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Permit I P A-A. 11 4— r CIT OF lG — R� — ELECTRICAL PERMIT s: COMMUNITY DEVELOPMENT Permit #: ELC2009 -00337 w s Date Issued: 07/10/2009 tT1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110AB04100 Jurisdiction: Tigard Site address: 11460 SW GAARDE ST Subdivision: Lot: 0 Project: Vanella Project Description: Replace existing meterbase with new 200 amp service. 7/31/09 ADDED 100 amp sub panel in garage• Owner: FEES MARTIN, JESSICA L & Quantity Description Date Amount VANELLA, JOHNATHAN J, 11460 SW GAARDE ST 1 ea Services or Feeders - 200 07/10/2009 $80.30 amps or less PHONE: 1 ea 12% State Surcharge - 07/10/2009 $9.64 Electrical 1 ea Services or Feeders - 200 07/31/2009 $80.30 Contractor: amps or less TICE ELECTRIC 0 ea 12% State Surcharge - 07/31/2009 $9.63 5405 N. LAGOON AVE. Electrical PORTLAND, OR 97217 PHONE: 503 - 233 -8801 FAX: 503- 872 -8290 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $179.87 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: O ((� OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. ectrical Pernlit ApplicatioRECEIVED FOR OFFICE uSE ONLY Iii City of Tigard IJ and ' Date/By: Received Permit No.. ELC2009 -00337 ' 13125 SW Hall Blvd., Tigard, OR 9722 �- 2009 Da 2 8 Plan Rewew ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: •t c i n u 1) Inspection Line: 503.639.4175 CITY OF TIGARD Dore Ready /By: furl 17.e :for Internet: www.tigard- or.gov B UI _ Not /Method: emental Information Th!PE Or WOItK .:. ' . P1IAriI REV AV - Please check all that apply (submit 2 sets of plans w /items checked below): D New construction ($J Addition /alteration /replacement 0 0 Service or feeder 400 amps or more ❑ Building over three stories Demolition ❑ Other h 1 available w ere the aver a le fau11 current ❑ Marinas and boatyards. ` C Gitiii '; WC ktittIG'T{dl!( ;, , _ exceeds 10,000 amps at 150 volts or ❑ Floating buildings. and 2 dwelling Commercial /industrial less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1 y g ❑ ❑ Accessory building amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump 0 Installation of 75 KVA or y 1 1 i i t li ' f i i e l 't�kk. + I ,,�� y,� .. LL �;�� , r , r"; ❑ Emergency system. .i ,;n e t ; 5,..11 +hr t : 19 : 401 !`!1 !eft ill,IQ� LO !x „f 015 1 larger separately derived system. � c..�r,�° I'1='' : ..',Y � .l" ' ` ,.�,� I '� ❑ Add ition of new motor load of Job no -. 8 0 - 446 ❑ occupancy. Job siteaddres SW Gaarde St reet IOOHPormore. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks City /State /ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than - ❑ Hazardous locations, 600 volts nominal. Suite/bldg. /apt. no.: Project name: V a ne 11 a ❑ Service or feeder 600 amps or more. r:. a: d a, iNn`l mt ,',L(ar u af Y l.i .c Cross street/directions to job site: DedC >/'4 . � row New residential - single- or multi - family dwelling unit. Includes attached garage. _ Subdivision: 1 1,ot no.: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no . Ea. add'I 500 sq. ft. or portion 33.40 1 1 , p , „ , ii rr K s .. t a ;{�� g Lim (with above energy, residential o' i , " ..rji �.. � rr :.n0. ., Y� 01!1 l� a',wI ,',3ir & ? +• :i, lrt43r. . ,'trPi 'tcsd 3trle i�;is °1 9� 1?A. {'n .1t ;ii,', sq. lt.) 7500 2 add (1) 1 00amp subpanel in garage Limited energy, multi- family _ residential Swnh above s9. R.) 75.00 2 Services or feeders installation, alteration, and/or relocation c5in" a aY''' rr e aye s4r.K':: 9 t • I�[q . a �i "r , : �' mom: i 200 amps or less 1 80.30 80.30 2 , :i ln? ,: i »t� ,fi ,: t s ^ t i 't l r I �',r: ; m I y 4,1�.)�E Z `� 1, t11 ;". 201 amps to 400 amps 106.85 8 2 Name: Johnathan Vanella 401 amps to 600 amps 160.60 2i 601 amps to 1,000 amps 240.60 2 Address: 11460 SW Gaarde Street Over l,000 amps nrvolts 454.65 2 City/State /Z[P: Tigard, OR 97224 Temporary services or feeders installation, alteration, and /or relocation Phone: --' 0 3 ) 9 9 8 - 7 7 7 8 Fax: ( ) 200 amps or Less _ 66.85 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 _ Owner signature: Date: Branch circuits- new alteration, or extension. per pane '{i' i �^ '1+'"a" ` s "! t< N rt I a r } pyrYU A. Fee for branch circuits with I ri i t; ,,t • "C.'rT6 1 A , t : : '( -' ° � iq;�,r }i A 6 d� 0 ) dll l i y •: above service or feeder fix, I l l . . , :,, ' 6.65 2 each branch circuit Business name: - B. Fee for branch circuits ' Contact name: without service or feeder fee, first branch circuit 46.85 2 Address: - Each add'l branch circuit 6.65 2 --- Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular - Phone: dwelling service and/or feeder 90.90 2 ( ) Fax: : ( ) Reconnect only 4. 66.85 2 E-mail: _ Pump or irrigation circle 53.40 s � sin � e' r ': ;h; tF' cviw� , rr r. y�� 2 l� 11 ..11.1.14, 7'.:.., i1l�lii.,ttf E' tl.:' I A a l °... ,..... n tl -. ' .i ,-� -�T g 1 lullZ#tca . ,, ,ll01 t k; Sign outline lighting 53.40 2 Business name: Tice Electric Company Signalcircuit(s)orlimited- energy panel, alteration, or Address: 5405 N Lagoon Av extension. Describe: Fage2 2 City/State /ZIP: Portland, Oregon 9721 7 Each additional inspection over allowable in any of the above Phone: (503) 233 - 8801 Fax: ( 503) 872 - 8290 Per inspection 62,50 investigation per hour (1 hr min) 62.50 CCB Lic.: 166 Electrical Lic,: 26-126C Suprv, Lic.: 2 5 8 6 S industrial plant per hour MI 73.75 : „ ' 1,ttitC? i. i Pr .:° ,.':u ,., `, i', i id, :c4, Suprv. Electrician signature, required: Subtotal: - - 80.30 Print name: Date: 7 / 2 8 / 0 9 Plan review (25% of permit fee): John lri J . Maloney t _ _ State surcharge (12% of permit fee): 9.64 Authorized sigrtatur r� / TOTAL PERMIT FEE: - �i - • �J $9.9g Print name: Date: This permit application expires ire permit is not obtained within 80 - days after it has been accepted as complete. • Number of inspections allowed per permit. 1 1 BuiidinolPennha\Ei.C- PermitApp doe 05tt3/06 44 Q - +6157(1 r05 /COt.1r1VEt3 ELECTRICAL PERMIT I- rii CITY OF TIGA►RD COMMUNITY DEVELOPMENT Permit#: ELC2009-00337 • 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/10/2009 Parcel: 2S 110AB04100 Jurisdiction: Tigard Site address: 11460 SW GAARDE ST Subdivision: Lot: 0 Project: Vanella Project Description: Replace existing meterbase with new 200 amp service Owner: FEES MARTIN, JESSICA L & Quantity Description Date Amount VANELLA, JOHNATHAN J, 11460 SW GAARDE 1 ea Services or Feeders - 200 07/10/2009 $80.30 ST amps or less PHONE: 1 ea 12% State Surcharge - 07110/2009 $9.64 Electrical Contractor: TICE ELECTRIC 5405 N. LAGOON AVE. PORTLAND, OR 97217 PHONE: 503-233-8801 FAX: 503-872-8290 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $89.94 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 9 - 0100. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.2``46.6699 or 1.800.332.2344. 7 Permittee Signature: VYL , Issued By: 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 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. -- RECEIVED Electrical Permit Application FOR OFFICE USE. ONI Ci >i O Tigard 0 9 2009 Received ty g Date Permit No.: ) -, —7 , - .. 1 3125 SW Hall Blvd., Tigard, OR 97223 " " ° "" " "` � � Phone: 503.63 Fax: S03.59a(t 1' OF TI Flan °` Other Permit: -1/ T I Ci . RD Inspection Line: 503.639,4175 BUILD D G R D ION Date ReadvlBy Juris Ed See Page 2 for Internet: www.tigard or.gov Notified/Method: Supplemental Information New Please check all that apply (submit 2 sets of plans w /items checked below): 0 N ew construction n /at Additioterati0n /replacement ❑ Service m feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑ Other where the available fault current 0 Marinas and boatyards. exceeds 10,000 amps at 150 volts or O Floating buildings. 1 ; 1 , 00100 ... - cQ1 O:A, TOO r less to ound, or exceeds 14,000 B+ ❑ Commercial-use agricultural M I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. 0 Installation of 75 KVA or ❑ Emergency system. larger separately derived stem. � e ii'' i t �'4 R � 4{ j�� , t y � y+� d i i e: r 1 e i i s B >�P Y 6 Y Ai A, ,tt, ,1 .,' {4;1 ; ∎ , ,;�1 „ . t a y , 1. ,.T, �i, 41 e . 7 % " < {, AA. ' tin ,1, ,,..d . I ❑Addition of new motor load of ❑.. .. job no . P 0 . 4 4 6 2 lob site address: 11460 SW Gaarde 1A Street 100HP or more. occupancy. _ ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZLP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than . ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Vane 11 a ❑ Service or feeder 600 amps or more. ...... i ilium tl i tc§ d t' 4t I k !7,1.:1' l - I 1 / t. G' r ' n :�e 1t III I ut`; Cross street/directions to job site: a p or f fi ll Qty p Fe Total 3 • New residential single- or multi- family dwelling unit. Includes attached arage. Subdivision: Lot nO.: 1,000 sq. ft. or less 145.15 4 Ea. add'I Tax map /parcel no.: Limited energy, sq. ft. de or portion 33,40 1 r sin k, iu � F nlwaiami: hr.. I , • a ly V li , � .v , r» A '' t.3..l ( r� dential 75.00 2 r i 'tp' f 1 1 1 t, : F 7 i fl s with abov R. Limited energy, multi- family 75.00 2 replace existing meterbase w/ new 200a servic- residential (with above sq. ft) Services or feeders installation, alteration, and/or relocation 200 amps or less 1 80.30 80.30 2 +. . +t, nilivi t ' 'Olt ligvi ?:�' 114.11, �l. : :.47,141,17';' ' 71-0-1.77, � i+�.'l ' i7ll 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name: Jonathan Vanella 601 amps to 1,000 amps 240,60 2 Address: 11460 SW Gaarde Street Over 1,000 amps or volts _ 454.65 2 City/State/z1P:Ti Bard, OR 97224 Temporary services or feeders installation, alteration, and /or relocation Phone: ( 503) 998 -7778 I Fax: ( ) 200 amps or less 66.85' 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 rungs , 100.30 _ 2 intended for sale, lease, rent, or exchange, according t0 ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 V 2 Branch circuits — new, alteration, or extension, perpanel Owner signature: jay ��,q{ Date: A. Fee for branch circuits with et`i°t ph7 rn$sca), k �q .` i`h °1 1 ,13 z1r ����!;1+}?t ;�a. ` 'r„lk:'', above rape circuit service or feeder fee, t�ri ..,5 3.1 .. „1 +., 1i.7 " °' i 6 65 2 each Business name: B. Fee for branch circuits Ivlthour service or feeder fee, 85 Contact ntlmc: first branch circuit 46. 2 Address: Each add'I branch circuit 6.65 2 — ---- ----- Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) M . Fax: : ( ) Reconnect only 66.85 2 E- mail: Pump or irrigation circle 2 wmi' i:�... " .ra ttld "r ,,,r i ti:, I e,S i ,,. ''f, t, >, w f., is�:t;a'; t;�S�, #; ,a , �� . i1 }li: °'�;f l'f��- , Sign or outline lighting 53.40 Ia Busincssname: Tice Electric Company Signalcircuit(s)orlimited- - P y energy panel, alteration, or Address: 5405 N Lagoon Avenue extension. Describe: P�2 2 City/State/ZIP; Portland, Oregon 97217 Each additional inspection over allowable in an : of the above Per inspection 62.50 Phone: (503) 233-8801 Fax: (503) 872-8290 Investigation per hour (1 hr min) 62.50 CCB Lie.: 166 4. 11 Electrical Lie.: 26-126C Suprv. Lic.: 2586s Industrial plant per hour 73.75 1 �1::r. t - 1 t o ,;,; ' , :.. V 1 ate 144 r t" 5j i ' ` d 1. Suprv. Electrician signature, required: (1 .�.r t'tl i ' Subtotal: 80.30 Print name: John J J. Maloney Date: 7/9/09 Plan review (25% of permit fee): State surcharge (12% of pcmtit fee): 9.64 Authorized signatur TOTAL PERMIT FEE: 89.94 Print name: This p er m it application expires if a permit is not obtained within 180 - Dat e: days after it has been accepted as complete. • Number of inspections allowed per permit. 1: 43uilding1PermiutEt,C- 1•ermitApp doe 03/13,06 440AGIST(11 /03 /COM/WEB ' .a ! Q Electrical Permit Application FOR O 09 2009 Received City o Tigard Date/Bo: Permit No. LX) " 13125 SW Hall Blvd., Tigard, OR 97223 Phone. 503.639 4171 F x: 503.5980,,Y( OF TIGARD Datese~° N Other Permit Inspection Line: 503.639,417.5 ~ 1 NG DIVISION Date Ready/By luris 91 See Page 2 for Internet: www.tigard-or.gov `'I~'®, Notified/Method: SupplementallnformatioL ..I PP1 _ Y (subtmt 2 sets of plans w/i1e. . Now construction /addition/alteration/replacement Please check all that a ms checked below): ❑ Servict or feeder 400 amps or more 0 Building over three stories. Demolition ❑ Other: where the available fault cumnt ❑ Marinas and boatyards. exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground, or exceeds 14,000 0 Commercial-use agricultural l and 2-family dwelling ❑ COMMCTcial/industrial Ej Accessory building amps for all other installations. buildings. [J Multi-family Master builder OtheC ❑ Fire pump. ❑ Installation of 75 KVA or ro jl'r ❑ Emergency system. larger separately derived system. 111I~, t „,may ! t~ rPN6 ~I, • ii~d ~ ~ . ~ 7°"I~ '~oi 7t ° , i t ~ ~ I'. ❑ Addition of new motor load of ❑ "A" "E" "1-2" "1-3'• 8 0. 4 46 2 I OOHP or more. occupancy. Jobno.. I lob site address: 1 14 6 0 5W Glarde Street „w,,..^ ❑ Six or more residential units. ❑ Recreational vehicle packs. City/State/ZIP: Tigard, OR 9 7 2 2 4 ❑ Health-cam facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg-/apt. no., Project name: Vane l l a Service or feeder 600 amps or more, "(~w rr t~t~ii w, #Z Cross street/directions to job site, ngcrl eta++ Fla ToW New residential single- or multi-family dwelling unit. _ Includes attached garage. Subdivision: Lot n0-: 1,000 sq. ft. or less 145.15 4 EEL add'l 500 sq. ft. or portion Tax map/parcel no.: Limited energy, es 33A0 1 residential 11 I r di(" ;j; with above . ft. 75.00 2 „ 1 r Limited energy, multi-family 75.00 Z re lace existing meterbase w/ new 200a service residential witbabove a .fl. Services or feeders Instal(atioe siteration and/or relocation 200 amps or less 1 80.30 8 0. 3 2 ~fdpl~4l "~~"~~hnR' 'lw'~o of 201 amps to 400 amps 106.$5 2 Name: Jonathan Vanella 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240,60 2 Address: 1 1 460 SW Gaarde Street over 1,000 amps or volts _ 4$4.65 2 City/State/ZIP.-Tigard, OR 9 7 2 2 4 Temporary services or feeders Installation, alteration, and/or relocation Phone.-( 5 0 3) 9 9 8 - 7 7 7 8 Fax: ( ) 200 amps or loss 66.85 1 Owner installation. This installation is being made on property that I own which is not 201 amps to 400 rungs 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 441 amps to 599 amps 133,75 2 13r~nnch circuits- new, alteration, or extension, per anel Owner signature: Date: A. Fee for branch circuits with •(i lie d i r-T-..,-~... i5f~i I~+i i d~,~i i~~1NIi Nr i ~f P~a~ ~a~tu I i, above service or feeder fee, u t-l' each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: ,vlrhoul service or feeder fee, first branch circuit 4b.85 2 Address: Each add'( Mulch circuit 6.65 2 City/State/ZIP: Miscellaneous service or feeder not included Each mantlt ictured or modular gp,90 2 dwelling. service and/or feeder Phone:( ) Fax::( ) Reconnect only _ 66.85 2 l;-mail Pump or irrigation circle 53.40 2 d ROO il,,vti . ~~{(sia.,i ~'SS..f~ Y i.,; 4 ..N~.', ~i'+ iBiMii!•(, Sign or outtinc lighting ~ 53.40 2 Btlsincss name: Signal circuit(s) or limited- Tice Electric COMpany energy panel, alterntion,or Address: 5405 N Lagoon Avenue extension. Describe, Paget 2 City/State/ZIP; Portl arid, Oregon9 7 21 7 _ Each addklonal ins cotton over allowable in an of the above Per inspection 62.50 Phone: (5 0 3) 233-8801 x I Fax: (5 0 3) 872-8290 Investigation per hour (I hr min) 62.50 CCB Lie.: 16 6 1 Electrical Lie.: 2 6,,•-1 2 6 C Suprv, Lic.; 2 5 8 6 S Industrial plant per hour 73.75 Sup ' rv. Electrician signature, required: it J Subtotal: 80.30 Print name: John J. Malone Date: 7 / 9 / 0 9 Plan review (25%ofpcrmit fee): State surcharge (12% of pcmlit fee): Authorized signalu TOTAL PERMIT FEE: Print name: pate, This permit applleadon expires it & permit is not ohtasacd within 180 davs after it has been accepted as complete • Number of inspections allowed per permit. t:\t3uildinglYermits\EhC-PtrmitApp tine 05173106 440-4G1 5T(, VOSICOA$NVLD ikeetrical Penilit ApplicatioREC.EIVED City of Tigard ReC41 er PermitNo ELC2009-00337 F Date/Ec: - 't 13125 SW Hall Blvd_ Tigard, OR 97223- 28 2009 plan Rcvie v Other r h a Phone: 503.639.4171 Fax: 503.598.1960 DateB Permit. ^ Inspection Line: 503,639,417] CITY OF TIGARD 1Jate Ready/By: ]arts >3 are Page _f- Internet: www.tigard-or.gor f3 ~~I Notified/Nlothod: Supplemental InforroaUon GDP 'X'X1PT8 UP WORK 1PfNl~l!T I~E1!.~K~ Q New construction Addition/alteration/replacement - pease check all A,at apply (submit 2 sets of plans w/items checked below): 1❑ Service or feeder 400 amps or more ❑ Building over three stories © Demolition Q Otber: where the available fault current ❑ Marinas and boatyards. C`Ax GD C'46N ~ti~rsUl~ exceeds 10,000 amps at 150 volts or Q Floating buildings. _ less to ground, or exoecds 14,000 ❑ Commercial-use agricultural 1- and 2-family dwelling Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ wire pump 0 Installation of 75 KVA or ©Multi-fat tly ❑ Master budder ❑ Other . ❑ Emergency system. larger separately derived system. A F n' ,o f Irr,'i , ml f•: El Addition of new motor load of ©'.A....E„ z„ ..imp", Job no-. 80. 44 6 lob 5ttc Addmsl 1 460 S W Ga ar de Street 100NP a more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle Darks. City/State/ZIP: T i ga r d r OR 9 7 2 2 4 ❑ Health-care facilities. ❑ Supply voltage for more tban _ ❑ Hazardous locations, 600 volts nominal. Suite/bIdg./apt. no.: Project Hanle: V a Ile 11 d 0 Service or feedct 600 amps or mom. Cross street/directions to job site: Deecri tin. F.e Toad New residential single- or mufti-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea, add'I 500 sq, ft. or portion 33.40 1 Tax maplpareel no.: qq Limited energy, residential with8boves . ft. 75.00 2 add 1 1 OOamp surjpanel in garage Limited energy, multi-family 75.00 2 residentiai(withabovesq.ft. Services or feeders installation alteration, and/or relocation 200 amps or less 8030 8 0 , 3 2 m l,V t . hsr4it~ s,M ai'* i`t~ ° r 1 ~w~tµ i . sit ilk f ,r - l 201 amps t0 400 amps 106.$5 2 Name; Johnathan Vanella 401 amps to 600 amps 160,60 2 601 atrips to 1,000 amps 240.60 2 Address: 11460 SW Gaarde Street over 1,000 amps or volts 454.65 2 City/State/ZIP: OR 9 7 2 2 4 Temporary services or feeders installation, alteration, and/or Tigard, relocation Phone: (r5 0 )998-7778 200 amps or less 66.85 1 Owner installation: This installation is being madc on property that I own which is not 20] amps to 400 amps 100.30 2 intended for sale, Ieasc, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133:75 2 Branch eircuits- new, alteration or extension, per panel Owner signature: Date: A Fee for branch circuits with !rr'" i'K~t, p it a ei~ ~x nu a e~ sot' " ` w above SGTVICE or feeder ilec, W each branch circuit 6.65 Business name, B. Fee for branch circuits " Wirhour service or feeder fee, Contact ntuttc: first branch circuit 46.85 2 Address: Each add'I brattch circuit 6.65 2 Miscellaneous service or feeder not included City/State/Z)P: Each manufactured or modular 90.90 2 dwellin , service and/or fccder Fax; Phone: ( 3 y~- ( ) Reconnect only 66.85 2 E-mail: T Pump or irrigation circle 53.40 2 Sign or outline lighting 5340 2 Signal circuit(s) or limited- Businessnatthe: Tice Electric Company encrgy pancl, alteration, or Address: extension. Describe: Page 2 2 5405 N Lagoon Avenue City/State/,ZIP: Portland, Oregon 97217 Each additional inspecdonover allowable in any of the above _ Per inspection 62.50 Phone:(503) 233-8801 Fax: (503) 672-8290 investigation perhour (Ihrmin) 62.50 CCB Lic- 166 Electrical Lic,: 2 6 -1 2 6C Suprv, Lie.: 2 5 8 6 5 Industrial pluu per hour 73.75 Suprv. Electrician signature, required: SubtotaL 80. 30 Print Warne: Date: 7/28/ 0 9 Plan review (25% of permit fee): Jahn J. Malone ~w $tatesurchar¢e(12%ofpetmitfee). 9,64 Authorized signatur TOTAL PERMIT FEE: 9 _ 9 This permit application expires if & permit is not obtalocd w'tthht 0 Print name: Date; days after it has been Accepted as complete. " ' • Number of inspections allowed per permit. r ~Buitdinu\PermhblEt.C-PermitApp.tloG Ot/.Z7/06 440-4615TO 1/05/C0WVEr3