Permit 1 ELECTRICAL PERMIT
" CITY OF TIGARD
PERMIT #: ELC2006 -00429
DEVELOPMENT SERVICES DATE ISSUED: 8/3/2006
-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S102BB -00412
SITE ADDRESS: 10130 SW KATHERINE ST ZONING: R -4.5
SUBDIVISION: KAROL COURT LOT : 011 JURISDICTION: TIG
Project Description: Ground service due to water line replacement. Job # J30092.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
DARRELL CALGANO WEST SIDE ELECTRIC CO INC
10130 SW KATHERINE ST 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 639 -0813 Contact #: FAX 503 - 736 - 0677
PRI 503 -231 -1548
FEES
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 8/3/2006 $80.30 LIC 13306
[TAX] 8% State Surcharge 8/3/2006 $6.42 SUP 4654S
Total $86.72 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: r
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'N: 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.
7� �r ^ ___ _ ---• ---_-_. _
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Electrical Permit A � ������ FOR OFFICE USE oNLY .
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,h""". xu/nvm /a^. 503.598.1960 �n ____� ' '_'___�
/"�"um"/�"m! 503.0.19.41175 K�[TYQFTlGARO = | m "~ '�"^ ~'
m^°^� ~°="`*p"."'."° __ _ �BUU ' OUVG !DIVISION Na »�«w"'/=/' ..�_��_ �l /t� | ____ __ _ �
TYPE w,WORN. PLAN REVIEW
--_--___-' __-___-
0 Ncr*msuuu^x/ / l'Icase cheek all that apply:
['Service over 225 ;imps, cornro'l TO lazardons locution
1 Deomm^m LJw*or
' . - --_----_'_' OServieC over 320 amps rating OBuildlIV. IWL:e 10,000 Sq. lt.,
CvuzC:wuY OF CONSTRUCTION
., -_ .... ___ -_
/ and z' family oma|ins Ej l LJ Accessory bv'ldmu
Onuiltlioli■, over three stories units in one structure
0 rcedcrrs, 400 amps or more
6m ,/! i ' f � � n x y ____ L� wuu,,»u.|ue' | | (*hu` _ _ _ DOccupant load over 99 persol is DM:mid:lentil:El structures or
�000,nx w x�
'xuu^r/ow AND -_--_-- ---'--___ -'___--'-_
Jon »^.:l,�D�� ��»i�:�� /�|�� � ��
01.1ealth-care facility
` �T 97 2 The ahove are nut applicable to temporary etaistmetion service.
FEE* SCHEDULE
-- �------- ,/~
s"i/amo��p� | nn�u Q/. 00 6 4e7 _
Cross street/directions . _- -___ -_--_ - -
I MOO sq. 11. or leSil 145,15 d
Ea. acici'l 500 sq. 0. or portiou 3:3.40 I
Subdivision: \ �o no.: _ ---_---- -.� -_-_'----_ --__--
1,iroiled energy, residential 75.00 2
Tax no.: -_' _
DEmRxP'uN mv WORu - Each manufactured or modular
__- '� � '- __- - _--' — _
yc. sr ~y • \-~���/' �" ^__ ' Sdrviees or feeders installation. alteration, and/or r4.■loca tier 2
200 amps or lt:tot 1 80 10 9g9 2
---- - 201 amps to 400 amps 106.85 2
^^ ' ''---------------��-- -----
.woow - -�l � _� �/ \/ _/^ ovt�L__ _____ __ __ 601 amps to 1,000 240.60 2
2
Address:
__-_____- �~--- - _-__ --__-� _ ltexonneet only 66.S5 2
(xty/Stxuo:|r Temporary tierVites or feeders installation. alteration, A lid/Or
celocal inn
)*"nc:(�»3 [Fax: )
Owner � c � � �u"o� l is being �u^ o^ /|�x�����x�mu
intended for Siiit1, lease, rent, or exchange, according to ORS 447, 449, 070 anti 701. 401 amps to 600 amps 133.7.ti 2
Owner signature!
_�_ _ __��__��___ ___ _�__ _ _���_
[] APPLICANT L] CONTACT PERSON A. Ihie tbr branch circuits with
--_-_--__---_'� _ - service or feeder lee, each
61)5 2
__
oux ' "`C,: ^u,"^; branch ciredi
_� — '-- _-_ _ _______ '--- - 1.3. fee Ibr branch circuits
Con launmvc without service or feeder ree,
--'--_'__--'__- --_--__-_--_' -__----
each branch circuit
Address: Each aild'I branch circuit 6.65 2
_ ' -' • __ _-- --_-_- --- _
City/Stale/City/Stale/ZIP: --' -- ---�--� Miscellaneous (service or feeder not included) . .. _ __
Pump or irrigation eirele 53.40 2
M `mw: ---- - � ---' ---
( ) Fax: : ( ) Sign Or °nil Inc lighting 5.3.40 2
_ ___ ____ �____..____________ ..... ________.
c-i. Signal eiretnt(S) of limited-
_______ - -
C'oNru^( TOR energy panel, alteration, or
_' __ -_' ---_ --_-� - ' _
Business name: West Side Electric {o
_--_- �--
Address: !A34Su8
__-__- . ___---______ - -- _ -- ----_
('i/yn,atunx`: PORTLAND, wo 97214 •
Investigation per hour 0 hr win) 02..50
_—_--_----_ _ -__----_--- _ ••
Phone: (503) 231-1548 -1- Vax; (503) 736 Industrial plant per hour
ELECTRICAL PERMIT FEES* ,
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tint name: j '/ �� | � � | — � -- �n� ^ "� ~ �- `°~ ^~— �--� ' ��--����� T*+^`'ER°"`^,'|P(�- � /~�`
Authorized signature: permit n u ,�"**
,ay. niter ...~~~ ~~, — . — _ — ,--
~ Fc121110114 SCt by . 1:ri.Cnunty »oild/ox/"dliSI'r
. --- ' --'--------- -- ----' — — —, ~~ Number "/ '.v.:."".° per paint( allowed.
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