Loading...
Permit CITY OF TIGARD ELECTRICAL PERMIT 1.• COMMUNITY DEVELOPMENT Permit#: ELC2014-00017 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/22/2014 (�'�� O g Parcel: 1S133AD02200 Jurisdiction: Tigard Site address: 10730 SW 130TH AVE Project: Westgate Baptist Church Subdivision: CHAPARRAL Lot: 1 Project Description: (1)branch circuit for lighting of flagpoles. Contractor: NORTH LAKE CONTRACTORS Owner: WESTGATE BAPTIST CHURCH 12900 NW LOVEJOY CT 12930 SW SCHOLLS FERRY RD PORTLAND, OR 97229 TIGARD, OR 97223 PHONE: 503-709-0985 PHONE: FAX: 503-641-3168 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 01/22/2014 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/22/2014 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a cop -,111 - •tes.or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344 c � Issued By: 1� Permittee Signature: O ilfr. WNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. ti �catio EC i�IE� ,r����� •h'zv7 7. 4,. Electrical Permit App - . Washington County.155 N.1"AV,Suite 350,!KM 21/Itch/II,OR 97124, oercn�' Phone:503446-3470,Fax:503-846-3993, Ins,ection Re+nests: 503-846-3699,www.c tt 1 , - 1 TYPE OF WORK .' 1 ' •! A A PLAN REVIEW ❑New construction Addition/alteration/replacement ❑Other 1` Please check all that apply: ❑ Service or feeder 400 amps❑ Hazardous locations _—_ _ or more where the available Service or feeder óta)amps or more CATEGORY OF CDN$bRuC I( tault current exceeds ❑ Building over three stones 10,000 amps at 150 volts or❑ marinas and boatyards +] 1 and l-tamil}'d��eliing �Commercial'industrial ❑Accessory huildin less to ground,orexceeds'� �aster builder ❑Other: 14,000 amps for all other ❑ Floating buildings ❑Multi-family installations. ❑ Commercial-use agricultural L:f JCS SITE INFORMATION AND LOCATION v buiWrngs ❑ Fire munp ❑ installation of 1511 KVA 0r larger Job no.: Job address: /0 .1.1..3 L.3 ❑ Emergency system derived s stern ❑ Addition cfnew motor ❑ ,""E-..I.2,"1-3••occupancy CityiStatelZ(F: �� _ load of i OOHP or more ❑ Recreational vehicle parks Suite bldg.i apt.no.: I Project name;Agyrder r.E64*,poitzs ❑ Su or more residential units ❑ Supply voltage for more than ❑ Health-care facilities 600 volts nominal Cross street/directions to job FEE.SCHEDULE • Description I Qty. Fre 1 Total - a • Subdivision: I Lot no.: Residential single- or multi-family dwelling unit • Includes attached garage Tax map/parcel no.: 1,000 sq.It.or less 163.75 -1 . — DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion douto --°--` Limited energy,residential lns.tw 2 . 7-(/r& ?D L6- L(G•Lw r -- ._ (with above sq.ft.) _--_-- I Limited energy.multi-family noon I 2 residential(with above sq.ft.) Q PROPERTY OWNER • Q TENANT Services or installation,alteration.andier relocation . / � ..,rte- 200 amps or less ln5-tit+ 2 Name: �J FS(6 -i ,6 r+1 s 1 /�++C erUcC k _201 amps to 400 amps — 158-On 2 Address: /2 F so ' ,) c G 1'fd(L`1 C��+tR>f z,b `, 401 amps to 600 amps 210.00 2 601 amps to 1,000 amps + 315,)0 Y 2 City/State/ZIP: (��'c ( Drs Over 1.000 amps or volts 1 530 00 2 Phone:1S03 ) 5 Z C f g sQa Fax:( 1 :.Temporary eervicee or feeders iaatxlvtttiss,sAaretien,oad/or relocation Mauer iaatallatioa:This installation is being rnatk on retiidrniial or farm property my-ned by Inc or a member of 200 amps or less 105_00 2 1 my immediate family. Ibis property is not inicndcd lot sate,exchange or rant.TORS 479.54041 t and 479.560411. , I 158.00 201 amps to 400 amps - [ - Owner signature: .Date: 401 amps to 599 amps 210.00 - '. 2 ❑ APPLICANT 1 © CONTACT PERSON 1lrsach circuit*-nw,e ,or r t A.Fee for branch circuits with Business name. TT +vpotl1 i/l uc-r i.} c._ above service or feeder ice, j 'U each branch circuit ' 34.1 Contact name: ��t�N -� B.hoe for branch circuits i tr i4� without service or feeder Address: C l l�-4 S SC,..) �Yw�I �i the first branch circuit I . i 2 -- — Each add.]branch circuit 9.25 City/State/ZIP: -I'L� n e" 9.!Z Z 3 --- —_- (service or feeder not Included) Phone:(803) S'7Z 737z. I Fax:( ) Each manufactured or modular I I 11:.25 2 dwelling,service,and-or feeder i E-mail: AD , dD S y d-O. Cc r3 Reconnect only ( IC,S.on — I CONTRACTOR Pump or irrigation circle j ins O0 i 2 Business name: ■ og-TZ,t LA KE N 1f 5 uC_ Sign or outline lighting i 10s i.1u 2 1 Signal circuu(s)or limited- Address: I'jt y) IQ th3 L.oYe- )Y CA— energy panel.alteration,or ; 'G5 tit extension.Describe: t City/State/ZIP: Po L4-ND i OR_ 617 9 -_ Sidi WPeelloa eve.lOrrahie is nay of the abovs Phone:( � 70 _09 Fax:( 1 Per inspection I 105.00 V E-mail: a1 fit- CCB lie.no.: / 17; Investigation fee(sere comrt:.,>- m is Electrical 1 e.no.: C,1 S 'CDM City or metro lie_: 214. a Other . Supervising electrician, `1�G 1 S ELECTRICAL PERMIT FEES r. 1 signature,required: g to Cunt Y 1 Subtota: 7 zr a Plan review( '-5%of permit fee) �� Print name: h of_r_ WIL1(GtfY�S' Date: fit/3//if a..) State surcharge i 12"in of permit fee) �.7 Authorized TOTAL PERMIT FF,F. • signature: ( J This permit application expires if a permit is not obtained Print name: f,�-�/ f i L,. L Date:I///3 r i 4' I within 180 days after it has been accepted as complete -+s ! r Number of inspections Allowed per permit. Revision 1,12 Location: Record Type: Inspection Type: Result: Comments: Inspection Date: Record ID: Inspector: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 10730 SW 130TH AVE, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2014-00017 Chip Barnett Violation Summary: Inspector Contractor