Permit QS_ er•: Yl
v :CITY OF TIGARD ELECTRICAL PERMIT
IN
COMMUNITY DEVELOPMENT Permit; #:. ELC2010 00005
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/05/2010
T.j GARD Parcel: 1S134CA00532
Jurisdiction: Tigard
Site address: 11725 SW MANZANITA ST -
Subdivision: PANORAMA NO. 2 Lot: 32
Project: Walters ,
Project Description: Change out 200 amp panel.1 /8/10 ADDED (1) 200 amp feeder to permit.
Owner: FEES
WALTERS, JONATHAN H Quantity Description _ Date Amount
11725 SW MANZANITA ST
PORTLAND, OR 97223 1 ea Services orFeeders -200 01/05/2010 $100.70
amps or less
PHONE: 503 - 294 -5901 1 ea 12% State Surcharge - 01/05/2010 $12.08
Electrical
1 ea Services or Feeders -200 01/08/2010 $100.70
Contractor: amps or less
WEST SIDE ELECTRIC CO INC 0 ea 12% State:Surcharge - 01/08/2010 $12.09
1834 SE 8TH AVE Electrical •
PORTLAND, OR 97214
PHONE: 503 - 231 -1548
FAX: 503- 736 -0677
Type of Use: SF
Class of Work: ALT Type Const:
Occupancy Grp:
Total •'$225.57
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: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property 1 own Which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' -'` r2 0 C6 0 na Date:
LICENSE NO. s � 7VC(` O l
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.
' 1:07AM West tic 503- 736 -0656 p.1
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n nnI ^g e � �'r as 141�y k � � � M � t� �IYra���l�r �! " 11Y o GJ 2 � " Pk � $7-s. '.5v ii� t k Tigard D B )i, , Pemnt No.' 'LC 2V /C/ a: LJ. . f all :Blvd., Tigard, OR .97223' Plan Revie v Other Permit rt:u . i>� : 5 03.598.1 D 9 �� 'i . L1F 1' IGARD na�erB one: .639.4171 Fax D
" i e l( 1 l a' ' In s lion Line: 543 639:4175 LDIN r4 Da ead I ons: ® See'page 2:far
'a` .iM ?211 { :: • Internet: www.tigard or.gov: - DIUI ' , Notified/Metho sup pienien at Information
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El 13ew construction Please check eck all that apply (submit 2 sets or plans'wlterns checked below): ,
❑ Service,or feeder 400 amps or more
Other' c 0 over three stories,
� Demol itlon ,
i , ,e v s i { >7� f a r , r wh ere the available fault current ❑:Mamas and boatyards.
* t ai t/ i .t 4y A r , , c l o & "r e r X p , i4$ti ex 10,000 amps at 1 Si] volts of ❑ Floating buildings. ,
i..; t'.kr [411 r r a .au;• s . „' 1 , 6 : r . ,!, r t P _ .....:.. . ! 1R +i ... i l ess t ounii; lit excee 1
/ /�� -a nd 2-family wellin . , i� u seag ri cultwa l
y' g ❑ Conimercialiind'us[rial [1 Accessory building amps for all ogler i nstallations. buildings.
❑ Multi - family ❑LMaster.builder ❑ Other: ❑ Fire pwnp. ❑ Installation of 75 KVA or
,';
u f" a 5 t ' a��y r N � °1'. $ a� ' r li r x s e ,:; ❑ Emergency system. larger separatelydenved system_
r..... �.,. +_, .., r01tt,.,., -.r v . _:.. ..._. ::.. . -..:.` i.,,_;:., ' , ❑ Addition of new motor load cf Q.. E
Job no.: 3� 7O2() lob site address: /172 � � 12/4,,774.0/ /? ❑ . Six or S r, or oreres d occupancy.
'7 more resien un ❑ Recreational vehic /cpatics.
City /State/ZIP: 77 a ,-d 9 72 2 \ ❑ Health -care facilities. El Supply voltaic for more than
9 l / ❑ Hazardous locations 600 volts nominal
g' p t. no.:
Suite/bldg./apt. /a P roj /4/Leek, � /r'�j ❑ Service or feeder 600 amps or more.
� Project name: �C7i2 /4/Leek, ,r�
r,444 '" "" :::.,j PJ �i:yW:17, t, : N 1. . > ''� s ., x . A igiih'?-i
Cross street/directions to job site: Description. j r Qty. .s._ Fe. 0 �� rnrd t 1
e
New residentiatsingle- or multi- family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1 000sq. ft_ or less . 168.54 4
Tax map/parcel no:: Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential
' ;, t i I.
Z :i1 <
1 [ hrl?i'ti5rf. .
yaii 'a fl 5: lit' 3r Jlkty tat r 5'. (wthb
'aoves .ft 67.84 2
;�...., t .: '. ,, . ...._ . n...... ; i y6i x4 F ,....... .ter. -: -1.':v l 51 .`/. Q ft)
Limited'energy, multi- family
�
r � / j a i:76."*". / b ex / S J 7 �l'97ff residential (with above sq. ft.)
67.84 2
/ Services or feeders instanation alteration, :and/or relocation
. #. r t r 0 -8 /(J
� � ,, , �ay4t t
.., _ r Fi c i,L 201 am to 400
200 am or less 100.70 7 - 1 4 2
LE ?.-- '�YiLr'z t - 5 1 $4 " t! t ° `F J a +>. t -
. t....,. ,.��t,. $; +.r ,, ., +-;t t_ s" , .,. . , . ' r & :.. :,.,,�, r ps amps t33.�6 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
Phone: ( ) 1 Fax: ( ) 200 amps or less 59.36 l
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, er panel
Owner signature: Date: A. Fee for branch circuits with
1 {lxyl'lt i t . � j ( `Gr' F s. o ... i ` y C I 5' � 1 ' a service or- feeder fee,
,.,itF,xEj'rr ,., . .J•. ... �.. . .._. 3 n _r`FSS,..., , __ ii _ , ,..t ,,.S 7.42 2
each branch circuit
Business name: B. Fee .for branch circuits
Contact name: without service or feeder fee,
first branch circuit 56.18 2
Address: Each add'/ branch circuit 7.42 . 2
Miscellaneous (service or feeder not included) -
City/State /ZIP: Each manufactured or modular 6784 2
0 dwelling, service and/or feeder
Phone: ( . ) Fax: : ( ) Reconnect only ^ 67.84 2
E- mail:: . Pump or irrigation circle 67.84 2
;le� �I !, :lt" r!�r,1 „li., x _ ai..` r ;' iii.. i.)!. . . . '' ,... 1 .` - '. . g_ `, a .if til ?. _: •:`;r.r.'.ti ii55 _ . A �M , Vi Sign or outline lighting 67.84 2
Business namef West Side Electric Signal eircuit(s) or limited-
energy panel, alteration, or
Address: 1834 SE 8 Ave. extension. Describe. Page 2 2
City /State /ZiP: Portland, OR 97214 Each additional inspection over allowable in an of the above
Per inspection 66.25
Phone: (503) 231 -1548 Fax: (503) 736 -0677 Investi gag_ per er hoer (1 hr min) 66.25
CCB Lie.: 13306 Electrical Lic.: 26 -135C Suprv. Lic.: 4654S industrial plant per hour 78.18
{
red���� � . .n r i..w.w�` l;Xi{i._ . ' Y iii F:7i °a�lir n:;liei� -is fP(
Suprv. Electrician signature, required. ' _ .,t. � � .� 'yf Subtotal / 00 70
Print name: Randall F Roberts Date: Plan review (25 Yo of permit fee):
State surcharge (12 %of permit fee):' /2 C__L/
Authorized signature: TOTAL PERMIT FEE: / /
This permit application eipires if a permit is not obtained within 1B0
Print name: Date: I days•after it has been accepted as complete.
' Number of inspections allowed per permit.
I: 1B uildinp \Permits'ELC•PemstApp.doc 10 /01/09 4W -0615T(1 /05/C014/WEB
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CITY OF TIGARD
n
ELECTRICAL PERMIT
V
i
_ COMMUNITY DEVELOPMENT Permit #: ELC2o10 00005
TIGARD,, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/05/2010
Parcel: 1S 134CA00532
Jurisdiction: Tigard
Site address: 11725 SW MANZANITA ST
Subdivision: PANORAMA NO. 2 Lot: 32
Project: Walters
Project Description: Change out 200 amp panel.
Owner: FEES
WALTERS, JONATHAN H Quantity Description Date Amount
11725 SW MANZANITA ST
PORTLAND, OR 97223 1 ea Services or Feeders - 200 01/05/2010 $100.70
amps or less
PHONE: 503- 294 -5901 1 ea 12% State Surcharge - 01/05/2010 $12.08
Electrical
Contractor:
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 $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: / , 1-- ` - --- Permittee Signature: &./ /9-6 vAl
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 603.639.4175 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.
tan 04 2010 8:29F1M West Side Electric 503 -736 -0858 p,2
Electrical Permit Application RECEIVE 1 - 11)h O1= Flt_' E. (SL i)` I.'
City of Tigard Date,Bv: it f C .. 1' Permit No _ ' ,/ 1 / • /
.II . • 13125 SW Hall Blvd., Tigard, OR 97223 JAN 0 4 '' '' " 1 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/Bv: Other Permit:
•1 1 C, ,\ R 1 ? Inspection Line: 503.639.4175 Date Ready/By: lurk E See Page 2 for
Internet: www.tigtlyd- or.gov CITY OF TIGAR Notified/Method: Supplemental Information
r st �a "Y» ° -. - , 4 r .��SIG� `� � lfi ll r. 1� . d? t t k " �tt:< i �+
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❑ New construction Addition /alteration/replacement Please cheek all that apply (submit 2 sets of plans whims checked below).
❑ Service ce feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Other: where the available fault current ❑ Marinas and boatyards.
NI`" li 1t` . ` l G F r +,�,'F•• 41* •+ Sp C. i t s r r 1 Y exi eeds 10,000 amps at 150 volts or ❑ Floating buildings
' - "`" °" less to ground, or exceeds 14,000 ❑Commercial -mse agricultural
X l- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ['Fire Dump. ❑ Installation of 75 KVA ar
s M rit�Y Cat, .. a f ' =•. s . + E mergent tem. larger s separately derived
1 4.4 .1tli ' 'iQ*Slji'HO t�'X �. Y system.
ep Y system.
, r
no.: "[�(x[.<� Job /274,,770,/,4_172 ID Addition of new motor toad of ❑ occupancy.
_ site address: f 100HF' or more. occupancy.
Job
/J SLt� ❑ Six or more residential units.
7'. �� / Q 0 Recreational vehicle pazks
City /State/ZIP: / / g al / 7223 ❑ Health -care facilities. ❑ Supply voltage for more than
i _ ❑ Hazardous locations 600 volts oomtnal
t. no.: Project name:
Suite/bldg./apt. /a �/ t / f 1J ❑ Service or fader 600 amps or more.
P GrlG /�� Jd "/1Q Q Service iy,..,* W.f4 .1.A.1
3 :
Deaeriptmn ply. 1 rec, Total (...`
Cross street/directions to job site:
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,300 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea add'l 500 sq. ft. or portion 33.92 1
Limited energy, residential 67.84 2
Lt
r t _! ..: . :,: : + .. . : a -.�. , c . (with above sq. ft.)
��r/t, / ChahgL
Limited eid energy, (with above residential with above s ft. 67.84 2
Services or feeders instaUatio 'on, and /or relocation
200 amps or less ` n, �lterat
bS /� 7 00.70 2
li Itin Ii. r . ;t I.,i n N
`- .a?�.: , �... +,.,, ...._- ./..
: 201 amps to 400 amps 133.56 2
Name: /-6/1 l le /h±..-.1- 401 amps to 600 amps 200.34 2
r 4 /h A.,/e? 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
CitylState,ZIP:
Temporary services or feeders installation, alteration, and/or
relocation i
Phone: ( 3 ) 29 y - .S yu (" Fax: ( ) 200 amps or less I 59.36 i 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps '25.08 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: I A. Fee for branch circuits with
,.?. -? 1},':" . - '�'lM it4 i' . 4i , ._ `' ...'.:: i T d, .., . above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: wtthoat service or feeder fee,
first branch circuit 56.18 2
Address: Each add'l branch circuit 7.42 2
_ Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 1
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
:w+ z + .�. ;3 1 . 4' a .. 4 4<<,;;>. P - 7 ...•` Sign or outline lighting 67.84 2
Business name: West Side Electric
Signal p anel, al or lion. or
energy panel, alteration, or
Address: 1834 SE S Ave. extension. Describe: I Page 2 2
City/State /Z1P: Portland, OR 97214 Each additional inspection over allowable in an of the above
Per inspection 66.25
Phone: (503) 231 -1548 Fax: (503) 736.0677 Investigation per hour (1 hr min) 66.25
x ; 'CCB Lie.: 13306 ;� Electrical Lie.: 26 -135C 1 Su prv . Lic.: 46545 Industrial plant per hour 78 18
V /' �/ /// ///J/�' �YSrs`!t r Subtotal . t{ t 1 i i (
S uprv. Electrician signature, req uired: �i /�„ /�.� /rte . '/Q'
Print name: Randall F Roberts Date:
Plan review (25 %ofpennit fee): y
State surcharge (12% of permit fee): 1 2
Authorized signature:
TOTAL PERMIT FEE: 1 6, K
This permit application expires if a permit is not o • • tried within 1
Print name: Date: days slier it has been accepted as con •ete.
• Number of inspections allowed per permit. ' `�
l : giuiWiag■PermitstELC- PermitApp doc t0/01 /09 440- 45 15T(1 )t5 /COM'WEB 1 / t
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