Permit •
•
as CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00349
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/17/2009
Parcel: 25111 DD13100
Jurisdiction: Tigard
Site 8632 SW MILLER CT
Subdivision: Lot: 0
Project: Sanders
Project Description: Replace panel
Owner: FEES
SANDERS, JOHN Quantity Description Date Amount
8632 SW MILLER CT
TIGARD, OR 97224 1 ea Services or Feeders - 200 07/17/2009 $80.30
amps or less
PHONE: 503 - 969 -2222 1 ea 12% State Surcharge - 07/17/2009 $9.64
Electrical
Contractor:
WEST SIDE ELECTRIC CO INC
1834 SE 8TH AVE .
PORTLAND, OR 97214
PHONE: 503 - 231 -1548
FAX: 503- 736 -0677 •
•
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp: -
•
Total $89.94
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: Permittee Signature: ON g���erTT4D/V
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 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.
4 Jul. 16 09 12:14p West Side Electric Co. (5031736 -0677 p.1
. • eat
Electrical Permit ApplicatiR i CEI V ED , FOR OFFICE USE ONLY
LIP City of Tigard ,p6 i� � /,11 Icy ,,,iv:d /� /J C�
of I h 9 7 ® Pcn No.: 6 -L f . O( OO e V /
13125 SW I hall Blvd., Tigard, OR ()7z�.0 L 14 200 I'I ut It,ylcw / /
Phone: 503.((30.4171 Fax: $113,59 {,196(1 1 Oilier Permit:
TIGARD Inspection Line: 50.1.639.4175 CITY ( ,'.i t v Dale tamely Illy: hero. lice Page 2 fur '
Internet: www.ligard-or.gov
` -- x% Nut111rtVMclhal: I Jupplcmcolal lufurrnal n
�' } ......... BUiI .nIN(i 131J�� N i /G _..._
TYPE OF WORK. PI.AN REVIEW
❑ New c011xiruction QSCAddition /altcratioIUt•eplacemellt I'lcase (:hack all 11.17 apply (sonnet 2 sets ofplalts w /ilvl a a a rel..w .
❑ Service or feeder 400 Mops or mom ❑ Building over ihice stories.
❑ I)cinolilion ❑ Other: where the available fault cuocnt ❑ Mal II la.5 at n( 1. ratyards.
( :ATE(:ORY OF CONSTRUCTION cneeeds 10,000 amps at 130 volts or ❑ Floating hudlhugi..
less to ground, or exceak 14,00 O et m,n,'raial -tee y;ric pl411p1
7 1 I- :nitl 2- (amit dwellin ❑ ('ommereial/induslrial ❑ Accessory building all far all other installations. I:mailings.
0 Multi - family ❑ Master builder ❑ Other; ❑ Dire pump. ❑ Installation of 73 KVA or
__
........... . ..
❑
.IOR SITE INFORMATION AND LOCATION Addisi,, i o . uw system. largo' separately denval system.
❑ AJJilun f u.w a s t ken! of ❑ "A" "P" "1 ] "I l ".
•
Ir/ Job no, :it,•iy 1 Job site address: g6 -i 2 !y ,_/ M : if J �.{ . low ii. Irr metre. (ncu{7aney.
❑
/ � J El 5ix or more resld,�rlal um L�. Keetcatiunal vehicle parks.
(ply /Slate /7.IP: / YG ❑ I Ir lhh cane !Ina lit il s. ❑ Supply voltage for more Man (" f. J 1 . l V 7 4' a}' ❑ 1 tai. r,L u'. IIR'aliom„ (41(1 volt.. nominal.
Suite/bldg./apt /;1171. no.: P roject natlle: % l V ❑Scrvi,',C or (Ceder (01) slops or more.
_ �(4 t i c { - - i/ 3 + ),7 L
FEE SCIIF.DULF,
Cross street /directions to job site: Iw,r.1 I Qlo I Fr, I • rm.' I •
-
New residential single- or mulli - funnily dwelling unit.
Includes attached garage.
Subdivision: IAl 110.: 1.00( sq. 11. ur less 143.15 4
Fa. add'! 500 sq. ft. nr portion 13.40 I
Tax leap /{7arct nu" !,smiled meet;,, residential
%5.0.0 2
DK :S(;RIPTION OF WORK - -- (wilh ala7vcx,p.11.)
Limited energy, multi - family 75.011 2
7 �!v�I i C%, I. �� residential (with ahuvc sal. U .) __._ _- _. _
' - - -- Services or feeders installation, alteration, anal /or relocation -
200 amps or Is?: ! R030 0, i 2
PROPERTY OWNER I 0 TENANT 201 amps tu400 amps _ I0(7.R5 -- __2._.
401 amps m 6(I0 amps 160.6( 2
Name; `J ( //�
.... ....__ l'N.V\ t..Vl. VL/ S __._..
601 amps to 1,000 amps 240.00 2
Address: - S L \ A- e, Over 1,000 snips or volts 454,65 2.
City /State /GIP:
Temporary services or feeders installation, alteration, and/or
-..
• - -., relocation -- _ •
Phone: ('x)9 761 -r 2_2,.2 L Prxt ( ) - 2(80 amps orluss 06.85 I
Owner installation: This installation is being made on propclty that I own which) is not 201 ;imps lu 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 441), 670, and 701. 401 amps to 599 amps_ 133,75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature. , .,- _ -• -_ !)ale: A. hcc lhr branch circuits will,
❑ APPLICANT F -- ❑ CON'I'A( "l' _ I'ERSON ab0vc wry iee or feeder fix, -.. - .. -- each branch circuit (1.(i5 2
DusinCtis name: I1.1 t.•c fur branch circuits --
('(llllat:) name; 4
- - - -- wi / /Idut service or feeder lee,
f brnch eitcmtl 40.85 2
Address; - .._._.. _ Bach add') branch circuit i 6.65 2
-- - - - - -• -• - Mi.cellartemt.v service or feeder not included
(City/State/ZIP: _ Itch ntamtlitt :turcd or nodular
9L9) 2
dwelling. service and /or feeder
Phone: ( ) - - I pax ;: ( ) Rcconuccl only 66.85 - 2
li -mail: Pudlp Or irri);alinn Circle 53.4( 2
.. _.. b - -- -
CONTRACTOR Sign or outline lighting 53.40 2
Business name: WEST SIDE ELE( :'I'It1C CO,' Signal circu(((s) r limited-
_ •. .,_. energy panel, alteeration, or
Address: 1834 SIC 8 111 AV E.
extension. Describe: Page 2 2
City /State / %1P: PORTLAND, OR 97214 Each additional inspection over allowable in any dlf thc?hovc _
Per inspection 62.50
Plume: (503) 231 -1548 I Fax; (503) 736 -0677 I nvesti1 gat inn per hour (I hr min) 62.50
4 /('('I1 Lie,: 13306 Electrical Lic.; 26 -135(' Su Irv. Lie.: 4654S Industrial plant per hour 73.75
- E1 F.0 RI(AI PERMIT FK
FEES
Suprv. Electrician signature, reijuired: 4 _ _ l.. -- Subtotal: 'g �), 5� ..
Print name.: IRANL)ALL KOI3I�RTS Date: "7 1 1 L.1 t 6 flan review (7.5 ° /uuf{x :rntit fee);
- t Slate surcharge (I2'%1 of penult alec): ..'' ei, & Li
Authorized signature: TOTAL PERMIT I:IiIi: �S 1.
This permit a pplicn(ion expirts ire permit iv nut obtained within 180
- Print name: - I Oa IC; ..._._ days a ver it Ilan been uceepled a_. cuuaplele.
• Number or iuspec■oas allowed per permit.
I •, n, add.. 11 :iI'ernliuu.L1'I'.•nnilApil.duc 115 /21/(k. 445451 Sill I /lit /('l1M /WI :U