Permit ; CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00296
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2012
:
Parcel: 1S135AA80052
Jurisdiction: Tigard
Site address: 10480 SW 90TH AVE
Project: Walkoski Subdivision: ASHBROOK CONDO Lot: 5
Project Description: Reconnect only.
Contractor: OWNER Owner: WALKOSKI, KELLY
10480 SW 90TH AVE
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 05/21/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 05/21/2012 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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. Thos .re set forth in OAR
952- 001 -0010 through 0 95 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503 32.198 0 1.800.4
Issued By: Permittee 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 503.639.4176 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.
May. 21. 2012 10:21AM No. 0605 P. 1
Electrical Permit Application FOR OFFICE USE ONL1
city f Tigard REI"EIV� � ° `'` a
�
'+ 131 SW Ball Blvd., ,1'igard OR 97223 MAY 21 2012 R
Date/13 : eview S /, Permit' No. -• eV X
Phone: 503.718.2439 Fax: 503.598.I960 Date/B : Other Permit:
T, CCA ii D Inspection Line: 503.639.4175 C I T Y O F TlG Dam Ready/By: • cur`s `� Sec Page 2 for
Internet www.tigard- or.gov r I Note ed/Meihod; Supplemental Information
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❑ New construction ❑ Addition/alteration/replacement
Please cheek all that apply (submit 2 sea of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ® Other: Inspect Electic where the available faun current ❑ Marinas and boatyards.
' "' i , ,� `,, ` h Yi p� ,,t 5' ti 0 exceeds 10,000 amps at 150 votes or ❑ Floating bUldings.
'r. y ,,, , ., ,.. :5t �i6 IiS 1, ' .tiSeL . d ;ewft.k.Or tru - , ;.lijs .'' -. r ' . - 'r 1ea9 to ground, r exceeds 14.000
d, ❑ Commercial -ass agricultural
® 1 and 2 family dwelling ❑ Commercialfmdustrial ❑ Accessory building amps for all otherinstallatiaas. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
r , ;, iii ?:::i�•;atci(J:i,RI-eyr'tits•' 7'r1i: r , 155. - t`5.•' ❑Emeency larger separately derived system.
t
� ,a-i 1',
' • ialbi: , eillt e4p: i lili ` ..f e X � Ft ! i . h r _ , �P E :: `'-?'e `� ' `r - = L'_= ❑ ❑ „ ., ,.1.3 ',
,,;:, �e �5'S r �. I, „� ,, 1- '.r,,:, ; ; r�, ; r ; � - e�,r�_ �t � Adelma n rg on of new motor load of A', "E ", "r. 2
Job no,: Job site address: 10480 SW 90 Ave, lo°IIP or more. occupancy.
_ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Portland, OR 97223 ❑ Health -care facilities. 0 Supply voltage for more than
❑ Hazardous locations. 600 volts nominal,
•
s or mom.
Suite/bldg./apt. no.: Project name: t - ,;. F �� I.r,NiFYmr"^ -' ❑ Service or feeder 600 amps , r,,.t rt � u ;i'9
CrO;;s street directions to job site: ne,atpdon Qa he. Tosel ' •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Loi no.: 1,000 sq, ft. or less 168.54 4
• Tax map /parcel no.: E add'1 500 sq. ft or portion 33.92 1 • Limited energy, residential
above sq.
EtAliiiriliV4tii i: *' - r
s' 4i' fl i 1, ± i iF. i ' (with ft) 75.00 2
� 3'lizdu`i iiiu,u tc'..W . �.. = 1tc:.r4ai.-_- r'.d':� lx'r� •r� tl�.�.. •i'�!i!f'a:cii... ..Bricle6; 4i : f;Mif "r Limited energy, multi-family
I need to get PGE to hook up the power so we can sell this property. I need a residential (with above sq. ft) 75 2
J ..
SWAMI or feeders installation, alteration, and/or relocation
Permit and inspection since the power has been off for more than 6 months. ASAP 200 amps or less 100.70 2
.' rfi •`" `" 4°.- r i♦' fP 1 %r n C'' �x••e�•rlit ?� j:'` +T '"r t irF 4
_:_- ' _a t •4 , i.{� t ig (��� r , i t L• W , ii ,,, ' 1; , >af;� 201 amps to 400 s 133.56 2
T= z-� ..., :ter: :.iabi∎�c 'J a ie aii. .m.., s' !.i c:i„errlti.ittk.;LL!ucro!:IA4 ..11:1 li!li:B; .?� a0' `.
401 amps to 600 amps 200.34 2
Name: Mr. Kelly Walkoski 601 amps to 1,000 amps 301.04 2
Address: 10480 SW 90 Ave. Over 1,000 amps or volts 552.26 2
City/State/ZIP: Portland, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)382 -9036 Fax: ( ) 200 amps or less 5936 1
Owner installation: This installation i r • in l made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for salt, leas • .. • r 4. c , : = r ? : cot . ' i g to ORS 447, 449, 670, an 01. 401 amps to 599 amps 168.54 2
Owner si afore _ f' / T Branch circuits- new, alteration, or ehttension, j tr panel
gn r, Date: Fee for branch circuits wrth
Y ,f ', .rYl �,f � iI:L1• Y 7- : Y' •.•-,`. , 1' 1 ,
. " e i 1 n� I T1- r , : •1v n , - i above service or feeder fee,
s.` at
' ¢■__ir
ia'�� .,
' ti..::::a__r_t - %` a........ .. . ...... ., 1 i.c .,- is „h;� 1 '.t,� �i, , .,ut;:u a;a: i!- , each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first •
Contact name: • branch circuit 56.18 2
• Each add'I branch circuit • 7.42 2
Address: Miscellaneous (service or feeder notincluded) '
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax:: ( ) Reconnect only 1 67.84 67,84 2
Pump or irrigation circle 67.84 2
E -mail:
r ; i ,r, ;, , n„ , •, ,- _ Signor outline lighting 67.84 2 r. y am ' ;,.re -. Y,ItJ: 1iIRIttli ' `:, f.0 . _ �� °�a4 � .. � ? „ r Jl 1: = Sign
or limited-energy
Business name: N/A panel, alteration, or extension., Page 2 IT
• Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min.) L66.25 /hr /hr
City /State /711': Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is
' call listed 'A hr mute 90A0/ hr
CCB Lie.: Electrical Lic.: Suprv. Lic.: 14; ,i!�r ?�c���•'li'ii `�'==riI' �;T`:i S" s ``� i; �� ,v.,3,' fr
p LL: IilJU1. 1. tILL 1l'fiu,r�dr,.r,rru,r,r0�flti- "•�,ti- �„�y��'krJ - y,
Suprv. Electrician signature, required:
Subtotal. 67.84
Plan review (25% of permit fee): 0
Print name: Date: State surcharge (12 %ofpenult fee): 8.14
TOTAL PBRl■'4'T FEE: 75.98
Authorized signature: This permit application expires if a permit is not obtained within 180
• days after it has been accepted as complete.
Print name: Date: a Number of inspections avowed per permit.
: 1Building tpernirs\E.C•PermisApp.doc 07/01/10 440-gt615T(L1/05/COM/WPS