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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00269 1 3125 S W Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2011 IIGARD g Parcel: 2S102BD02201 • Jurisdiction: Tigard Site address: 9984 SW WALNUT ST 11 Project: Chalet Village Subdivision: NORTH TIGARDVILLE ADDITION Lot: 39 Project Description: Units 11 -18: (1) branch circuit per building for GFCI Contractor: JARMER ELECTRIC INC Owner: CHALET VILLAGE LLC 5105 SW 45TH AVE #200 BY RANDALL REALTY CORP PORTLAND, OR 97221 9500 SW BARBUR BLVD, STE 300 PORTLAND, OR 97219 PHONE: 503 - 246 -5381 PHONE: FAX: 503 - 244 -8037 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 05/24/2011 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/24/2011 $6.74 Type of Use: MF 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 AR 32=0 1 -0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By Permittee Signature: �AL�% �( 7 C�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' Date: LICENSE NO. Call 503.639.4176 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 Ap l i c a t i o n 1 �V I c i I ; e r r i• rr t r: ()NI 1 City of TigstYl MAY 2 2011 F I t Permit No zp,,_ O2 ? 1315 SW BlvdTigard, OR 9 Review Phone: 503.639.4171 Pax; 503.598.1960 1 _, Da yi Other Permit: Inspection Line: 503.639.4175 lr i �i o T r I � ,�t'�1 D Date Ready/By; r ams: a Sec P age 2 for Internet: www.tignrd- ot.gev BUILDING ENVISION Notlred/Method: Supplemental Information T1 Oki woR1c t I' i 22Eva+'9v • ❑ New construction . -Addition/alteration/replacement Please cheek all that apply (aubmit j sets of plans w /items clteckcd below) ❑ Service or *odor 400 amps or mono ❑ Building over thin stories, ❑Demolition , ©Other whets tlnc available fault currant D Marione end tioatysrde. .. , -- •:' • '. e.A Oli .CO t ,(''rlolq • • accede 10,000 amps at 150 volts or O Floating buildings. El 1 -and 2- family dwelling ❑ Commcrcial/industrial lam to ground. a =cads 14,000 © Commercial -use agricultural ❑ Accessory building amp for all other installations. buildings. eiMulti- family ❑ Master builder ❑Other: O Fire pump. Otnstnliationof75KVAor • .,.30: aria . Jr oatifatoNE A• 413 136C477074 system. larger separately derived system. ❑ Addition anew motor load of 1� "A ".'B". "1-2, "1-3 ", Job no.: � � / I Job site address: d g c , q s i Le i K Y 10at9Par more, occupancy. CV i D Six or more residential units. ❑ Recreational vehicle mules. City/State/ZIP: { I G _ . a Hnr h-cue Facilities. ID S 1 voltage Ibr more than ® , ❑ Hazardous locations. Supply veette nominal, Suite/bldg./apt no.: vii projcvt k .L name: �, i 1 ( Ll Service or feeder 600 Amps or mom 111 flt s}E..- Cross street/directions to job site -: ,, a � ° i ;/ i 9 nertaroaoa n vn. l "to. I Trow i - . v .. - New raddeutiui single- or multi -htmIIy dwelling unit. includes attached garage. Subdivision: Lot no. 1,000 sq. ft or less 168.54 - 4 - Tax map/partxl no.: Ea. add" 500 st !portion i . 33.92 1 Limited energy, maident�- 67.34 2 • " DESCRIP TTON'OF *OM , (with above eq. a.) q� ,r1 t ° , . ft . )t. 1 s. x Limited energy, multi- family A - l c t „� t' l am! 1 �r 4 n J S ? k- 4 . residential (with above aq. 0.) 67.$4 2 Service' or feeders lnsta(lafi eitetalton, and/or relocatio ( (4 j .. a' . (`'i : 1 ; f ; - '.. off fee ,t' tn 200 amps or lass 100.70 2 .' '� . ❑ TENANT 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 snips 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 55226 2 City/State/ZIP: Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 39.36 I Owner Installations This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447. 449, 670, and 701. 401 amps to 599 amps I 168.54 2 Owner si arias: Branch eireoib, new, alteration, or extension, pe r panel Sn Date A, Pm ?or circuits with . ran 0 ANT • .. 'I ' •d 'CONTACT P$RSON above service or feeder fcc, each branch chant 7.42 2 Busintlss name 9. Fax for branch circuits _ Cotltact name: without service or faedct the, I 56.18 3L 12 2 drat branch Circuit — Address: Each add l branch circuit 7.42 _ 2 • Miscellaneous (service or feeder not included) City/State/ZIP: Each manufeehnedodular 67.&1 • 2 • dwelling; service and/or feeder • Phone: ( ) • flax: : ( ) Reconnect only 67.84 2 E-mail: ' Pump or irrigation circle 67.84 2 Cd1h7RAC"LOR SIgn orotttlino lighting 67.84 2 . Business name: „1 El-Le-TV J C. I N 0-. Aped r t i t (s) i W Address: 51 aS ax) 4 'p Ow ' — . extension. Describe: Page 2 - 2 , City/State/7_iP: r- oefl -Al t•ID O 12—. 94 I Each additional ins , ectlon over aliowabte in a , • of the above For inspection 66,25 cm ., ljilcrle :(503) (941(g • 53c11 I Fax: (503) 04,ek-'Sp3-it investigation per hour (i lrmin) _ - 66.25 . CCB Lie.: ere-{ I Electrical 144 S k .Liek end how industrial 78.18 • .: ,: ,' :•.B1E,ECntICA1, I'ZRMFt Suprv. Electrician signature, required: i„s•...� A.e . r. ,.,..�,.r ,.., Subtotal; I X Print name: '5T A(M 5i 11e • Date; ,5 / , Plan review (25% of permit the): Authorized signature: State surcharge (12% of permit fee): k, '7 t/ TOTAL PERMIT FEE: (9?„ 't z., . Print name: �, Date: Th is pe licPtion expires Ito permit in nai obtained within Igo days after it has beat accepted as complete. ■ Number of inspeatiosa allowed per permit. t; lmdloata •Ormite‘ELC•PermltAppatac Ioioiit9 440.4a1sr(1nllS/COM NEED