Permit C ITY OF TIGARD ELECTRICAL PERMIT
C COMMUNITY DEVELOPMENT Permit #: ELC2012 -00248
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/26/2012
Parcel: 2S110AA00200
Jurisdiction: Tigard
Site address: 14130 SW 105TH AVE 26
Project: VOIEN Subdivision: 2011 - 041 PARTITION PLAT Lot: 2
Project Description: Repair /extend (2) branch circuits due to fire damage.
Contractor: DEKORTE ELECTRIC INC. Owner: VOIEN, BETH TRUST
5331 SW MACADAM AVE #258 -113 BY VOIEN, BETH TR
PORTLAND, OR 97239 24 VILLA POINT DR
NEWPORT BEACH, CA 92660
PHONE: 503 - 288 -2211 PHONE:
FAX: 503 - 292 -8237
FEES
Quantity Description Date Amount
• 2 crt Branch Circuits wo /Purchase 04/26/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/26/2012 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
Total $71.23
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 2- 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: eVJ1 Permittee Signature: A/ / CI - 170 /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 603.639.4176 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.
Z002/003
04/25/2012 11:29 FAX
•
•
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RECEIVED _. .. _., ., ._ . . . ..
Elechical Perinimmwksak trua
7.• ■:•P'. (.::• if 7.
City of Tigard t APR 2 5 2012 ;;.;igzErrAtir P.4 weze.zoi.2 -, .2 V, '
4 ,- I' '3125 SW Hall Blvd.. 'Tigard. OR 972.23
. Phone: 5 03.718.2439 Fax; 203.598.1960
T c,.... t'.. D th•Pecion Line: 303.639.4175
SI Soo Page, for
Inathe; vrrowtigard•or.gov CITY OF _ . _.,... i . ,.." •
BUILDIN I
Sepplennotalledbrinetlen .
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o New construction .." • ddition/altandon/replar.ement P1 cheek idl that sooty (w.W02 seas e pleas write= ebegrid Woo=
Service or feeder 400 snaps TW11 13Builensver ease nuke.
...0 Demolition 0 Odies .
where thenvelable fault aurt a Marines end beaver& •
• • •_, .::.•-r;f4i;i::'T 7 Y - ;t
,:2 ;:A -7. ..5.4:' '., ':'..:.:',:.-:::.' ."2.,--1,..",.... - '".1,;:- - - '. • ; cOCOZU 10,000 • • 02 ISO fts 04 I:MOW •cald•0
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0 I - and 2-family dwelling Ei CommercieVmdusUial 13 Accessory building Asps kir &alba inevileriont
1 0 O buildings
fulti.family 0 Master builder Other: . . • iie pump 0 histaltaian of KvA or
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Job no.: 1 L i3.1Z Job site address: Nis° s l 4 . , , . 110(IRPormars •••41•09Y•
sr 'Sher me residential units . CI Reerestional veer.* perh.
City/StattIZIP:--rt 7 2.2_1 • . - .... .. - faslitim 0 Supplyvolisso tor more then
• 1- - - • - • inortiora. 600Voltearaninat.
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Sbitlebidg-faPt. no Project name ' . !...- 1. .0rdbadtr600 ferie4r
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Cross street/dizections to job site:
....._____
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Subdivision:
I Lot ea: I , , .4fLOrlati 1604 I:I
Tax
- -- , A io d d di noe R. or perks t 33.92 MEI
map/parcel 120.:
75.00 . ' ''''''. -, ;;C.I ' -4 '..- - 'A ' .■ ': : . '% ' ' .',"'.. .1 , .. . : r• -- '.-•,-... , ,1.,;:.,....."'''' 1.,-,. .r• • - ', twith above eq. 0.) 13
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Lislited mew, ands•tharily
75.00 .
s• rNt?..f t‘ce C...444, e.1 Q..ebilk 4 boc. c :rs..);Its,A+) Zdantial. L • • . , 13
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-
il - oribeelets • • - , • • sdectostlanooldier relocation
- t . : - d.L•.......66.-..- 1a- 209 - sagas 100.70 El
rFmtitiiiiv t" v-,• '''Wkg;F. 1- ..;:5T - 4 - Za:. - -.-f;'-:::..:: , .. , ... ,- 'i:, 20 im3131 t° 44X1araPI 13.,36 I 22
N 1 min to 6 0 0 4 mrP• I 200.34
aric: 0
-_-____. 60 .4. 1 7r0 to 1 on5sx I 30E04 1
52. i 2 2
Addnass:
901a 1000 saws arcs* 126
______
- 7: :.:.. min.** 4 0' loshalkelewselherVistat and/or
City/State/ZIP:
Phone: ( ) --- . =t ax ( • y . . . drape ei late I 11.1 I25.08
fga6 El
Owner Installation: This installation is beingxnade en plumy that I own which it het
1
intended for sale. lease, rent, or exchange, amatding tb ORS 441, 449, 670; and 70i.
Data 10 sitiptito,ssaataps .. 16834
' - .. *men- aeso. • . • • .
Owner 4imature: or vinuatos, mlearral El
2
&Its Ibr %lima eine& writ
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• - nr 7" -' .7 . „4 ,:ig 9 = ; ' "Apr _,...!e:4e....:,;:.,. 7'7 - ' 7 1 . 7 ,7: ' . '_ _ 7,777:-:::,......777.7„ aboveservite 2r feeder fee.
' : ': r ..... ' ..": ' '" '',.. , ,..',,,;,;,:„' ,-.,..,-. - .,-..; ",.f.- '•'-', soelibraneb cirruit 7.42 1_2
Business name:
P ea* o= 1 56.12 2 • COITteet Mete:
I i 7,42 2
Address:
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,
CitY/StateraP. - • ''. .. ...", d'lad ar ra°41ar I 67.84 a
Er.,., aretidaiddicir fired.: 1
arje.
Phone. ( .) Fax - ( )
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1. Or krliasfrootirch 61.84
E-mail: _
. ,4 1 67.84
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"ee • keit:m*0. et earandoe. Pate 3 2
FIUSinesfiar...1 nan2 . sflownhte In =yet the above
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Addrm , 5111 _5i 4.1 /13 .0.4.a2mpl
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1. City/Stata 1 .2., eli 2 1
„., ..; . plaza (1 lupin) 1 MIN ist
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VPhone: (s ) vas...4 Fax (.5 ) • - 1, za =• vdidiao fee is I 90.01 12
777 --:.•,_ ' , , ..._, , _
CCBLiC.1511 5 ElectlicalLic.:3 c Sugrv- tic: LieisS
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Subtotal: limps.
Suprv. Electrician Sittortere requited: .„.. 4 . . .." _Jim", ' i Pisa review (2 . • of pant they
. Print name: Date:. 1-11 2 • .1 _ ! Stasi snaolvega (12. ofpireit fee)t
• •
i . TOT PgRUIT FEE: 1101171M
Authorized signature
-
- .771•! "mat appneanan eessa:rara.p,orant4s assabtata • within 180
-___. i dayseateels Biabenesprod as eaanslete-
I Print name: -------17Dertet . . . . t. • +bar 91.ireirecliOrsaa•cd t i•roul '
I Nadierrernre...ELoParreAopeoc Cali! a
' 440 - 4615 Th 0944:010voltn ! • .'
.
, . 1 . . . • • . . ,
04/25/2012 11:29 FAX Vi001 /003
5331 SW Macadam Ave Ste 258 -512
Portland, OR 97239
Phone: 503-288-2211 Dekorte Electric
Fax 503 -292 -8237
Fax
TO: City of Tigard Front Atika with Dekorte Electric
Fax 503- 598 -1960 Pages; 3
Phone 503 - 718-2439 Date: 4/25/2012
Re: Electrical Permit Application CC:
El Urgent X For Review ❑ Please Comment ❑ Please Reply 0 Please Recycle
• Comments;
Atika Taylor
Dekorte Electric
5331 SW Macadam Ave Ste 258 -113
Portland, OR 97239
Phone: 503 -288 -2211
Fax: 503 - 292 -8237