Permit v CITY OF TIGARD ELECTRICAL PERMIT
11111 2 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00607
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/22/2012
Parcel: 2S 102 DA00600
Jurisdiction: Tigard
Site address: 13500 SW HALL BLVD
Project: City of Tigard Library Subdivision: BARNUM PARK Lot: 9
Project Description: Installation of (1) feeder for car charger.
Contractor: JARMER ELECTRIC INC Owner: CITY OF TIGARD
5105 SW 45TH AVE #200 13125 SW HALL BLVD
PORTLAND, OR 97221 TIGARD, OR 97223
PHONE: 503 - 246 -5381 PHONE: 503-639-4171
FAX: 503 - 244 -8037
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 10/22/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 10/22/2012 $12.08
Type of Use: COM Electrical
Class of Work: ALT •
Type of Const:
Occupancy Grp:
Total $112.78
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 thr R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 .1987 or 1.800.332.2344. •
Issued By: Cam/ Permittee Signature: 41111 /(, / 9-1---
OWNER INSTALLATION ONLY
The installation is being made on property I own4hich is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' _� • - J . ` Date:
i
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.
3.0/22/2012 12:38 5@32448037 JARMERELECTR IC PAGE 03
Electrical Permit Application E c p ill 1 4 4I■ 4 'iii 4 I I '''.1 4 1 N. I 1
City of Tigr MI'
Jae go .. (6 A MOT! Parma No
P .;EZ.C1404,20 • 1114 ad " 13125 SV/ Hall BlvtL, Tigard, OR 97223
- ...-1-...1., ...., - i al
Lk. OC T I - 2 2 9n +
hone: 503.7181439 Fax: 503.598.1960 4. u 1 laii Other Permit:
I , , I , Inspection Line: 503.639.4175 Dam Ready/Br. lurk 13 See Page 2 for
Internet: www.dgard ary oF TIGAil i! Notified/Method: Sapplemental Inform. '
V . 44'.W. r ;:ffn?;:.t! , .if-Sl'i:Autr - -,7--;"1'42:" ,,,,,,,rr ) 1'1'; , , i ';: r i, ; b 4 , ..■• . V--,:e 4 Ziq "1:7':;` : n' •■• f;:, 7 , 'I.V. , -. 1 3 - at;.11 , 1.;;j1:i ' ,
', - tk;.: r-,-;afi .14 i , .;"..-'' ; .............,;.■ Tte:ON:4 4 -, .7.7,L:-.,'!:?
0 New construction .;. Addition/alteration/replacement Please chock all that apply (submit 2 sob of plans w/items checked below):
CI Service or feeder 400 ewe or more CI Building over three nudes.
0 Demolition 0 I, .. cr: where the available fault waned CI Marian =I boatyards.
._
" Ry:;•! g :4.P..---J4 = ,- , ,-, 1 ‘i 't exceeds 10,M0 amps at 150 votes or 13 Floating buildings.
:•;1'•- '4 '"'. ) .' 1 14'4:'4=',' - a:•::.:-"I v L:ti-g r -.'-...., , J,,Ae , -..'zz,'....-,-,,,‘..;:;“Fz,:',;‘....a...:-..;,:=.1..filiy,t4-44;4in.z,y.'.3..-..:Y.I.vIdtz.1....1 len to ground, or exceeds 14.003 0 Comunercial-use agricultural
0 I- and 2-farnily dwelling ,;. Commercial/industrial D Accessory building ibr all otheir izosigadicall. beading.
0 Multi-fan:di 0 Master builder 0 Other 0 vas pump. 13 InnallatioTh 0'75 KVA or
..,‘ • ----r".-4- :.:- .., ,,,,..: -2. -...--.n4.% .-tt74r,. 1.- • , , ' • . ...) -, -.",•%"4 ,-r- :„. -,, ..1.,-,„: ,..,-,,,,,,- 0 Emergency eystem. larger Beparately derived system.
1 4 ' ; ? . ! . . 7 t - : t i l _ t : 1 ; . 4 . , - . . % . 4 ; , . . t . - . . ; ..;:., ;4"-r; . ; - ; ! , 1 ! - . . 1 . . Z - ! - 9 , . ; ` , ‘ , 4 . : . - , : , . . . - S . . . 4 " : M 1 6 : 4 3 - 4 : 4 * . . i ' " " : . : 4 1 " 0 A d d i t i o n or a c w mom t o a d af 13 -4", "E". "1-r, -I-3-,
,...
1 1 1 . 1 1Mr i r, 2 100HP or more. occupancy.
Job no.: l ' 1 911 - = Job site address: i 0 10 mil , 0
, ..i 0 SW or more residential units. D Reavadonal vekkle parks.
City/State/ZIP711 11=111 0 Health -®e thcilltim 0 Supply voltage fix more than
_ .• A. •••• 11. Harardout location. 600 volts nominaL
Suite/bIdgJapt no.: Project name , - i2 b L Ze fig 0 Service or Soder 600 amps or more.
7., ).
Cross street/directions to job site: 1 II •
New residential single- or multi-funny dwelling unit.
include' 'Melted garage.
Subdivision: Lot no.: 1,030 sq. ft. or less 168.54 , 4
Ea. acld'1500 skit. Or portion 33.92 1
Tax map/parcel no.: limited energy, residential
'"'"",7'''',t' Wr-TI'21'';' P'.,1'4',' +'' ''t,i'll'ili (with above sq. ft.) 75.00 2
n . -... - J.'.- - ‘..-.. ', -,, .n.,s.' t c -,'. , .;,c41n.4.1.:1I! '',; 4 I .1'; Limited , muth
75.00 2
. ... residential (with above sq. ft.)
Services or leaden Ha alteration, end/or relocatitip
200 amps or lees 1 100.70 WV 2
1',- • - .....:e. f : -- ': -4"1,ir:-T?..-1: Lii7:-:: ,..?:;sa75:4,7: 201 amps to 400 ImIps 133 56 2
t!-IZA: '44 '..84.',::.......i4.....'.Z.:;':: ..:7 i-A , .;:hri.r,:r '.'
4°1 aniPa t°6°° ani"
601 amps to 1,000 wept 200.34 2
301.04
2 -
Address: Over 1,000 amps or volts 552.26 I 2
Temporary urvices or feeders Installation, alteration, and/or
City/State/ZIP: relocetion
Phone: ( ) • Fax: ( ) 200 amps 07 1553 5936 1
Owner installation: This Installation Is being made on property that I own which is not 201 amps 10 400 amps I 1 1 F:
intended (Or sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps
Branch dreamt, - new, alteration, or extension, per panel
Owner signature: Date: A. Fee Re breach Wade with
7.42
,, lry..,,>•-;1?-:;‘.5.-i.'":..7'rttz-1,10.7:,t-zi.,!iN'''.7-FzTe-11';‘,:.1;,.:,",'!:,'-;''1,:TI:4;717'..'";-"'.,';"C;,:,f!.'3',57.tfl above service or feeder fee, 2
'el-, .r•'13'n,7`; ?-5=i'i P v/:::-.f Pzf `.. ..r7::',";1 .‘"--::, ‘7,;, -.., -:- ..1.,..4;,..„..1, each branch circuit
Business name: B. Fee 1hr branch circuits ntraord
service or %oder fan, first 56.18 1
Contact name: branch circuit
F4oli add' I branch circuit 7.42 2
Address: MIseentneous (service or feeder not included)
Each maaudictured or modular
67.84 2
City/State/ZIP: dwelling, service and/or Died&
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E _ , _ _ ___ ._. Sign or outline lightiag 67.84 2
r- ; - . ',.',., -4 : '''
i.STZ:ii.r.??,t1;. .....44.4, 4 .4:P L.,, Signal circuit(s) Or limited
. penal, alteradcm, or exreasioa. _ Peke 2 2
Business name: „ m 4 , e ; 7 ,z1 .. _-L-- ,:.
Each additional Inspection over allowable In any of the above
Address: i7 c. s . 7 1 i 2 CZ.' Additional inspection (1 hr min) 66.251 hr
investigation (1 hr ink) 6625/ hr
City/State/ZIP: 11 , i f' -- - # 4 - A e,:c -, / hum)
ci .., 4.- d.'-' • Industrial Ow (I mn 78.111/ hr
Phone: (1.6 , ) ) / 414 . 7 f ,
/ Fax: ( $ (,))) .,..- ify - ir/z„ 3. 7 Inspections fin which no fee i5 • lv min 90.00/ hr
11232.12151. Electrical Lie : "G. Pf4"e_EMIE115311
. ,
Suprv. Electrician signature, required: 11.' , - , . . . ,.., - ..A fir -
Plan review (25% of permit fee): ---•
Print name: 5 k et. r , e a,.. , i t,,,,-. ,-- Date: 1 717111 State surcharge (12% of permit fee): . I v
TOTAL PERMIT FEE: 1 ; % I ' M
Authorized signature: This permit application expires Iii permit is not obtained within 180
days after It has been accepted as complete.
Print name: Date: • Number of Inspections allowed per permit.
tusaw1reasereaum.r-Pere,b404oe 07401110 440-46151(11/05/COM/WEB