Permit 3/2-17//A &c r► -ca "r„,„fri-
CITY OF TIGARD ELECTRICAL PERMIT
a.. COMMUNITY DEVELOPMENT Permit #: ELC2012 -00151
T I G AR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/21 /2012
Parcel: 2S109AA05700
Jurisdiction: Tigard
Site address: 14433 SW 128TH PL
Project: COVESCO Subdivision: ELK HORN RIDGE ESTATES Lot: 23
Project Description: (2) branch circuits for ground and garage door.
3/29/12: REPRINTED permit to change address.
Contractor: ARLO ELECTRIC INC Owner: COVESCO INC
50705 NW CLAPSHW HILL RD 16630 SW SHAW ST # J
FOREST GROVE, OR 97116 ALOHA, OR 97007
PHONE: 503 - 357 -2350 PHONE:
FAX: 503 - 357 -9159
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 03/21/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/21/2012 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344..
Issued By: r_ Permittee Signature: !u
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.
CITY OF TIGARD ELECTRICAL PERMIT
1111
a COMMUNITY DEVELOPMENT Permit #: ELC2012 -00151
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/21/2012
Parcel: 2S109AA05700
Jurisdiction: Tigard
Site address: 14430 SW 128TH PL
Project: ZABETI Subdivision: ELK HORN RIDGE ESTATES Lot: 23
Project Description: (2) branch circuits for ground and garage door.
Contractor: ARLO ELECTRIC INC Owner: ZABETI, HAMID
50705 NW CLAPSHW HILL RD HAJIAGHA, MARJAN R
FOREST GROVE, OR 97116 14430 SW 128TH PL
TIGARD, OR 97224
PHONE: 503 - 357 -2350 PHONE:
FAX: 503 - 357 -9159
FEES
Quantity Description Date Amount
2 at Branch Circuits wo /Purchase 03/21/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/21/2012 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 co 0 or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ,
Issued By: —' •er ittee Signature:
O WNER 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.
03/16/2012 01:46 5033579159 ARLOELECTR IC PAGE 02/03
Electrical Permit lica CFIVED 1.01:0111, I VSi 0 .1.,
City or Tigard Reccivod
Darc/11 : MAIIIM 1:153MEN
Iii ----- 13125 SW Hall Blvd., Tigard, OR 97MAR 2 1 2012
Phone: 503.7182439 VW. 503.598.1960 Mar Pamir
1 1 4: ; \ 1 ) in Linc 5°3 CITY OF TIGARD „ ' . Ready/By: E la See Pam 2 la
Internet vrww.tigard-or.gov Piorificdteicirod: Mgt Sep • immoral arwroation
AOC DIvisinm
:,.. ,.::..,,,,,,....„ , 1:•.• 7,- - . ... ..... i n e../ . 1.:.:. ..: If': n .:' : .".: ,..,,..; .',.i; ..777r 7 • -
0 New construction Pt Additiontaltorationhoplacanent asse chock al t apply (sate* sem apt= write= clackad bat
13 Saved or raft 400 amps ammo CI Bulliing ova era sorbs.
El Demolition Pother: abets the nvitilablc that current ['Modred and b:oryards.
it* ;' i ?:1 2 . 0 : iellagdattliVirtettiolC: 4.L.77.7coP . ,..,.'"" ; y i :: ,.:.:. : : f weeds 10,000 me w% volts or CI Flom* buildiap.
lats to ground, or aeon* i4,000 D Commercial-an agricaltutel
1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps aw all other indolkalcata. tailltlitipa
0 Tvlufti-fitraik_ 0 Master buildar 0 Other. 0 Fire pamp. CI Installarlon of 75 KVA or
''' •. ` 1. ' 4(.. • . 2' ' .'"' ''''''''' ' ''''':41jr.g114144001/Aleilb)CAltinfteteliki ;-::: :: " '. • ',: ;;:. •‘• ;,......:: .. ClEmmlFatr Bram bow aparately icrivat mum
. •.‘ , 4 7,••• • ;•••-.% •:' •".. : .:. ,":"' . • . 1 •• . . - •••• . - .. • . . 4 „ . ..z;:.;:..g. ,f . ;,e.'i■ • • : *.■ 0 Atbittlos dam molar lasd of CI "A",11^, "1-2". "I-3".
Job no.: Job site •
addrese. La93.0...ajaiala.R1_ 100HP or mom. oecommcy.
CI Sis or man reddernial UM& CI Romagna! abide crabs.
City/State/Z1P: 73 0
b ars> _ , watb....1 mid.. 0 Suy
0 Hairdo= locations. ppl wim f
p br moro Son
600 volts nominal.
Striteibldginpt. no.: Project sine: Zile MT:17 08enico or ttedcr GOO amps or mom
- ••.;:..9,;•;1 ..:..; pEZSecitppliVii....'..;z'..,,:
Cross strect/direetions tojob site: Overawe' - "" . . i um i rm. i Total 1 •
----.- New remoral angle- or multlibmily dwelling unit.
e icAdr ,,,, . 71, br- /f 113 3 Wilda attaelted garage.
Subdivision: pe-- r o - 6:1.1,:iN-a__ I 113"°*: 1,000 5. ft, *dad 168,54 4
Va. all 500 . R. or portion 3392 1
not map/parcel no.: • - I - . • I . Limital coney, residential 75.00 2
" ''.. ' t ' s . ' ... foircttott .'1%*: ,;::.,.,. ." :.;;•":"..pi...it '•::.• V. ith o it
Z -*:•.:',,,...:11.,11:,......•.!...::: • . . • • -. ...., . . - , t ...., .. ..., '4 w
.. . ..,... ....,. .. :-.... iinited crorm muitiamily 75.00 oAct 2
Vt/ \ft brStk, c011 (' ....__B_gl id AD____ , nakantial (Mei above al. ft.) _,
Services or fe ts
eders lostiladon,,olieratiOnon
. d/or reloelltlotr
eaS1eer----,49 /12 I. '. ll .� .. 4 ' 5 200 amps or las 100.70 , 2
f.`?:.• ..'1:0ol/Wile. "'
0#4314t :. . ::' ' ' .: ' •:1:•::•:::*".:' . ., - .111 atrogor.....•:.:• .....,.: 201 amps to 400 omm 13356 , 2
-Z...w.- - .......■ • ‘'..' ..: --. ' '''' •' ". ' • ';Q:.6 401 amps to 600 amps 200.34 2
Name: C MeS . 601 amps to 1,000 amps 301.04 2
Addrima: Ovia nips or volts 552.26 2
1■1••■••••■"'.............11■•• Temporary cervices or feeder; Installation, alteration, and/or
City/Statc/Z1P: Monti=
amps or km 59.36 1
Phonc: ( ) tfax: ( )
121.03 2
Owner 1033811111i001 This installation is being made on property that 1 own which is not 201 finill3 til Mg MIPS
401 amps to 599 amps 168.54 2
intended for sale. lono, rent, or =dump. according to ORS 447, 449, 670, and 701.
Brandi drains - new, alteration, or artession, ner miner
Owner signature: Date: A. Fee Iln branch circuit, with
••••• • • .".• .::, ' • • ...:ty: Mitt:ANT • ..• . .. :... :.: %•t:. . : ;!.;;;,,•:::•:, treltonect .)..; abovc %TACO Of Ilmdcr fee, 7.42 2
Business mane: 0. Pee for brands chain without
or Ruler 6:o, DM
Contact name: branch circuit I 56.18 r . A R 2
.I
___. Each addg brand circuit j I 7A2 [ 1 , LILL!
Adchmis: ' atisedloncous (service or feeder ant included)
...... -...... ----- Snob manufatorti or modular
City/Statc/ZIP: them% service ani/or &odor 67.84 2
Reconnect only 67.84 2
Phone: ( ) F:
( )
Pomp or iwigation circle 67.84 2
E-mail: sign co outline lighting 67.84 2
... - :, ...2.,___. '.. :031 :;".!%.:. ",..„• ' . . Signal &wigs) or limited.antsu
Rusin= name: 0 riorleary...."ILIC , Mal. eltrnal ok or exteradon. _ ppm 2 2
1 , &di oddiboual inspection over allowable in any of the OA
Addmss: '51) 1 C 1 i r . Additional insocenon (1 hr intn) 66,25/ hr
111V4S6p;ation (1 hr min) 6625/ a
CitYlStafta ..it• 0 # q7n_4• Wanda' plant (I lir mei) 78.18/ In
--
Phone: ... Inspections Ibr which no faa is
us FIR - !Jii- ) a5 - 2 - :. - 7 - 15.2 smeificallY lisnd (Mimi") 90.00/ br
CCB Lie.: 3524 Electrical Lit- i 8 Suprv. LW.: )
El
A •
Suprv. Eiode: a , re, required: :-.2 /0/ 10/S 9 P Subtotal: 12 3.0
im mil 324() - , • Stercri :
Print narne:1:2) ciALI ... la x i pi- _ Date3 ..pp..) a.. -------- 6garchalromorpermitico 7 . ...3
TOTAL PERMIT FEE 7/ . 3
Authorircd signature: vets Feriae applicanno expires If a permit &Int tinaltiei Mein UM
dap after it has been accepted as template.
Print name: I Oslo: • Number of instead= almod Pw P cimit
1A8tAtOnPrxmlesOILC-Peor h Ant** 0741/10 440.4615m mecum
03/16/2012 @1:46 5033579159 ARLOELECTRIC PAGE 02/03
Electrical Permit A lica _ ; ci.: ..
CE1VED 1 orli usi
City of Tigard Received
Dater II : 11161111M 1=1212MIPIPM
11, 1 13125 SW Hall Blvd., Tigard, OR vrAMR 2 1 2012 Plan Review
Phone: 503,71112439 Fax: 503.598.1960 That/ft : Other Permit:
Inspcetioti Line: 503.639.41 75 CITY OF TIGARD Date Ready/By: t...:L.. FD See Page 2 ibr
Internet wv.rw.tigard Notified/MMhed: FIEMI Supplemental Information
piu3au cheek all that apply (submit MIA of pions wfitems checked below):
0 Ncw construction pi Addition/alteration/replacement 1:IPA:mice or feeder 400 amps or more 1:1Bnilding over three stories.
O Demolition 0 Other where the available Mott current 0 Marinas and boatyards,
`,.:•';:.;!:,''''',.i'..':•,:::....!•!1,::... .:
..' '', , .., ;..: ;.:1.:,.:.. ,••••:::::",1 .,: exceeds 10,000 amps at 750 volts or El Flouting building%
- .....t•••• • • ...s. ', • • - 1.....1.---,1.-...L...i.z....i..L;=:-.... 5 kete to grotmd, or exceeds 14,000 0 Commereird-tere wieldier&
■.■ 1- and 2-family dwelling CI Commercial/industrial 0 Accessory building amps r all other instaihtiona. battings.
O Multi-family 0 Master builder 0 Other: 0 Pita puma. 0 instal1ationof751C,VA or
larger separately derived grim.
• 4.h1W eirix&ei
"..:"1....F ::..-.. ';': ' '. '''...= '-., ''''.'•': • - '''''''..• '• CI Addition of new meter load ef D"A" "E", "1-2", "14",
Job no.: I Job site 100HP or more occupancy.
te address: Lay_ 3 1 ,-. et mere resideminl units. 0 Recreational vehicle palm
0 Realth-oure facilities. 1:1Supply voltage for mom then
City/State/ZIP: 7 ; b pa, 12 ___ o Hazardous locarleas een volt:nominal.
Suite/bldg./apt no.: Project name: 721-e '7T7:—.J.,_ 13 SerViC0 OT fetter 600 ampa or mons,
— / 'j':.::' EEV.SefillYEEE•!
Cmss street/directions to job site: aleUioonn I olv. Pre. i Totel i •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision:
— Lot no.: 1,000 sq, ft mins 1611,54 4
----- — Es. add'I 500 sq. It or portion A 33.92 1
____L—
Tax map/parcel no.: --------- Limited energy. residential 75.00 2
''''''. Y: • ''''''' '..; ' ''''''''' ." 4 '1;'::.... :':' :.;.liECitfkritfit fotAktikft: ''......:'....' • ,." :; '::••.':. • ',;.:......:.
' (with above sq. R)
Limited energy, multi-family
i ' a brO_Cil.+1 gr..:— residential (with above sq. ft.)
75.00 2
Services or feeders installation, alteration, and/or relocation
A .1 . IC) 0 (Ct be_ 0 e r €3 200 aims or las 100.70
133 .56 2
PlititV Oftkit i.
t• ...'...:' '.......' '..l •:•; .1:Elitikl•re......:' s.:.:•,.!.. • : -.....:; 201 amps to 400 amps 2
.. ..... .
' 401 amps ro 600 amps 2D0,34 2
Name: Di d2. z ae _ L. _all a • — . - 601 amps to 1,000 amiss 301.04 2
Addrms: Over 1,000 amps or volts 552.26 2
--- Temporaly services or feeders Installation, attcration, and/or
City/Statc/ZIF': relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 t
201 amps tn 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 40_1 amp to 599 amp, 168,54 2
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee (be branch circuits with 1
•
.':•::: :itittatjait: :..'" . ...'1,;:..RtillqltIcCOVi... a fec 7.42 2
B. Fee for branch Circuits without
Businew name: — service or feeder fee, Ora
branch circuit I. 56,18 Ski 2 2
Contact name:
----. ---- Each add'I branch circuit
1 7.42 _ "7. q2. 2
Address: Miscellaneous (service or feede r ant included)
Each manufactured or modular
City/State/7..TP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
. , Pump er irrigation circle 67.84 2
E-mail: ______ or outline lighting 67.84 2
.-- —,..—
......
CO ,... ....,.:::;...:,,....: :,.., ••••• fi:•!.:"iL,Z..,L Signal circuit(s) or limited-energy
pod, alteration, or extension. Page 2 2
Business name: fir 1 _ Each additional inspection over allow in any of the atm;
Address: . 0 . 1 - 2 . 125 ifu . Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 6625/ hr
City/Statc/Z ' . ...Le Industrial plant (I hr min) 78.18/ hr
Phm: : ....;1 . L . c" ranDi Fir? Irexpections for which no Me is
3recificallylistedSA hr min) 90.00/ hr
CCE Lie.: 524 Electrical Lie.3: e &e suprv. Lic.: 1 ''..!!:.^':.: f,',..: i...:' :i
Subtotal:
Spry. Electricien dire, required: --2 / V I 4 9 .. .
Plan review (25% of permit !be):
Print (A(N 'p . rl-,.,\ier. Date 'Op --) a - . stale =dine 02% of permit fcc): --/ . 63
ToTAL PERMIT FEE: 7/ as
Authoriled signature.: This permit applleatirre expires Ifs permit Le net attained within 180
days otter it has been eteepted en eemptete.
Print name:
..-. Onto • Member of inspections allowed per permit
..
SABthiel;nR \PerfratAELC-ItTmh.Ipp.d0C 07/01/M 440.1615T(1 MS/COM/WM