Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT D: ELC7 /2007 864
DATE ISSUED: 12/27/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AC -00500
SITE ADDRESS: 14775 SW 109TH AVE 1 -4 ZONING: R -12
SUBDIVISION: TIMBERLINE APARTMENTS LOT : JURISDICTION: TIG
PROJECT: TIMBERLINE APTS
Project Description: Reconnect.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: Contractor:
TIMBERLINE APARTMENTS LLC WEST SIDE ELECTRIC CO INC
BY WPL ASSOCIATES 1834 SE 8TH AVE
522 NW 23RD AVE PORTLAND, OR 97214
PORTLAND, OR 97210
Phone: Contact #: FAX 503 - 736 -0677
PRI 503 - 231 -1548
FEES
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 12/27/200' $66.85 LIC 13306
[TAX] 8% State Surcharge 12/27/200' $5.35 SUP 4654S
Total $72.20 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: ' ��'L t — J � ,/ /� Permittee Signature: ., .C....eJf L `n
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: 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.
M iii_
Electrical Permit Appiticatim ^ R
.. City of Tigard l V Received FOR O P1C1 USE ONLY
° 13125 SW Hall B vt1., Tigard, OR 97223 Date/13 :/ "air — / (✓ r r
' Phone; 503.639.417t Fax: 501.595. It -'- '
'...IGt RP Inspection Line: 503.63 0 t '� 2001 Other Perron:
,
Internet: www.iigard- or.gov �+ �V t- �y DateReady/By;
`j� 1 i OF t �GARL N°ttfied/Med od: Su ar f
Su P ettt e sl 2 or l ttfurwtuiuo
TYPE U r� DIVISION
�. h _ PLAN REVI •
0 New construction
Addition alteration /replacement Please check all that apply (submit a sere of plane wlitems Clocked below);
Denwl;tion Urhar; 0 Service er feeder400 slaps or more 0 Building over three stories.
CATEGORY OF CONSTRUCTION where the available fault current ❑ Martians sod boatyards.
exceeds 10,000 snips at l50 volts or ❑ FI eeiing bt.ildings•
0 1- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building css in ground, or exceeds o rs.
amps for all other iustu:Lations. b C u o ne liar - us e agriculwral
t family
0 blister builder
Other: 0 Fi:e pump, ❑ Installation of 75 KVA or
JOB SITE U-4FOR1v/ATION AND LOCATION —1 f] Emergency system
Luger separately derived system.
job m1 ?—!7 [S rub site address: 9 ,t 0 Addition uf new rawer load of 0"A^ E "l -2" ^l•9
J K) �r 775 5 1 1t 4 Ay) LOOHP ormore. occu-wuy.
Ci ;y /51aieIZII': rc-1---,- C _�ZZ� ❑ Sizor more residential whs. 0Supplyionalvehicle
1 [ ❑ Health -care tbeikies. ❑ Supply voltage for more than
S uira'bldg.Jupt, no.:- Project nal tc � , f_ '` ❑ HazArdaW locations. 600 volts nominal. '1 rr y l tt , C Service or feeder 600 amps or enure.
Cross strreudirectionslo job site: T v.,.. � v 1tEE: SCHEDULE
7
Desert •
( �` New residential single- or multi-badly d unit.
1 Subdivision: Includes attached garage.
I Lot no.: 1,000 sq. ft. or less ' 145.15 4 -
Tax map:parcel no.: EL add'l 500 sq_ ft. or portion
33.40 1
DESCRIPTION OF WORK • _ Limited energy. residential
(with aboye sq. It.) 75.00 2
K f Limited energy, mwti- fatnily
2 s..e. residential (with above sq. +.t.) 75 2
t. Services or feeders installation, alteration, and/or relocatlou
PROPERTY OWNER i 200 amps or less 80.30 2
Name: I ❑ 41;NANT I 201 amps to 400 amps 106,85
/�� 1
�n .l f--F py'Y 401 amps to GOO amps 160.60 2
'
Address: 5.,_.) 5.,_.) A �f 601 amps to 1,000 amps 240.60 2
Address: .3 5 t ,//�� / I r 1,PD ,..,5 . f e flip p Over 1,000 amps or volts 454.65 2
LP_ I/S 0 W . Q 7 FA Temporary services or feeders installation, alteration, aodior
Phone: iG ( J / C/ 7 1 relocation
` 5 4 , S � $ gP 0 i Pax ( ) 200 amps or Tess 66.85 1
201 am
Owner Installation: This installation is being made on property that I own which is not Ps to 400 amps 100.30
ir.tended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner sigratttre; Date: Branch circuits -net►, alteration, or extension, per panel
APPLICANT t A. Fee for branch circuits with
❑ CONTACT PERSON above service or feeder fee,
Brainless name: each branch circuit 6.65 2
B. Fee for branch circuits
*thou: name: ou: service or feeder fee,
Address: I first branch circuit 45.85 2
Each add'1 branch circuit 6.65 2
CitylState /ZIP: Miscellaneous (service or feeder not included)
Each manufactured or modular
dwellin , service and /or facitr
Phone: ( ) Fax: : ( )
90.90 2
E -mail: glenng @westsideelectrle.com Reconnect only r gs /7 2
:. Pump or irrigation circle 53.40 2
_ CONTRACTOR • I Sign or outline liglttir.g
Business name: West Side Electric Co., Inc. 53.40
Signal circuit(s) or limited -
Address: 1834 SE 8th Ave. energy panel, alteration, or
extension. Describe: ! Page 2 2
City/State/ZIP: Poniard, OR 97214
- Each additional iuspectIon over allowable in any of the above
Phone: (503) 231 -1548 Fax: (503) 736 -0677 Pot inspection 6 2x0
CCI3 Lie.: 133116 Investigation per hour (I ; r min) 62.50
Electrical Lie.; 26-135C St rv. Lac.: 4654S Industrial plant per hour
73,75
Suprv. Electrician signature, required; ELECTRICAL - PERMIT FEES
�'/..� Subtotal: 4 G . 8,c rr
Print name: Randall Roberts Date: h6 k."7 Plan review (25 %ofpermit fee):
Authorized signature: State surcharge (8 %ofperrnir fee): 3
TOTAL PERMIT FEE:
Print narn : T his p ermit apptientioo expires tr' permit Is not obtained within Q
Date:
1 days after it has beau accepted as complete.
itasitdirisJ'cnnitsyELC- Pcnniln ice ` Number ofinspxhiunsa llowed r
k Qil2.rOG 440.46137(11/U3/CO.'.JWFB per penult.
Z d L866 68Z� NVdW00 012j10713 301S ISM d ZZ t�0 LO 9Z oea