Permit -. CITY OF TIGARD ELECTRICAL PERMIT
t Permit #: ELC2010 -00236
C COMMUNITY DEVEL
Date Issued: 05/12/2010
„TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101CB00400
-- Jurisdiction: Tigard
Site address: 12700 SW HALL BLVD, BLDG# A
Subdivision: Lot: 0
Project: Archer's Precision
Project Description: (4) branch circuits for lighting retrofit
Owner: FEES
TCTPI LLC Quantity Description Date Amount
25977 SW CANYON CREEK RD #J 4 crt Branch Circuits 05/12/2010 $78.44
WILSONVILLE, OR 97070 wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 05/12/2010 $9.41
Electrical
Contractor:
STONER ELECTRIC
1904 SE OCHOCO
MILWAUKIE, OR 97222
PHONE: 503 -462 -6500
FAX: 503 - 659 -4968
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $87.85
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 throu h • ' - 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.
At '' dA/ f}PPL_ tcy- r
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' Date:
LICENSE NO.
Cali 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.
May. 11. 2010 1.18FM No. 2662 P. 1/2
Electrical Permit Application
,,. 0111(1, Hs,: ()Nix
City of Tigard MAY 11 Z010 i „...,< Azolm i calmamm, 6
I 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
: p Phonc: 503.639.4171 Fax: 503.598, Other Permit:
I ( A — - -
„ i ., Inspection Lino: 503.639.4175 MR OF TIGARD Dalein .
Date Ready/By: n See Page 2 for
I i Internet: www.tigard-or.gov BUILDING DIVISIO , Notified/Method: INIE Supplemental Information
....---
TYPE OF WORK
D New construction kAddition/alteration/replacement Please check all that apply (submit 2 tels of plans wiitems checked below);
0 Service Or Ikeder 400 amps ar more I=1 Building over three stories,
0 Demolition [11] Other: where iho available holt current n Marinas and boavords.
i..ii_W/0" dORY 'Ot`diAlgTRUCtiok' - ' : : , '' '. - ' ' . t , , .. exceeds 10,000 amps at 150 volts or 0 nulling buildingx,
MIS to ground, or exceeds 14,000 0 COrrogroi41.040 08rirOhoril1
0 1- and 2-family dwelling M--Commercial/industrial 0 Accessory building amps for an other installations. buildings,
0 Multi-family 0 Master builder ii Other: El Fire pomp, 0 Installation of 75 KVA or
1:1 Emergency system. larger separately derived system.
Y 7 ' t t4541gLar k O 010.ENT,tM , 419):.LOCAHTION '. . , 0 Addition ofnew motor load of ID A ' E”. "12". "1-3".
100HP minor& occupancy.
Job no.: 2.3 2 4, z k I Job site address: / 2, 51,..1-14.,4_, 0 Si . - -
x or more re units. 0 Recreational vehicle parka.
0 Health-cam facilities. 0 Supply voltage formore than
City/State/ZIP: r; , 40.4 0 Hazardous locations_ 600 volts nominal.
Suite/bldg./apt. no.:&p4 '4• Project name: 19z - #2?C/S/oils) ID seiyice er teeder 600 amps Or more.
K-1 1 i ' i' • : ,• •
Cross street/directions to job site: nenriation I Ory. I Re. I Tata 1 •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft, or loss 168,54 4
Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map/parcel no.:
Limited energy, residential
67.84 2
: • '.,;;: " !;" ' DESCRIPTION :OF FORK:Wi: (with above scLa.)
Limited energy, multi-family
67.84 2
.1.:// -4,4/ A ."/ et.bir/A/Z /277e0 4 residential (with above sq. ft)
Services or feeders installation, AlterAtion. and/or relocation
200 amps or less 100.70 ' 2
E :444,411Y .:!1 .! !: .: : ::;, V ;,;:":.:'.' 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/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on properly that I 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 amps 168,54 2
Branch circuits- FICW, alteration, or extension, per panel
Owner signature: Date: A, Pee for branch circuits ivirh
,...6%*S 0 ? ' ':: '''''-': ::.'. 2 .: 7 1Ci:P!' , WIZO: - Migq6VEM5i344 . 1 . 4•4 above service or feeder fee.
. 7A2 2
each branch circuit
Business name: B. Fee for branch circuits
. —
ividut to service or feeder fce,
Contact name: first 56.18 5- 2
first branch circuit
Address: Each addl branch circuit 3 7.42 22,“,.. 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 irrigation circle 67.84 2
:CONTRACTOR ' . Sign or outline lighting 67.84 2
Signal circuit(s) or limited-
Business name: STONER ELECTRIC, INC. energy panel, alteration, or
A 1904 SE OCHOCO extenf,ion. Describe: Page 2 2
— - ,
C MILWAUKIE, OREGON 97222 Each additional ins_peellon over allowable In any of the above
Per inspection 66.25
Phone: ( 503) 462-6509, 1 Fax: (503) ,.....„„ Investigation per hour 0 hr min) 66.25
6 ; 1 / r CCB Lie.: 44823 i-/ Electrical Lie.: 26-122C T &V Li e . ' 3496S - Industrial plant per hour 78.18
:ELECICRWAL FERKfTF-5
A'&1
Suprv. Electrician signature, required: p1 4 ,...t AL-........„ Subtotal: 76 ,, ,$4—
Plan review (25% of permit fee): iffr
Print name: MICHAEL FALCONER Date: Sir r h
State surcharge (12% of permit
Authorized signature: TOTAL PERMIT FEE: 87, fas' .-------
This permit application expires an penult 14 not obtaioed Aviihin 180
Print name: I Date: days after It has been accepted as complete.
.
-
• Number of inspections allowed per pennit
I:MoildingVentio\aLC-vorltApp.doe 10/01109 140