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Permit ►►tom ° �P2� ° /'bb ( eiijc°_u /73. * 7 CITY TIGARD ELECTRICAL PERMIT 11111 I: COMMUNITY DEVELOPMENT Permit #: ELC2009 -00586 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/30/2009 Parcel: 2S102DA00401 Jurisdiction: Tigard Site address: 13125 SW HALL BLVD PD Subdivision: Lot: 0 Project: Police Modular Project Description: Add (3) branch circuits. 11/5/09, adding (2) additional branch circuits. Owner: FEES TIGARD, CITY OF Quantity Description Date Amount 13125 SW HALL BLVD TIGARD, OR 97223 3 crt Branch Circuits 10/30/2009 $71.02 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/30/2009 $8.52 Electrical Contractor: 2 crt Branch Circuits w /Purchase 11/05/2009 $14.84 OREGON ELECTRIC CONSTRUCTION INC Service or Feeder 1010 SE 11TH AVE 0 ea 12% State Surcharge - 11/05/2009 $1.78 PORTLAND, OR 97124 Electrical PHONE: 503 - 234 -9900 FAX: 503 - 535 -2763 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 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. ATTENTI regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -00 through OA '952 -I $ 100. You may obtain a copy of the rules or direct questions to OUNC by calling 5 . 6.6699 or 1.800.332.2344. Issued ' — �� V y� 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 ONL _ • SIGNATURE OF SUPR. ELEC' .fit! Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an Inspection that business day. 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. -J v • e electrical Permit ApplicgtifiECEIV OR ()I l i(I U I e$Ni I City of ' igard 0- 0 Permit No. 9 --4:3 5.8 d/ ' , a 13125 SW Hall HIvdL,'1'igarcl, OR 97 V 0-$ 2009 Pla Review - Photte: 503.639.4 171 Pax: 503.598.1 r 17 2009 Date/By. Permit - T 1 c; A H T) Inspection Line: 503.639.4175 Date ReadyiBy. funs: See Page 2 for .- .._ lntenrct: www.tigard- or.gov CITY OF TIGARD Notified/Method: / . 1 fiJ Supplemental information • .. TYPE .01 I I ING DI� :';F• : •. . 7 . : ' PLAN: REV1tvW. • :_' Please check all that apply (submit 2 sets of plans w /items checked below): ID New construction CI Addition /alteration /replacement ❑ Service or feeder 400 amps or inure ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. - exceeds 10,000:imps at 150 volts or ❑ Floating buildings. " . :, iGA :C :: :: . : ' •.-':.:.:': : less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all dhet installations. buildings. ❑ Multi - flintily ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of75 KVA or ❑ Emergency system. larger separately derived system. .1106 SiTE INFORNIIATIQN- AND `LOCA'i'ION': • - - Addition of new motor load of "A" "I'i" "1 -2" •' 1 -3' Job no.: 75242 Job site address: 13125 SW HALL BLVD IOOI IP or morn. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State:/Z1P: TIGARD OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than ❑ Hvanhars locations. 600 volts nominal. Suite /bldg. /apt. I Project name: POLICE MOD OUTLETS _ crvico or hactter 600 amps or inure. . Cross street/directions to job site: -- - - - - -~ • .: ; "''.FEL ;SCHEI)IILE - . J _petalptlon I Qt I N• ee. I Total - L - - -- - - -- -- New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: - -- I Lot no.: 1,000 sq. 11. or less 168.54 4 - - -- Ea. add'l 500 sq. It or portion _ 33.92 I fax map /parcel no.: Limited energy, residential (with abuse sq. 0.) - -- 67.84 ADD TWO NEW 30 AMP UPS OUTLETS __ -- Limited energy, multi- family n - -- - - - idcnlial (with Whore sq. a.) __ 67.84 2 ADD TO PERMIT # ELC2009-00586 Services or feeders installation, alteration, and /or relocation • - 200 amps or less 100.70 - -- 2 ❑ •PROPERTY OWNER. :;`❑.'TENANT :: • � � :: : 201 amps to 400 amps __ - - -- .. - 133.56 2 Name: 401 amps to 600 amps 200.34 2 - - -- - - - - " - -- -- - 60 I amps to 1,000 amps 301.04 2 _ Address: Over 1,000 amps or volts 552.26 2 City /State/ZIP: Temporary services or feeders installation, alteration, and/or - - - - - - -- - -- - - -- -- - - - relocation Phone: ( ) Fax: ( ) 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 amlx to 599 amps 168.54 2 Owner signature: Date' Branch circuits - new, alteration, or extension, per panel ------- -.. ".... _ -. -- ... _..._..-- .- _ - -_ - -- - ------ -..._ -- A. Fee for branch circuits with . • - ❑ 'APPLICANT :._ .. - : I • • . ,,❑:CONTACf PERSON:.'.: above service or feeder fee, 7.42 2 each branch circuit Business name: 13. Fee for branch circuits without service or feeder fee, Contact name: 56.18 2 first branch circuit Address: Each add'I branch circuit 2 I 7.42 14.84 12 -- - -- - Miscellaneous (service or feeder not Included) _ City /State/ZIP: Each manufactured or modular dwelling, service and/or feeder 6784 2 Phone: ( ) [Pax: ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 CON'I RAC7'OR Sign or outline lighting 67.84 2 - Business name: OREGON ELECTRIC GROUP Signal circuit(s) or limited- energy panel, alteration, or Address: 1709 SE 3 1u) AVE extension, Describe: Page 2 2 City / State/ZIP: PORTLAND OR 97132 Each additional Inspection over allowable in any of the above Per inspection 66.25 Pl (503) 234 -9900 Fax: (503) 535 -2763 Investigation per hour (I terrain) 66.25 CCB Lie.: 203 Electrical Lie.: 26 -95C I Suprv. PERMIT, FEES Lie.: �� 45495 Industrial plant per hour 78.18 _ • �T�,� r " ItICAI, Suprv. Electrician signature, requires �. - -- ELECT Subtotal: 14.84 • Print name: RICHARD MCELL.IOTT Date: 11 -4-09 Plan review (25% of permit fee): State surcharge (12% o of permit fcc): 1.78 Authorized signature: (:? 1 ,. i 4 • ,, �� v } � TOTAL PERMIT FEE: 16.62 - Print name: RICHARD MCELLIOTT I Date: 11 - This permit application expires If a permit is not obtained within ISO days after It has been accepted as complete. ' Number of inspections allowed per permit. I mnuitding '.Pemtitsn.e.- PennitApp.dnc ta'01 /117 4.10.46 151'(1 Ii051CiM/1VEn , CITY OF TIGARD ELECTRICAL PERMIT I II I7 COMMUNITY DEVELOPMENT Permit#: ELC2009 -00586 Date Issued: 10/30/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102DA00401 Jurisdiction: Tigard Site address: 13125 SW HALL BLVD PD Subdivision: Lot: 0 Project: Police Modular Project Description: Add (3) branch circuits. Owner. FEES TIGARD, CITY OF Quantity Description Date Amount 13125 SW HALL BLVD 3 crt Branch Circuits 10/30/2009 $71.02 TIGARD, OR 97223 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/30/2009 $8.52 Electrical Contractor: OREGON ELECTRIC CONSTRUCTION INC 1010 SE 11TH AVE PORTLAND, OR 97124 PHONE: 503 -234 -9900 FAX: 503 - 535 -2763 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.248.6699 or 1.800.332.2344. / Issued By: Permittee Signature: CAI i9// 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 603.639.4176 by 7:00 a.m. for an Inspection that business day. 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. v e 00 I C-.,-- CZ 5 r CEIVED Electrical hermit 1�[3>pl� rill( OFFICE 1 USE. ONlV City of 'Tigard Reeeived w , Q Dae/B . • , / 9- nnitNo: • / a 13125 S W Hall Blvd., Tigard, OR 97 /3C T 2 9 2009 '.. C Phone: 503.639.4171 Fax: 503.598.1960 -MIMIIIIIMIII Other Permit: :It G A R I) Inspection line: 503.639.4175 CITY OF TIGARD Date Ready /By: 3olC el See Page 2 for Internet: www.tigard or.gov Notified/Method: J I Supplemental Information I . 9, Y OF NORK _ _ Ali VIE Please cheek all that apply (submit i sets of plans w /items checked below): ❑ New construction ® Addition /alteration /replaeemCnt ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Oter: h _ where the available fault current ❑ Marinas and boatyards. :'s : s at 150 volts or ❑ Floating buildings. - - - ; ; CATEGORY : .G NS'IIt'UC°[I ='.�.' '. �. :' : > ; ; ;� `-.., : :' :�' exceeds 10.000 amp g less to ground, or cxcxeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling El Commercial/industrial ❑ Accessory building snips for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or : :. ' . ..1OB`'SITI "INFORMAT1ON..AND -!L !LOCATION :�; : :.... ; :. ::: :'_ �.:. :. , ❑ Fmcrgehtcy system. larger separately derived system. - ., ...: .: .. - . ' � . Addition ofnncw nnotor lead of ❑ "A ", "L "' "1 2" "I -1" Job no.: 80016 -125 Job site address: 13125 SW HALL BVLD loOtip or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City / State/ZIP: TIGARD OR 97223 ❑ tlealth -care facilities. ❑ Supply voltage for more than ❑ }Wardens locations. 600 volts nominal. Suite/bldg. /apt. no.: MODS Project name: POLICE MODS ❑ Service or feeder 600 amps or more. Cross street/directions to job site: - r . 5: , .EE-, SCHEDI[LE :; `: :.. ;. :.-' J Description 1 Qty. I Fee. I Total I New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: I Lot no.: 1,000 sq. 0. or less 145.15 4 Ea. add'1500 sq. ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential 75.00 2 ' DESC IPTION.'OF::: i ; : : : :;';:; r: ,'. :'.= :.-. ;` :.� : ;' : ; '. : : ,.'� � �. : : = :�,�; .... . �... ,.. .. WORK; ^. : :.. : : ;,, ;;,.:: , ; :' : ;`= ice.... ., (with above sq. n.) ADD THREE CIRCUITS TO POLICE MOD AT CITY HA - Limited energy, multi - family LL residential (with above al. 0.) 75.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 - ."o _PROPERTY :OWNN ., :, : :' :: : -' .:ll o rTENANT '' . : :: :: " :4 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City / State/ZIP: Temporary services or feeders installation, alteration, and/or relocation _ - Phone: ( ) Fax: ( ) 200 amps or less 66.85 t Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10(1.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: - -_ Date: A. Fee for branch circuits with ::❑.- APP IC '. = . -•: :', ` ": .`0 % CONT .p4ti ON : , _ > above service or feeder tee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits $ f IF without service or feeder fix , 1 46.85 Contact name: 4 .85 2 first branch circuit Address: Each add'1 branch circuit 2 / - 1 6 s .6? 13.30 2 Miscellaneous (service or feeder not included) City /State/ZIP: Each manufactured or modular 90.90 2 Male: ( ) Fa dwelling, service and/or feeder x:: ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 '`... GONTRAC'1'OR. :' :: _, :• :.: i. Sign or outline lighting 53.40 2 Business name: OREGON ELECTRIC GROUP Signal circuit(s) or limited - energy panel, alteration, or Address: 1709 SE 3 AVE extension Describe: Page 2 2 City/State/ZIP: PORTLAND OR 97214 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (503) 234 -9900 J Fax: (503) 53 . 2763 / Investigation per hour (I hr min) 62.50 1!/ CCD Lie.: 203 Electrical Lic.: 26 -95C Suprv. Lie.: 4549 p � Industrial plant per hour _ 73.75 �V _. ? :El ECTRICAI' :;;PERM I I FEE5. : - • Suprv. Electrician signature, requi 6 . .. k ,•� '. Subtotal: 0.15 Print name: RICHARD MCELLIOTT Date: 10 -29 -09 l'larrreview (25 % crf pemit fee): P/( C ? State surcharge (12% of permit fee): 7 - 3 Authorized signature: � �, (-- e, ( " 1� t� TOTAL P ERMIT FEE: 67 Print name: RICHARD MCELLIOTT Date: 10 -29 -09 Phis permit application expires If a p enult Is sot obtat within Igo days after It has been accepted as complete. ns C� 1.-/- • Number of inspections allowed per permit. I J I :iauihtingePennes I.C•PerntitApp.doc 052306 440• 151(1 U0 `COM•wEB t / :rte,. ,1 ��J1 IN ,t CITY TIGARD ELECTRICAL PERMIT t: COMMUNITY DEVELOPMENT Permit#: ELC2009-00586 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/30/2009 Parcel: 2S102DA00401 Jurisdiction: Tigard Site address: 13125 SW HALL BLVD PO Subdivision: Lot: 0 Project: Police Modular Project Description: Add (3) branch circuits. 11/5/09, adding (2) additional branch circuits. Owner: FEES TIGARD, CITY OF Quantity Description Date Amount 13125 SW HALL BLVD TIGARD, OR 97223 3 crt Branch Circuits 10!3012009 $71.02 wo/Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/30/2009 $8.52 Electrical Contractor: 2 crt Branch Circuits w/Purchase 11/05/2009 $14.84 OREGON ELECTRIC CONSTRUCTION INC Service or Feeder 1010 SE 11TH AVE 0 ea 12% State Surcharge - 11/05/2009 $1.78 PORTLAND, OR 97124 Electrical PHONE: 503-234-9900 FAX: 503-535-2763 Type of Use: COM Class of Work: ALT Type of Cons(: Occupancy Grp: Total $96.16 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 4 work is suspended for more the 180 days. ATTENTI regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00 through OAR'952- 04,01D0. You may obtain a copy of the rules or direct questions to OUNC by calling 5 6.6699 or 1 81111 .23 4. r Issued , Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property i own which is not intended for sale, tease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONL SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. CITY OF TIGARD ELECTRICAL PERMIT r COMMUNITY DEVELOPMENT Permit ELC2009-00586 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/30/2009 Parcel: 2S102DA00401 Jurisdiction: Tigard Site address: 13125 SW HALL BLVD PD Subdivision: Lot: 0 Project: Police Modular Project Description: Add (3) branch circuits. Owner. FEES TIGARD, CITY OF Quantity Description Date Amount 13125 SW HALL BLVD TfGARD, OR 97223 3 crt Branch Circuits 10/30/2009 $71.02 wo/Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/3012009 $8.52 Electrical Contractor: OREGON ELECTRIC CONSTRUCTION INC 1010 SE 11TH AVE PORTLAND, OR 97124 PHONE: 503-234-9900 FAX: 503-535-2763 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon taw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952.001-0010 through OAR 952-001-0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: i Permittee Signature: dzL OWNER INSTALLATION ONLY The installation is being made on property i own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 603.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the job site at the time of each inspection. Elef laical Permit Awl-ic-SwRECEIVED City mf r1g$rd Kcieived ' j 9 mrit, No.: Plan R"~- 131'15 SW Hall Blvd., Tigard, OR 97~~ T 2 9 2009 Pla Plan 12eview Phone: 503,639.4171 Pax: 503.598,.1960 tither_Permit: )ate,13 . _ Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/ay: P6 See Pnge 2 for 9% j Internet: www trbtrtd or gov Notified Methnd: Supplemental Information 77. 'Of V0 E] New construction Addition/alteration/replacement Please check all that apply (submit 2 sets ofplatu w/items checked below): ❑ Service or fu:der 401) amps or more ❑ Building over three stories. Demolition ❑ Other: _ where the available fault current. ❑ Marinas and boatyards. - t. 1',[ 1 (.,[I<lt I+ cON ti I R 6 i9x exceeds 10.000 amps at 150 volts or ❑ Floating buildings. - less to ground, or exceeds 14,000 ❑ Commercial-use agricultural 0 1-and 241niily dwelling ~ 10 Commercial/industrial [1 Acce sorv building an,psfor all otharinstnnutions. buildings. IV] tilti-finmily 0 Master builder ❑ Other: ❑ Fire pump. El Installation of 75 KVA or El Frrrcrgency system. larger separately derived system. T. y - JD13 SITI 1Nl 0121bf A 1 fOP N11-I.°L1C 1 ! ]a i Y ❑ Addition ofnew motor load of - Job no.: 80016-125 Job site address: 13125 SW IIALG F1V1A 1001111 or more, occ upmicy. I - ❑ Six or moro reeidcatial units. ❑ Recreational vehicle parks. City/State/ZIP: TIGARD OR 97223 ❑ Health-care facilities. ❑,supply voltage for more than ❑ Ilaxardons loeations. 600 volts nominal. Suite/ble.ig./apt. no.: MODS Project name: POLICE MODS ❑ Service or feeder 600 amps or more. Cross street/directions to job site: SC1i DUILE .1 ncscriptipn Cee. 1*(! :W - _._.____New residential single- or multi-family dwelling unit. - includes attachecfgar•age. Subdivision: w Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add') 500 sq. it, or portion 33.40 1 Tax snap/parcel no.: Limited energy, residential DLS 21:PT10N k • ~VQltte (with rrhove sq R.L 75.00 - 2 AI)ll'fIIREECiKCUI'pS'I'OPOLICEMODATCI'rYIIALL Limited energy, multi-family 75.00 2 _n`sidcmtial (with above sq. fl. Services or feeders installation alteration, and/or relocation 200 amps or less 80,30 2 L~:;1'ft(31?IRd1 ®1lfdPR CJ,TbfYOt~f 201 amps to4UUamps 106.85 - 2 Name: 401 amltslo600amps 160.60---------- 2 - 601 amps to 1,000 amps _ 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State/ZIP: 'femporary services or feeders installation, alteration, and/or - relocation Phone: ( Fax: { ) 200 amps or less _ 66.85 - 1 - µ ~ - 2 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 1(1(1.30 _ intended tin' sale, lease, rent, or exchange, according to ORS 447, 419, 670, and'701. 401 amps to 599 amps - 133.75 2 Branch circuits - new, alteration, or eand Owner signat ure: A. Pee fi)r branch circuits tvit7r eabove service or fader tee, each branch circuit 2 Business name: B. Pee for branch circuits - without service or feeder fee, 1 40.8 I / Contact name: 46.85 ~ _ first branch circuit Address: Each add'I branch circuit 2 13.30 2 - Mixcellaneous service or feeder not included) City/State/ZIP: Each nranufacturLd or modular 90.90 2 -dwelling, service and/or feeder Phone: ( ) TFax:: ( ) Reconnect only 66.85 2 E-mail: Pump or irrigation circle 53.40 2 17 CUN7 RAC.POR Sign or outline lighting 53.40 2 Business name: OREGON ELECTRIC GROUP Signal circuit(s) or fimited- energy panel, alteration, or Address: 1709 SE 3no AVE extension. Describe: Page 2 2 City/State/ZIP: PORTLAND OR 97214 Each additional inspection over nilowable in any of the above - _ l Per inspection 62.50 Phone: (503) 234-9900 lax: (503) 535 2763 _1-_-_.___-.._.__. Investigation per hour (I hr min) 62.50 per C,CBLic.: 203 Industrial plant hour 7375 ~Electrical Lie.: 26-95C Suprv. Lie.: 4549 p W, rI~FC rltlG At rFR1171 t :1 r S S Suety. [ lectrit tan signature, rcyu4`,ya_)Z4:~, a Subtotal: O. IS Print. name: RICHARD MCELL oyr Date: 10-29-09 - Plan review (25% ol'permit fee):- " nn State surcharge (12% of permit fee): 7 d~ Authorized signature: TOTAL PERMIT PEE: 67 'his permit application expires if a permit is not obtai Nithin 180 Print name: RICHARD MCELLIOTT Date: 10-29-09 days after it has been accepted as complete. • t✓ * Number of inspections allowed per permit. i ]r,Building)Pennitsltii.C-PcmrirApp.Aoc 052306 415ftt 1/0 .'COM%WED r' r / R.l.~./~ ;,17, E ltsr.ctlr>Ics►a Pea-mat ~p12a>icarI IECEIVED City ()fT1giA1'd mlCiB 3 oq Permit Nn.. ~i SQ ® 13125 SW Hall Lilvd.,Tigard, OR 9721mv O;p 2009 plan Review - - - v Phone: 503.639,4171 Pax: 503.598,1 17 L J D,U~DY aher Ponuit a Inspection Lino: 503,639.4.175 [talc Readylny^-- rd see Pagel for Internet: WwW.li aril-or. ov Notified/Method: Su dementA Iifurnri l 0un b CITY OF TIGARD pl ,t.:.,. i New construction Ad Plcase check all that apply (submil 2 scu of plan, w/items checked below).: El ®t.hUbtl/illierat.ion/replacetuent ❑ Service or feeder 400 amps or more D Building over three s(orics. ❑ Deniolil.ion ❑ Other: where (he available fault cumnt ❑ Marinas and Miatyarda. =f:• , > _ c ~ is CAI'kGOR1C 06 C UNIS['1ZUC LION ~ ' " exceeds 10,000 amps of 150 vvlLa e r ❑ rlnatinl; buildiut;a. loss to ground, or exceeds 14,000 ❑ C'unUnetcial-use 0griculhtnl ❑ I and 2-tanlily dwelling , ® Commercial/industrial ❑ Accessory building amps fur all other instullatiom. buildings. ❑ Multi-family ❑ Master builder ❑ Othcr: O Fire pump. El hnmllati nt or75 KVA or ve:ney system larger separately (loriml system. 1013 SIYG EIV 1 1tA9A.~ (QN rtLVU r OCn 1 ION , ❑ Addition orucw motor load i , Job no 75242-~ Job site address: 13125 SW HALL BLVD 1001 It, or mo";. neet'pancy' _ ❑,Six or more mWcnlial units. ❑ Rcrrcational vehicle parks. City/State/1_1,: TIGARY) OR 97223 0 Health-care facilities. ❑ supply voltage for more than ❑ Hazardous localions. 600 volts nominal. - Suite/bldg./apt.no.: _Projectname: POLICE MOD OUTLETS 08eavice or feeder 600 amps or more. 1 Eu.-Scljriitlh:: Crass slrcet/directions to job site: Dticrquimt (fir. F~-I rat„1 ~T New residential single- or intilt i-faroily dwelling unit. Includes attaclied garage. Subdivision: ----T - Lot no,: 1,000 sq. ft. or less - - - 168.54 4 portion 33. 92 1 La. add'I 500 i 11. or "fax map/parcel no.: Limited e,nnll - - enm'bl i'c'S <1 Kl: 67.84 2 r, (withalwwsy,a•) - 1)i $C&IC;f.IQN:;OE .WORK 2 ADD TWO NEW 30 AMP UPS OUTLETS rGi(I Li es7idcn ntcatial (l (with muabove uvo s. fl.) q 67.81 ADD TO PERMIT ELC2009-00586 - - - - Services or feeders installation, alterntinn~and/or relocation - 200 amps or less 100.70 2 ;PROL'FitTY ntyN~R ❑ '71 NAN`I ' ' ' 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 - 2 1101 amps to 1,000 amps 301.04 2 Address: Over 1;000 amps or volts _ 552.26 City/State/z IP: - - Temporary services or feeders installation, ultt ratiai and/or - relocation Phone: ( ) Fax: ( ) 200 amps or less -T - - 59.36 ---T 1- _ amps to400 elanp{s 12 5,08 2 - Owner installation: 'Ibis installation is being made on property that I own which is not 201 in(cnded for sale, lease, reef, nr exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps _ 168.54 - - 2 Branch circuits new, alteration, or extension, a anel Owner signature: Date:__.._-___-.-- A. Pco for branch circuits with 0 APPL ICAN f r : T t ONTAG f I'EItSON r above st;l'vicc or fce(Icr fee, 7.42 2 each branch circuit _ Business name: E. Pee for branch circuits - - Cantata name: ' - _ _ ndtlrurrt service or feeder tee, first, hmnch circuit SG.I $ 2 Address: - - Liachadil'd branch circuit 2 - - 7,42 14.84 2 - Miscellaneous (service or fectler not Included) City/StalealP: Each manufactured or modulur 67.84 2 dwelling, service and/or feeder _ Phone: ( ) Fax~(_-___) - Reconnect only 67.84 2 E-mail: Pump or irrigation circle.- - - 67.84 2 r., GnN,I KaCSign or outline lighting 67.84 _ 2 Business name: OREGON ELECTRIC GROUP Signal circuit(s) or limited- - energy panel, alteration, or Address: 1709 SE 3tu' AVE extension, Dcscrihe: Pap c2 2 City/State/ZIP: PORTLAND OR 97132 - -~V-- Each additional Inspection over allowable In tiny of the above - - Per inspection 66.25 Phone: (503) 234 9900-- _ Fax; (503) 535 2763 - Investigation per how (1 hr min) 06.25 - - CCR Lie.: 203 EI(chical Lic.: 26-95C Sup,. Lic.: 45495 Industrial plant per hour _ 78.18 5 Et ECTKIG iAt ' PER k F'1 S Suprv. Electrician signature, ILquire(' •a Sublo btohd: 14.84 Print name: RICHARD MCELLIOT'1' - Date: 11-4-09 Plan review (25%ofpunnit fee): Stale surcharge (12% of permit fcc): 1.78 AUt1101-iZed Signature: rly,; N - TOTAL PERMIT PF.L - I(i.621 Print name: RICHARD MCELL1077 Dale: 11-4-09 This permit application has been if a permit Is not obtained wirhiu ISU days ps after er It has been accepted as complete, - Nunlicit) f inspections allowed per pcmtit. I:UtuiltinylPrnni,v\L•Lr:-PamiiApp.tuc 10'01/119 4.10.460T(I Ii05/C0NfAVT:R