Permit CITY OF TIGARD ELECTRICAL PERMIT
;� ). - COMMUNITY DEVELOPMENT Permit #: ELC2009 -00207
Date Issued: 05/11/2009
TLG,ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101AC00200
Jurisdiction: Tigard
Site address: 7020 SW GONZAGA ST
Subdivision: Lot: 0
Project: Davis
Project Description: Ground electrical service due water pipe repair.
Owner: FEES
FOREST PARK ENTERPRISES LLC Quantity Description Date Amount
2104 HOT OAK RIDGE ST 1 ea Services or Feeders - 200 05/11/2009 $80.30
LAS VEGAS, NV 89134
PHONE: amps or less
1 ea 12% State Surcharge - 05/11/2009 $9.64
Electrical
Contractor:
WILLAMETTE ELECTRIC INC
PO BOX 230547
TIGARD, OR 97281
PHONE: 503 - 624 -3631
FAX: 503 - 624 -2938
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $89.94
Required Items and Reports (Conditions)
This per i is issued subj.. to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be d e in accordance with - • •rovd lens. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the
180 ays. ATTENTION: Ore! •n =w regLI s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 001 - 0010th ough OAR • 52 -001 010i. ou Flay obtain a cop of the rules or direct questions to OUNC by calling 50 '6.6699 or 1.800.332.2344.
Iss ed By: v !/ Permittee Signature: .1. Ate
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'N ' d .��.�ii ,i ((- Date: ! 45'
LICENSE NO. ' 5
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 -,
(ioi /06, 2009 WED 8:02 FAX 5036242938 Willamette Electric L 002/002
Electrical Permit Application FOR OFFICE:U ONLY .. ::: ' '
City of Tigard . received a Eke 4 � �
h atcJ6 : �Q � / / � Penult No.: ..' I 13 t 25 SW Hall Blvd., Tigard, OR 97 ; lan Review
Phone: 503.639.4171 Fax: 503.598.1960 Datc /B : Other Permit:
I it; A It D Inspection Line: 503.639.4175 MAY p 6 2009 Date Ready/By: See Page 2 for
Internet: www.tigard or.gov Notified/Method: EMI Supplemental information
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New construction Addition /altgt��T1�TC trig'
Please check all that apply (submit 2 sets of plans wrtems checked below):
VUIL6JtP� ij ISION ❑Scrvicc feeder 400am amps g
El Demolition ❑ Other: c ❑ Building over thr stories.
t „ -' � -.� � � where the available fault current (] Marinas and boatyards.
� ; : t%'" , - •e` : � � r, 0: '+ ' S'a?'<'' exceeds 10,000 am sat 150 volts or F! t'
'a,' x` . r;:' °:'�%'y�, y.•�� - p ❑ oa to buildit
'- 'M' ''' > s r it I_ ~: '',' " " '• ",. ,3. . 'f''''4 :.�„% z :a;'k'; ,.,r'.r't:," B e a
—c s ti- a- : -,€:.'..:,;,.0.yy� less to round, or exceeds 14,000
(8, 1- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building B ❑ Commercial-use agricultural
rY S amps for all other installations. buildings,
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
r;zs+ _ �.,.r ,, �- •xwts :-���c`� ��•vu < -.aM. v�,s: ....,�.,,:,..:. ,. , � „�,�,,, ❑Emer enc s stem, tar erse prat! e deriveds stem.
;CL•Yn0���_'T.',V.S ' : ns,. :.� `:j�� .��-.& .yt;^"'i ..” , �,c' B Y Y B p Y Y
vac: .ht> - ❑ Addition of new motor load of (;I "A ", "F. ". 'I -2 , '3 ",
Job no.: y5 Ef'/ Job site address: 1v 9W aOfJ.M 44 s( 100HPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: '7 .20 Die 9 Z q 7 ❑ Health -care facilities. Cl Supply voltage for more than
/ G��J ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: I Project name: DA t!(.5 ❑ Service or feeder 600 amps d 6 0 i s or more.
3' r- gf `c _i= a2 W,E Ttw:: ; 3; 5 ,� Y III , Rlig
Cross street/directions to job site: Description l Qty. I Fee, I Total
New residential single- or multi - family dwelling unit,
Includes attached garage.
Subdivision: ( Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'! 500 sq. ft. or portion 33.40 1
r ,.. Limited energy, residential
fir:..'-' V' .> 1' - } - Y' -�Y�� �,- �<_...ria�.:x,:f.r�.; .��
J ; ,,$s : > "= ..A.: =r3 3 = ';tf,= 1 .ic":;, a'a rfx' - 75.00 2
:-';f -° - <�.�•, w!".?t .-::U t tti �rl.> ;R�`VV:ars .`a'rz'2...y,> :iii a,:. z
,.- .,rv.: . ,:,�.:r_,.a:,,w...,. ; . ,.,.:., <�„'�.,...:'. st; �,,;., >.�,�..., <...:.�, ^:�:a:z.:s:. ; v':�'�itr`f , ;,.��f.,<€4•< (with abo' sq. R.)
Limited energy, multi-family 4elVitio #!hate/ 4 S FieCG residential (with above sq. ft.) 75.00 2
' Services or feeders installation, alteration, and /or relocation
Wa 7rr4 Pin- ��P�l�
; ,' , --` : nr ,- ,._.,. ;, = g8 "s; ?:>: o<a7:<¢ ++: i'a a, 200 amps or less / 80.30 ')- a 2
���. .,F ,. _�,..,�.... ,'.� -` .:%.� �^' r:x.:r• .a:•'.c r�....�� • :1G�1'��i1 %�-,„ . , .v::: „ >., 201 to 400 amps o am
,rc4'a".,., ,... . ,,, a.:etv`�. s _„ ,��%`�?„4K�W1, , .>.. ,�.,..�.,.,< " "_,..�- 1.. > - .,: >`•y p amps 106,85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not ' 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
L yr ,, Y A. Fee for branch circuits with
, ,,f 4, ,. _ C , Arp l rr �• t ' ' .CONTA ' PERSON ` '= ;` above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Each manufactured or modular 90.90 2
Phone: ( ) Fax: : ( ) dwelling, service and/or feeder
Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
c :`i{ e.R �.hT1''r':�." 3 '�� i: ,,iii ,a.. i V j''.':4:: ::.eY•" _ _
�v�r� <.C.>?r:��'.v; %��i T:i�i: "" C<: rr,:'ti fir::'.:. - -
., , _ .•,.,�:� ">;;�'Ct)i 'Y'�fAtTOlti'� :ear '��;> Si or outline lighting 53.40
Business name: Willamette Electric, Inc. Signal circuit(s) or limited
energy panel, alteration, or
Address: PO Box 230547 extension. Describe: Page 2 2
•
City/State /ZIP: Tigard, Oregon 97281 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 624 - 3631 Fax: (503) 624 -2938 Investigation per hoar (I hr min) 62.50
CCB Lic.: 75059 Electrical Lie.: 34 -283C Suprv. Lie.: 4226 -S industrial plant per hour 73.75
Suprv. ,, , yiy y � j ay .... `'' , '�
Electrician w•%itl� %�)).r'�.`1i: Gl,°(C.S�iL%.�. : ti4; � %i.'K.4h
trician signature, required: - --"' -' , Subtotal: r T $O
Print name: David Fife Date: Plan review (25% of permit fee): —
06 MA / 0 State surcharge (12% of permit fee): r, 6e/
Authorized signature:
TOTAL PERMIT FEE: Pjg; w
Print name: Date: This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
I. Number of inspections allowed per permit.
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Application Status: Is5.-„,
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Address: - :•.-: - , 7. -- -..; -- •.•: - 7 :G:-7: C , "1:. - 2: :
Owner Name: 7 :.: ,-'• = :: •• E.' LLC
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3.-223C Electrical WILLAMETTE ELECTRIC INC
Supe'viscr WILLANETTE ELECTRIC INC =
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