Permit .
` CITY OF TIGARD ELECTRICAL PERMIT
P_--, COMMUNITY DEVELOPMENT 1 Permit #: ELC2012 00606
Date Issued: 10/22/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S102DB00500
Jurisdiction: Tigard
Site address: 8815 SW OMARA ST
Project: Senior Center Subdivision: BURNHAM TRACT Lot: 8
Project Description: Installation of (2) feeders for car chargers.
Contractor: JARMER ELECTRIC INC Owner: CITY OF TIGARD
5105 SW 45TH AVE #200 13125 SW HALL BLVD
PORTLAND, OR 97221 TIGARD, OR 97223
P
PHONE: 503 - 639 -4171
PHONE: 503 - 246 -5381
FAX: 503 -244 -8037
FEES
Quantity Description Date Amount •
2 ea Services or Feeders - 200 " 10/22/2012 $201.40
Specifics: amps or less
2 ea 12% State Surcharge - 10/22/2012 .$24.17
Type of Use: COM Electrical '
Class of Work: ALT -
Type of Const:
Occupancy Grp:
Total $225.57
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. ATTENTI • • : f -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -00 % hrough OA' 1 0090. You may obtain a.copy of the rules or direct questions to OUNC by calli I • ..1.;.4‘2.1987 r or 1.800.332.2 •4.
Issued =y: _ .. ! /�� J ,.
Permittee Signat . ' 1 4'r( , 1e1-0■____
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. ' , ,' ` ( t ao--�..—d
Call : .639.4175 by 7. 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.
10/22/2012 12:38 5032448037 JARMERELECTRIC PAGE 05
Electrical Permit An
PlicatiorRECEIVE 1 ,„„ ", , ,, 1 I , I t)N.I 1
city of Tigard Blvd., 11, Ti, OR 97 AeP Pilmingo.; ege,ida-6.069
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11, 's
1 i ,, i ir 1 312 5 SW Hall gard223 0 C T - 2 2 2 0 12
Phone: 503.718.2439 Fax 503.598.1960
14'41Fillilligli=11111111 Otner Permit:
I I , , ,. , Inspection Liam 503.639.4175 ete Ready/Sy: huh: iii See .esse 2 cur
Internet: www.tigard-or.gov CITY OF TIGARD Clete Sapplemeetal Interim
F.PTE,;,tz,7-7,F,'„wg "A I': ' •• "-- 4:n I 'It i, ," ro,r I:' 7, , ::,;1. •,; ',,,,;;-%
+ :+.2 Ai 16 'A L O.qt=L!' , ..".': '3,5: r. nfi6f;t:',.t:',"c;,Y ,,,"1..!, ;.;.,-,L, . , :-': - , , ,^.:: , : , 1;4-' , ',"‘Y,'?1 , 1 , 6(1 , :;',, 4 . ;;'.' ■: ,',"/+. .) ',,,,; : .`, ;:?,.. ,,t,.', it ,','''?,, i•C ".?,- `...r.
0 New construction 7.1 Addition/alteration/replacement Please cheek ell that apply (sebreit 1 sets of plate wiltente checked below)
CI Service of fbeder 400 amps or more El Building over three etcrim.
0 Demolition 0 Other: where the available Bath entrant 0 Miriam end boatyards.
, k10 -i" ' ',„,,,.) .,;`Kr' ' :',., ;-,,- ,..':,', . , I , . ; ,: . ', I .‘,.. exceeds 10,000 amps at 150 vale or CI menu buildings.
k- ,,04cr- i. ,
:',,:.,9? , f,..,;,.,,v..1:1 , :2„m".„.,, --..1 . -. p
,;t .; , ig .,,,,, ,. -.' '4 ..;, -,:;;',.;‘ ,',3?As.,..4 :4 ' k b , groun or cxcm 14 0 c ommac t a L tne agr
0 1 - and 2-fiunily dwelling '..7 Commercial/industrial 0 Accessory building amps flu all other installations. buildings.
E3 Multi-family 0 Master builder 0 Other: ClFirs pump. 0 tristallstioe of75 KVA or
vehicle ‘1" .*:',,,,, • ), ';.'","•''-:' orA -A" ';''''' ''e -'';'' ?' ",;'''''-' "-%'''s Pr,'''I'''-' 0 ennenq 2,1"In' larger separately derived greens.
t , Yt'"V"'''.4 - , k ■ :, .). ,..'' ..: :Al ..,,, ,.,, l r..1. ', 4 ' ' ''''" 4 . ' 1.S.;z , ,-VC" '. 0 Addition of new motor load of 0 "A", "E", "1-2", "1-3",
ril TA "i11;10-witilb‘14.11111111 100HP or more, occupancy.
Job no. Job site address • Alilli l 'Airs - ..tili . 1 sk IL . .. a
/male „. me Cl Six or more residential units. eetsi parks.
1=2:8imr,,,onimi tFv ,,,, i , E ......................... 0 nestion Supply voltage for more than
64:10 volts nominsi.
Suitc/bldg./apt. no.: Project mune: _ f p g__ et/Jr-fie.- CI Service or feeder 600 amps or mere.
''';e ' ... ;''''' ' 7 ;';- 7 '-. 1 ,, , ";::'-: ? '7 , : r ', i: ,- ::,,,,:::T: .!- 7 ..'' ;.:];',w7:;;;4 • Cross street/directions to job site: Downlption 91r. wee. row •
New residential single- or mold-family dwelling unit.
Includes &latched garage.
Subdivision: Lot no.: 1,000 sq. it. or less 168.54 4
Fa- edd'l 500 sq. ft. or portion 33.92 I
Tax map/parcel no.:
Limited team residential 75.00 2
1 ..!1":: : :;',4t . ! . .: . 4,....itUKAII,'c'• 5 i-%::-..:0,;..-',-,,..., , .: .,:..,..'. ::;,;',-,- ';', ,:''..if,-.:•;.;A;vi'vr.i-ri ,': `r;`,'", O (with lb "' 841 ft
ited Lim energy, multi 75.00 2
1 tWetmMllk.vtAIIIII. residential (with above sq. ft.) .
Services or fraders Installation, alteration, and/or loco
200 amps or less r g 100.70 . 2
j ‘ 4 : :,. I ' -:':■"" C 1 ''.:.-: . -... i .rr e, 7 ''' ',;(,,. r ''' '3'7:2, 201 enips to 400 maps 133.56 2
N x.:,..,1,..,c),..at'.:4,;',:\:,1,4:4.,,.^.1T.1:71-1.2.."..„..,,ii„
401 amps to 600 maps 200.34 2
ame;
601 anips • 1,000 in 301.04
Address: Over 1.000 amps or volts 552.26 - J 2
- Tempo rary services or feeders installation, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36
201 sums to 400 amps ___] I 125 1
Owner installation: This installation is being made on property that I own which is not I 2 2
401 amps to 599 amps S4
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Braila circuits - new, alteration, Or enchmsion, perpancl
Owner signature! Date: A. Fee for branch circuits with
1" ', ' ';',f,',"' .,■ ,-,.'",: ::"17.-`, '2-:!‘"`":N", ',T-i ',,J'%., :,,qi-,,Taiii i r.,,, s, I .,:, ,,‘,1', -, „'• ,..- r. ... above service Or Rieder fee, 742 2
. . L I il--,:',:`,V rlig.11::,Dg,) 1 ; ,-, ,t,Lim•_IV:::;... cac h ntic h c h t ,th
Business name: B. Fee far bunch circuits without
service or fbeder Ste, ant 56.18 2
Contact name: branch circuit
Bach addl branch circuit 7.42 2
Address: miserliseesee (service or reader not Included)
Filch manufactured or modular 67.84 2
City/State/ZIP: dwelling, service and/or iheder
Phone: ( ) Fax: : ( ) Reconnect on 67.84 — 2
Pump or irrigation circle 67.84 2
lltail:
Signor outline lighting 67.84 2
giqt .7rl' signal oirooko) or limited
panel, alteration, or extension. Page 2 2
Business name: ,.., ; 4 e , , ,,r . .,. .
Each additional Inspection over allowable in any of the above
Address: 7c -3 ci;...: .413 ..rl .7 4,..c.- Additional inspecticm (1 In miu) i 6625/hr 1
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: - , :7 e).‹. '', 7, <? I industrial plant (1 hr min) 78.18/ hr
Phone: (1,4; - j ) Ifi4 -c-'‘:,., IEMEINZIEN12111 IniVectims thr which 5° fBe is
s • - Ill - I limed In min 90.00/ hr
MI: •MMIlle.
Electrical I ic.:194 / SuPry. tic ' 4 / 1 ...? V 5 i;' - :4 - ..iii ,TiET51 .T.
Subtotal:
Suprv. Electrician signature, required: ,, -
mr. plan review (25% of permit fee): .---•
-..
Print name: 7 ,_,,..... I Date: ‘ Ol State surcharge (12% of permit fee): R p
4 ,72. fi i'd /,4,...z, , 6i , f 0 : 0 '..• , 0. •
TOTAL PERMIT FEE:
Authorized signature: Tbil permit application expires Ira permit b not obtained within 180
days after It has ban accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
lABulklin1tOsnaS4RIX-PontbApp.dsE 01101110 440-4615T(11/051COMMED