Permit CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: ELC2013 00218
T E CA.RO 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/15/2013
Parcel: 2S102AC01101
Jurisdiction: Tigard
Site address: 12562 SW MAIN ST 100
Project: Max's Brew Pub Subdivision: BURNHAM TRACT Lot: 1
Project Description: (3) circuit branches for new patio work
Contractor: JARMER ELECTRIC INC Owner: 12562 MAIN ST LLC
5105 SW 45TH AVE #200 BY GEORGE DIAMOND
PORTLAND, OR 97221 2839 SW 2ND AVE
PORTLAND, OR 97201
PHONE: 503 - 246 -5381 PHONE:
FAX: 503 - 244 -8037
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 04/15/2013 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/15/2013 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 OA 9 2- 001 -00 0. 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: ch,f Permittee Signature: D N. I o 2. 4770k!
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 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.
04/11/2013 14:49 5032448037 JARMERELECTRIC PAGE 01
Electrical Permit Applicatio> E C F +D 1(11Z ( 1 1 1 1 ( 1 1 ' t 1\ 1 1
I N ..--.. City of Tigard Received a �iIS 3 s� Permit No.: 6 ► 3 -v0 3 /S
• 13125 SW Bali Hlvd., Tigard, OR 9722 PR 1 1 2013 ,
Plan Review
Phone' 503.718.2439 Fax: 503.598.1960 1]ate/B Other Permit:
I 1 Inspection Line: 503.639.4175 LAITY OF TIGARD Date Ready /By. tests' / Id See Page 2 for
Internet: www.tigard- or.gov ' , 1 , ' , Notified/Method: ' . Supplemental t.forrration
I
gr t tai►`!` I'Iy'it 14. r�i 1 .. r , - ° 9 t.l
❑ New construction 1 Addition/alteration/replacement Phase check all that apply (s • ,• 7 sets of plans w/iatm checked below):
O Service or feeder 400 amps or more ❑ t3uildina over three stories.
❑ Demolition ❑ Other: where the eveilebte fault currant El Marinas and boatyards.
» ;, Z ° ` 1 , 4 ) *� i, : . „ r r ra�, t � 417 � $ ��+ .:4v � i ` � . r . : M, ' . s at 150 volts or ❑ Float buildings,
,� fill .:4444,1 ^7 exceeds 10000 am p Floating �a,
lets to ground, or exceeds 14,000 ❑ Commercial-me agricultural
❑ 1- and 2 - family dwelling Commercial /industrial ❑ Accessory building amps for all other trutallatlons: buildings.
❑ Multi fhtnily ❑ Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA or
Y
r s Fan „. 'I F Ica ' 4 A z *r ' ∎ 7 { � .p ,l i ❑Emergency system. larger IL-mutely derived system
l
1 81.1 tt ,,fl'ai. l tt:nu5 Aoki , a"" ir,fiti h . " d,. , • 'ii,.. � 1,' ' ❑ Addition of new motor load of ❑ "A" 'E "i 2^ t - ",
Job no.:' r Job site address. ` I00HP or more. occupancy.
./► t _ L i , I 1 V ❑ six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: r l• L .1 016 a s ❑ ❑ Health -care thcititws. ❑ Supply voltage tin mole than
Hazar locenons 600 volts nominal.
Suite/bldg. /apt. no.: (. Project name0 1 llik k t ❑ Service or feeder 600 empe or more
newel • Y i � :e l+`' !$ .., eve" MI � ,w. ( r: s t »w
Cross street/directions to job site: o s: I , ,,.w _.ro „ -' «,. -,,, �c r•�• K • .A.�. "< ?
J oacrtpuoa SM. �a. � •
New residential single- or multi - family dwelling unit
------ Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or ksa 168.54 4
Tax map /parcel no.: - Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential
i i N" 17 , :: 1, ! , .';' , ' , , , !'4' .. 1„ . 'Y,''. 'ti slaw: �ti ..r w 1 t� a s, rr` with above sq 1 73.00 2
,.t ,,, . « , .,...L, 4,w.tr . A.. ,u . . 4rN 1r w :.1... �r lu :'_4 Limited energy, mult fam
Mi s 111 s` 1111136114i, residential (with above SC ft.) 75.00 2
Services or feeders lnitallatio alteration, and/or relocation
200 amps or less 100.70 2
;. .. 1 6: t tC1, a ry!9C is- l r A
sr t � ir/ / i! u % , `i e ;, r " ) a, f 1 r ti " •r -, e lii a " u ? 201 amps to 400 amps 133.56 2
, f, 14r :lixila t„w.,1 ,w,,, -1i, - ,..sure,. ? „ 4. .:At 4. 4 .)a $, r∎ , ; . .ut.'11.1.4g,iR rr � M"15,,,�A) at 4
Name: 401 amps 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
City/S Temporary services or feeders installation, alteration, and/or
_relocation
Phone: ( ) Fax: ( ) 200 amps or less = 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.0E 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - hew, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
1 1 3:
is y t�ti 4 ''� 377'itef « �t ,, 1 ter :: r Y! t :e " above service or feeder the, 4
r 1. n ; 114 t ii Rw. :..A .ear w n ca r �+ (4 A , N ,' , M MU•a . , n;i aiei wn iSO ,+lk +4uiw each branch circuit 7. 2 2
Business name: B. Foe fbr branch circuits without
service or feeder f first \ 56 t1,03 2
Contact name: branch circuit / _
Each add'I branch circuit 7.42 p - I 2
Address: Miscellaneous service or feede o included)
Each
City/State/ZIP: manufactured and/or 67.84 z
Phone: ( ) __..,. Fax: : ( ) Reconnect only 67.34 2
Pump or irrigation circle 67.84 2
E - mail -
' :�i R 1 sign or outline lighting 67.34 2
t J m eNa'�.' ti F: 1 . t 7 ,7 ,k C to r . , . .. . „{�,�.`�
, , :� . _ � .. , , ,,w � ; ,� :�e >l1Yfi', signal circuit(3) or luaited�hergy
,e- Business name. J ele en E, 6C j /' f C., Poch adds don. or extension. Page n 2
�� ./ .� Bach additional inspection over atiowable in any of the abtwa
Address: ) / C,... - .xse r 1/6 ire 2_ 1 .- z , Additional inspection (1 hr Join) I 66.25/ hr
5 47 �} Industrial (l Ire n1371) 66.25/ hr
City/State/ZIP:
L r .. �'� ]ndusttial p4ust (1 hr min) 78.18/ hr
Phone: (fG 1 ) 2f14, j r ` Font: (52-PP :/ / - k&.;”' 1 Inipeaions for which no fee is 94.00/ hr ■
fimil lusted % hr min
CCB Lie.: 4,47 1 7 Electrical Lie. :p4 fitgc_l Suprv. Lie.. 4145 /Pi' 5' ,„ ...,j..._j `,r. 1,a;,, ... w, .. _ i, „:.r:.., r.
Subtotal: ■ li•
Suprv. Eli icien signature, required: i „,,,,. r . --
∎ • `.,.� _ Plan review (25 �6 of permit fee): ��-
Print tame: 3 f f4. ! ./1y': tar /? -- / Date: 111 )(43 _ State surcharge (1276 of permit fee): ,
Authorised signature!
TOTAL PERMIT FEE: , `/ � , j \ ,
This permit application expires If a permit b not witiia 150
Print name: Date: days after it has be accepted as complete.
• Number of inspections allowed per permit
InIntik1ing1Pa m,ctr \Et_C•ParmitApp.doc 07/01/10 440461 ST(11/05 /COMJWFB