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Permit . P_ILprsn* *o Q.dd ecytkracAor • I N q CITY OF TIGARD ELECTRICAL PERMIT a COMMUNITY DEVELOPMENT Permit #: ELC2009 -00517 T t GAD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/06/2009 Parcel: 1 S 125DA00400 Jurisdiction: Tigard Site address: 9130 SW 66TH AVE Subdivision: Lot: 0 Project: Lane Project Description: Replace existing service panel and run new wiring. 12/17/09 Performance Electric added to permit as contractor, signature on file. Owner: FEES LANE, CHRISTOPHER J Quantity Description Date Amount 9130 SW 66TH AVE TIGARD, OR 97212 1 ea Services or Feeders - 200 10/06/2009 $100.70 amps or less PHONE: 4 crt Branch Circuits w /Purchase 10/06/2009 $29.68 Service or Feeder 1 ea 12% State Surcharge - 10/06/2009 $15.65 Contractor: Electrical PERFORMANCE ELECTRIC 15727 SE HAPPY VALLEY TWN CTR 170 HAPPY VALLEY, OR 97086 PHONE: 503 - 558 -0496 FAX: 503- 558 -0693 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $146.03 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: 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' - r p `� c � * c'l n . Date: LICENSE NO. 1" 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. lec 17 09 08:57a Performance Electric LLC 503 -558 -0693 p.1 R ECEIVED Electrical Permit Application �1 a X f , '� E° it' `r [[LR.tiI , 'R'�- ``i�.�r�'1'�cil �4�,�* rt .` � . City of Tigard Received Permit No.: ���/� Dare/By: v °e v 13125 SW Hall Blvd., Tigard, OR 97223 Plan R DEC 17 2009 v ew ' CYJ`'7 NI, I x : Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: T '',! G Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready,By: 7um. Pl See Page 2 for vvw Internet: w.tigazd- or.gov BUILDING DIVISION NotifteNMetod: Supplemental Information OF WORK PLAN REVIEW ❑ New construction dditionfalteration/trplacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Dcinolition ❑ Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ['Floating buil +dings. less to ground, or exceeds 14,000 ❑ Commercial - use a ncultural 1 and 2- family dwelling ❑ Conunercial(industrial Accessory building s ry g stops for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire tip. ❑ installation of 75 KVA or JOB SITE INFQRMATiQN AND LOCATION ID Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A °' °0' ' 1 -2" "1 -3" 100HP or more. occu Job no.: &� ! ( 1 lob site address: '3/30 6 0 Q �� etjon- " —�+ ❑ Six or more residential units. ❑Recreational vehicle parks. City /State /ZIP: �t / . / / -7•9 ❑ Health -care facilities. ❑ Supply voltage for more Ulan J ❑ Hazardous locations. 600 volts nominal. Su[te/bldg. /apt. no.: Project name: r El or feeder b00 amps or more. C FEE SCHEDULE Cross street/directions to job site: oeserippen tee iota New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq_ R. or less 145.15 1 4 Ea. add 500 sq. R. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential /� ,,,,, DES O OF WORK (with above sq. R ) 75.00 2 / e �,� Limited energy, multi -family residential (with above sq. fl.) 75.00 2 Services or feeders installation alteration, and/or relocation 200 amps or less 1 80.30 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: (V? t / ' J 4 l..Q _ 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 _ 2 Address: �1 Over 1.000 amps or volts 454.65 2 City/State/ZIP: // !� / Temporary services or feeders installation, alteration, and /or / relocation Phone: ( 5C / z) 6 j . Fax: ( ) ' 200 amps or less j 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 500 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 1 Branch circuits— new, alteration, or extension, r panel Owner signature: Date: A. Fee for branch circuits with ` ❑ .4PPLICAIVI' ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits `—" Contact name: without service or feeder fee, ' first branch circuit 46.85 1 2 Address: Each add'/ branch circuit 6.65' 2 Miscellaneous (service or feeder not included) 1 City/State/ZIP: ' Each manufactured or modular Phone: ( ) Fax: : ( ) dwelling service andior feeder 90.90 I 2 Reconnect only 66.85 1 2 E - mail: Pump or irrigation circle 53.40 2 CON RACE•OR / 2 Sign or outline lighting 53.40 2 j Business name: 1 &le - C yr —1C Sig circui(s)or limited- ,% _ cc --v r'/ energy panel, alteration, or , Address: /5-737 I frf � / v , / 1 " � -/— - extension. Describe: Paget 2 1 V C /� / �V City/ State /ZIP: /ltd / / e , e 97 c v J , Each additional inspection over allowable in any of the above Phone: ( S F ._ ^ Tl 0 2 Per inspection 62.50 (J`d / Investigation per hour (t hr min) 62.50 / � '� i — CCB Lic.: tJ��s Electr Lig tz p rv, , i • ` / I p per hour 73.75 Suprv. Electrician signature, required: ir ''' / ELECTRICAL PERMIT FEES j Subtotal: Print name: ... r rt9id 1'Q 14 11 CTS Date: / /z t 05 Plan review (25% of permit fee): `l State surcharge (12% of permit fee): Authorizd signature: TOTAL PERMIT FEE: This permit application expires I r a permit is not obtained within IRO Print name: D ate: days after it has been accepted as complete. Nutttber of inspections allowed per permit. aGBUi:3:rgWemct ; lELGPemlity: do e Of23lC J S A7 a4 15T(t troy ;CO.Wwea s sir ; CITY OF TIGARD ELECTRICAL PERMIT q ` 3 : COMMUNITY DEVELOPMENT Permit #: ELC2009 -00517 +� u„ Date Issued: 10/06/2009 T E GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S125DA00400 Jurisdiction: Tigard Site address: 9130 SW 66TH AVE Subdivision: Lot: 0 Project: Lane Project Description: Replace existing service panel and run new wiring. Owner: FEES LANE, CHRISTOPHER J Quantity Description Date Amount 9130 SW 66TH AVE TIGARD, OR 97212 1 ea Services or Feeders - 200 10/06/2009 $100.70 amps or less PHONE: 4 crt Branch Circuits w /Purchase 10/06/2009 $29.68 Service or Feeder 1 ea 12% State Surcharge - 10/06/2009 $15.65 Contractor: Electrical OWNER PHONE: FAX: Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $146.03 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 do acco'• - - - 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: Oreg•• law - •uir - s you to follow the rules adopted by the Oregon Utility Notification Center. ose rules are set forth in OAR 952 1 01 -0010 through OAR 95 - - ' 1 -01 • r Y•u may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 0 . :10 •32.2344. Is ed By: „ Perm ittee Signature: _ % A ' J OWNER INSTALLATION ONLY The installation is being made on property I o w is not inte d for sale e or rent. OWNER'S SIGNATURE Date: 04,7 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. Electrical Permit Applicati o , � ; _ oli o il 11(1 .us o � ;l �, , -. C F R i Cl Received ©� Permit No erm. A !1n'q �, `J of Tigard g I DateB C� i � �t!! . 7 "� ° 13125 SW Hall Blvd., Tigard, OR 97223 Pl Review I, ® '"- Phone: 503.639.4171 Fax: 503.598.1960: j 0 6 2009 DateB : Other Permit: ' f I G'A R D,, Inspection Line: 503.639.4175 Date Ready/By: KIM ® See Page 2 for Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: Supplemental Information . • TYPE OFE'P 1NG DIVISION • PLAN REVIEW ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. ❑ Addition of new motor Toad of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: (� 30 S iv ' 66 I00HP or more. occupancy. ❑ ..— ❑ Six or more residential units. Recreational vehicle parks. City /State /ZIP: / ` O/ 7 � � 3 ❑ Health-care dour facilities. ❑ Supply voltage for more than ! V J y ❑Hazrdous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: /// ✓ t- ❑ Service or feeder 600 amps or more. FEE SCHEDULE . Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 * New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 I Limited energy, residential 67.84 2 • . DESCRIPTION OF WORK . (with above sq. ft.) // Limited energy, multi - family /4 [vi 'Wei /0/2„..-* 2 E/G 7� ..S ' 'eq / "1" e residential (with above sq. ft.) 67.84 2 Services or feeders installation, alteration, and/or relocation 'Or) 4eh - Ai -," ? / atI7re• 200 amps or less f 100.70 M. 7 0 2 LJ4'PROPERTY OWNE> � ` ❑ TENANT . 201 amps to 400 amps 133.56 2 Name: 7 / X 9� P p 401 amps to 600 amps 200.34 2 �� f 601 amps to 1,000 amps 301.04 2 Address: 9i 3 ,> v!� Cj 6J Over 1,000 amps or volts 552.26 2 City /State /ZIP: / T y 4// 6. 97 .2,2 3 Temporary services or feeders installation, alteration, and /or / relocation Phone: (Se 3 ) 7a6- &3 y,,,2_ 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, ept r exchglrtge, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 v � - V im ( Branch circuits - new, alteration, or extension, per panel Owner signature: Date: /0/6/a 9 A. Fee for branch circuits with . . • ' ❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, [! 7.42 /0.6 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 56.18 2 first branch circuit Address: Each add'( branch circuit 7.42 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 CONTRACTOR • Sign or outline lighting 67.84 2 Business name: Signal circuit(s) or limited - 0 0 1'12' energy panel, alteration, or Address: extension. Describe: Page 2 2 City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 66.25 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 66.25 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: ' Print name: Date: Plan review (25% of permit fee): -ffs, State surcharge (12% of permit fee): /5". (e Authorized signature: TOTAL PERMIT FEE: / /fi , 0 This permit application expires if a permit is not obtained within l 0 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\ Building \Permits\ELC- PermitApp.doc 10/01/09 440 -4615T(1I /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $67.84 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $67.84 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC- PermitApp.doc 10/01/09