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Permit t CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00272 T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2011 Parcel: 2S102BD02201 Jurisdiction: Tigard Site address: 9990 SW WALNUT ST 1 Project: Chalet Village Subdivision: NORTH TIGARDVILLE ADDITION Lot: 39 Project Description: Unit 1: (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 0 9 -001-109e. You may obtain a copy of the rules or direct questions to OUNC by calling 5 or 1.800.332.2344. Issued By: Permittee Signature: vA 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 E G . , P , , F ( I I : (Ill i ( ' l • ; 1!`1„ O I.Y Cl o Tigard R eCe l y; 0.5/2,//, 44A Permit No.: City g MAY 2 3 2011 t>ah� ��C� //— et, ,p 7�- 13125 SW hall Blvd.. Tigard, OR 97223 plan Review Phone: 503.639.4171 Pax; 503.598.1960 Date/By: other Permit: I ; , , s I . l , Inspection Line; 503.639.4175 CITY OF TI G Ash D Date ReadyBy; ra ds: El See Pago 2 for Internet: www.tigard- or.gov • BUILDING DiVISM , Notified/Method; �� Soppiemrntal lnformstlon • • rat OF WORK i�tiax; ItE VIEw • • • Fiasco cheek cell that apply (submit nets of plans w/ltems checked below); ❑ New construction 71 : ddition /alteratio n/replacement ❑ Demolition ❑ Service or feeder 400 amps or morn ❑ Bonding o ver three stories. © O ther: - whore the available thult current ❑ Winne and boatyards. tATtOt tx t3>F c01518'1`1ttyL.'t`ION . acoccds 30,000 amps at 150 vt11k or 0 Floating buridings dwelling less to ground. or exceeds 14.000 0 Commercial -use agricultural ❑ 1- and 2—family y g ❑ Commercial/industrial ❑ Accessory building amps for nil other installations. buildings, Multi- family ❑ Master builder ❑ Other: O Fire pomp. ❑ tstatlation of 75 KVA or ❑ Emergency system• larger separately derived system. ' . • . , an sin . ] i ltimit y 1TiJYtH ATii} miCAT1<ON Cl Addition of new rector load of 0 "A" "6" "1 -2" "1 -3 ", Job no.: ) 4 73 I Job site address: c q 0 W bi(f ti' l0al4 e re e, occoccupancy. ❑ mar Sur or more residentia] units. ❑ Reeroatienal vehicle parks, City /State/ZIP: ,� 9 7 ,�Z-3 a Health-care facilities. ❑ supply voltage fix more than 0 Hazardous locations. l00 volts neminot, Suite/bldg. /apt no.: ' P roject name: C. k kL, .1 0t i 1 4.4 CI Service or feeder 600 amps or more. Cross street/directions o,lob site: .p„ �.( r ,� p ,/ ef ei . V neeeruon iLr oa . .� J I total ! J New residential single- or multi- family dwelling unit. J includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 16834 4 Tax unap/parccl no. Ea. add'I 500 sq. it. of portion 33.92 1 Limited energy, residcrrtial 67 S4 2 . '' 1�CRilprl'JON`OF rtllfORi C , . • , (with above sq. ft.) I p r A � fYt $ (� _ t r 6 P CT. Limited energy, multi - family (17,84 2 t ` (`[ 1`�� residential (with above cu. a.) r p �'' Services or feeders Installation and/or relocation i i'4 K- l're t Q--' L) f .. P 'ZOV-m..S _ .. 200 amps nr lcss 100.70 2 '— ' PRO1WIT `.OWNER . •. • • • ❑ TENANT 201 amps to 400 amps 133.56 2 Name 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: .Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary cervices or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I 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 Branch circuits new alteration or extension , er . anal Owner signature: Date: A. Pre for branch circuits with ' d APPLIIrAN • d 'CONTACT PERSON above service or feeder fcc. 7.42 2 each branch circuit Business name: 0, Fcc for branch circuits (, without service or feeder fec, L �' l z Contact name: first branch circuit I 56.18 S Address: Each add'1 branch circuit 7.42 2 • Misedlanenna (service or feed not included) City/State/ZiP: Each manufachrrcd or modular • dwelling, service and/or feeder 67.84 2 Phone: ( ) • I Fax:: ( ) ' Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 • CON ACtOR . • Sign or outline lighting 67.84 2 • Business name: ..5AR TER E . L i zi C I N yL Signal me al r limited - energy panel, alteeration, or Address: 5j O._ yV11 'Q extension. Describe: Paget 2 City/State/ZiP: ' 011 fLA f■ID r3 ta. _ Each additional Inspection over allowable in an pf the above Per inspection 66.25 `��) p`16 -r(p 53 ( Fax: Phone: + I (503 • "' 5d S'i tmrestigation per hest (i hr aria) 66.25 ( CCB Lie.: (60, Electrical Lic.: 2, I Su ! . Lic.:4 B rum Induanial plant per hour 78.18 _ .. in;1 criacm, ' PER14 I ntI .. Suprv. Electrician signature, required: r •.a ..- r-.. -- -.---. Sub total; 1 Print nam SHQyyltg , e • f EM Plan review (25 %of permit fee): State surcharge (12% of permit fee): 6 - 7 tJ Authorized signature: TOTAL PERMIT FEE: ( 7 . c Z This permit aptileotioa expires if a permit is not obtained within 180 Print name: Date: s days after it han been accepted as complete. — Number of inspections allowed per permit. 1;17nalkin wenrite \L+tC.PernitApp.doe toryor/no 440- 45ur(rt/a5/comAvEB