Permit A` ELECTRICAL PERMIT
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CITY OF TIGARD
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` I =- COMMUNITY DEVELOPMENT Permit #: ELC2010 -00213
�' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/05/2010
T 1 G ARD gar Parcel: 1 S 136AD04000
Jurisdiction: Tigard
Site address: 11505 SW PACIFIC HWY A
Subdivision: Lot: 0
Project: Shears Ahead
Project Description: (3) branch circuits
Owner: FEES
PACIFIC TERRACE COMMERCIAL LLC Quantity Description Date Amount
BY EDITA M SMITH, 833 NW 170TH DR
BEAVERTON, OR 97006 3 crt Branch Circuits 05/05/2010 $71.02
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 05/05/2010 $8.52
Electrical
Contractor:
HUGHES ELECTRICAL CONTRACTORS INC
9640 SW SUNSHINE CT #600
BEAVERTON, OR 97005
PHONE: 503 - 626 -3344
FAX: 503- 4o4 --33
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 throug •, - '52 -101 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: e/
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.
F rom: 04130/2010 14:18 #537 P.0021003
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Electrical Permit Appli � g,< rya 8rFICL use 0N,-.„..,. ..:
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City of Tigard //�( AP Received ��
13125 SW Hall Blvd., Tigard, OR 9922 Q 2 Plan Date/B Review : S S /Q j��r Permit No . 2o /® -,e,04:243 r . Plan Review we
$,..i ' - , t' '' • Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TrI GA [' I I nspection Line: 503.639.4175 On OF TIGARD Date Ready/By: lures: See Page 2 for
` - "`t " s I nternet : www.tigard•or.gov DIVISION Notified/Method: � �� Supplemental Information
TYPE OF WORK 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 0 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 0 Accessory building amps for all outer 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 load of ❑ "A ' g 1 -2 ", I -3"
Job no.: 1 0A291 Job site address: 11505 sj j Iuy IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
❑ Health -care facilities. ❑ Supply voltage for snore than
City /State /Z1P: Ti
[ I )� ❑ Hazardous locations. 600 volts nominal.
3 7 Su /apt. no.: p Project name: Alma ❑ Service or feeder 600 amps or more.
n FEE SCHEDULE
Cross street /directions to job site: ,y �r 2 /9 l Description ,
.. Q Y- Fee. 1 'total
New residential single - or multi - family dwelling unit.
Includes attached garage.
Subdivision: , Lot no.: 1,000 sq. ft. or less 168.54 1 4
Ea. add' 1 500 sq. R. or portion 33.92 i
Tax map /parcel no.: Limited energy, residential
DESCRIP'T'ION OF WORK (with above sq ft.) 67.84 2
Limited energy, multi- family
Tie=datp tt-( tsar!x ate stnrit fris
residential (with above sq. ft.) 67.84 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 300,70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
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 /o
relocation
Phone: ( ) Fax: ( ) 200 amps or less 5936 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT XS CONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: B, Fee service or for branch
de r fee, circuits without
ic feeder ee, first
Contact name: Rir3c gl air branch circuit 1 56.18 56,18 2
Each add•1 branch circuit 2 7A2 14.84 2
Address: 9640 SW Shx'lirte Ctr StB 600. Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /ZIP: al CR 97005 dwelling, service and/or feeder 67.84 2
Phone: (503 ) 626.3344 Fax: : ( 503 ) 626.3377 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: ) Icxtritzil _frm
Sign or outline lighting 67.84 2
CONTRACTOR
Signal circuit(s) or limited - energy
Business name: 1 panel, alteration, or extension. • Page 2 2
11e5 F I^ nral S Each additional inspection over allowable in any of the above
Address:
9640 3d 9rxhirta rt FOD Additional inspection (1 hr min) 1 66.25/ hr
Investigation (I hr min) 66.25/ hr
City /State /ZIP: Eimsderba..4 CR 97005
Industrial plant (1 hr min) 78.18 / hr
Phone: ( 503) 626.3344 1 Fax: ( 553) 2 Inspections for which no fee is
— / specifically listed (7a hr min) 90.00 / hr
/� CB Lic.: 49850 Electrical L 2 � uprv. Lic.: ear (_� ELECTRICAL PERMIT FEES
Oil
Subtotal: . , , a S uprv. El ectrician s requ Plan review (25% of pemtit fee): 0 00
Print name: u T ram Date: 04 State surcharge (12 %of permit fee): 8.51 • •
TOTAL PERMIT FEE: 79 455 -
AUthOri2ed signature: This permit application expires if a permit is not obtained within 180
Print name: Date.
days after it has been accepted as complete. ?q � 2`
' Number of inspections allowed per permit.
1 . \Ra PermitApp doc 10/01/09 /� M/
440- 4615T(11105/COWEa
VT I
From: 04/30/2010 14:18 #537 P.001/003
El ectrical Contractors iv
F_/ incur ,s.0/ jj 4 yeA6asiiii g �)uaiitr 7
WA LIC: HUGHEEC14800
9640 SW Sunshine Court, Suite 600
Beaverton, OR 97005
Phone: 503.626.3344 Fax: 503.626.3377
nonab @hugheselectrical.com
Fax Cover Sheet
TO: PERMITS - CITY OF TIGARD ATTN:
FAX: 503 - 598 -1960 PHONE: 503 - 639 -4171
FROM: NONA BOWLING DATE: 04/30/10
RE: PERMIT APPLICATION — SHEARS AHEAD #10A291
No. of Pages including cover: 3
Message:
Please issue permit per attached application, use the payment authorization and please fax permit to
503.626.3377
Please let me know if you have any questions.
Thanks!
Nona