Permit II n CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00375
1 3125 S H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/22/2010
'TIGARD. g Parcel: 2S114BD01000
Jurisdiction: Tigard
Site address: 9920 SW RIVERWOOD LN
Subdivision: PICKS LANDING NO. 2 Lot: 71
Project: O'Keefe
Project Description: (2) branch circuits for heat pump and service outlet
Owner: FEES
O'KEEFE, JOHN & LISA Quantity Description Date Amount
9920 SW RIVERWOOD LN
TIGARD, OR 97224 2 crt Branch Circuits 07/22/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 624 -2074 Feeder
1 ea 12% State Surcharge - 07/22/2010 $7.63
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 $71.23
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 • 2- 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 B :
/..'ef,
Y Pemiittee Signature: O� �7 - /c. L-% e r�770 6-
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.
Jul 20 2010 5:44PM West Side Electric 503 - 736 -0656 p.2
RECEIVED
Electrical Permit Application rOki)tFI( 1'.1 sisi „1.,
III_ City of Tigard JUL 2 1 2010 o e ,° i V ed 7- ' Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
�a< t� �C - //Q '�QJ f
Phase: 503.639.4171 Fax: 503.598. MA/ OF T IGARD D ` ' : Other Per4EC r /Q ro353
1 . , ; I Inspection Line: 503.639.4175 Date ReadyBy: fill See Page 2 for
Internet: www.agard- or.gov BUILDINQ DIVISION Notifed/Method: Sap ple, „tlaformation
.•:. �.. t.. f' i1)... . ..... - : .,yw.,- k::a: :•4.. .., ; ... : •. : .jo. ; .. �4::...�•:.:• �•• ? ^>!; . .t:il : ".: ^.:: •..tr .iF ,; -_ ✓^'r -,
1 f k dl. t> J i. .1 [ �.. -. {.. .. 1NI , nr �, RxS�i1: -h: Asir.
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4 >.. .✓... j ; ' . r .r .�. :ti• •„ -: _9i... . ..;dr:T .. 1 .. :. - �;: .�J it,, .' . ��;1+!a�::..: S�i.'wT ~r.'."ii:�•' .�jM
ID New construction 1 Addition /alteration /replacement Please check all that apply (submit 3 sets of plans whtema checked below):
D emolition El ❑ S ervice or feeder 400 amps or more ❑ Bwldmg over three stories.
❑ here the available fault currc t ❑ Marinas and boatyards.
: ( r 11}.,ryr'. "X ^T. l•x n _ _ :
_y 4 � .'c' .'' ;� 7 ..? ti t 7 : 't n ri a y � exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
�.u�? v��>.G �•lu4:.�,- � 4,..:i ..,!:ei.ti`<:k .., .. I .._, . ..._ ..:, ,. :. •...,x � k , ';t,..: .:i't..a, t....: ..
- lose to grosmd, or exceeds 14,000 ❑Commercial -use agriculture]
1- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building amps for all other installations. build ngs.
Multi-family 0 Master builder El Other: lose
Pip- ❑ Installation of 75 KVA or
— iiv ` - �'iif `� :'., " . tT 4 5 . ` Mrs ' y. r -
.r k , _.: :
24 > , •; i :r,,; :. ❑ E,meagc"Y system• larger separately derived system.
F t ' ` +l 4>< f t b d �9 •'�y,. Mrs �Vi!'i: ?;'•=%?: :: : ❑ on of new
r�
=i ° �• .r� .yz r..:...�r a4 =..': .. ..: -. _. _ 'L` �:•,. ... ,�,; .fta .... ..,..d •r �•• Addition motor load of
_.... ^_ � , Y' .. _,.. _.... �. ... ... ._ . - : ! . _ . ❑ „A,• ..E,..,l- 2,..,1_3„
Job no.: J/9 y/ c/ I Job site ad ss: 9 240 J ' AiiseittOCf LA. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle petits,
City /State/ZIP' • e O� 9 72 2. ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: 6) /Pea // P sc . cm f7 6 0 �ps or more.
Cross street/directions to job site: oncripmoa i ' oty. ' 1 ra. 1 Total I •
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'l 500 sq. ft. or portion 33.92 1
y,. I � Limited energy, residential
67.84 2
k A�
r 4444 •a .: ,-44 ,-.}r ft: i:r•,t.N , �, 1 r 6 (•• t t ,, . " ° - : r . , .. : r 1 , e: us, ∎ "si r _ ,, ( e l w ve sq. A .)
Limited energy, multi- family
i of /- n j /i 0 S J /1/ (' j) 'Cr," 6 /� residential (with above sq- R 67.84 2 .) 1
�� s !' Services or feeders installation. alteration, and/or relocation
200 �.
amps or less 100.70 2
'�r, ... jyn t , t • '" w •r. mo` ;'� R= 5 *`' }r' •�,..� t. ?v9' .. 4 201 amps t0 4U1Jamps 13156 2
401 amps to 600 amps 200.34 2
Name:
60] amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State/ZIP'
Temporary vices or feeders installation, alteration. and/or
Phone:( )
I Fax: ( ) 200 amps or less 59.36 1 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, r panel _
Owner signature: D
_ gn - A. Fee for branch circuits with
ere y . all er , . , 3 1 4 1 . , above service or feeder fee,
a , f 3 � .. ' ,'. t .:•..:. ? ' : j . a r each branch circuit 7.42 2
Business name: B. Fee for branch circuits
without service or feeder fee, / t'
Contact name:
first branch circuit r 56.18 6i 2
Address: Each add'I branch circuit / 7.42 •7 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 6784 2
dwelling, service and/or feeder
Phone: ( ) l Fax :: ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
,- r, -4 ; ,..4'..1.-41,,,,-,:;,.E_.2.=2, ?, 5 -' r b f ' w' 7 �, t,, ;• h ,i; ! ^ a 'p s / $i or outline ll tin 67,84 2
- Business name: West Side Electric Signal eircuit(s) or limited-
energy panel, alteration, or
_
Address: 1834 SE 8 Ave. extension. Describe: Page 2 2
-
City /StatelZ[P: Portland, OR 97214 Each additional inspection over allowable in an of the above
— Per inspection 66.25
hone: (S03) 231 -1548 Fax: (503) 736-0677 Investigation per hour (I hr min) 66.25
CCB Lie.: 13306 " Electrical Lie.: 26 -135C " Suprv. Lie., 4654S 'f Industrial plant per hour 7838
P:rt{:iat • . w - t ';.• i. Y :., r ! C' �.f � :f J‘ . -.: }Y �i.7�3:��'A+t,�c�'•dfi ��.,
Suprv. Electrician signature, required: Subtotal: ~ 6 6
Print name: Randall F Roberts Date:
Plan review (25 %ofperrnit fee):
77/2/A61 State surcharge (12%ofpermit fee): 7 6 .s
Authorized signature: TOTAL PERMIT FEE: 7/ , . i....7
- This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1: vail4ingTenut6 \ELC- Permirnpp.doc 10(01109 440.4 LST(t uosrcoM/WEa