Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00211
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2012
Parcel: 2S102DC00600
• Jurisdiction: Tigard
Site address: 8930 SW OMARA ST
Project: Demmin Subdivision: EDGEWOOD Lot: 9
Project Description: Panel change
•
Contractor: WEST SIDE ELECTRIC CO INC Owner: DEMMIN, DWAYNE W
1834 SE 8TH AVE 8930 SW O'MARA ST
PORTLAND, OR 97214 TIGARD, OR 97223
PHONE: 503 - 231 -1548 • PHONE:
FAX: 503 - 736 -0677
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 04/13/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 04/13/2012 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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: •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 - 0010th • gh OA 4 52-0 .u 0 e 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2 44. .
Issued By: Permittee Signature:
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' . GQ1� --=L_ Date:
LICENSE NO.
Call 503.839.4175 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 -04 -10 13:15 WEST SIDE ELECTRIC 15037360677 » 5035981960 P 1/2
Electrical Permit A licatia CEIVED I (win 1`1 , 1 1,i 11 N t 1 /� µ q
City of Tigard and moved J I , Permit No.: ��� il. -49.2a
.1 .... 13125 SW Phone: 03639.4171 Fax 503.598 t960pR 2012
Plan
Other Pamir
Inspection Lino; 503.639.4175 _ Date Readyfey. ru^c E Se Page 2 for
= Nobfad/Methad Supplemental lnformadea
Internet www.tigard•or.gov r 1 TI GARD
.:
,:;.,�, r; +.,1,;'1'' x• �1• % ' .r "'t- e .a„r�,c !7,;';s,.'+,ct.,. �, %?Zg- :.:',g 10....Te. s.,n;w.d„ :
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'`1�� + -.. ' ::� .�, ffr ^ ^.tF.�_• 4 .•..+i:uj:t
13 New oonstuetiOn % • ddition/alterationfreplacement muse awl all giber any (submit lama of plans wrrtmra wed below):
0 Service or Roder 400 amps amaze 0 Building over three stories.
❑ Demolition • Other where the available huh current 0 Matins and boatyards.
vr';iiy;' "., ,' , • suite M;^" ..':. A::;:;.,; .. ;' moods 10.000 amps at 150 volts or I3 Floating buildings.
y x: ,1h{.._ ___ _- ___ _ 'fir:::_h :
. ... ',',...'..k.7..- few to glared, or exceeds 14.000 O Cw ga:me al-me agricultural
12 I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps far another inetalladons. buildings.
• Multi - family ❑ Master builder ❑ Other ❑ Fire pump. 0 Inaallation of 75 KVA or
V,i�,l:,: z i :F: t „i.y_' cr'- .�z .•...�,.awcrS.i� -"-^4 _ - 8t�. ��, i. ,... , "..> O *aax:y:yuem. larger separately derived system.
.._�:„ � : '� : . v _-.,,._ 7. '. air .��, `c ?r....�•:: 0 Addition ofmwmeter load of O- A- ,"�. "1.2 ", "1 -3 ".
Job no.: ,7C( Job site address � 30 S10 C�inara Sk' 1 or more e rem o •
( City/State rLIP: i r d H � ❑ Supply voltage for more then
T / c i '/ 9 7 z. z3 mimaL
Suite/bldg./apt no.: Project name. /)ea n)r) J(lJl(�!m 0 Sn feeder NO amps or mar
✓ erae or eede
, ,yP ❑ Hazardous locations. 600 volts oo :: ;!g,: ?;; ::. , ,;
Cross street/direotions to job site: Deo:Wm 1 012„ f Foe. I Tatar 1 •
New residential single or matt-family dwelling unit.
Includes attached garage. _
Subdivision: 1 L n o. ; 1.000 sq. ft or less 16854 4
- I Ea addi 500 sq. fl or portion 33.92 1
Tax map/parcel no.: Limited coati, teSidenhal 75.00 2
A'''t r,7 '5:1'. 'iV:ZY;`-"�,, ' /r,iv ' , ?,'r, , ' y 5 l ii i v ' i r ) , „ �.} l . 1 (with abov 80. 1/•. , Qll P /j Limited emgy. mutti•fiartily 75.00 2
C ' residential (with above skit.)
Services or feeders Installation and/or relocation
200 amps Weiss / , 100.70 MO Tr - 2
;ye��. 77 , 7 w%s71 --- „-7i'r-.%•••,..i,' A' .' •rri' .1 '.\ .� p. • 4f.P.. f. 10400 133.56 2 •
W -L . a,?r' ' w 'l�xN:J� �2 •_ .Sx,�r^• :�e�1t s3' 201 ��
401 amps to 600 mops 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1.000 amps or volts 55226' 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) r Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 ®pa 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 try 10599 amps 168.54 2
intended for sale, l ease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - mew, alteration. or extension, panel
Owner Signature: Date: A Fee for branch circuits with --
i " t _ .v,`c r ' :: . a ; . i . i° c`� r u > ;` above service or feeder Re, 7,42 2
g ,r.7 ,,r ter, r ate'', •" '4 3 :G lI V } mph wand,,;,eoil
Business name: B. Fec for branch re
nch circuits wrrho
service or feeds fee, first 56.18 2
Contact name: branch circuit
Each ado branch circuit 7,42 2
Address: Miscellaneous (service or feeder not included) -
Each manufactured or modular 67.84 2
City/State/ZIP: _ dwellie s, service and/or feeder ,
Rcmnnca only 67.84 2
Phone: ( ) Fax:: ( ) pump or i,ri on circle 67 ` 2
E - mail: Sign or outline lighting 67.84 2
71 ter: : : { . Jzr z. " ""f' •: r.` 7r£ ' ' ' .11 :4-' "e ,'> ;, Signal tueuit[s) Or limited -malty
usiness name: anel, alteration, or extension. Page 2
B
West Side Electric Co., Co . , Inc. Inc . Each additional inspection over ollowabh in any otthe above
Address: 1834 SE 8th Ave. Additional inspection (1 hr min) , 66.25/ he
Investigation (1 In min) 66.25/ hr
City/State/ZIP: Portland /OR/97214 1 Whist/jai phot(Ihrmin) 78.18/hr
Phi: ( 5 03) 231-1548 I Fax: (5 0 3) 736-0677 - Inspections rot which no fee is 90.00/ hr
specifically listed 0%1 hr min)
CCB Lie.: 13306 Electrical Lic.: 2 6 -13 5 C Suprv. Lie.: 4 6 5 4- S ' /G -
Subtotal:
Suprv. Electrician signature, required: , L 0.4r Plan review (25% of permit fee):
Print name: Randall F Roberts Date: 4a// 2, Sloe surcharge (12% of permit fee): 2
TOTAL PERMIT FEE:
Authorized signature: This permit app8etieo empires if • penult is not oh • ;if Tr"
days after it bs been aeoepua to
Print name: I Date:: • Number or inspections allowed per permit- �// n 7 Q •
lac- rcrmieApp.dsc 07/01130 4Ca.esiirt11,03MOMrwEB /�