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Permit (77) CITY OF TIGARD REVISED ELECTRICAL PERMIT q.a.1 -) • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00555 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/25/2012 Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST Project: Greenway Cell Site /Day Wireless Subdivision: ASHBROOK FARM Lot: PTS 5 & Project Description: (1) 200 amps or less for feeder for celll site 9/27/12 REPRINT add (1) branch circuit Contractor: WEST SIDE ELECTRIC CO INC Owner: SUN LIFE ASSURANCE CO OF CANADA 1834 SE 8TH AVE BY NORRIS BEGGS & SIMPSON PORTLAND, OR 97214 121 SW MORRISON ST #200 PORTLAND, OR 97204 PHONE: 503 - 231 -1548 PHONE: FAX: 503 - 736 -0677 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 09/25/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 09/25/2012 $12.08 Type of Use: COM Electrical Class of Work: OTR 1 crt Branch Circuits w /Purchase 09/27/2012 $7.42 Service or Feeder Type of Const: 0 ea 12% State Surcharge - 09/27/2012 $0.89 Occupancy Grp: Electrical • Total $121.09 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 OA 952 -001- 90. You m y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.. , I Issued By: %r Permittee Signature: OOki APR-16477e . 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 503.839.4175 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. y CITY OF TIGARD ELECTRICAL PERMIT ,1 ' 2 , COMMUNITY DEVELOPMENT Permit #: ELC2012 -00555 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/25/2012 Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST Project: Greenway Cell Site /Day Wireless Subdivision: ASHBROOK FARM Lot: PTS 5 & Project Description: (1) 200 amps or less for feeder for cell) site Contractor: WEST SIDE ELECTRIC CO INC Owner: SUN LIFE ASSURANCE CO OF CANADA 1834 SE 8TH AVE BY NORRIS BEGGS & SIMPSON PORTLAND, OR 97214 121 SW MORRISON ST #200 PORTLAND, OR 97204 PHONE: 503 - 231 -1548 PHONE: FAX: 503 - 736 -0677 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 09/25/2012 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 09/25/2012 $12.08 Type of Use: COM Electrical Class of Work: OTR 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: Ore on 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 OA 52 -001 090. You may obtain � a c py of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 61 / Permittee Signature: at A Rob .1 fO 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. 2012 -09 -24 02:52 WEST SIDE ELECTRIC 15037360677 » 5035981960 P 2/2 Electrical Permit A licatio EriCii 1.0R 01.1..1( . 1 I. ti 0.1 ' Tigard er r R l� /43- s CL.(�o1.f1/ Z. op gr. Il CI of Tig t `" Permit No.: . r Phone: 5 503.18 24 9 Tigard, :503 981960 S E P 2 4 2 012 P Rr„i- Other permit: Date/B ' Inspection Line: 503.639.4175 _ Date Ready/By: IEEE 0 see Page 2 for i! i;..l,u Internet: www.tigmd-0r.gov tr'4I1 ` - ir t /t. ( NohfieNMethod: Supplemental information � � y >i a'� rp,�p { I�Rr , f/' S "3T > B.L.' .! ' 7 1 k , *':,- , 71 - ' , .:„ , , .::•:i. ' ,c � . ^`" . . r. ,. /i.+F�'.�'T /'0 ,« w , �' / 1+i , � iSL".gir. t + t - . a. L 1 1 ' ^ a .t. d'nn mi • .'�n ''..c..,,,,..'•;*.;" . .a s - • ' -"'�• -', �c.`�' �"'- �� Please check all that apply (submit $ eels of plans w(tems checked below): El New construction Addition/alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stones. ❑ Demolition ❑ Other where the Available fault current El Marinas and boatyards =. ` 4 .' /i ' -: Iw r f , ? ' " rT -• «1^ t a, q i': t sr,r�^ 1 T ye exceeds 10,000 amps at 150 volts or ❑ Floating building. u ^ ' ' •' .^ V'" , ,!:.7- o, ,;%-"f.-4:,' ,,�-`. �- f, -.._... .`a.. .` `.7L_..! .._? &... + •,'. u.. .Si teas to ground. of exceeds 14,000 17 Commercial -use agricultural El I- and 2- family dwelling lg Commercial/indtutaial ❑ Accessory building amps for all other installations. ❑ buildings l . of 75 KVA or CI Master builder El Fire pump. Multi-family ❑ cider ❑ Other: ... ❑gmer�neysy . largcsepluate►yderivedsys<em. �' S _ '9 . 7. '' r . l a, t r : u 4 :n -iii3 "L^�*'. 'G�s • S . t1+ ; ❑ Addition of new motor load of ❑ - A", „'' '` ' '' '", 3"Je ,� ? -- ._ -1 :;:i3 .. a%rrs . ,_: .. ' m.- ?-.a «iL "E". 1-2°. • 1-3 ", J � � 3 �-� /� Sid (' 100HPormoro. occupancy. Job no.: Job site address. X 100 Sl v a L J _ ❑ Six or more residential unite. ❑ Recreational vehicle parks -- _ / p � 171Z_1 l� Healthcare facilities. ❑Supply voltage for more than City /S1atc/ZIP: I j f( r IVC J 0 Hazardous locations, 600 volts nominal. il l // J //t _ f. /! l _ 13 Service or feeder 600 amps m more, Suite/bldg /apt no.: _ project name: 6 / J K (p lY /ik11J f : .11,V . i Cross street/directions to job site: DKtrisuos OMR Fee. New residential single- or multW roily dwelling unit. Includes attached garage. Subdivision: , Lot no.: 1,000 sq, R or less 168.54 4 33.92 ' I Ea add'I 500 sq. fl. or portion Tax map /parcel no.: Limited energy, residential 73.00 2 ' F .. t, - 1 • t � . F��� 't h l .a r'"' (with above sq_ ) '( 1 t• d ..k ., 1e•{_•• .in,.'Jf�•li. -i�K'' • :1x �Ri�, Limited energy, multi- family 75.00 2 residenua�ww'ith above sq. IL) F OP 7✓ C - Se rvices or feeders Installation, alteration, and/or relocation 200 amps or less 100.70 /(x) 2 2 ... ,,'-' - c -, i ;4. -- t.v+ 1 y ; c ; 4 -c ti :2 7. sin'^. 1 'fF.4 201 amps to 400 amps 13356 2 z x - . Fg..... +rA c eZ,I . S2, ti >.., :2t'. "t. es.e. , : .. _' .:.v? V. 4.214.6e 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 Address: Temporary services or feeders installation, alteration, and /or City/State/ZIP: _ relocation 200 amps or less 59.36 1 Phone: ( ) Fax: ( ) 201 amps to 400 amps 123.08 2 Owner installation: This installation is being made on property that i own which is not 401 amps to S99 a 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449.670, and 701. Branch circuits - new alteration. or c:tenslo net Date: A. Fee for branch circuits wi h Owner signature: _ , . above service or feeder ibe, 2 j, r 3. '7 742 ^-� • ? • i, L : .1 e f F i ;)La . each bra nch c •�> � �� r T V'' wnliz•' u! S _.S ..i ... . .u:�... r.:ac.. B. Fee for branch circuits without Business name: service or feeder fee, first 56 18 2 branch circuit Contact name: _ - Each add'I branch circuit 7.42 2 - Address: Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 City /State/ZIP: dwelling. service and/or feeder Reconnect only 67.84 2 Phone: ( ) Fax::( ) Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 if. • -Yror S,.cc�� F � '5 r`, . 31714143 i a$0 Signal clrcurt(s) o r ll mlted4tlerSi '''r �.?>.'`hX7-vt2� �!: d nti.n:.. ,.�.�2:1.�ct 2 panel. alteration. or extension. pyre 2 Business name: West Side Electric _ _ Each additional Inspection over allowable to any of the abov Additional inspection (I hr min) 66.25/ hr Address: 1834 SE 8 Ave investigation (1 hr min) 6625/ hr City/State/ZIP: Portland/OiR/97214 Industrial plant (I hr min) 78.18/ hr F ax: (503) 736 -0677 - l� I 1br which no fee is 90 hr Phone: (503)231 - 1548 Ifical listed ti hr min CCB Lie.: 13306 Elev . ;.)1. Lie.: . -13 Su ' c 5698 -S < ,` �, + _ � . i 7,3• : 71 , 777 -,: ''g , ! �._..:. -a' :.'• • .• 0 , - W- iP r Subtotal: P X11'7 Plan review (25% o permit fee): Suprv. Electrician signature, requir-e . o �- Da�: ! / 90 of permit fee): / z Print name: Brent G Wall _ �/1 `f r State surcharge (12 - - TOTAL PERMIT FEE: 1 e Authorized signature: -WS permit ncneoe eipi accepted Pe is within 180 days after It has been Print name: I Date: • Number of inspections allowed per permit, _ -� 4404615T(1 trosrconvwen I: VtaldintV4rm >n1ELC•PetmitApp�deC 07/01110 RECEIVED .• . • room bu3 :?152479 roux: cox »o: IlooS EP 2 7 2012 outorsy: • 1,3 A L. Inspection Line: 503.639.4175 Date Ready/By kris: la See Page 2 for Internet: www.tigard- or.gov CITY OF r iARn Notified/Method: 1 Supplemental infennatioe : ; k%- : �t.� r�1a^;''y;ti :;Jk(,���'.'• ..h.. +✓If ' (.' r r r <: :fib. ..� , :e. , , q`''1 �;;�.':'. ti4 >'.',a s.>r_, �. .1,.� � � t . ,° ' w >, ; � ' r 0,: s;• a Y i t'�a .; �i �`` 1., . `ii k � ;i• ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 1, sets of plans whims checked below): 0 Service or feeder 400 amps or more 0 Building over three stories. ID Demolition ❑ Other: wh-e_re the a fault current 0 M�arin/as and boatyards. ,'"`^...... .,u 1� r 1,.�'ki•'} �,��'p� o: /,� h,� _� V . IG ... W exceeds 10,000 amps. at ISO volts or O Floating buildings. �: :,..ci= :: tit;,: 1i {'4�4i!!r!��F!l. :. a . �.•.aZ"+.i.. i 1.r.� r t! ��l "' loss to ground, or exceeds 14,000 O Commercial -use agrictutural ❑ 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for ell other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: 0Fire pump. 0 installation of75 KVAor . ;M ' }.';_. , <�t r., " '_ �, s ❑ Emergency system. larger separately derived system. i% r * iWa;:< i f_ ,r«5li o ., .,I :wi f;, t:•:a'. 0 Addition of new motor load of ❑ "A ", "E". "1-2 ". "1-3 ", Lo dt) n .� p 0... 5 1 OOHP or more. octupartcy. Job no.: $`� J Job site address: V o Six or more residetuial units, 0 Recreational vehicle parks, City/State/ZIP: 't `6 ^ra_ on '2-2- 0 Health-care facilities. ❑ Supply voltage for more then 0 Hazardous locations. 600 volts nominal. • Suite/bldg./apt. no.: I Project name: Civak,(1W Qp gNI O Service or feeder 600 amps turnery. fi r• y, =ati Jr g 4 y � ED oL.C. v.Y�.. , Cross street/directions to job site: naerretmen a:•, hl�•: J Qtr. I Fee. I Tom_ I - New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: I Lot n0.: 1,000 sq. EL or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Age 6" tin " "i %, l a `. r« Limited energy, residential 75.00 2 " -It i s ''' E with above Sq. R) . "� 11: i;; t:! dC.' iU :� .i<�.�4Yi :. @�¢fi+i.u�:i�i�jti ,. b �.:. ..= `,}7r�,��',���v„...,_.�.<. -' • �d7 i �A� �'E.+���7 Limited energy, mule- ihmily 75.00 2 'dirty �\y( G` {� residential (with above s9. ft ) Services or feeders Intaltatlon and%or relocation e U ,2_. 2-. - Ob ' , 200 amps or less 100.70 2 l r-, CI�R 1',) b' • M ' : 43 77Z, h_ , , a . g Y C I .95 : ;'; 7:, 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or (cedars installation. alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I 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 to 599 amps 168.54 2 Branch circuits— new, alteration, or extension, r panel Owner signature: Date: A. Fee for branch circuits with it8�y,r lfti. ;ll3t r { *1t'f." rt { ? "'' above service or feeder f . :, etp le 1y 'ei�u"' 7 :r.Me . ,.v;,•;t;�. _ a.,- f' �: �ti',.., �.'. lei '� ' ..._ O •�`� = "":�` each branch circuit � � '<<. 42 2 Business name: B. Fee for brunch circuits without service or feeder fee, first 56,18 2 Contact name: branch circuit Each add'l branch circuit 7.42 _ 2 Address: Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 _ 2 E-mail: r y y � }�� +� «, Sign armadillo lighting 67.84 2 - ;Vi'l z6• ?��;•xt ills .∎ %..� y��T4. �oR�?JF!! •' T- JSdA, Signal cireuit(s)orIimicd•encrgy Business name: West Side Electric panel, alteration, or extension. __, _ Paso 2 _ 2 — Each additional inspection over allowble in any of the above Address: 1834 SE 8 Ave. Additional inspection (1 hr min) 66.25/ hr City/State/ZIP: Portiaod /OR/97214 Investigation (1 hr min) 6625/ hr Industrial plant (I hr min) 78.18/ hr Phone: (503) 231 -1548 I . Fax: (503) 736-0677 inspections for which no fees • . ificall listed Y. hr min 90.00 / hr CCB Lie.: 13306 El " ..9. Lic.: • 13 - Su - . Lic 5698 -S On ; ' ,IASEMIRI 4VER111F1:1 'FJJFS=a, ,t :N;'%m. Subtotal: '^J , N2 Suprv. Electrician signature, rexluir_, 077* - e Plan review (25% of permit fee): Print name: Brent G Wall 53 ate: 9 211 f el. State surcharge (12% of permit fee): , $'� TOTAL PERMIT FEE: ^ X33 i Authorized signature: This permit appileadon expires if a permit is not obtained within 180 days after It has been accepted as complete. Print name: I Date: • Number of inspections allowed par permit. I:1 BuildingWemtltAELC •PermliApp,doc 07/01110 440.4eiSTp1/e5/CQMrwEa Z / # L8661£Z£09' 0961869£05 0 l °!a1 °al3 @P!S ls@M:w0JJ'. 17£ :£1!21 —LZ -60