Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00110
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/22/2012
Parcel: 2S103CB02100
Jurisdiction: TIGARD
Site address: 12190 SW JAMES ST
Project: BIG MOOSE DEVELOPMENT Subdivision: WILLAMETTE Lot: 8
Project Description: Replacing meter base and moving existing panel and (10) branch circuits.
Contractor: EDCO ELECTRIC Owner: BIG MOOSE DEVELOPMENT INC
PO BOX 180 9450 SW JAMIESON RD
GRAND RONDE, OR 97347 BEAVERTON, OR 97005
PHONE: 503 - 935 -7434 PHONE:
FAX: 503 - 206 -7466
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 02/22/2012 $100.70
Specifics: amps or less
10 crt Branch Circuits w /Purchase 02/22/2012 $74.20
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/22/2012 $20.99
Electrical
Type of Const:
Occupancy Grp:
Total $195.89
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 OAR 952- 001 -0090. You may obtain a co. of the rule �`rect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ , " Permittee Signature:
4l
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.
FEB -21 -12 10:32 PM Ed Cocuzza 541 994 939004 P.03
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+ Permit ApplicationR C 1 1 1 t 11 it i I I I I 1\ Y
Electrical
�� � i '' Received �] ,
City of TI Rrd Re e i v : / ) ermn w l�--� JJ �� _„ V 1
13 125 SW Hull Blvd., Tigard. OR 97223 FEB 2 2 201 2__.. .. - - -. -- C l -4.4.11.114 Pl Rev iew
Pli,mu: 50.3.7 I X.2439 boat: 503.5431 196d1 t>ale/n (Ab 1'trmil
Inspection I.inc• 501.639.4175 Dame Read /H 'situ. l are taw or
I ,.• If l) fk C I T Y Y Y Re 7 f
lidenat. www.iigardau.guv 1 � t I OF TIG N.tifodrmuil ■,J. �- /o frill p,t,ulo�syoa
-- -...._ _ . _...._. ( /J� I�IG Qj� S _— �Ptint Wattle' �' . 1
TYPF. OF WOlIIPI 11��''
■ New construction '. Addilitrn /alter ti9n/Teplaxernenl - -_- - - --
PL AN: ltENIEW
El Demolition ❑ Other: rt I
CATEGORY OF CONSTRUCTION M�1SC CII. A all eWt' IV (submit RL In „t tltW In M :11g �hx b
❑Service or feeder .1 amps or More C1 iii i1Jim ,avc+ line.
■
l•.
- and 2- u nilydwellinK Commercial /industrial Accessory building where the avalluhl Nub current mow:,
N crwcds 10,000 an •, al 12 nrlli or Li M: ' • lnv
end I r+r4 k
❑ Multi -famit • 1.3 Master builder El Other in ?paned, Ia - toasts 14,1100 l
JOB SITE INFORMATION AND LOCATION am • all other i radiations.
mN binldlrtt�s
• rluh t . U Commercial-use
- FJob al i 4, /h . IMP. Ohre wimp.
Job no.: sil address: Icullur�l
1111
_. ... ❑b:mer syul . buildings.
City /StatcJZII': / / ( t -- � I
7._�l c ❑ nee nn oor an: ad of Inslall+Imnor75KVA1
I Ixll Ip cur 1 I 07" Suite/bldg./apt. no.: Project Warne: /j,�, t 0 -^ 6 ._ Larger v,,p,rmNy derived sysltm.
�-a/� � .. Uti m,u cu,nc+calJrl max.
Cross street/directions to job s11e: - I: " "I , i•i ",
r r( 1'j'�? . 7 j ... / 5 � ❑ Health- . • r: facilities
A J l rs ti 1r XX I f , }- :for n I 116„ lout „n. rev Ifa101 vehicle
- �'•F--1�_ _.Pf.. n. I . / , ,.. i J �1 .,_2_,:..-- CJ ,rvl,., r, retain fy00
Sul,livisinr.. no.: parks
._. _ Go� �►2 Ctr Lot no: amps or
......... —.— �..� Supple vi+nage
Tax map/parcel nn.: / more than
11!. . _ / --61.1"‘ ... .. r MN1 vial4 pnmuMl
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DESCRIPTION a F ORK
_. _ - FEE moms )I)LiQ `
t - • C•' ,r_. 10- c ()Se t Yi.Sf /V6 At lie L_ _.. • — .1.111.cr,mmen ll1111 . LMIwt
C New residential w • k- or multi. fancily dwellhlg unit.
• lodes attached 'rage. _
0 PROPERTY OWNER ❑TENANT. It. or less — II
Name. Fa. add'I 'r1 �M11 r
% � ' r / op taw .
c IArno ' coergy, (VS ;, in
S .i CU .T • I' 4 U' d el 51 with a , .....2 ft. _....... .... __ 75.(10
Address;
" mull lamas? 73 1x)
City /State /ZIP: 6.e.-4/,,r./ /jet L ,. f t _ . residential (with a • sq.13.) .
Phone: - c, ) 5:2 ' `, (l -- l uN Services or fettle . natallation, 'literati and /or re don
/ lixl amps or less Ir. 1(x) 70
Owner installation: 'this iii titllation is being made on property that I own which is not 201 amp% In 400 am. Y 133.56
intended fear sale. lease, rent, or exchange. according to ORS 447, 449, 670, and 701, s. -4W , 1 >s to 64X) aril. • _NM =
171 am l0 1 t 1) a 3111 • • -
�1WI117 Sll;ltatllft:. Date: 6
- .� . .: ._.. � .
. ■ APPLICANT (�''� CONTACT PERSON over I • ii • tit ills Ell 552 25
J �� - • �- I ' - mpuerry uervie or feeders installation, alteration, and/or
Business name: r . „1 �C'' i -4. / iC �,_ atioo - - -....._.
_ *— 21X1 amps 0 ` == -
('unlRCt rltunc: 1
4 .. se 1 201 amps to 400 am Et
~ ttl�0. • 71
Address: �,r -• -- • 1 .. • , .99 amt I hR.54 •
- f
-- - - • • Branch circuits •- • alteration or ealenaiu , • r y, Del
(.` ity /State%71P: f A h're li +r branch cir its wish
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• .. .' aln,sc scl vin is r • Ier I'ee,
Phone: ( 5 , C' 7 c. 1 i / / �y/ �� r
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] l R Fee tiff hmnrh cir its w ithout E t'I . ' , r - /0 /C d £. %1 Ct. /�. r' d' / service or feedcr f• .• first ■ �;
: CONTRACTOR _ branch circuit _
' — Each .. • : chclr • it
- � �
Business name: � '� P .. f . Miaeeilaneou9 sw e or feeder not included
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Address; j , ' v 7 `/( 'U ~ - Faeh manufactured
dwealllnk service an.11:1:1
City/State/1111: ti 1 r / C- - • /. Roconneer
de :•y 41.1 • G g ,_ ��r
Phone: r s 7 ( Pump or irrigation cir 67 B•4 � J
(S ) L . 3y Fa) ) ,2i2 . _ '7�L Sigel or outline llglltl _ � n'/ X4 —ill
Signal circa' •2 li , l
CCU I,il:,: J r�� P 1 ?II;t:Irieal Lic.: Suprv. I,ic, _ IV 8 b'Y
e • ratio or vitro Pace 2 _ II
SupN. Electrician signantre, required: / i° I / F4101 ndditionulins , lion over allowable in ai of , abov e
A-' A t v `
Additional inspection I '^'^ ) 66. 2s / hi •
Print name: /
_ • , fi�fC vt ( , (18tC� I ��Z investigation (1 hr m ) M+ Ly/lu
Indtlstti.J plant (I hi in) _ in IR /hr • '
Authorized signatWC: t . - ..._._
' -- �t rlC� -._ . t {G lnspesti for which o fee is op Ial/ lir i
541 994 939004 P . 04
FEB-21-12 10:33 PM Ed Cocuzza
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11.111111ENMEMEnail
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Plan revicw (25% of perniii 14):
SUR swim' gc (12% (if perniii elm: 410
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'MEAL PLItM11' 11:411=Ini I I Or / f 4. 4 C
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Tbl% permit am;nrali;;...pl ir.■ permit h I obtained wl 1n I: , dayc aner has been accepted a%
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* Nuitilmt ..Iiiimweiiim% allowed rm.,' pvi ma
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