Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Permit
CITY OF TIGARD ELECTRICAL PERMIT ` - COMMUNITY DEVELOPMENT Permit #: ELC2011 -00255 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2011 Parcel: 2S104AD03401 Jurisdiction: Tigard Site address: 12828 SW WALNUT ST Project: LEWIS Subdivision: BELLWOOD Lot: 50 Project Description: (1) branch circuit for vehicle charger. Contractor: JARMER ELECTRIC INC Owner: LEWIS FAMILY REV TRUST 5105 SW 45TH AVE #200 BY LEWIS, BRIAN C & CHRISTINE C TR PORTLAND, OR 97221 12828 SW WALNUT ST TIGARD, OR 97223 PHONE: 503 - 246 -5381 PHONE: FAX: 503 - 244 -8037 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 05/13/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/13/2011 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 -0090. You may obtain a copy of the rules • -ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. gib Issued By: - Perm ittee Signature: 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 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. • Electrical Permit Application :1 $1 i tllz t11 a l( l< 1 .`I< ()at.a City of 'Tigard V 1+- �� Received 13125 5W Hall Hivd., Tigard, OR 9 may' S�� _it � P vices Other Permit; • II I Phone; 503.634.4171 Pax; 503.598,1964 Date atcJB v: , I, I , Inspection Line: 503. 5 Date Ready/By; ram: P`( � 1i "`" ®sea Page 2 for TntcrnCC wWw.tignrd- or.gov M G sR otificel/Metltod; Supplemental information TYP t o* w `1 1 . er I2 ❑ New construction edition / alteratio Jt1 nt Please check all that apply (submit 2 seta of plans w/ltems checked babes); ❑ Demolition ©Other: B ) " ❑ Service or feeder 400 amps or more ❑ Building over three stories. - where the available ;Omit current ❑ Marinas and boatyards. ' .... • , • • . e'A'r'EGaRY t t r r." o tv1+L"`t`idN =seeds 10,000 amps at 150 volts or 0 Floating buildings. 1- and 2- family dwelling ❑ CommerciaVindustrial ❑ Accessory building lase to arme other exceeds ons. 0 Commercial use agricultural g amps for nil other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: C Firs pump. ❑ Instaliation an KVA or '...tom• SITE oiod ;I1atIiJ►N ANIS 13f1CA T10N ❑ Emergency system, larger separately derived system. • Z ❑ Addition of mw motor toad of ❑ "A ", "E", "1 -2 ", "1 -3 ", Job no.: c t9 © Job site address: / a gag 51,) be.: itL. f let tv ormore occupancy. O Six or more residential unite. ❑ Recreational vehicle parks, Cit /Stiltc/ZIP: C Hcalth -care Facilities. ❑ Supply volfa for more ihin y / �. CI Hazardous locations. 600 votes nominal, Suite/bldg. /apt no.: 5 I Project name: ❑ Service or feeder 600 amps or more, ..��'. Cross street /directions to job site: _ . DeeeHnaon j C .Fees - I - TOlsl - j" New residential single- or multi- family dwelling unit. includes attached garage. Subdivision: I Let no.: 1,000 sq. ft or less 168.54 4 Tax map /parcel no. Ea. add'I 500 sq. R or portion 33.92 1 Limited energy, residential 67.84 2 . ' • DES RI IICO'OP !Qit , - (with above art. ft.) _ Limited energy, multi - family 11.5 -izc.66.- > ek,e_ e p,{r' residential (with above sq. a.) 67.$4 2 Services or feeders instailation and/or relocation - 200 amps or less 100.70 2 .' ' R ID ANT 201 amps to 400 amps _ 133,56 2 Name: 401 amps to 600 amps 200.34 2 ' ,_ 601 amps to 1,000 amps V - 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; ( ) I Fax: ( ) 200 amps or less 59,36 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 Owner signature: Date Branch circuits —new, alteration, or extension, per panel A. Fee for branch circuits with a APR'! -I AIV'I • ' f ' 0 'CONTACT PERSON above service or fe eder fc c, • each branch circuit 7'42 2 Business name: — B. Fcc for branch circuits . Contact name: • wirhonr service or feeder fee. / 56.18 6 .If 2 first branch circuit Address: Each add9 branch circuit 7.42 2 — Miscellaneous (service or feeder not included) City /State/ZiP: _ Each manufactured or modular Phone: ( ) Fax: : ( ) • dwelling, service and/or feeder 67.84 2 Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 • CONTRACTOR Sign oroutiine lighting 67.84 2 Business name: „OAR...I/If- fL FyCT/2-( 0, ' Signal cincuit(s) or limited - - Address: ) r / h ^ p o extension, ,��6 hen. or Page 2 2 City/State/ZIP: f- Ole: to /40 '7 O 12-* q q I Each additional inspection over allowable in anv of the above Phone:�)3) f(p 5'3 ( Fax: (503 G Per sti lo on 66.25 ° "T"C Od3� Investigation per hoar (I In min) 66.25 CCB Lie.: ' G�1 Elect Lie.: Su rv Lie. t r Industr rant d 40 P t hour 78,1 a 1 •Suprv. Electrician siinli required: c,,w -- ' , 7/ .e.,....--.........--, i t 9 - ' ELECTRICAL PERMIT FEES Subtotal: SG, . / X Print name: V1 l 5- 4Y1t� / Datc. 5_ / i - /' . Plan review 25% of permit fee). State surcharge (12% of permit fee): G :7-4 AuUlotizt.d signature: - TOTAL PERMIT FEE: /tea Print name: i Date MB penult application mints if a permit is not obtained within 180 days after it Inca been accepted as complete. Number of inspections allowed pa permit. . t ;lfidtd411"Thita12LC•PermltAppdoc r0ro1/09 440 46I571l tn5/COMAN88 i .