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Permit (146) CITY OF TIGARD ELECTRICAL PERMIT IN • COMMUNITY DEVELOPMENT Permit#: ELC2017-00142 and OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 03/02/2017 TIGARD 9 Parcel: 2S104BD02200 Jurisdiction: Tigard Site address: 13640 SW FERN ST Project: Nathman Subdivision: HANDY ACRES Lot: PT 28& Project Description: Replace 200 amp service and(1)branch circuit. Contractor: HILLSIDE ELECTRIC LLC Owner: NATHMAN, CHRISTINE P& 50705 NW CLAPSHAW HILL PARISI, BERARDINO FOREST GROVE, OR 97116 13640 SW FERN ST PORTLAND, OR 97223 PHONE: 503-357-5368 PHONE: FAX: 503-357-9159 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 03/02/2017 $100.70 Specifics: amps or less 1 crt Branch Circuits w/Purchase 03/02/2017 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 03/02/2017 $12.97 Electrical 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 - -• ••. - 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. TENTION: Oreg•• law re. ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 thro gh OAR 952-•r -0090. Y. y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1.87 or 1.800.332.2344. Issue By: Permittee Signature: -AV/ r 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' , i �0/ , � Date: .0/7LICENSE NO. '3 3, -i 5 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. Mar 02 17 08:48a ARLO ELECTRI. i4 : .lit 5033579159 p.1 I` 1 J ' EiectricaI Permit.A�p�Iicatio*r j,-.) c 1.11111111111111111131111110. City Of Tigard .-- ��'`'' ../, //i? � f Permit No, Z/20/7;Oa/yam - R 13125 31V Hell M Tigard,Olt 47213 + 'Pian Review ' I Mom $03.718.2439 P m Refen,.i$k0. r M` tlamly: Wier i►aemlt. Inspection Linc_ 503.639.41 Pete Reoty,' j: Jori*: td Seo Pale 2fer Internet: www,tigord-or.gov Notifiedli. aho:t SuppkseMetlrforamite TYPE OF WOIt1 Pt[AN 1 ►{�. . . ' . . Q New conatrtiction 0 Addition/Rheration/replacement Pi sa check ell ihnr tp�►IY[submit Tc ofpt+r�es w/llama cheated t:abwx 0 Ser,ioe or feodet 400 amps or more ❑>ata78ln%aver thee dories. Q Demolition 0 Other: *lira mo evadable ttrntt Cunni ID Minion and boatyards. _CAMOICY OF CONE/MOO-MN 1tl 00o onot 150 volts or CI 1�OlRittijl>trildiagt. • lass to sratpd,tit exceeds 14,000 ❑Consameatte sa elpiroltersl , 0 1-and 2-I1trtily dwelling 0 Commcrchwindustr1sil Q Accessory building amps for all oiherinetallatiore. buildings, 1 ❑Mutts-thmiiy 0 Master builder 0Other. CIPim num El losIalletienof75KVAor nintrpncx s . ept -iyeder+�a • JOB SlTE•INFOIMATMON AD ILCATON'. aMelon ofsew mow load oP El"A"-t'.`i-2""i-3. 3nh rim: Toh site address / �^ 100HPormore. cee►wency- f.• (J I Csitar mate eseidentisl waits. �11teernenttl vehicle pants. Cit fSttrze/?.1P '7-- l� C' 1 ©Health-case faoifirles. CI Simply vdtep fir more than --.--_ 1 b - f 1 c2 - \,. v T(-- f I ❑fietaldoud kcatiane. 600 year soroieei, SuiteMUldg./api.tto.: Project dame: ©aetVioe or mor coo amps or Isorm, V. (.Foss str�eelldiroctions to.10 site: wimps); _ 1 arm(• In. 1 -UM ' �.„- �gyp— ^^ grtet,- L - New residential single nr multi-fsmBT fivelling edit. C-'. & V i C - � e-- I'm:hides attaebed garage. Subdivision: Lot no.: 1,000&Y .or less /6$.34 4� Tax m / arae/no,: Ea.add'I 500 seq.it or porttan - 3192 I P Chained wetly,residatttioi • D 1i '#OW Oil? *mac . twidt abn a s4 it) 7!00 2 . - LIrnite_d energy,.multi-tinnily 75 00 2 (with ab reatdeatisl(wiove s+ft4 _ - .. ---._--. __..__ $etrvteoa or ftrders insatiatealleratMpp,and/or ioloonlion 200 amps or loss _ 1 _ 100.70 I 00.7, ,L2 rt 1t`lLSlPE2;9'1(GINNER .Cl TENANT 70I sips to 400 alms . 133i56 2 -;q J� 401 amps in 600 amps 20034 2 Name_ - ✓V/9 r-/ !,gA-1 601 amps to!000 maps 301.04 2 Addresta: Over 1,000 amps or volts S5226 2 Cit lS1nLcIG11'' Temporary services or feeders lnnmilatlon,aiferatJon,as slier )' relaea'lon ---I-- - Phone_t ) Fax:( ) 2AO amps of left 59.36 1 mps Owner installation-This installation is being made on property that I own which is not 201 ------ 400 amps 125f1R 2 99 mi intended far side.tease,rent,or exchange,according to ORS 447,449,670,and 701. 401 e��to nk's-ns 16B.Sa Z Imola dreatlla news utnaraai, er slat svlo.,per pastel Owner signature:_ Dole: _ A.ice fir branch citteits with ,above smite or Roder fee. - 0 APPLICANT j CONTACT PERSON' each Manch cirwla 7A#2 2 Business name 13.Fee Tor branch circuitsw/t6r't service orfbaderfce,fitSt 9G1$ 2 Contact name: hcircuit — ....--.._._...r. ..,�, ...�. „� - Nth add'I breach circuit 7.42 2 Address: -Miscellaneous service or feeder not in • - City/Slat11) MEI Each manufactured or modular 2 dw el1inmerviae and/or 4tedes Phones( ) Pesc:( ) Reranaeet only. 67.84 2 T;-maul: ! or illiJpation solo ._-- _ .s7,84 -2 Sign or eszline 9gJit ig 67.84 2 CONTRACTOR sigma Grxrit(slorlhritad artnr 13nsin�s name; IIIIIII ),‘,...• ' } r �!eland, or etdpertsien_ 2 /i �1 / �1 - - t..�.- Each additional 1I pecslon over allowable in any anise above Address f Additional it am:tinn(i Ira min) 6625/br Ci /4tlflef7T �� �lr -? '"J„ 1 ! leveed .tlon Ll hr min) Sl hr • lrtdutelle/pleat{l hr rnin> 76,l$.ltt - N Phone:( �j) -2,....c...`,1 Fax. j > a 2.2:.:1� inspections for which no ttie is 90,ow hr spacttically listed('35 Far MO CGN t.ic_. :l� !2 •) . E1ccf icsl L,ic.: -1 Q`ID Supty,Lic_: So, '� 117(KCAL PNRMIT•PEi$.: i Sups-v.1.;lactuician ai atu required: 1 1 Subtotal: gtt re Y� J J y� ]"� P �IIt Plansa lew(2.5%ofpermit(be): 7 Print name:TDOn , m 1 ' 'e"-'�i ate:' )-c , •- i `1 State intrehergc 4129b ofpouit fes) � TOTAL PERMIT FEE: ^AUtllnrirLd SignitnTe: _ CI✓ti '` � Th6'seemis aeolicedoe expIsts Wei permit le notnAteload within 1Po ��y days eller It Mas teen accepted aaeaatpbie, Print name; 1�1 . t�/r + 1 )�N_i ' Date: •..•/~7 • Plumber ofimp :ilomallowedperpennnint, / ilaseennR�r tirt�r.,c:-ramu �,rneov aminoen 11' v-aoimnms'csrtutrrvrnl � / r ��... City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13640 SW FERN ST, TIGARD, OR, 97223 June 12, 2017 at 1 :17:46 PM Record Type: Record ID: Residential - Electrical ELC2017-00142 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: New panel not labeled for multiple circuits. 110.22 Provide supplemental grounding for new panel. 250.52 B(3) Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13640 SW FERN ST, TIGARD, OR, 97223 June 12, 2017 at 1 :17:46 PM Record Type: Record ID: Residential - Electrical ELC2017-00142 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: New panel not labeled for multiple circuits. 110.22 Provide supplemental grounding for new panel. 250.52 B(3) Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13640 SW FERN ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Electrical ELC2017-00142 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor