Permit a CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00294
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/17/2009
T. [ G A R. D g Parcel: 2S101AA09700
Jurisdiction: Tigard
Site address: 12585 SW 68TH AVE
Subdivision: PP1996 -024 Lot: 1
Project: Thannical & Robinson
Project Description: TI - (7) branch circuits.
Owner: FEES
PARAGON PROPERTIES LLC Quantity Description Date Amount
12585 SW 68TH AVE
TIGARD, OR 97223 7 crt Branch Circuits 06/17/2009 $86.75
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/17/2009 $10.41
Electrical
Contractor:
DMS ELECTRIC INC
8504 SE STARK ST
PORTLAND, OR 97216
PHONE: 503 - 516 -8393
FAX: 503 - 252 -6611
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Total $97.16
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. ATT N: Oreg la uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001- 10 through OAR 9 01 -0100 u may obtain a copy of the rules or direct qstis t OUN g " ^ ^
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 503.639.4175 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.
J.
... Electrical Permit Application ,a - , r� i' - aa, :' -' "i FOR OFFIC:F. USE ONLY
City of Tigard • % kece,.ed r 7 P Krum N,L/ •,���
Roe Lit CO"
13125 SW Hall Md.. Tigard. OR 97223 2009 Plan kr.leo II!
¢ Phan; 50.:.639 1171 Fa\ 5(13.59 19611 JUN 1 U±hrr Pet;r t
D ate Hr
I'IGA RD Inspection l ine' 503 639. - Done Reads I - - � 1,a, ' 0 4•e Pa¢e 2 for
Internet u.1on llgard- or .+go% rs ■.' , : , Notified Method 1 j Supplemental Information
1 „ c "�
TYPE OF «'011ik. PLAN KEN IEN
❑ \k\. construction : \dditinn all( ration(r�pint enter ( Please check an U:at apps. (,uhmrt 2.z :, , - f pLm- a non., L1' .1,:.i' J ..
❑ Sell ice or ftedtr lilir any, of more ❑ Iim!dn•c user lac: ,', r:: •
❑ Demolition ❑ Other: ..here the a.ari: hoe fault a :Tr:nl ❑ Mann : -. 1' .n. :rd,
I (':1TE:GOKI OF CO\STRE CI'ION 1 exceeds 1 0,,)0n an:p, at I su .oIt,,,r ❑ f !, 4or,;' bnd.!:rr•..
less :o around, w c■crr,t, I-1 In .1 ❑ I . lnn.,r..il o,: 1 r:.u
❑ 1- and 2 1111iiil. n\.klling MI Commercial 'industrial ❑ Accessory building a : np, f „ all (Off ;n,tal!atnm, h.
❑ \fluff -1 iniil ❑ \taster builder ❑ Other: Ohre pomp ❑ Lnl.11l :u,r.,.1 -s Is \:'1, r
,1013 SITE I\FORJIATIOI\ AND LOCA l'lO1 ❑Cax,f'cm. ,. hn'.r .cp r•a:;, .lr....1 .s- e;
- -- - __ �`_ ❑ Addition of ne„ motor load of ❑ \ } • I ` :
)oh no: 1 ' 25 &5 5-w (0)5 fy `� I IIt1111P :nrnc oi:111' ec.
fah �I10 annrCSS: ' ��� iii/// v
-- -- -- _r4 { ❑ S,. „r morn r,i,lcntlA um a
(, ❑ ,,. : : :nn., :. :h..: 1
'• ,.
1
( Slate /11': ❑ Heahh ro
-c e fac'lhu ,ts e, ❑ �r :ppl..ul( Inn A r
c • II'
❑Itat,uduu. „c, 6 rr,„,r. :.d •
`title bldg. ,tp no Pr
.. 1 Project name � lC0 q. Z /1 j� t - \ - p
` - � V ❑ Sr. rcc ur feeder h to amp, o; nn”: - — - _ -
FEE SCIIEDt LE
( Toss street direction, to job site: mruriprom OI,. •er. i r „ ___
\c.% residential single- or multi -fami■ d..elling unit.
Includes attached garage.
Suhdi. ision: 101 110•: 1.0(10 so 0 or le ss 145 1 . 1
a\ mat parcel 110. • I - a. add] 5110 , ft or por 1 33 40 1 }
I P Limited encrg. residential
- - — -; ru ±
DESCRIPTION OF WORK (.,nh,,fu,.esq h I
Inntitedencrgs.mule -famih 1 - ! , - On
Altering two lighting circuits, adding additional receptacles on the new wall. _ residential I• :M o ,•4 n 1
I_
services or feeders installation. alteration. and 'or relocation
2(10 amps or less 1 so ;u 7 ,
CI PROPERTY OWNER ❑ TE \A \l 201 —
__- - _ Ill amps to 100 amps � 11)b �> -1
\atnc: 401 amps to 1011 snips Ina 611
601 amps to 1.0011 amps , 24116!1 , - ' -, , - -
Address'
Orcr 1.000 amps or %ohs 454 (,' }— ,
( it. Stale 71P: I emporars services or feeder, installation, alteration, and'ur____
_ relocation
1 ( 1 i F a\: ( ) 2200 amps or less 1 66 S: r T
201 a mps to 4(10 amps i 1.1n ;o 1 ,
Owner installation: I hi, instal la m tion is brine mink on prope that 1 0..11 .shish iS oat
' intended for sale. lease. rent. or c\change. according t0 ORS -1.17. 449. 670. and 701. 401 amps to 599 amps { I ;; , �
Branch circuits - nes.. alteration. or ;.ten sion. per panel
ON% tier signature: — late: • —
fee liar branch circuits a uG r
ID :1PPLICA\ 1' ❑ COKTA(' A. f ' 1' PERSON abo. a ser. rcc or feeder tee. 6
branch circuit aJJ
mime: yy� S //� ,/� each branch circuit
Business
/7 ! __ E.L1o,C i2�C . fi Fee branch circuits
u frnm o ice or feeder Ice. ' 1
ConLtci 1181110: �+ L 46 k;
v� i vs/1 evs �y _ ' first
� branch ccircuit circuit \ddress: e 0 ! �C ���� // ^ S - F r l''ICI circuit
1 6 (,: ,
a V J �[• I� 1liscellaneuus (service or feeder not included)
('n■ Slate /IP: l-ach manufactured or modular • - - 1 -
Po 2 ��� D R. - - _ - +1 +1 111 r
8 d..el ser. ice andha feeder
Phone: (6 1 7 2 i Pa.:: toe I.�s / ll - + --
Z 6 R econ nect °i lls 66 1(5 ,
1 -mail: — — — - -
Nunip or irrigation cuelc 5140
('ON _ Sign or outline hill,' mg , 5 1 111 �?
Signal circuit(,) or limited- 1
Rosiness name: Dins Electric, Inc. 1
(mew, panel. alteration. or
\ddress: 8504 SE Stark ST cytenston I)cscrihe. I 1'a L - 2 -
-
( iI■ Stale /IP: Portland. OK 97216 i Each additional inspection 0% cr allonahle in an of the ahu.e
•
( 1 Per Inspection f `11 --
Phone: (5031 209 -9298 I I a\: (503) 252 -6611 -
I In.estigation pe hour, I hr men 6.' i0
Ll'( li I.ic.: 118073 18073 I I.lectrical I.ic 37 42(' 1 Sum's I.ic.: 4542S Industrial plant per hour 75 .1 - M•I.E :( "1'131( .11. PERMIT EEES /7--•-- ,/
Sups. I Iectrician signature. required: — -
:a Fes' +_ l I (. ��_ . �a _ tiuhlot,
Print name: \'aeile I'etrila __ y I Dale: 6/12!211(19 an re. ii: 125 "., of permit ;c c; B"
d _ - State sot 112 "ooi permit 1501 f f) , Y/
f" i
\uthori /ed signature: ms = s s, 101 Al PI R\1I1 11 1 97. /t,
' 0: - y j - - this permit application expire, if a permit is not nnraincd ailhin 1811
Print name: - - / e`Itl1 — ., s - u 5.17ftSC(li x �I )810: / - c' d ex ais after it has been accepted as complete.
/ \innh: tit
r of - p:e6nu, a!l V..1 p:m:a
1 1! • ' „,. 1'., ' .. 1 1 l l•.,,n.111,, -,t,•. •.,, _ 111 ih +11: j ((1 \1 ..t n •