ! 6714 2
E Signor outline lighting I 67.84 2
;: , �M ).! (:47 6 , 4 r i I M .' L `4 'd. a4P 3� S!�� W�' "u. °c r,..ra4 „si :�'k 4C)S si crreuigo or limited_energy 1
Business name: West Side Electric Co„ r Inc_ panel, alteration, or extension. Paget 2
Each addidonal inspection over allowable in any of the above .
Address: 1834 SE 8th Ave . Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Port 1 and/ O /97214
Investigation t l mm) 78.25/ hr
Industrial plant (1 hr min) 78, IV hr
Phi! (5 0 3) 231. I Fax: (5 0 3) 736 Inspections for which tto fee is 90.00/ hr
specifically hawed S Munn)
CCB Lic.: 13306 Electrical Lie.: 26 - 135C Sunni. Lie.: 4654 - S S `' �` �' `' +,fin; , .�.. W � 2 t1 '`'' . " ;: ,
W Subtotal: 5 G e
Suprv. Electrician signature, required: ..
0/.J .. Plan review (25% of permit fee):
Print name: Randall F Roberts Date: / 2 / /2_ _ Stare surcharge (12% of permit fee): 6 L L —
TOTAL PERMIT FEE: 4,2.. 1
Authorized signature: This
permit application expires K a permit Is not obtained within 180
Print name: Date: days after it has been accepted as complete.
N um b er of inspecti allowed per permit.
l'. t $yildinglPemdtEILC.PaenutAppdpt 07101110 440 4613T(li/03/00W EB
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