Permit :..;. a CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 00632
T t t,AI D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/25/2009
Parcel: 2S101 DC01100
Jurisdiction: Tigard
Site address: 7298 SW TECH CENTER DR
Subdivision: Lot: 0
Project: Multi -Craft Plastics
Project Description: Provide power to new tool.
Owner: FEES
LACHENMEIER LLC Quantity Description Date Amount
7298 SW TECH CENTER DR
TIGARD, OR 97223 1 ea Services or Feeders - 200 11/25/2009 $100.70
amps or less
PHONE: 1 crt Branch Circuits w /Purchase 11/25/2009 $7.42
Service or Feeder
1 ea 12% State Surcharge - 11/25/2009 $12.97
Contractor: Electrical
OREGON ELECTRIC GROUP
1709 SE 3RD 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 $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 acco ith 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. ATT ION: Oregon, law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001- 10 through OAR 952 -00 c0. Y• . may obtain a copy of the rules or direct questions to OUNC by callin .246.6699 or 1.800.332.2344.
Iss ed 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' _ Q �l�- �� 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.
\,.. / ' .
Q Ued>t1rnc 8 °a1°rmll>t p q • ���ED .��- ' ^° - ..1-1 , � , - • t +t)R trr l ►c1 1 sr+ ONLY"
City of Tigard Received // Permit No..
Date /13y: // ,-.0.-t t B .a-•^
(:::,: . 13125 SW Hall Bivd.,'Tigard,OR 97' 2 2.0 -` " D
� �j�� - Plan R eview
11 •• Phone: 503.639.4171 Fax: 503.598!} N(1 Date /By: Other P .mtil:
'1'tG u- htsp i ine• 503 619 417 f� Date RexdylBy: - - - -� i + +ris' fib See Yt +{e2 for
i...;:.,:, _ • : >,:' Internet: www.li rd - or. G ov �l
1t%t b Q� � `' A l Notified/Method: -- __ - - -- i // � Supplemental information
GDWIs .. • "'- . _..... -,-
PLAN REVIEW-
-' __
El New constntction C.4 Addition/alteration/replacement
Pease check all that apply (submit 2 sets of plans wlitems checked below):
0 TYPE l) tym �
Se, vice or feeder 400 amps or more ❑ Building over three stories.
Demolition ❑ Other: - where the available fault current ❑ Marinas and boatyards.
'CA'T'EGOR OF CONSTRUCTI ` ` ` . exceeds 10,000 amps at 150 volts or 0 Floating buildings.
- - - - - -- less In ground. or exceeds 14,000 0 Commercial-use apiculture]
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: 0 Fire pump. 0 Installation of 75 KVA or
JOB:SITE INFORMATL•N AND LOCATION - ?� A Mitio ncysystem, tamersepuruely
� L - ] A ddifiin anew motor load of
Job no.`75480
�' -- e
City/State/ZIP: TIGARD' Job site address: 7298 SW TECH CENTER DR 1' or mere. residential occupancy. y. El Recreational 0 Six or more sidential units. ecreational vehicle parks.
OR 97223 ❑ Health -cure facilities. 0 Supply voltage for more Than
❑ N ardous locations. 600 volts nominal.
Suite/bkdg. /apt. no.: I Project name: MULTI -CRAFT PLASTICS ❑ Service or feeder 600 amps or a ore.
FEE SCHEDULE
Cross street /directions to job site: nestion ___ L 4!y._ __L Taal I
____________ - - - - 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. R. or portion 33.92
- - - -- - - -- - -- - - - --
Tax map /parcel no.: -
Limited energy, residential
' DESCRIIP'1'1oN OF WORK (with above sq. R.) _ 67.84 J - 2
PIiO1'llllE POWER TO NEW TOOL W - - - - - -- Limited energy, multi-tinnily 67,84 2
_.__ -_ _. --- - - - _._..__- residential (with above sq. It.} __`
Services or feeders installation, alteration, and /or relocation
- ____ _ 200 amps or less 1 100.70 10.70 2
u PI ;OPER1 Y OWNER 0 TENANT 201 amps to 400 amps 133.56 '
Name: i . 1 1 E L �_V� + _ 401 amps to 600 amps 200.34 T - _ J
A - 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 feeders installation, alteration, and/or
-- ___--___ .__.______ -__- ________________ ___ relocation
Phone ( ) Pax: ( ) 2 amps or less _ Y _ __
59.36 1
Owner installation: This installation is being made on property that 1 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 amts 168.54 2
Branch circuits - new or extension, err panel
Owner signature: - --- . - - - - -- -- - - - --- Date:
- ., - . - . - - -- . A. Fee for blanch circuits with
❑ APPLICANT . ❑ CONTACT PERSON above service or feeder fee, 1
7.42 7.42 2
• . ..-..
each branch circuit
Business name: B. Fee for branch circuits - _
- T - -- -- -- without service or feeder fee,
Contact (tame: 56.18 86.18 2
first branch circuit _
Address: - - -- f rch add't blanch circuit -_ _ 7.42 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) -'� Reconnect only 67.84 2
E -mail: - Pump or inigation circle 67.84 2
CONTRACTOR 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"D AVE extension. Describe: Page 2 2
City /StatelZiP: PORTLAND OR 97214 Each additional inspection over allowable in any of the above
Phone: (503) 234-9900 Fax: (503) _535 -2763 -- -- Per inspection -- - 66.25 -
-- - investigation per hour (1 hr min) 66.25
CCI3 tic.: 203 Electrical Lie.: 26 -95C Suprv. Lic.: 4549S industrial plant per hour 78.18 -
- -__ ELECTRiCAT PERMIT FEES
Suprv. Electrician signature, require c\r- � =1... :.; 3 -.) - 1 2 -
Subtotal: .4-rr !D$
Print name: RICHARD MCELLIOTT T Date: 11 - - Pfau review (2S %ofpermit fee):
State surcharge (12% of permit fee):l'T /a • 7
Authorised signature: °' ( '° ti ") 'TOTAL ' , ERMFI' FEE: x.32 2 '
- - - - '1'hls permit application expires if a permit is nit obtained within l8 a 9
Print name_RICHARD MCELLIOTT Date: 11- 24 -0.9 - days }Merit has been accepted as complete. /� Z
Number of inspections allowed per permit.
I9Rmlding `.renniti\ELE- rcrrni,App.doc 10 %01/09 440- 4615 1'05 /Cl)M;W1 /R