Permit CITY OF TIGARD ELECTRICAL PERMIT
, COMMUNITY DEVELOPMENT Permit #: ELC2012 -00257
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/04/2012
Parcel: 2S101AB01606
Jurisdiction: Tigard
Site address: 7357 SW BEVELAND RD 210
Project: Mission Increase Subdivision: HERMOSO PARK Lot: 17
Project Description: Branch circuits without service
Contractor: WEST SIDE ELECTRIC CO INC Owner: MIF LLC
1834 SE 8TH AVE 5665 SW MEADOWS RD #160
PORTLAND, OR 97214 LAKE OSWEGO, OR 97035
PHONE: 503 - 231 -1548 PHONE:
FAX: 503 - 736 -0677
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo /Purchase 05/04/2012 $108.12
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/04/2012 $12.97
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $121.09
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. ATT • _ • . • regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 110 through OA • 5 r • 1 -r. •0. You may obtain a copy of the rules or direct questions to OUNC by ca 32.1987 or 1.800.33 .234,4.
Issue. By: / ' !# //■. �� � Permittee Signatur ` . ' -.�1 • (
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' 0111W y _ f r , ( 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.
2012 -05 -01 14:27 WEST SIDE ELECTRIC 15037360677 » 5035981960 P 2/2 Si
Electrical Permit A pp lication RECEIVED , Ilk OIII (I I ',I 1 \ I
City g of Tigard Received Permit _
He a_pv
� I),,.:.: i
13125 SW Hall Blvd.. Tigard, OR 97223 Y - 2 2012 pub f
Phone: 503.639.4171 Fax: 503,598,1960''
Inspection Line: 503.639,4175 Date Ready/By. huts: El See Page Z for
Internet: www.tigard•or.gov CITY OF TIGARD Nen6edAvtethod V Supplemeo,al Informatics
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❑ New construction [7 Please chock all thm apply (submit b sets of plans whims dnecked below);
❑ Demolition ❑Other 0 Service or feeder 400 apps or mon s 0 Building over three stories .
where the available fault cheroot 0 Marinas and boatyard&
0 4 ;=1;;;� `7 y...afi'FJ - r ,. ? .�Y , �r, ^'• t,,: " -. ,. 4 :.•> ' ' exceeds 10,000 amps at 150 voles or Q floating buildings.
:
❑ I- and 2•family dwelling R^ Commet'eialfmdustrial 0 Accessory building amps e of or m zta11 ons, ❑ t'�asial•m.ie ag+icultural
wi+ anrya for dl other installations, buildings.
❑ Multi family ❑ Master builder ❑ Other: Once pump, 0 InamUmion of 75 KVA or
;i t + CL n v-:,,,, r . z ' :r ... „ c. , o Q Emagetlnyy aystan, larger acpara fly derived system.
. r ., i .0 , ,. '? . , r '. > r, i :',.3' , a: r .x ict Y: "s' � 0 Addition of new motor load of ❑ "A". , >E'. "1-2",'l.3".
Job no.: ,rr7Ogg Job site address_ 73 7 ‘y,/ geoe[¢rrd 100HP or more, occupancy.
0 Six or more midWtid units. CI Recreational vehicle parks.
City/State/LIP: ', a • s / i ' . 22- o Health-care facilities. 0 Supply votive for more than
• Hazardous locations. 600 volts nominal.
. Suite/I: J t. n0 -: project name: ` r S or feeder 600 amps or mom
`
Cross street/directions to job site: m..606., x '. I oar- 1 tree. ) seq. ,. _ I •
New residendsl single- or maid-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 16834 4
Tax tnap/parcel no.: Ea add'l 500 sq. R. or portion 33.92 1
Limited energy. residential
f'i'f; "ii,Q;'i . „ {.. a, l ,z: •' .i. n . r
... . , .5,..,- N• (with above say. R) 75.00 2
,
is •..@v- .::.n4z,:r_.':�a�?1k�SSi
Limited energy, multi- family 75.00 2
L f r e v / /7 T .7,3■/Q,1/ �/17doIO residential (with above w, ft.)
Services or feeders InstaUatlonolteradon, and/or relocation _
200 amps or leas 100.70 2
13
a ': -- n . .. _ , ., 1 r. ! Y. v �'w 9 r ` ' i S ' 5''s) "4 trip 3.56 2
�... �..r_'.:. �': `' !S'"':v �...�:. � ..: ' N"` :F•Y �3': 201 amps to 400 tri
1.f
Name: 401 maps to 600 amps 200.34 2
601 amps to 1.000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration, and/or
City /State/ZIP: relocation
Phone: ( ) [ Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 smite 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 imps 168.54 2
Branch circuits — sew, alteration, or extension, per panel
Owner signature: Date: A l Fee for branch circuits w ith
.-�, w Mart�.1` -. �,r nC Vp a b o ve service or feeder fee,
•la , . �'. 1
r r� ; - . 7.42 2
. each branch circuit
Business name: B. Fee for branch circuits wnhom service or feeder fee, f
rafi l
Contact name: branch want
56.18 � 2
Each add•I branch circuit 7 7,42 S"'/ d x 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or under
Phone: ( ) I Fax: : ( ) Recotmoctonly 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
',y �{ Sign or outline lighting 67.84 2
,',!:;?$, `'.; o.::,,Ir' i d%,'44-,? ,. 1. 7';;. : i ' 7?:. :7: ::' . . :, ; ; ,1: - • tea . ]. - l +^ti U' V t3MCW. ,y" Signal circuit(,) or limited - energy
Btsiness namc: West Side Electric Co . Inc. parrei• alteration, or extension. ( Page 2 12
Co., Each additional lopeetion over allowable in any of the above
Address: 1834 SE 8th Ave. Additional inspection (1 hr non) 66.25/ hr
City /State2IP: Portland /OR/97214 Industiialilats(1 hr 6625/ hr
Industrial plum (1 hr min) 7&18/ hr
Phone: (5 0 3) 2 31 - 154 Fax: (503 /nspectians for which no fee is 90.00/ In
V
r specifically listed (Si hr min
Cal Lie.: 13306 ElechicalLie. :26 -135C Suprv.Lic.:4654 -5 4 * : •?fr;t ° i• • . w ., ,.. '1'a.':: ••; - " 7 7 ; ' .' ; '-. :" !Z ? ,
Suprv. Electrician signature. required a / Subtotal: /Q ff f Z
/Gt_ i Plan review (25% of permit fee):
Print ulnae: Randall F Roberts Darr..( 2. /2- State surcharge (12% of permit fee): / 2.17
Authorized TOTAL PERmrr FEE: / 7 -/ , D 1, ,
signature; This permit apphealion empires if. Wait Is not obtained within ISO aD,µ�
uthorized si
days s ler it bas been accepted as complete.
Print name: Date; • Number od iat micas allowed per perms.
F 1H•C-PaoutApp.ace 07101/10 440.441ST(l1105/COMnvh3