Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00334
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
Parcel: 2S 115AA01100
Jurisdiction: Tigard
Site address: 16055 SW 108TH AVE
Project: Oak Tree Apts Subdivision: WILLOW- BROOK -FARM Lot: 27
Project Description: (2) branch circuits
Contractor: JARMER ELECTRIC INC Owner: OT2 LLC
5105 SW 45TH AVE #200 633 NW 19TH
PORTLAND, OR 97221 PORTLAND, OR 97209
PHONE: 503 - 246 -5381 PHONE:
FAX: 503 - 244 -8037
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 06/04/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/04/2012 $7.63
Type of Use: MF 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 95 - 001 -00 0. You may oobbt copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. .8
Issued By: i �+' 1.1 Permittee Signature: OA A • PLj d,4 D
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 603.639.4175 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.
05/31/2012 13:53 5032448 JARMERELECTRIC PAGE 01 <di,
a eon . `..I 1 1 \1.
Electrical Permit Application MAY 3 1 2012 I 111 I it I I
City of Tigard
_ �M��_/ .. DO ,' Permit 13125 SW Nall Blvd., Tig&d. OR, 97ITY OF TIGARD , , ;�
_ Phone: 503.718.2439 Fax: s03.s01 DIVISION Data " Other Permit. LIM I . t 11 Inspection Line: 503.639.4175 Date Iteedy/gyd El sec See Page roc
: z 1.iormtstb n
Internet: www.tlptd- or.gov Notified/Method:
1 tl I n rIy'( i � 1
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tp
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�r 1 7 ! ;�t`., :,,!' ci9F °.Jr_ :N.,.,. x:• , ..rvl(.: ,nicrl. cw.I.i.._..t. �.fFq .i 1 1 . +n ?UG : ?Fl.:r.r 1 f al.l.. ._ .....t7 :•
❑ New construction i 1 Addition /alteration/replacement pleas an that apply (sn see of n ouns wrmetos checked below):
0 Service or Oates 400 amps or more 0 Building over three stories.
❑ Demolition • Other: where the avelleele molt maw I7 Mathias and boatyards.
f r V !, '1 t .{ 1 1 r fi i ,1 1 t , : , f 1 , 'l l f C 6 ' 7..1 ilt 11 . I h •( 1' � e
s wes s 10 ellre Or 150 vain Or 0 • w .tin g ball n .
i ,It .,, , ,,r , r f ,::1,' a
MV ! 7,,,,,,.,1?- - t N J ( ,' . .. , t r. 7.`. 1.1411,1” , . 4. { h : l , r
. 1 . ,.a -.. ,. m r.r,... f .,..t. _ - .,. tidr . .b,, , i.. ,I ., i•w ,i , ,�u3r..1.1., :3 e; Wm to ground, or exceeds 14,000 0 Comm6reisl -ace aariuuhwal
❑ 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for an otter batonetlom. b.0awge"
Multi- family ❑ Master builder ❑ Other. O Pie pump. fl Isemmation of 75 KV A or
f ,,r. r n i - 4 r° r n ,x,:, : , r f r ru c r l ,w . l t 1 ' . 1" O Bmtergenell system. 1L-'1' separately dettvad mum.
.5,,;,' ti' n "s ,1 ' . , 1 I 1?R A4
3r : , fi . : 1 � 0 w O "A ". °B". ••
�LLu •�, . ,. �e., 1h , . f ....., <1'1J.... / ... . . .� .n.. 11 1 c t1. 1t 1�i + ., ... ..{I...I.M,tn� ofno motor Addition °I- 2 ", "i-31
Job too. Job site add[ ass lo or o mom. occupancy.
M 1 1 � • ❑ six a more residential mite. Recreational vehicle parts.
City/State/ZIP: ,
& ' V ` , 13 H�dow lam: 6 o lts 1. more than
h_,L
Suite/bldg. /apt. no.: # • + ►, 11::=111911M211111 ❑ scr'lcO ar 600 •mPs or mero. 1 1 ' i
Cmss street/directions to Job site: neseiedm pm_ Fee. Too •
New residential single or multi family dwelling unit.
Includes attached garage. _
Subdivision: Lot no.: 1,000 say. ft or less 168.54 4
Be. edd'I SOO eq, ft or portion 33.92 1
Tax map/parcel no
' { sa.r I 2
a)�i<i.�{ } t- 1Jt ,. �� t t r t r { { i1 N .� 14 11� ir(I�tOfl�m� 75.00
r I /h.... i:.. ... c / . , �.‘,'
. ... .�, .M i ,..._.� ! �f.! 1.. ..r , r ... ,x' , .. Limited energy, ibmily r
( 'Nee/ C(ecu / s residential (with above.m.t) 7S.00
Services or feeders lMallatlon and/or relocation _
200 amps or km 100.70 2
y , / n 7 t r ,1 it t /, 1 tin + 133.56 2
t 1,' t I e 1 r "1 •( , ;' I I ' r r i i' 201 to
>j t4 � y 1 I �) � ) 1. , ';:-'1 .•- J ,.., • ; :. . : .'�. _. � I t . ! I, Y.. :. /.
.L., n. r. .S t,�, ., 1, r - - ... , A..t2 I I .A S ♦•.
Name: 401 amps to 600 amps 20034 2
601 maps to 1,000 amps 301.0 2
Address: Over 1.000 [antis or volts 552.26 , 2
Temporary services or fenders installation, alteration, end/or
City/State/ZIP: relocation
Phone: ( )
Fax: ( ) 200 amps or lt®3 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 fps 123.os 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 tows a 599 amps 168.34 2
Branch eirenits - new, alteration, or extension, per parcel
Owner signature: Date: R. Fee fir Bch circuits with
k i ii � Vi, r 1 ' u t"t lc::-=''i A .. I 'I r; I ',1"-,;,:l.- " 1 h a ,' f c i c vt,' i h t, p t• u_a• above service or feeder ibe• 7.42 2
_,I. �,. .• .,,,,,•,,, ;;;;:-..14, . f , Y,,.._ , . , ,, ,,.. 4 ,!_.• ',-I,','`,
t ,r.....t•s d
L ,.
, .,.:..t.r, _ „ I , - ,t.. . i s ir ir ,:,:, each branch circuit -
Business name: B. Fee for breech circuits wtthaa
service or ffedar fee. first i 56.18 1 2
Contact name: branch circuit
Doh add branch circuit r i 7.42 1 7, . • 2
Address: Miscellaneous bailee or fader not Included) ,
Each maauftemored or modular 67.84 2
City/State/ZIP: E
tttalb service audror feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation drab 67.84 2
E err outline g 67.84 2
yi'i ,t� It t/, c 1 1 t 1 `, t tl t 'f t rl
1 yfy ` t ` V ti 1 I r 1 . .f.
tpn � -
,t.A.l ' .1j � �r �,,<;." I . .. ..d •... .. , G ;.. .,.. ,J..ua.. , .. n , •. a, .La . a - ., aX , I r ., . ? . , . ••. • .,1 Signal circuit(s) or lrmEad-0atlrBY
Business name: ,.i r°-P
At E r° e_; /' ! .z = Dme1. ahan m amerfsl over allowable any of the above 2
Each additional Inspection
Address: . 7o .s j SFC.- °'i/, j) - z '.c'',C• Additional inspection (1hrrat) 66.25/ hr J ,
City/State/ZIP: . r- rf
Investigation (1 he min) 66.23/ hr
City/Stat
i eti i ,.. e) �. %i, t / industrial plant (1 hr tan) 78.18/ hr
P one: (5;53 ) I4(4 7 7 f f j , Fax: ( 3) r - c'er Inspeeaam ibr which uo foe is 90.00/ Iv
1,
I. listed Si SS hr m
I .
, lectrlcal Lic.: ? 4 t.,r.. ,,.r ... . _'... , „ , r
Subtotal: h
Suprv. Electrician signature, required: ■ � � . - ._ •
Plan review (25% of permit fee):
E Date: �,!}� State surcharge (12%of Pamir
M fee): O �. r '
�s TOTAL PER FEE: C\ . !/6 i� V'
Authorized signature: This parmlt.pplidifpls ettPir•s If a permit b not obtained within 180
Print name: Date: • N days after It has bass accepted as complete.
tmtber of inspections allowed per pertain.
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