Permit *' fit,
� CITY OF TIGARD ELECTRICAL PERMIT
i, _ 4
° PERMIT #: ELC2007 -00228
COMMUNITY DEVELOPMENT DATE ISSUED: 4/11/2007
T p 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102CB -00303
SffE ADDRESS: 13165 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT : 033 JURISDICTION: TIG
PROJECT: A & W
Project Description: Replacing meter base. Job No. 9212
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
MAKO PROPERTIES WILLAMETTE ELECTRIC INC
14188 NW STONEBRIDGE DR PO BOX 230547
PORTLAND, OR 97229 TIGARD, OR 97281
Phone: 503 - 645 - 4616 Contact #: PRI 503 - 624 - 3631
FAX 503 - 624 - 2938
FEES •
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 4/11/2007 $66.85 LIC 75059
[TAX] 8% State Surcharge 4/11/2007 $5.35 SUP 19655
Total $72.20 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 • : - han 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those r. es are set fort' • : 952- 001 -0010 through OAR 952 -0 01 -0100. You may obtain copi -- of these rules or direct questions to OUNC at
503.2 9 or 1.800. 234
Issu =d By: /_ �� , jj , L _ P erm itt ee Signa - e: //, ; L/ ��
i
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'N: `�� i /frFff'7( /ids ------ 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.
APR 10 2007 7:03AM WILLAMETTE ELECTRIC INC. 5555555555 p.2
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r 1'J p '` „ p ' - " Please c heel all that apply:
tic _.
LI t>: cor,h t,r,,Ion t t3 , re • to t 11'ii�il ❑ amps, Il � Service over 225 ant s, comet I Hazatdowi location
E, t t ">
�.� _ ?c lticitilo - -- -- - - -- - �..__ [] Sen'icr -. over 320 amps - taling ❑ 1.3uildng ovef 10,000 sd. it .
(A 1t'fi+6,O3E, t t F oico of 1- an nv
d 2 - family dwellings 4 or more .., residential
,J 1 - and 2-Ian dwelling Pe ❑ Accessory building - -- in DSystem over 600 volts nominal units o s'rrictul e.
f 11 1 !1
❑ Huilding over three stories OFeedets, 400 amps or more
iN/lulu- family ❑ Master builder ❑ Other:
['Occupant - e =T persons toad over 99 peons Manufactured structures or
J S . * 1 , . - .04 F :t: ❑Egress lighting plan RV park
L
Job no.
❑Health -care facility ['Other:
Job si-le address:
�zl t Submit 2 sets of plans with any of the above.
City / State/ZIP: The above are not applicable to temporary constr'aetioii service.
iI1 aAs2s7 1 e5a
Suite/bldg. /act. no.: Project name: A it :+i°nsa : e:t• ' :
Des cription Qty. Fee. Total
Cross street /directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
_ 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft- or portion 33.40 1
• Limited energy, residential 75.00 2
Tax map/parce1 no.: Limited energy, non - residential 75.00 2
c _ t : i , " ,� Each manufactured or modular
r_.• �c ' m
dwelling, service and/or feeder 90.90 2
_IS [z•'PL1.c,aw ia. tv11ETlm AS< Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
, - ,r ii , a - 1 amps to 400 amps • 106.85 2
.t
} €id�ki -firA. K�i l, �,.__._. 600 amps 160.60 2
. � ... ..., ,, , w.. ,., . �,_,_, _ ...._..__ ,.-- 401 amps to
Name: h'1„+1Sr:► 'y�patrtds 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 , 2
Address 1 B8 r.t� S?D►.1t5gWDua.
R econnect only I 66.85 6,6„ $+ 2
City / State/ZIP: "p 02.1 - 1 „6.1i 0(2. 972.,2, Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( t 03 ) Lvus.. ,4414, 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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
x -s- ,t A. Fee for branch circuits with
$Ah _aa�} ... ' t ' -• c- S ° 6.65 2
,...., ,.._ .�.. _. _. •>`- service or feeder fee eac
Business name: branch circuit _ ,
H. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'i branch circuit 6.65 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E-mail: Signal circ.iit(s) or
x rd p .� y,�„C e •b -It- -7 t. ,r -=? µ is . A `: i5 . ,,' gegypan el, alteration, o
'tY Si .tit(s) or limited-
energy , .q,� .:u,._ "'"''':. . .,.... _ o tr .ter ._.:tra = -- it . _ extension. Describe; Page 2 2
Business name: J! <s, eft L
, /et: trr�. 1%4 c
Each additional inspection over allowable in any of the above
Address: 1'O 3 e.>ix Z-'° ffi Sit' ? Per inspection 62.50
C ity/State/Z I P: T, g, of. :,: Or ` e ? S • -) investigation per hour (l hr min) 62.50
j Z ,� 3' e Industrial plant per hour 73.75
Phone' (5C ) 6 L `St " r.7 t. i'c i Fax: ( �v ) - � � `,, r7tsr .r s?F 7 d l.. " ;
s
,,��r I Electrical Lic.: r�„ �' 4- 5uprv. Lic.:
CCB Lic.: ��°"'_' 7 Subtotal
Plan review (25%o of permit fee
Strprv. Electrician signature, rcqun•edzF_, ...._._.,•. - - -- - ~--
Date: LI_`�..n
State surcharge (8% of permit fee) i g
r
(
Print name: - ( tu /�ryf / f 7 _Y� TOTAL 6'EV2147DI F1EE ,? _� .
Alai - tort zi 11 signaturl: -- __- _ -T_ -_- Ttrt; : permit applif:ntinn expires ir permit is not uhtaiaeti wi.thita 130
- -- days after 11 has item accepted 25 1.01111 -
- Print a s ill -- 1- Date: Fee nxr'todology set by Tr:- County Building iudusny Service nuaxl
_ "= Number or inspections per permit allowed,
440.4411 5'I'(1 n /02/COMI W 811
,AMud ding \Ver,rit,W.I.1: 1'ennn A14: dm; I 2111