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Permit td i ° - - � 4 .� cork. -4; CIT F TIGARD ELECTRICAL PERMIT e V a :; COMMUNITY DEVELOPMENT Permit #: ELC2010 -00099 °' Date Issued: 03/03/2010 T t GAR L? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S 102 BB00829 Jurisdiction: Tigard Site address: 10470 SW JOHNSON CT Subdivision: Lot: 0 Project: Mobley Project Description: Install (1) 200 amp or less panel, and (1) branch circuit for GFI outlet. 3/18/10, adding (3) additional branch circuits. Owner: FEES MOBLEY, MELEAH Quantity Description Date Amount 15702 S NEIBUR RD OREGON CITY, OR 97045 1 ea Services or Feeders - 200 03/03/2010 $100.70 amps or less PHONE: 1 crt Branch Circuits w /Purchase 03/03/2010 $7.42 Service or Feeder 1 ea 12% State Surcharge - 03/03/2010 $12.97 Contractor: Electrical WEST SIDE ELECTRIC CO INC 3 crt Branch Circuits w /Purchase 03/18/2010 $22.26 1834 SE 8TH AVE Service or Feeder PORTLAND, OR 97214 0 ea 12% State Surcharge - 03/18/2010 $2.68 PHONE: 503 - 231 -1548 Electrical FAX: 503- 736 -0677 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $146.03 Required Items and Reports (Conditions) This permit is bject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done 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. TENTION: Oregon la ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -1.1 -0010 through OAR 95 01 -010. u may obtain a copy of the rules or direct questions to OUNC b g 503.246.6699 or 1 ..800.332.2344. Is ued By: \ • Permitte _ .%/ t _ - - ' ._ 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 0 LY SIGNATURE OF SUPR. ELEC' / Date: LICENSE NO. � / CaII 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. CITY OF TIGARD ELECTRICAL PERMIT IN '' Q :,-• - COMMUNITY DEVELOPMENT Permit #: ELC2010 -00099 :T IGARD: 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010 Parcel: 2S102BB00829 Jurisdiction: Tigard Site address: 10470 SW JOHNSON CT Subdivision: Lot: 0 Project: Mobley Project Description: Install (1) 200 amp or less panel, and (1) branch circuit for GFI outlet. Owner: FEES MOBLEY, MELEAH Quantity Description Date Amount 15702 S NEIBUR RD OREGON CITY, OR 97045 1 ea Services or Feeders - 200 03/03/2010 $100.70 amps or less PHONE: 1 crt Branch Circuits w /Purchase 03/03/2010 $7.42 Service or Feeder 1 ea 12% State Surcharge - 03/03/2010 $12.97 Contractor: Electrical WEST SIDE ELECTRIC CO INC 1834 SE 8TH AVE PORTLAND, OR 97214 PHONE: 503 - 231 -1548 FAX: 503- 736 -0677 Type of Use: SF Class of Work: ALT 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 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 AR 952-001-0100. You may obtain a copy � of n the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Q� \ 0 . ,Q1 11/11 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' c.....\ Q ^ • Date: LICENSE NO. �` Call 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. Mar 01 2010 6:03PM West Side Electric 503 - 736 -0656 p.l Electrical Permit ApPlicati rornP 2 2010 FOR OFF ICE t SI <;:\1.1 C i ty o T i g ard Received 7 • 13125 SW Hall Blvd., T igaz. Sa' Plan Date Review __..4 ` ���� • Phone: 503.639.4171 Fa i. 1 '',.. � Other Perrnd: Inspection Line: 503 - t -. ' ..-^' : ; "1 I �;:, I: c, Date Ready/BY" `` ` 65 see Page 2 for M Internet: www.tigard or.gov Notifiedethod: I �� Suppkmental Information r titi � y, I r ,t� .. ' ip n , n: t t it S' >i ,t 1; (t�t�,r.. _ ,., , . , .r..v.. .sir ti.. ,A Yt, :. +.� eNF! ; . �� J . , , ..• �- � r .......... ... � - � ' � .. r k F � i .fit ❑ New construction Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wino= chocked below) 0 Service or feeder 400 amps or more ❑ Building over three stories El Demolition Other where the available faun current ❑ Marinas and boatyard :407ar„4y,,+,f :,.S� .. ` ❑ ,r .. . , '� . ry> r • -_ . s y exceeds 10,000 amps at 150 volts or ❑ Floating buildings . �� s tilt t '. leas to ground, or exceeds 10,000 ❑ Commercial-use agricultural 1 - and 2-family dwelling Commercial/industrial Accesso building auras for all other installations. buildings. Multi-family 0 Master builder El Other: Fire pump. ❑ Installation of 75 KVA or i - r } , �j9 y,�� ...+ t 1 wry <y�� , , I - t ❑Emergency system larger separately derived system. li t �, la ,..:r. . ,. " ,1: . ,71f.t IFR it, ._ _. .�.�,.. r s`�,•/ ,,._ .. ' r '- .. 0 Addition of new motor load of •. .. .. - �.. , , - >. Job no.: a il 7k, g g Job site address: AO Y 70 S w J U�t I'1,(1I t ( I00HP or more ❑ occupancy .. 0 Six or more residential units ❑ Recreational vehicle parks. � City /State /ZIP: / �, ��i ode r /'try 9' 7 1 � ❑ Healthcare facilities. ❑ Supply voltage for more than LC l ❑ Hazardo is locations. 600 volts nominal Suite/bldg. /apt. no.: Project name:0414 , Z1ele°�t/ • 0 Service or feeder 600 amps or more. Cross street/directions to job site: Description ' "" '� ' ? "� 1 G'ry• Pea 1 Totd New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 4 1 168.54 ' 4 Tax map /parcel no Ea. add'! 500 sq. ft. or portion 1 33.42 1 Limited energy, residential T ? x '?NI 1 .r� -. .. :' r.:_ (with above sq. 8.) 67.84 2 /r� /' Limited energy, multi- family 67.84 2 � 7 / c �►�lI2 ye- (. ��D �f�� _ residential (with above sq. ft.) Services or feeders installation. alteration, and /or relocation y-.t 200 amps or Tess ✓ 100.70 /040 7? 2 4101K . * 5t ii:5 .... x _... f . i? : •Ci' . L ... I ' i 201 am s to 400 amps r P p _ I33.56 2 Name: 401 amps to 600 amps j 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 ' City /State/ZIP: Temporary services or feeders installation, alteration, and /or relocation _ Phone: ( ) Fax: ( ) 200 amps or less 5936 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 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration. or extension, per panel Owner signature: Date: A. Fee for branch circuits with v— . - f:' , ..`:' ' • 0 t ,, 1 1Yt r � above serv or feeder fee, r- each branch circuit lYd '4'� ' �' �'°E L°N -,y / 7.42 7 y 2 Business name: B. Fee for branch circuits without service or feeder fee, Contact name: first branch circuit 56.18 12 Address: Each add'I branch circuit 1 7.42 I 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 67.84 2 -- dwelling, service and/or feeder Phone: ( ) Fax ' ( ) Reconnect only_ 67.84 2 E -mail: Pump or irrigation circle 67.84 2 .,1i l t l t • + >'% < , Si or outline lighting Wa. "t, `t; r.,l,..l,...., )�$. :.... :? I .. Sign P* g 67.84 2 Business name: West Side Electric Signal circuit(s) or limited - energy panel, alteration, or Address: 1834 SE S Ave extension. Describe: Page 2 2 City/ State/ZIP: Portland, OR 97214 Each additional inspection over allowable in any, of the above Per inspection 66.25 Phone: (503) 231 Fax (503) 736 - 0677 Investigation per hour() lu min) 66.25 I CCB Lic.: 13306 Electrical Lic.: 26 - 135C { Suprv. Lic.: 4654S Industrial plant per hour 78.18 :`'ll Ci`atex[:T11 :Amer Suprv. Electrician signature, required: 4 '� ... Subtotal / L 1 ' , _ : . Print name: Randall F Roberts Date: Plan review (25% of permit fee): State surcharge (12% or permit fee): / 2 .77 Authorized signature: TOTAL PERMIT FEE: ( Z / OrJ This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as compkte. ' Nuu:ber of inspections allowed per permit 11Buldt Pen its1ELC- PermitApp.doc 10101/09 4404615T( I I /05 /C0M.'W58 iZi) cii \_clAsi. \(___(:.„) \ Mar 17 2010 4:51PM West;t ,a 2c 503-73G-0656 p.2 Electrical Permit Application , l I:( Orr I(I: I:si.. t,� .� Application - I ;. � City of Tigard - Received ° F' ,-- • 13125 SW Hall Blvd., Ti d, OR 9722 ' I' ", ' �/ i,''��' f° 'I.'R`,' Date.: Permit No.: • il h lr . ., ©� ;r`L+'.,'`�� Pleas Review Phone: 503.639.4171 Fax: 503.5981 �, -)7 1 i 1, Date 1 B : Other Permit: Inspection Line 503.639.4175 �� �� Date Read /9 hu ms. T1 GAI:1± l Ready /By. la see Page2 Internet: www.tigardor.gov Notified/Method: Supplemental Information M > feat - M - } { y N(i � , r' r n * ❑ New construction A Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): . ❑ Demolition O ❑ Service or feeder 400 amps or more ❑ Building over three stories D ❑ where the available fault current ❑ Marinas and boatyards. r , r exce 10.000 as 190 volts or g mg fr'i'I 'v '{�r�i'!'� 9 r• 5 T � r d i t : i amps ❑ Floating buildings. less to grotmd, nr exceeds 14.000 ❑ Commercial -use agricultural p-1- and 2- farnily dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or W.W _, � �sn � � ,,, t r c • •, r , u Emergency system larger separately derived system :: - . s 4. ! ak i tr�r °!rF "fi ' . !?� t N 1 4 >; / .: ' r ❑ Addition of new motor load of ❑ � 7 .. Ty ?(K /0 'X 54)37),4„, fns, �7� Six occupancy. )ob no.: Job site address: ❑ Six or more residential units. ❑ Recreational vehicle parks City/State/ZIP: 7 / 4 J ? ❑ Healthcare facilities. ❑ Supply voltage for more than ❑ Hazardous locations 600 volts nominal Suite/bldg. /apt. no.: 1 Project name: ` � t f ' f e ei 4 /' / C ,.,, ❑ Service or feeder 600 amps or more. ■ 1 1 Dry. � F 1 Toot' ;.,;, Cross street/directions to job site: Description ' 1 , New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 Tax r / ° + : 41 11 r �, t r Limited energy, residential .\fit.i.r�...�:jald,.n: _ ..i ., -@ ..: 114i,r !' , :�� .. r . (volt) above sq. it.) 67.84 2 i d Limited energy, multi- family .f1 t 7 C /Zit'', C?. /'..04 o X - . � � .. r/ residential (with above sq. ft.) 6784 2 N . V Services or feeders installation, alteration, and /or relocation ,( ?ex1 5rIN)a Pe.,2k et-6610(0-000F" 200 amps or less 1 00.70 2 l n1 ?'ac' r'l' it h i .. ... ,,. ,: is 7 r r :...:,....,, ,", ll ....,. ! .; ;. . :tk ., 20 1 amps to 400 amps 13356 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City /State /ZIP: Temporary services or feeders installation, alteration, and /or relocation 1 200 am or less 59.36 l Phone: ( ) Fax: ( ) amps Owner installation: This installation is being made on property that 1 oval 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 panel Owner signature: Date: A. Fee for branch circuits with i ' ? d „wP t kAlrr . : in i'tr a above service or feeder fee- 7A2 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee. ) first branch circuit / 56.18 Sc, — 2 Address: Each add"' branch circuit Z 7.42 / % O 2 Miscellaneous (service or feeder not included) City /State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 ,, x _ l +.s - _ f.it i:taP .. ti. ? E'„; .: :h, ,r , t�TR':. a ' ; (N. , Sign or outline lighting 67.84 2 Business name: West Side Electric Signal circuit(s) or limited - energy panel, alteration, or Address: 1834 SE 5 Ave. extension. Describe: Page 2 2 City /State /ZIP: Portland, OR 97214 Each additional inspection over allowable in any of the above Per inspection 66.25 Phone: (503) 2314548 Fax: (503) 736 -0677 Investigation per hour (1 hr min) 66.25 CCB Lic.: 13306 Electrical Lic.: 26 - 135C I Suprv. Lic.: 4654S Industrial plant per hour r 78.18 Suprv. Electrician signature, required: 4 - l Subtotal: / -- Print name: Randall F' Roberts I Date: 3 / 7l0 Plan review (25% of permit fee): s r- 1 State surcharge (1 of permit fee): g --- 1 Authorized signature: TOTAL PERMIT FEE: 7 k rte, This permit application expires if a permit is not obtained within 180 Print name. Date: days after it has been accepted as complete. s Number of inspections allowed per permit. 3 I.\ BuildinytPennes `ELC- Pe+m9App.doc 10/01/09 440 1615T(1 1105 /COMIWER