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Permit (4) q CITY OF TIGARD ELECTRICAL PERMIT 1111 1 COMMUNITY DEVELOPMENT Permit#: ELC2014-00436 T I GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2014 Parcel: 2S 103D D00700 Jurisdiction: Tigard Site address: 13765 SW PACIFIC HWY Project: Colony Properties Subdivision: MELROSE Lot: 7-8 Project Description: Install new panel Contractor: LOVETT INC Owner: COLONY PROPERTIES PO BOX 86280 4817 SW STEPHENSON ST PORTLAND, OR 97286 PORTLAND, OR 97219 PHONE: 503-737-8423 PHONE: FAX: 503-288-1630 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/06/2014 $100.70 Specifics:, amps or less 1 ea 12%State Surcharge- 08/06/2014 $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. ATTENTIO • regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 rough 0 95 - 01-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503�a2.1987 or 1.800.332.2344. Issued By. Permittee Signature: L � 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. Aug. 4. 2014 3:04PM RECEI lv j 1g No. 1651 P. 2 Electrical Permit Application FOR OFFICF Ise ONL1 City of Tigard AUG 4 2014 °t yNifraii PermitNo.: ELC)p/ -Do a 13125 SW Hall Blvd.,Tigard,OR 97223 P�Review • Phone: 503.718.2439 Fax:It .k ��,`A�� Dam/13 . Other Permit • u t Inspection Line: 503.639.41/5' I [ V C V Ready/By: ®See Page 2 for I Internet: www.tigard-or,gflUILDING DIVISI I ' NotiGed/Method; Supplemental Informati on �3 '5F: 74y 653:i r f I k ifs ' ✓ft 44 >. t- y i ,1 •• 7t J't J 1 �7 �F 1 Li" 2 : .y�:.. L.. L .,.. _.t._.I :'_a . �44.aY..n.w... ;.4•.•, ,. . ., ' -7 .. ...: 1. 3... ,..:i..Leii.. ❑New construction ®Addition/alteration/replacement Please check all that apply(submit A sets of plans w/items checked below): ❑Service or feeder 400 amps or more ['Budding over three stories, El Demolition ❑Other; where the available fault current ❑Marinas and boatyards. ' t t .. `r'.'E T c`rtil r aWiii ° it `n d o-7 1' �,.j ' :r°° �" - 1 exceeds to,000 amps a is0 volts or D Flinging buildings. w " less to ground,or exceeds 14,000 ❑Commercial-use agricuhural ❑ 1-and 2-family dwelling DCommcrcial/industrial ❑Accessory building amps for all other installation. buildings. ❑Multi-family ❑Master builder ❑Other; ❑Fire pump. LI Installation of 150 KVA or « , ,47 r,a.r,s 7 _� c ,:��,ii"`, :s, ❑Emersency system. larger separately derived system ..:x^i�i,,.f.. i •."c �ls;.`IY�Cy!' 31 t 3<6Orj , le i7_ �'t .. ❑Addition of new motor load of 12"A""E","I Z..."13". Job no.: Job site address: s t,,) c p•(.(F)c 100HP or more. cr y. O Six or more residential units, ❑Recreational vehicle parks. City/State/ZIP: f _A.. C1L.q 1 "1-1-3 ❑Health-care facilities, ❑Supply voltage for more than ❑1•Iarardous location 600 volts nominal. Suite/bldg./apt.no.: Projtct name: epu,N y 'zo/ 77E5 ❑Service or feeder 600 amps or more • r p as s._, I t ,. .�L ` ..Cross street/directions to job site: n.r . Qty. Fee. Total New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision; Lot no.: 1,000 sq.ft.or less ' 168,54 4 Ea.add'I 500 sq.ft or portion 33.92 1 Tax map/parcel no Limited energy,residential �. 5 d �ia _ R T4 a-.,;Vi :V ''. 44Ar-Rgia: _ (wih above s(1,ft-) 75.00 2 IP/�'�� Limited energy,(with sq 75.00 2 1' � residential(with about sq.R) Renewable Energy ❑See Page 2 Services or feeders installatio alteration,and/or relocation .: :' p r i17. y i d i m 11 .' r z .7 201 amps or less ( 100.70 2 g .�--7 20l amps to 400 amps 133.56 2 Name:���C P `Q_. C 5 ( l s,�• 401 amps to 600 amps 200,34 2 Address: 'l ,-f 7 S-J a .k- l.J 5 N ' 5- 601 amps to 1,000 amps 301,04 2 Over 1,000 amps or volts 552,26 2 City/State/ZIP:Pd it7-1.lA"A-4 q.1 '7.--1 1 Temporary services or feeders installation,alteration,and/or Phone:( ) l Fax;( ) relocation 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 • 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701, 401 amps co 599 amps 161.54 2 Owner signature: Date: Branch circuits—new,alteration,or extension,Rer panel 'i;; 'F x. t$ J 5. tt ,ii; q `il ` �p ,t ,® +«-:�Wr�a7:^ .a'4:` a A.Fee for branch arcuitswfrh , ',y" -•. r,_ u l °A•�u .t..;..' I1tE ',.t�f^�.. 5��1..'^:v'.v`^,...3-. ±�r . above service or feeder fee, Business name: L 041._--r-t— each branch circuit 7.42 � 2 B.Fee for branch circuits without Contact name: `� g��JU�Y4 ti service or feeder fee.first 56.18 2 branch circuit Address: Each add'l branch circuit 7.42 2 City/State/ZIP; Miscellaneous(service or feeder not included) Each manufactured or modular 6784 2 Phone: '90 )7 0 — 3 Fax::(s LB) 24-e---/L-3 0 dwelling,service and/or IZeder Reconnect only 67.84 2 E-mail: a . Pr D v c f 4- st1-.1)f ens•G Pump or irrigation circle 67.84 2 ; bs r V''.�,,n ', a '1..4., , ti' s.*_ iiw``5.: �a 7"12''.«. ay4?i'•`F' sign or outline lighting 67.84 2 Business name: Lai t.n- Signal circuit(s)or limited-energy Sec 0 6 g-l� panel,Each alteration,l or extension, Page 2 2 Address: )✓ach additional inspection over allowable in any of the above inspection(1 hr min) 66.25/hr Clay/State/ZIP: P 0 M1-��,mo+n MS Z p L In vesngat on(lhr min) 6625/hr Phone:( ) I Fax:( 7/i)/. 7 , ,ii//� Industrial plant(1 hr min) 78,18/hr • Inspections for which no fee is 90 00/hr CCB Lie.;/Z,c t)7 I Electrical Lic.:e;1-�'s,7 Suprv.Lic.:s t.f , '53 s, ct+fi�cagl�• listed('/2 hr mm �r uY1 F.9"iif:4t:3`•:f]!M 1?I '�t .'/i.w. x .t 3 a �.42'e` ztiaa.�t Suprv.Electrician signature,required; v�t Subtotal: /049•'t 0 Print name: 77 L � 4 r' Date: p/ Plan review(25%of permit fee): 4.7 r '7 ( i State surcharge(12%ofpermit fee); !Z•03 Authorized signature: �u�A TOTAL PERMIT FEE: I 12 77$ Jffi / ©� This permit application expires if a permit is not°M aimed within 180 ISaie; days after it has been accepted as complete • Number of inspections allowed per permit, l:lliuildiataervws'II.0 PennicApp_EL.R ERS.doe Rev 05/21/2013 .140.46I5T(I1/OS/COM/WLtt