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Permit ( ( /26 - 4 9 .' CITY OF T I AR® ECTRICAL PERMIT I pi -i. i'.'I'< COMMUNITY DEVELOPMENT Permit #: ELC2009-00594 T t CAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2009 Parcel: 1S134CA00614 Jurisdiction: Tigard Site address: 11080 SW 121STAVE Subdivision: Lot: 0 Project: Chaney Project Description: Install (1) 200 amp panel and add /alter, (10) branch circuits. 11/25/09, adding (8) additional circuits. Owner: FEES WINDSOR PROPERTIES, LTD AND Quantity Description Date Amount CHANEY, JOHN R & PATRICIA K, PO BOX 647 HILLSBORO, OR 97124 1 ea Services or Feeders - 200 11/03/2009 $100.70 amps or less PHONE: 10 crt Branch Circuits w /Purchase 11/03/2009 $74.20 Service or Feeder 1 ea 12% State Surcharge - 11/03/2009 $20.99 Contractor: Electrical STANS ELECTRIC INC 8 crt Branch Circuits w /Purchase 11/25/2009 $59.36 6602 NE MARINA ST Service or Feeder HILLSBORO, OR 97124 0 ea 12% State Surcharge - 11/25/2009 $7.12 PHONE: 503 -789 -9793 Electrical FAX: 503- 648 -6556 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $262.37 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 wit expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: It law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 thr gh OAR 001 -01 . u may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. , Issued By: P f-= Perm ittee Signature: ' ( ( 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' _ `P-1 t � Date: LICENSE NO. G 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 in `1 a 0_or r'Q-C Par c.2..� 4- o_ ir CITY OF TIGARD ELECTRICAL PERMIT 3 a =' ^_ COMMUNITY DEVELOPMENT Permit #: ELC2009 -00594 i " 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2009 T f C 'r\ Rip 9 Parcel: 1S134CA00614 �7�MaAtit;a��: x�: Jurisdiction: Tigard Site address: 11080 SW 121ST AVE Subdivision: Lot: 0 Project: Chaney Project Description: Install (1) 200 amp panel and add /alter, (10) branch circuits. Owner: FEES WINDSOR PROPERTIES, LTD AND Quantity Description Date Amount CHANEY, JOHN R & PATRICIA K, PO BOX 647 HILLSBORO, OR 97124 1 ea Services or Feeders - 200 11/03/2009 $100.70 amps or less PHONE: 10 crt Branch Circuits w /Purchase 11/03/2009 $74.20 Service or Feeder 1 ea 12% State Surcharge - 11/03/2009 $20.99 Contractor: Electrical STANS ELECTRIC INC 6602 NE MARINA ST HILLSBORO, OR 97124 PHONE: 503 - 789 -9793 FAX: 503 - 648 -6556 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $195.89 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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. � 1 Issued By: Permittee Signature: SiCSL OC , nVt X 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. ` k , CITY OF TIGARD ELECTRICAL PERMIT IVY rI C . 2 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00594 A RI?. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2009 4ra�s, +1/ isr* Parcel: 1S134CA00615 Jurisdiction: Tigard Site address: 11080 SW 121ST AVE Subdivision: Lot: 0 Project: Project Description: Install (1) 200 amp panel and add /alter, (10) branch circuits. Owner: FEES WINDSOR PROPERTIES, LTD AND Quantity Description Date Amount CHANEY, JOHN R & PATRICIA K, PO BOX 647 HILLSBORO, OR 97124 1 ea Services or Feeders - 200 11/03/2009 $100.70 amps or less PHONE. 10 crt Branch Circuits w /Purchase 11/03/2009 $74.20 Service or Feeder 1 ea 12% State Surcharge - 11/03/2009 $20.99 Contractor: Electrical STANS ELECTRIC INC 6602 NE MARINA ST HILLSBORO, OR 97124 PHONE: 503 - 789 -9793 FAX. 503 - 648 -6556 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $195.89 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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ofN c. ‘(1.S �J \ l A 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' (� n A. Date: LICENSE NO. r 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. ,uicu II:QI . r. erillit PAl1CSt;on RECEIVED • FOR OFFICE USE ONLY IN City o� Tigard Received . . 1-3.115 5 W Hall Blvd, Tigard, OR 97223 Datc ; Per No. , �T tr r? Phone: 503.639,1171 Fax: 503.598.1960 0 V 0 3 2009 Plan Revie �VJ T inspection Line: 503.639,4175 Date/By: Other Permit: ns TICARD p Internet: www.ligard- or.gov CITY OF TIGARD otified/Me See rage 2 for — ' . ,' N9t Supplemental Information ['i 0 wO : �� , . tr e i r . tltod' T ❑ Ncw construction g Addition /alteration/r laCement Phase c heck all that apply Cp Pp y (submit 2 sets of plans w /items checked below): Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories. Ot her: r d5 .! .OF'`t01 A*RtlieiI J1( - o feat 150 volts t Marinas bu d boatyards, where t he 3V3tlab) t ❑ 5 yar s , �• exceeds Iu,vUU amps at 150 volts or �] Floating buildings. ❑ 1 - and 2 0 less to ground, or exceeds 14,000 ❑ Commercini - nsc agricultural Y dwellltl $ 0 Commercial /industrial Q Accessory building amps for all other installations buildings. ❑ Multi- family ❑ Master builder Ot her: 0 rim po mp ❑ r ❑ rnntoilntign of 751CVA or .. 0 Addition of new motor load of is srfl uvFr�itrAr`r41�( ;, Job no. � Emergency system. larger separately derived system. .,�. "l ,,. ,' ❑ ❑ "A" "E" "1 -2 ", •' 1 - ;••, : Job site address: / 1 Q r Q S ( J 1001{r or more. occupancy. ❑ Six or more residential units. LJ Recreational vehicle parks. Ciry /State /Z1F: / a „ �/ /'1 _ ❑ Health -care faeilitics. ❑ Supply voltage for more then •�"�. �J�t_.ff -- . ❑Hazardous locations. 600 volts nominal, • Suite/bldg, /apt, no.: Prnjeet name: �� ❑ Sgorviao or fonder 600 empa or more. Cross street/directions to job site: . • ;'i ,w`' 1 ' . 1, S.l'I3P.):14 t • .. Dluri 1 Fee. Torn! . — New residential sint,+lr or multi - family dwelling_ unitt. Includes attached garage. Subdivision: - Lot no,: r.__ 1,000 sq. ft. or Tess 1 168.54 4 La. add', 500 sq. ft. or portion 33.92 i Tax map /piicci 110 TX(S ; O Limited energy, residential 'CDESCR1P ,N. WORD: _swish above sq. R.) 67.84 2 Limited energy multi - family 67.84 2 — residential (with above sq. ft.) _ Services ur feeders installation, o e 200 amps or less rye 100. , n 2 ;;i� PR i :-OW1S.igl '•` 201 amps to 400 amps 133.56 2 ran, a era a p Name: vv J 0 S 8 P�L.+n 401 amps to 600 amps 200.34 2 ~ - 601 artrc to 1,000 amps 301.04 2 Address: /' `Q 7 Ovcr 1,000 amps or untie 552.26 2 Ciry /State /ZIP: ' j , / 6 Q , Temporary services or feeders installation, alteration, and /or �� rehuMtien Phonc: (o3) Fax: .k 2 amps or Icss 59.36 1 GS�� l7SS ts3)�� -3.1 p Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for solo, least, rent, or exchange, according to OR5 447, 449, 670, and 701. 401 amps to 5 99 amps 108.54 2 Owner signature: date: Branch circu - new, alteration, or extension.per panel A. Fee for branch circuits ,with n A1yPi IttANT z ,: •61. r k cr' 'azt a i� abovc serv or f ee d e r f ee, J 7.42 17 2 each branch circuit Business name: _ 8. Fcc for branch circuits without service or feeder fee, Cent ct name: 50.1 z first branch circuit Address! Each add'I branch circuit 7.42 2 Miscellaneous (service or fccd_er not included) _ _ _ City /State /Z1P: Each manufactured or modular dwelling. service and /or feeder 67,$4 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 �_ 2 E-mail: Pump or irrigation circle 67.84 2 CON"1 "R4,C'1 • Wt,' Sign a outline lighting 7.24 2 '� ro g Business name: .S: , y� Signal circuit(s) or limited- e Uydi. - /--.PV C energy panel, alteration, or Address: 0 ee C d '�J 6 n"A n"0 N extension. Describe: Page 2 2 City /State /GIP: / 4 �E,� s (��,� ,4 ) - Each aaditiunal iva er�t liuu over aituwable In any of the abuse T Per inspection 66.25 Phone; 6a ) .y1 �,- 3 I F ax: ( s , 3 V 4, c5F4 Investigation per hour (1 hr min) 66.25 CCB Lic,: / 5/ 2Q 5 Electrical Lic.:..; - G -,7jJ Suprv, Lic.: , g")S industrial plant per hour 78.18 q�; d , .... RICr A 'PER1Vil FEES p I'� dd l• l� � 1 i;• d1� rv. We signature, re ire t – — c �� Subtotal: / �`J .� Print name: -.W I Date: Plan review (25% of permit fee): State surcharge (12% of permit tee): arc. -r Authorized signature: TOTAL. PERMIT FEE; / 9 D Print name: _ This permit application expires if a permit is not obtained within 180 __ Date: days after it has been accepted so complete. -- — Nnmhar of inspections a tlnwnd par pnnrat T\ 0uildino1 Permit! `EtC- t'annitApp,doc 10/0 Imo 440 - 13T(11 /05 /COM/wl_•n