Permit rf CITY OF TIGARD ELECTRICAL PERMIT
111- , . Permit #: ELC2013 -00446
COMMUNITY DEVELOPMENT
Date Issued: 07/30/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S102AB05000
Jurisdiction: Tigard
Site address: SW NO ADDRESS
Project: Main St. Off - Street Parking Lot Subdivision: KINGSTON Lot: 2
Project Description: (1) 200 amp service for car charging station for new parking lot for the City of Tigard on north side of Bumham
Street near Main Street intersection.
Contractor: JARMER ELECTRIC INC Owner: CITY OF TIGARD
5105 SW 45TH AVE #200 13125 SW HALL BLVD
PORTLAND, OR 97221 TIGARD, OR 97223
PHONE: 503 - 246 -5381 PHONE:
FAX: 503 - 244 -8037
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 07/30/2013 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 07/30/2013 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 9 1 -009 . 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: Permittee Signature: eA/ / W(- �77e .1/41
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.
07/26/2013 07:41 5032448031!', JARMERELECTRIC PAGE 01
' , i' D
Electrical Permit A iication
�Y Tigard o ` " 7� �3 Ecc�o�� — Ooy y6
City of JU L 2 � 2013 Parma
s 03.716 2439 Fax: 503. 9 4 '� OFTIG Plea Review
ARD 1:1414/Br 1:1414/Br ° %Tao /3 — 000/ 0
imlINGDNISION Date Inspection Line: 503.639.4175 ' • dy/ y: t El See teen 2 for IAt
Internet: www.tigaid or.gov Notl ., Supplemental Informetloa
a M ' t,14 � � ;� {�t true r w} a,f 47. •zirn� 7 t �.r ac+ k t,j y ,r rt t1 ; , mow! "7, T i t,•il i r) I .::r I ,an,t y a : 1 n Y', . . vl
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d j 1111. A1,�� / r41�d 1,� L JIr: � gl�� � � § � ��a �dn�:.,. �' t� r. e, av ti. ��� r.' F .�G. :, � 2 1f.:��lwbi l µ - F� 1:�4,t # a : :r _, k .�nrr.11n i t , z .Mr rrxl.rd - ;i,. !,��T,;�rd
❑ New construction 0 Addition /alteration/replacement Mean cheek all that apply (submit } sets of plans wAteme chocked below):
Demolition ❑ � ❑ Service or feeder 400 Ewa or more ❑ Building over duce stories.
�r 1, a1... 1 where the available ! s ❑ Marinas and boagrords.
+ �, r~, ; x1 5 �1a`d}, .4F:: t � 4_,.ti_deI ' 1 ' ; : 7 Y r 1 5.Cr' l ltli -sx 1yy r '�' r - " y.' .exceeds 10.000 amps of 150 volt! Or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ conmmsial•,ae agricultural
❑ 1 - and 2 - family dwelling 0 CommerciaIfindustriai ❑ Accessory build amps for all other installations. buildings.
0 Multi- fbmily ❑ Master builder ❑ Other: ❑ Fire PumP- ❑ huger of 75 KVA or
rt i F t t*i Ut r 4 '^ iµ1 r y J iy : .. rq !i' J _y i rl ∎ r 7ti f ,t ❑ 11nergeecy rigors Iw a separately derived xyBtcm
Fi ,1 r 1 � �1 r ,, ,Lj i ' ,F rs t � i l t ,� J . ti ' k at`� � —,?., - r 7 � ` l ut ,,M � y 1 newmotor load of ❑ "A "E", "1,2", "1 -3 ".
� l t,; ;lea. - , r ✓a, .r..�_ . rk. yr :� r,.a, �� . J a ,. .u,a�,t ljl_,. +`r,.. ,u :,�.� ❑Adelman
Job no.: 1 Job ante address.. t - mi l ► y a 100HPor ccc `Y.
t ` \ — 1 L� ..i1ti. 0 six or mom teeldent i malts. o Recreational vehicle parka.
City /State/ZIP: \( y r •, , ; -Saw's rt. ,.w Q Health-care 1:1 suppl voltage fr mare than
p r •—' .) • JJ» a ❑ Ham dam locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: gu/ziV#9/ f ST fa service or ateder 600 amps or aw,e
. ran �' ri i ,?. � . :,7 ?.2� I .. r`14.4 "*U1 r'' :P . $0Ile :i
Cross street/directions to job site: c4t f ,(10 *,6,/ - S - S wr coy. Yee 7edi •
New residential single- or multi - family dwelling unit
Included attached garage.
Subdivision: I L no.: 1,000 sq. ft or lass 16834 4
Tax map /parcel no.: -Limited 1 ` y, res de tia lion 33.92 1
.'T'1, 1 ai;1, ', NL { i I ]T Q.< a' r or > rank t. t � 4 i' F ri 'h,5n it t �. .'.. ^ ,P
; ia :.
energy, reaidmtisI
1 � } ,' - , � �d rb 5 ; 1 , T,; .. , 7 4 t . tri ( : '...1,..;, y "
J I + I ,A (with above mult 73.00 2
film _. . .....�. .. , t Y - .Y r I�' ^.d i .,rL . . ... " v ,.. �Ac.. t.. ;'^,L .,1_�. . N ..., .P . .. 1 . .. .rA i 1. J...h ,�: ,••• tinily
residential (witlt above so. R) 75.00 2
ELEC /C,, -/ n �1 / J '7 70 A/ - Services or (wi a ove so. tlon and/or n
gg
200 amps or Iwo , 100.70 2
C* e� , C tux , \' ?> ' "'.7' °1` KI {{ J e Q ' r.-h';';:','111.1':.'.4,','41,7,:::',;:, c r tg:P 77 , =?,.. = ' 201 amps to 400 amps 133.56 2 -
�il,1 :�.�'Aic
,.�.c: � •is�
lh,. :r .
,_twr•: +r`; ;;—;1 LE [2 tV ..l,�.fi _ �1,• i�i ?. ,..L :',t.i�v -1
.' ,•• _ •_kAr 'e. 'k ••.ei :. •
Name 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Ova 1,000 amps or votes 552.26 2
Temporary services or feeders Installation, alteration, and/or
City/State/ZIP: relocation _
Phone: ( ) , Fax: ( )
200 amps or lees 1 5936 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 z
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps t0 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel _
Owner signature :. Date: A. Fee for branch circuits with
d
liFf t ,• ! + !. 4i r a 'i4 n : Ws ' t 'p .. h F . . ay V f J � I a v ti it,t .zt , / above service or feeder fbe,
.ai c i� . , : � - .,,W " r ;oo,4:; .err.,;., /i'l; r ..:'4j i ."t tr. n ! r r _ 7.42 2
� �,.. , . <,..•11 pace b ranch circuit
Business name: ' B. Fee tr branch circuits without
setviee or theft foe, first 56.18 2
branch circuit Contact name: Each add'I branch circuit 7.42 2
Address: Mtacellaaaope (service or feeder not Included)
Each mami$schned or modular 67.84 2
City/State/ZIP: �
service /or feeder
Phone: ( )
I Fax:: ( ) who ' 67 2
,
Pump or irrigation circl 67.84 z
:
Slga o< att Fighting
y 67.84 2
iC, r.;r 9 ''" 3 te r . ?�, { , aY
. .r�.\ y t ', a ti r ,. ' � . + r :ti p n1 i � 1 X �_ .:
:!r<h: ✓.,�ial.nSt..t.,.^.t. vG�r.J..�,rri>r. ».. 1...1. :,. i,. -...� ,::. - ...rv ..i.1. . -, -brc el..t7 . . ... lx .7., . L ��F•r Signal ClreUlt(s) O� limited-0IIeI�
Business name: ` j i A - e A g A �L t er. i '' ` jr,Le Each additional iaspecdon over allowable ila any of the above Z
Address: ¶ 0 . 5 / 44 - .f e 2. ,-rC. Additional Inspection (1 hr min) 6625/ hr
Investigation (1 hr min) 66.25/ hr
ry
Ci /State/ZIP' n ^� 4,1– ,4 4 C. ti /.9 9 R•. 7 industrial plant (1 hr min) 78.18/ hr
one: (5 3 ) 27� /? ., r � S Y Fax: ( C i) ....?W - ee,,'.i ,' � listed Lorain 90.00/ hr
k
i CH Lic.: ,q2 f I Electrical Lic.; /1/41c- Suprv. Lic.: qe.i /4 5 '.1 l� !c� a , eact, ,.,,,,.:!:.t , :1..,.w,�1:0 , ,. :,.� r4 w5'4* S hun r.:iv
Suprv. Electrician signature, required: , , .... Subtotal: 1 ilk ,
Plan review (25% o f permit fee): •r
D a te U) • • State surcharge (12% of permit fee):
Print name: ,S 0 r ( lyf; � ,, - ., ► , J l j
Authorized signature: TOTAL PERMIT FEE: 1
Thb permit application expires • • permit Ii not obtainod within 180
Print name: Date: days attar it has been accepted as complete.
• Number of inspections allowed per permit.
1: 1auiWaePere„IU1E1C- Pme,aApp.doe 07A1/10 440.461ST(tl/OS/COM/WEB