Permit -.
` CITY OF TIGARD ELECTRICAL PERMIT
IN y q
,,a COMMUNITY DEVELOPMENT Permit #: ELC2009-00641
Date Issued: 12/02/2009
T t G A D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
ti , R , ,,.,,t Parcel: 2S112AD01100
Jurisdiction: Tigard
Site address: 6650 SW BONITA RD
Subdivision: PAUL SCHATZ FURNITURE Lot: 1
Project: Thomasville
Project Description: Add /alter (3) branch circuits for receptacles and lights.
Owner: FEES
PACA PROPERTIES LLC Quantity Description Date Amount
6600 SW BONITA RD
TIGARD, OR 97224 3 crt Branch Circuits 12/02/2009 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 12/02/2009 $8.52
Electrical
Contractor:
WILLAMETTE ELECTRIC INC
PO BOX 230547
TIGARD, OR 97281
PHONE: 503 - 624 -3631
FAX: 503- 624 -2938
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 IS copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: -n f\ 0 C, / QbI JLX A,L Permittee Signature: C p
OWNER INSTALLATION ONLY
The installation is being made on property.) 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.
12/61/2009 TUE 8:31 FAX 5036242938 Willamette Electric a002/002
Electrical Permit Applicatio
CEDED
FOR OF USE OI\ LY :: : ;
•
City of Tigard Received
: Plan n R 13125 SW Hall Blvd., Tigard, OR 97223 Da : .......411
Review
Phone: 503.639.4171 Fax: 503,598.1 C 01 2009 DatelB Other Permit:
1 1 c, A R I Inspection Line: 503.639.4175
Date Ready y: See Page 2 for
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g g ni No fed/Mcihod Supplemental upplemental Informal on
iN£ A P :igO} ,�} ){ }, `'' ORAWA.' il "ri ri (1. if _ t•.. v � � r �� , :` A iT t-�; ` s . $ li [*.% ; PWA'►1tr Xill y K .R Y t A `
❑ New construction I Addition/a teratio rep acement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or fcedcr 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
�,
• "s� 7 ' �i` -',,, r '� �'`t'�"�'i t,,'1. ' rii6iVedifiltateitaLv ''t' r f 1 . 3'W- 1 cv'' v i ). ra exceeds 10,000 amps at 150 volts or
z�l,.;c . ,.. r . t ilti s..h .,, > . -.... , nIrv r ,. , ... o;1,:.. ?, P ❑Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I - and 2- family dwelling mmercial /industrial ❑ Accessory building amps for all other installations. buildings.
0 Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
wX� }! ( r5s is u yG rte, s s # t ❑ Emcrgcncysystem. larger separately derived system.
3..e ".3eFvr,. -t4',.r:: t1r.1FENFO D�7G�k'IO `s ,v { ?�?'.
.. �=<3i ,tLS -t, c. _ ❑ Addition of new motor load of ❑ "q° ^P° `•I -Z" - 1-3 - ,
Job no.: 2 9 2 1 Job site address: 6630 s w c o ve t /a t00HP or more, occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: T: 7 2,41 O /Z. ❑ Health-care facilities. ❑ Supply voltage for more than
/ ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: I Project name: 7 o 04 as e. N t ❑ Service or feeder 600 amps s or more.
;: naZ-ni_ tl.rswj.: tfr3,i );'
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Cross street/directions to job site:
Description t Qty. � .a�
Fee. 1 Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 4
— Ea. add'/ 500 sq. ft. or portion 33.40 1
Tax map/parcel no _ - Limited energy, residential
': .t' < w z . ' ± _DESCRJPT1ON OF WOit.k f S is ' _ (with above sq. ft) 75.00 2
Limited energy, multi - family
4 J c.i r Y (. °/ e a J d /Z Gf • . / ' / 4 Er residential (with above sq. ft.) 75.00 2
Services or Feeders installation, alteration, and /or relocation 2
F 200 amps or less 80.30
) .. �.a ( I :fti'A k N , g i { �'a Z Y c 1 a�1 3 i 201 amps to 400 amps
,,n„ „<..<„ F ,cE .,: P 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: ( ) 1 Fax: ( ) 200 amps or tess 66.85 I
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: Branch circuits — new, alteration, or extension, per panel
Date A. Fee for branch circuits with
ZRI e', ',tJ AP J.t1CP{:N0. t ., .0 `poi r cr i Rgor' above service or feeder fee, 6,65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee / 46.85 rArad 2
first branch circuit %"
•
Address: Each add'I branch circuit 2 6.65 L 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
Phone: ( ) Fax:: ( ) dwelling, service and/or feeder
Reconnect only 66.85 2
E -mail: Putnp or irrigation circle 53.40 2
.4 . _ , .. "- , n',..s. ; ,..:s..,;. ij., _ g NT.ItACTOR,`�. .- k „ ;,; '' Sign 05 outline lighting 53.40 2
Business name: Willamette Electric, Inc. Signal circuit(s) or litnited-
energy panel, alteration, or
Address: PO Box 230547 extension. Describe: Page 2 2
City/State /ZIP: Tigard, Oregon 97281 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 624-3631 1 Fax: (503) 624 -2938 Investigation per hour (1 hr min) 62.50
CCB Lic.: 75059 Electrical Lic.: 34 -283C Suprv. Lic.: 4226 -S Industrial plant per hour 73.
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Suprv. Electrician signature, required: 1 ---" Subtotal: „ • t.02
Print name: David Fife Date: g - _ d 9 Plan review (25% of permit fee):
State surcharge (12% of permit fee): TOTAL PERMIT FEE: p C�
�
Authorized signature: ��/ 7 l .5L
Print name: Date: This permit application expires if a permit is not ohtai ed within 180
days after it has been accepted as complete.
' Number of inspections allowed per permit.
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