Permit CITY OF TIGARD ELECTRICAL PERMIT
il
' . . COMMUNITY DEVELOPMENT Permit #: ELC2009-00674
TIGARD' 13125'SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 12/29/2009"
Parcel: 1 S134BD00100
Jurisdiction: Tigard
Site address: 10650 SW 121ST AVE' 24
Subdivision: WESTWOOD GREEN APARTMENTS Lot: 0
Project: Westwood Green: Apartments
Project Description: (7) branch circuits to rewire kitchen due to fire. 1/7/10 ADD11) 200 amp service.
Owner: FEES
GARDNER FAMILY PROPERTIES LLC Quantity Description Date Amount
15315 SW ALDERBROOK DR
TIGARD, OR 97224 1 ea 12% State Surcharge - 12/29/2009 $12.08
Electrical
PHONE: 7 crt Branch Circuits w /Purchase 12/29/2009 $51.94
Service or Feeder
0 ea 12% State Surcharge - 12/29/2009 $6.24
Contractor: Electrical
SQUIRES ELECTRIC
PO BOX 16851
PORTLAND, OR 97292
PHONE: 503 - 252 -1609
FAX: 503 - 253 -5831
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $70.26
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 - 001,0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permi Signature. 0/11 f}PPc. 769770
y: 9
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.
Can 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
; RECEIVED
Electrical Permit A licatibn ' .` Yy s��°
PP JAN 0 5 2010 �� °i ,`� � ; r ;oI R r ffe f:475., 4. '� �(a,'w' .
% City of �1
'Received erirait No ,��
ai r G! Date3y: J p ad �! 0.6
y / • .13125 SW HaitB1yd Tig3id,-OR 97 223CITY OF TIG AR D Plan Review tl
m i ,1,•,.... Phone: 503.639.4171 Fax! 503. Dit /B Other Permit:
<tr r tl IftaLDING DIVISIO
*L i (; A R I . inspection Line: 503.639.4175 Datc Rgady /By: Iliall El See Page - 2 f r
°�Txt,v7 ^ Internet: www_tigard- or Notificd%Mcthod: Supplemental1 formation
lAl a, +l,r� e ., ° {M .o'w i ut .W . ,9 M : „�,A' A, ",; Ay4 1 i t. .:'"Y, , , r i '4ipl i } AA 0�r�,°. Y,1" i
'tM . r l 4 VR1 r�
New construction Addition/alteration/replacement l wr vE t q '
❑
please chrxk�all that apply (submit 2 self: of plant; w /rrems eh kad.bclow):
1: Service or feeder 400 amp's or more Q Building over M stones.
❑ Demolition ❑ Other:
where the available fault current El marinas and lira ands.
�. . 1) �y��¢�'.�" ae an ? Fau l u t a`afit ',�< �r F N r� :,�id
' " - ' ` 4'"(#60 llgi , , n i P! '$ l Plr,'r'
�. M1 I H„i .S.<, l i'��t ❑
exceeds 10,000 amps at 150 . FIOating:boi /din
lees io ground, Or exceeds 14.000 ❑ Commercial use iicultural
' El 1- and 2- family dwelling 4 Commercia1Jindustrial ❑ Accessory building amps for all other installations. buldin ,
❑ � ❑ Master builder Other: pump, El Installation of 75 KVA or
ivlulti- famil , ❑ ❑Fir um
',i f3 ^ . � l a �� r ) a' ° Emergency system. large .e r separately ivcd system.
_ q ` 4`_ • e as tt 0 Additi o f ne�v motor Ioatl of ely '7-3
Job no.: Job site address : :1 eU,' j,C .0 up 1J 1,y ' 1 or more. occupancy.
' v o Sift or more residential units. ❑ Recreational vehicle parks.
CityIStatc /Z qt,,,y- D (] Heaitlr... f tciliti . ❑ Supply voltage fcj
� r more than
� ❑ Hazardous locations 600 volts nomrn h
Suite /bldg. /apt, no,: �� m
Project nae: -Pt Q4 1".x_42.1__1".x_42.1___ 0 Scryiee or feedci 600 amps or. more
"�i r ' aMlI EC,I „a Y, ;:.:,,5' , ti.:: ii `JP!)..s , ;. . al 4�i V r x1
Cross street/directions to job site Peaenpnon t- A• I
l o n�. 1 Pee j - t etra, 1
Newiresidential single - or multi - family dwelling ttni' .
Includes, attached garage.
Subdivision: LLot no.: 1,000 sq. ft. or less 168.54 4
Ea add"' 500 sq. ft, or portion 33.92 1
Tax map /parcel no.: Limited energ , residential p
4 2
( "'i: II:.fN I Y 't Vii k t � III ILL M .. . ., 'ay, 61.0
ho "...,£�Il r .0§;Y21F n t0.01 �'ig'g:' . t . Y (with ith°' sq. ft -) _
Ala Limited energy, multi family
A l (./ [ .; _ () �- J Y residential (with above sq. ft.) 67.84 2
Services qr feeders installation, alteration, audio r relocation
�" k { CI^�K' L n -s ` , q , � , i w N n" v t , w 200 amps or less / 100,70 ebb ' 7 2
t r,1'' i 1 :kil ' i x l o- 1li 1 0 ; ...1 V jki': t 'r, :: 1; 201 amps to 4 00 amps ._ 133.56 2
Name: 401 amps 1,(:: 600 amps 200.34 2
601 amps to 1 amps 301.04 2
Address: Over 1 amps or volts 552,26 2
city /State /ZIP: Temporary services or feeders installation, alteration, and /or
rcklcetion
Phone: ( ) Fax: ( ) . 200.ampsor less 59.36 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 4 449, 670, and 701. µ 4O1 amps to 599 amps 168.54 1 2
Branch circuits - new, alteration, or extension, per panel
Owner Signature �y , Da A. Fee for branch circuits with
k .' ,r' IN FRO O ` ifre 'r?drl�' I AI ?ry *i�F�l � ° ' � ..r t tit AiliJ4��'tp " II/ ,Alt .,:I above service or feeder fee, ..
each branch circuit 7A2 2
Business name _ 5. Fce for branch circuits
without service or feeder fee,
Cootactname: _ first brmch circuit 56.18 2
Address: Each •add'I branch circuit 7,42 2
Miscellaneous (service or feeder..not included)
City /State/ZIP: Each manufactured or modular 67':84 2
dwelli, service and/or feeder .
Phone: ( ) Fax:: ( )
Reconnect only 67.84. J 2
E -mail: Pump or irrigation circle 67.84 2
o- ' r .w ..Ja ,, / i 0 irf.gp �N p,n r ' N : L 11 Y1 I' sip or outline ll htmo-r
,x, i. .,, $i, R � ; - „s r, e., ' .,y I i S�tl o o _ 67.54 2
Signal circuits) or limited-
Business name: (1 r e.� ,� o� Y . i e_ Vie .. energy panel, alteration, or
Address: (( L - / extension. Describe: Page 2 2
City /State /ZIP )(t. k,l ' 1 9 74 --9,) Each additional inspection over allowable in any of the above
_ Per inspection 66.25
Phone: (6D 5 - / 1 _ t 5 Fax: ( ) j t3 1 . 5 j / investigations per hour (1 hr min) 66.25
CC 131,ic. z J Gi , : . 5. Elcctri Lic - '6 / Suprv, (Jc.: J Industrial plant per hour 78.18
G44. " 01 1 0 111 t i�,r.
,. _..,,��n I S ri.. ��._2.
Suprv. Electrician signature, requi' d: Subtotal:
__ /C
• Date: Plan review (25% of permit fcc):
Print name:
e. 60 r L�s il/6 / �
State surcharge (12% of permit fee)!
Authorized signature: TOTAL, PERMIT FEE: - 4,
This permit appiieation expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete_
• Number of inspections show 1 7 per [q
l.1 SuildinttlPermitz \ELC- PeneitApp, 10/01/)9 ' � ,� ;,r .� 410- 4615T(1.1 /o5 /COM/\VEB 10 Q tfxA.i. sot. -- f t'
- Z
zoo/zoo d 121.017# c�� # 1(QS � �s fnbs V ` + / Lss s9zso X10=
CITY OF TIGARD ELECTRICAL PERMIT
` ''-1 ; a , COMMUNITY DEVELOPMENT Permit #: ELC2009 -00674
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/29/2009
Parcel: 1 S 134BD00100
Jurisdiction: Tigard
Site address: 10650 SW 121ST AVE 24
Subdivision: WESTWOOD GREEN APARTMENTS Lot: 0
Project: Westwood Green Apartments
Project Description: (7) branch circuits to rewire kitchen due to fire.
Owner: FEES
GARDNER FAMILY PROPERTIES LLC Quantity Description Date Amount
15315 SW ALDERBROOK DR
TIGARD, OR 97224 7 crt Branch Circuits 12/29/2009 $100.70
wo /Purchase Service or
PHONE: Feeder '
1 ea 12% State Surcharge - 12/29/2009 $12.08
Electrical
Contractor:
SQUIRES ELECTRIC
PO BOX 16851
PORTLAND, OR 97292
PHONE: 503 - 252 -1609
FAX: 503 - 253 -5831
Type of Use: MF
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 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: �� ` 16- �— Permittee Signature: D ��G% C/9" �J
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.
CaII 503.639.4176 by 7:00 a.m. for an inspection that business day.
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 Application D E c 2 i ...-_-. _,..4 L2,-,..t, • ....- - , . ,...-.:-,:- -- • 74
4 8 2,;:;
pr City of Tigard C/ry -e,...eived , ,
, vii q OF ri, Vatidi Permit No.E
C,02009
2:1111 I 13125 SW Hall 131vd., Tigard, OR 97 • rk3A 4. ;4 „
A. ; B , ' Phone: 501.639,4171 Fax: 503.598,1960 ' 0/PA/ °' Pemite4A2 - 002,2
Lin: ine- 503 639 4175
r - - -- -- --- - "
- ') 413 Y , Jorn
See Page 2 for
Intrnet: www.tigard ou - .,' eihod: .. Supplemental Information
- ;.71:5 . .:77.1.T7i . .... - ,Z,,.=., -r.;ciR,Z. ": :7;...".) . T , 7 14 '. ,'''F t:7 ;'7, , ""`I'o-c.. 77 '-W. • n ''' ' . ' F''''. ' - . , .. , -.1- . 0.- - 0.11-4 , 1r ..
,,,,,:i?,4,..4-..0.11,,...--...,;,..,, .,, ....:„. grat „R„ 1, „:4( ik,;i, Y! . 4 ..., ...-,■.4,',?".:-.;: ..'+?,,.f.•!:..,.;;:,:
D New construction Ifil Addition/alteration/replacement Please check all that apply (submit 2 set of plans vilitems chocked below):
a.. 0 Scrvice or feeder 400 amps or more 0 Building over three StOrieS.
r] Demolition • Other where the available fault current 0 Marinas and boatyards.
77 4. n;vfroi4vre.f,.....i&g exceeds 10,000 amps at 150 volts or 0 Floating buildings.
.i.-..t...:Hi' . ': 3 , .7'. .....:•:, , ‘, , .,...i , f,egle J' :,■,....,!'..:. .- . It: 1 *'i k.
0.!.14■::
less to ground, or exceeds 14,000 0 Commercial-uw agricultural
El 1- and 2-family dwelling if/ Commerciallindustrial 0 Acccssory building amps for all other installations, buildings,
D Multi-family • Master builder 0 Other El Fire pump. 0 Installation of 75 KVA or
B 0 ErneTneY sYstem. larger separately derived system.
i , '. ,,,, ,,,,,4 • :.:le- _. +._ , . ;,,T,rseirgazir„,e...„. ,,,,,,v,, 0 Addition of new motor load of 0 "A - E", - 1 -.2" "1-3",
Job no.: 1 Job site address: 1b4,5 d t t) /,,,21,5i- . mom, . mom. ...inc.,.
0 Six or more residential units. ID Recreational vehicle parks.
City/State/Lir 1 7:co,t-c, El Health-care facilities, 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bIdglapt. no.: Project name: ,q,, . Serviee or feeder 600 amps or mom.
ig-CaeSef:Oi 7
Cross street/directions to job site: Description Qty. Fee. Tenn •
New residential single or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 168,54 4
Ea. add'I 500 sq. It or portion i 33.92 1
Tax map/parcel no.:
Limited energy, residential
Nte=a14 "c ',.. e . . 7 0141"W" ...; W pc . with above .. ft.) 67.84 2
.., ...,,,„ . . ,!:7.:zr::■::,.;:l ':
Limited energy, multi-family
II
+d La4- ct- e chi; fi'e.e- due 4E9 residential (with above sq. ft,) I 67.84
Services or feeders instalLstion, alteration. and/or relocation
...7 r C 200 amps or less 100.70 2
F. 44 m4. Ni.. 201 amps to 400 amps 133.56 2
... ',..".'A, ' .; .....1.- .. 4 - 4.,.._..., ,.....;,....,, ....,....i,:t.i1,..",',Olait2,741.-ak.ii*?, :14.
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps II 301.04 2
Address: Over 1.000 amps or volts 552.26 2
Ci /State/ZIP: Temporary services or feeders Installation, alteration, and/or
ty
relocation
Phone: ( ) I Fax: ( ) 200 amps or Icss 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 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 new, alteration, or extension, per . anel
Owner signature: Date: A. Fee for branch circuits wish
'-',..•,-",, c■
-P'T , ..A lik irttyp,,,-pki' , 4, 7( AttlitiOLSOI 742
F.t.,:-.k- above service or feeder fec,
each branch circuit
Business narrile B, Fcc for branch circuits
without service or feeder fec, i
A-,
ContaCt name: first branch circuit 56.18 ,ig
Each af ranc circui 7.42 44 , --m
Address: Edcl branch 2 te
Miscellaneous (service or feeder not included)
City/Statc/ZIF': Each manufactured or modular
67.84 2
duelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only = 67.84 all
E Pump or irrigation circle 67.84 I I I I I II I
'I.7;a0latZt* Sign or outline lighting 67.84
Signal eircuit(s) or
Business name: name:k_39w' re ._, kl ; A____,
energy panel, alteration, Of
extension. De.scribe: Page 2
Address7N - Ea< /4
City/State/ZIP
112,+ C.t-44d D k 97,49-1 Each additional ins. • ction over allowable in an of the above
Per inspection 66 /5
Phone: 6%)3)) -- 6. -70 • Fax: ( 1=.1565 6g3/ Investigation per hour (I hr inin) 11 66.25 MI
CCB Lic.:,,3 0g..6" Electrical Lic - ' ...//ofe_ t/< Lic.:2-iga2„± industrial plant per hour = 78 MINIM
Suprv. Electrician sigmature, requi ,:., - a , -.- - Subtotal: /00 b PM
,.. -
. Plan review (25% of permit fee):
Print name:4)e %. 9 to.' re'e, Date: irj..).
State surcharge (12% of permit fee): a . t) ,f
....---
Authorized si 0 gnature: TOTAL PERMIT FEE: , if:
This permit application expires if a permit is not obtained within 80
Print name: Date: days after ii bas been accepted as compktc.
• Number of inspections allowed per permit.
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