Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2020-00045
Date Issued: 02/12/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S102BC00111
Jurisdiction: Tigard
Site address: 12528 SW BROOKSIDE AVE
Project: Arms Subdivision: WALNUT ACRES Lot: 10
Project Description: (1)200 amp service for manufactured dwelling(ADU).
Contractor: M & E ELECTRIC Owner: ARMS, STEVEN TIMOTHY& EMILY CLA
15708 NE 81 ST AVE 12530 SW BROOKSIDE AVE
VANCOUVER,WA 98662 TIGARD, OR 97223
PHONE: 360-573-0459 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 02/12/2020 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 02/12/2020 $12.08
Type of Use: ADU Electrical
Class of Work: NEW
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 952-001-0090. You may obtain a.copy-oi..the rules or direct questions to OUNC by calling 503.2 2.19 7 or 1.800.332.2344.
Issued By: -> .r _ Permittee Signature:
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.
Electrical Permit Applicatio rOu o,-i-t(-t t i i O.. ,
City of Tigard . V ,,,„,, 7 �r�
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i= 25 Mk'Hall RI,d..l i'ard.OR 'l 's r// r Z ®y
F JAN 2 r�ri.Kr,.K..a
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2020 „ate i„ Related Permit.s
Ti(aARt> Instxwtionfine 7.5ii6394175 . Reath:bite ti} ?urn.. 0 srcPage2for
intcrnct u, e ngard-or gos
CITY FT@ ofrod hlrlh.at Su lemrutal Information
pp
TVPE )F EMI D1NG DIVISION PLAN REVIEW
Eg Ness construction ❑Addition,alteranonrepl acement Heave se:heck all that artgb(wino t a uh,of plan.w'tterna elr.atJ
ci Ser ,,•or lordo 400 amps ur more- 0 Building ocet three,t 0,0
❑Demolition 0 Other: .r ti ,it,a,adabr.tacit Curo'nr 0 blooms and boatyard:
CATEGORY OF CONSTRUCTION 1 c.:eai.1<,tit,amp.a,150 volts„t 01 foaling bnddmg.
ie...tow urd-of 1,*,cra6 14.10' 0(onunerccd-a.e agncuitutai
® I-and 2-family dwelling 0 Commercial industrial 0 Accessory building imps for IS o:lx•r,n tattamon-- bo ddmgc
0 Multi-family 0 Master builder 0 Other: 01 no pump 0 hrstatlatnnt„f 150 KS a nor
JOB SiTE: INFORMATION AND LOCATION ❑iaurraerx.,'rem btger>rparairl deco d
Job u: Job site address to\dduu,n of mw-motor load of ...tent 12530 SW Brookside Ave., I(R WI it'or mom
Ti ard OR 97223 ❑Si.,n uwre rc,ukntwl units ((f a(
('Icy-Sfafe TlP' ,( ❑}{cahh care Lx dines. ❑Itr.re;nt naf:ebr.tr part.
0 Surpl., hag: or Inwn didnSuite-bldg.apt. Project name:Arms Accessory Dwelling Unit ❑na(adw lratron
Q Seri ice la t edd 6tr l aril(,or morn. gilt)roll to eunai
Cross street-directions to job site: SW Woodward Lane FEE SCHEDULE
peudia)or. I Qt.. I Lich I total I ` ,
.'less residential single-or multi-faints dwelling unit.
Subdivision: Lot;r_ includes attached garage,
Tax map:'parcel s: 2S102BC00111 1;),x)w rt.„rles< Inc.sa 4
La add':5IXIsy fi or portion 13'12
! DESCRIPTION OF WORK 1 United energy restdenrial 5 ntr
(wth abo.e sq ft)
I-United cinrg.,.multi-fauulo ., Ord
•
re.idenrial(with uho.c Al-ft.I
Renessablc Lnerg"s 0 See Page 2
0 PROPER ) OWNER I 0 TENANT Services or feeders installation.alteration,and/or relocation
\aline:Steven Arms lax)um,or tcc. t i00.70 ta,.'>?
r
Address:12530 SW Brookside Ave., zt)t anrpa toa x amps 3,Sb
_ 4(ll amps to tux!anµ+.. .014 1 2
C ity'State:ZIP:Tigard, OR 97223 (It any(.lu 1 000 amps l sot lU
Phone:( 971)940-6415 Pax:t i (her I.Ixhi amps at suit. s52.-t,
Tempuras services or feeders installation,alteration,and%or
Email:armssteven@gmail.com relocation
Owner installation:"this installation is being made on property that I men which is not 2(Y)amps for Ices I as+b
intended for sale,lease,rent.or exchange,according to ORS 447,449.670,and 701. 2(1 amps 1o40(iamp, i:5.U8 2
Owner signanure' _ .___,.:__...__- Date: hit amp,to iQ°(amps j I63 54 '
APPLICANT Branch circuits-new,alteration,or extension,per panel I
f 0 CONTACT PERSON A I cc tin branch 01eruts K lib
Business name:Wolf.Industries above sco tee or feeder tie. _a_
each heurch circuit
Contact name:Travis Huegel m-FCC for branch circuits:shoo
sus ice or firdcr tic fnl
Address: Si.'I* -
1601 SE Commerce Ave, branch cuentt '
City-State-ZIP:Battle Ground WA, 98604 Eachadd't branch timid 7.42 I 2
Miscellaneous(service or feeder not included)
Phone:
060-335-7792 Fax::l ) t rich m y anufacnired or modular ,
dwelling,nervier and or feeder 6"'.?i4
Email:
Reconnect'rill 6'.14 ..
CONTRACTOR Pump nor in!gallon circle 6'tt4
Business name:Wolf uolM G A 4'-� f l ec,4-f ;G„,vt Sign nr outline lighting 67.94
err--
Signal circuins)Of Minted-enete)
Address: , 15-7oe Nfl- 4 �sri �v� 0 See Page 2
panel,
1 F Each additional inspection over aliowablc in any of the above
CityState-Z.IP: V
✓1^
r�� eivul , Additinualmspccticm{I hrmin) 66.ti5.hr
"1 '702
Phone:t 360 -3.I)c{ Fax:I )p 9�iGf_O/�, brwestigatlnn(I Iu mini 90 Oft hr
,ail:th@woifind.com 34,0—0'93 .0q„� ! 3 f tndu.tn ri plant t I hr min) ,ti 18 hr
Inspections for wile!!no lee is ,in tit, hr
(.CR Lie.: 5 2,z '3 1 Electrical Lic.:J1i Eu..e.E q ,upr�'.Lic.:;3 5 iii 5 spc Jfi nmy hated t.. hnnml
/ ELECTRICAL PERMIT FEES
Supra.Electrician signature,required , �; r (� 1'r 4.,, !' ,, s'.__ Subtotal— ��
a
Print name: `/ ,• �' :i Date ,; /n �`/' ❑plan R.s ic,.Required( .a'o of permit foe).
``�- fA li/
{ Stale surcharge(i 9�of permit feel- 1�,(�
Authorized signature: it)Ifit.PER stif FF.E ! (Za
Phis permit application expires if a permit is not obtained within IRO
Print name: i ra- i 5 .. Date: i I—Z. 'lc/ dais after it has been accepted as complete.
• \timber rt inspections alkavert ter tr,-nnn
I..Uu,idin;kermir,iii I'c»m Apr Ii.R t.Ki-:.,1,-ii,m I-'' 4404r•I•i(11'0('tlst wl'R