Permit ) I
/ t
CITY OF TIGARD ELECTRICAL PERMIT
a : COMMUNITY DEVELOPMENT Permit #: ELC2009 -00259
Date Issued: 06/03/2009 •
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
T (G A R L� 9 Parcel: 2S 110BA04000
Jurisdiction: Tigard
Site address: 14380 SW MCFARLAND BLVD
Subdivision: Lot: 0
Project: Jenkins
Project Description: Change out existing gas insert & fkue.
Owner: FEES
JENKINS, ROBERT EBEN & Quantity Description Date Amount
WENDY MK, 14380 SW MCFARLAND
TIGARD, OR 97224 2 crt Branch Circuits 06/03/2009 $53.50
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/03/2009 $6.42
• Contractor: Electrical
ARLO ELECTRIC INC
50705 NW CLAPSHW HILL RD
FOREST GROVE, OR 97116
PHONE: 503 - 357 -2350
FAX:
•
Type of Use: SF •
Class of Work: ALT Type of Const: •
Occupancy Grp:
•
Total $59.92
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 ac ance wi 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. ENTION: Oregon AI• quires u to . follow the rules adopted by the Oregon Utility Notification " Center. Those es are set forth in OAR
952 -001 -0 0 throug OAR 952 - 001 -■ r0. Y•u obtain a copy of th rules or direct questions to OUNC by calling 503.2' • ;699 or 1.800.33 •4. /
Issued y: Signature: L� 1 �� �� Permittee Si ./ //W tLd�i4
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 INSTILLATION ONLY
SIGNATURE OF SUPR. ELEC'N p , # ; / , ,� _�/ Date: ei 3
LICENSE NO. - pla1 S •
•
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.
May 12 09 03:21p�I�. p.
Electrical Permit Appliu t on • rutc ell. rl1'' :';,r o`I. \'
d
City of Tigard li Q 2 6 9 LI IlamitNO: Ga '1,0 0 , : i
• 13125 5W Hall Blvd. :Tigard. OR A 3 Pka Review Other Permit
Phone: 503.639.4171 Fax: 503.iytl•196d -Q 1(aH�r� Gele/B : - tvr,w it @! $ocPa3e : for
.I.1 ci •,;` 0 Loa fectiOn Line: 503.639.4175 (.e' ' ' � �,� Dm neuJylbS: I
l C� { � ,llr ` _' C Supple manualln(ormotiva
!planet: www,Si d.Or. ov '; \r ; 11 NntifladrAfethud:
❑ New construction Additlon/olteration /rep laccmcnt 'leak elle:k ill that apply (subtnit 2 sets of pLms warrior checked bell w):
0 Service or (ceder od•/ ainpt or more Q a adding Over three corks.
❑ Demolition ❑ Other: v_ where the available Gut: current ❑ Marinas and b0wymdt.
- CATE OP CONSTRUCTION' u, tc:'dt 10.030 amps w 130 voles or 0 Flowing building:,
- tata to b'ow ty 0=46; 15,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Acctssury building amp; fdr all other Uzi:llations. bu ildings.
Elfin puny. ❑ haslet anon of 7s' KY:. or
❑ Multi Mltstei builder ❑ Other: lar'ersc oronely stem
• ri . 'Pk: mk. :RiFOIc 11�ATION• AND LOCAflON •• • _ .• Addition area, system. w motor had of ❑ •w; ": D "t 2" ':1.3'
10010 or LOON. ocnrayaaey.
)ob n0.: lob site addr•ca5: f -' See 5 - 1 G. d • l j I 0 Six or more rnidertiai males. CI Ra :reari011al vn:hide oinks.
p Heeltheale ftualitiec. ID Sappy valeta, for hum than
City/State/ZIP: j • l G � G� �fC� G C� 7 2.24 ]Hazardous wc:nione. 600 vole nominal
t r] Satilee a reader 600 onus or more Suite/bldg./apt. no.; Project name:
•'•' . • % lzEE :SCH(LO LE,. , ..
Cross street/directions to job site: r WA' .1 y/ nerulpllun I ON. I re<. I '+'star 1 '
New residential single- or multi•fantily dwelling trait.
49 C f ta 8 :04 - .. Ineludtt attached Karage• ._ Subdivision: �-• 1-- l Lot no,: 1,000 sq. ft or lass
145,15 4
t� LLa��C'I ( /t•�l,S _ Ei. add'I 500 sq t or portion 33.40 I
Tax maplpsrccl no.; Limited energy. residential 79.00
DP,$CB.WTION' OF WORK -... .. (with ,hove sq a .)
c ..• Limited energy, multifamily 75.00 2
• J .s_ .f•t'° C ti i i� . [.ii r ! residential (iub q• n
.bovesi , _
r Services or feeders instillation, alteration, and/nr eclat:stiv
200 amps or Imo 80.30 2
.'.:: ' .'C PROPERTY : OW�ttl2' •. ..' . • 2.,TENANT' , .. . 1 amps to ups 106 85 2
_
20 a00 s
. • , • ' \ ... 401 amps to 600 amps -T- 160.60 2
Name: k • J �t�i 1 6- i.4(_S 601 amps to 1,000 slaps 240.60 2
Address: Over 1,000 tamps or volts 454.6$ 2
31.1,01,7 _ ✓ 1t E' ' Temporary services or feeders installation, alteration, and /or ,
City /State/ZIP: retoeodou _
Phone: (67)3 ) 6 3 0'a -� Fax: ( ) 200 amps or less 6615 1 `
Owner installa This installation is beung made on property that I own which is not 201 am to 400 amps 100.30 ' 2 .
intended t'or auto. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps ro 599 amps 133.75 _ 2 ;
Brand circuits - new. alteration, or catoiriov. oar ponce
Owner signature: Date: _ A Fec for brunch circuits with
A1P•('1<.IC.A . . •. CONCC : - : . ; :' - :.• .. above sorvice feeder fu;, o.65 2
� 'C,TA cacti branch circuit
Business: name: j4 t'z vt it.)/PeAll U1 gilt 1.0t el B. Fee for branch circuits
n wirhosu service or feeder fox, / 46.8 ` 5 / r- 3
Contitet mime: a - ` '! • - flyd branch eircull � • a
Address: Each Odd'1 branch circuit / j 6. �, , l05 2
rp 4 .y CO a .6 , t A , • MiaecllaaGiUi (service or feeder ant included )
City /State /ZIP: .1 /, . /fin Y G))i?� Each minutia:ruredormodular 1 90.90 2
) � C' dwellinp service and/or Order
Phone: (Its) ) , 3 i C(. 5 0/3 I Fax:: ( '' ) 6 ,) ■ t. • Roconne t only 66.85 2
pintail: Pump or irrigation circle 53.4D
CQN crkoR : .. . Sign or Curtin lighting
53.40 2
::.:• `^ : Signal circuit(s) or limited-
Business nume: i !]. , gAr � sacra pad. uluastio: , of
J t extension. Describe: Page 2 2
A(ldrtad SG OF 4 0 • , . -
City/SBicfZlP: tax �- - ' i /Y11 , Each additional infection over a in an • of the above
r -
Par inspection I 62.50
Phone: (503) sr) - ,3.50 Fax, ( ) _ iD Q 1 Invostigariun per hour (I trmin) I 62.50
-
1 10 CCB I..ie.:357 6 ^).., I Electrical Lie. • -)1 ; Y a Suprv. Lic.3 a ) S h 9 . r I 73.75 ,
ii 1 te Suprv. Electrician signature, required:: ' . Subtotal: S3 . 50_
L Il - r • Plan reels++ (2514 of permit faze): -
i... i 1 Date / �� Suitesureluugo (12%ofpermit fee): 6 , 1 -42-
Authorized eigrraturo. / TOTAL FERMI ' FEE: Sq , 9,2 _
� T his penult application @spirts if a pernir is out Amour within IR
Prim name': QQTD r' , 0-1; 111°--,_ I_ Dar `q' -) . _v 9 da eft.. it bus nose beeeptod as euoplele.
Number of inspoeuonr allowed per penal:.
InbuildiettytrmiMeLO•Pe r iiAer (toe OOR)roo 44e•45I5T(1 tlasie mrse
10/10 3OVd OI8103 6SI6LS££0S 1Z :01 600Z/01/S0