Permit N(b�l i ELECTRICAL PERMIT
- ' ' 0 8 ' r t'41 1; 10 ° /tjy 0( TIGARD 1 �4�tX PERMIT ELC2008 -00117
IN COMMUNITY DEVELOPMENT DATE ISSUED: 3/3/2008
U
�T IGAR D _ 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 114D0 - 00101
SITE ADDRESS: 17005 SW 92ND AVE ZONING: R -4.5
SUBDIVISION: COOK PARK LOT : JURISDICTION: TIG
PROJECT: COOK PARK
Project Description: Installing (2) branch circuits for heater and gas pad.
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: X
Owner: Contractor:
TIGARD, CITY OF OREGON ELECTRIC GROUP
13125 SW HALL 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Permit 3/3/2008 $53.50 LIC 203
[TAX] 12% State Surchar 3/3/2008 $6.42 SUP 4460S
[ELPLCK] ELC Pln Rev 4/14/2008 $62.50
REQUIRED ITEMS AND REPORTS
Total $122.42
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 for
more than 180 d .ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 -00 - 010 throug' O: ' 952 - 001 -0100. You may obtain copies of these rules or direct questio . -OUNC at 503.246.6699 or 1.800.332.2344.
_________)
Issued Permittee Si natu 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
z- J SIGNATURE OF SUPR. ELEC'N: C�� -- `6t'/ ('/s -Y• (5 DATE:
I
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 -11 -08 12:12 FROM- OREGON ELECTRIC -MAIN 5032349900 T -116 P. 001 /003 F -240
TRANSMITTAL SHEET
`OREG
RECEIVED
QA ` � �;� Nr'r� 1 1 2008
r �
{ ELE L �_� k� C!TYO1- T:
F
7 ,9 c.,lcfi:C O euJ:4.7ta^cr "
f5O3) 2,3 9� Oo �,
TO: CITY OF TIGARD - �
ELECTRICAL PERMIT PLAN REVIEW SECTION \)\e 4.:
FROM: LAUREL SEMPREVIVO GONZALEZ O 4
OREGON ELECTRIC CONSTRUCTION (GROUP)
laurel @oregon- electric.com 608. - ,e // 7
DATE: April 11, 2008 " /o j
� ?00 5
PAGES: 3 — INCLUDING THIS SHEET A k i n t72/ L
RE: PLAN REVIEW FOR A PERMIT APPLICATION IN PROGRESS
GOOD MORNING,
PLEASE FIND PLANS TO REVIEW FOR A PERMIT THAT WE APPLIED FOR AND
THAT IS ON HOLD WAITING FOR THIS TO COME IN. THIS IS FOR WORK AT COOK
PARK. PLEASE CONTACT ME WITH AN AMOUNT DUE AND I WILL FAX OVER THE
CREDIT CARD INFORMTION. (503) 234 - 9900.
CONTACT: SHAWN HEINIGE, SERVICE SUPERVISOR, OREGON ELECTRIC GROUP
503 - 535 -2673
503- 793 -5706 (CELL)
peal CITY OF TIGARD ELECTRICAL PERMIT
J P/
PERMIT #: ELC2008 -00117
COMMUNITY DEVELOPMENT DATE ISSUED: 3/3/2008
4 1,P . - RD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 114D0 -00101
SITE ADDRESS: 17005 SW 92ND AVE ZONING: R -4.5
SUBDIVISION: COOK PARK LOT : JURISDICTION: TIG
PROJECT: COOK PARK
Project Description: Installing (2) branch circuits for heater and gas pad.
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TIGARD, CITY OF OREGON ELECTRIC GROUP
13125 SW HALL 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
1EL.PRM"fj [LC Permit 3/3/2008 $53.50 1.1C 203
[FAX] 12% State Surchar 3/3/2008 $6.42 SUP 4460S
Total $59.92 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 for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You ma obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
s
Issued By: / _, /....;.....„. ,.�_= Permittee Signature: 5ee / 'd
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: 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.
-28-2008 04:39PM FROM -OR ELECTRIC SVC 5035352763 T -732 P.001 /002 F -511
a •u�t+,Ll itLQ! rC d -HII1[ IICStIoId • T 3 e �N
�: 4 City of Tigard ■ 1 ;
K: r' , 13125 SW Hall Blvd., Ti �) ECEV t r f ° P ermit No �ro,ii /'�
� , OR 97223 Plan Review a nti ' l
Phone: 503.639,4171 Fax: 503.598.1960 Dste /B Other Permit: `/
t 7 (j , "
\ I i j, N ol
hispcaion Line: 503,639.4175 FEB 2 8 2008 Date ReadyiBY N
,. z " ° •^ ^.. Internet: www,tigard- or,gov Jens: % See Page 2 for
ifiedlMethod Supplemental Information
TYPE OF WORK I PLAN REVIEW -
New construction ;�r � `.
IN e L , , Please cheek ell that apply (submit 2 sees ofpintts w /items checked below);
❑ Demolition O(h�. 0 Service or feeder 400 amps or more 0 Building over three stories_
where the available fault current ❑ Marinas and boatyards.
CATEGORY OP CONSTRUCTION _ exceeds 10,000 amps at 150 volts or ❑ Floating buildings_
Accessory building
❑ 1- and 2-family dwelling ® Commercial /industrial [] -- less to ground or exceeds 14.000 0 Commercial•we agricultural
amps for all other installations, buildings,
El Multi - family
0 Master builder Q Other: CI Fire pump. 0 installation of 75 KVA or
-
_ 1O8 SITE INFORMATION AND LOCATION CI Flrnrgency system. larger scparotdy derived systcn
ltd ��
Job 00.: 70010 - 102 Q AdNtia of now motor load of ❑' A ".' [ , �) -2 ", 1.3",
I Job site address: SW 92 Ave 10014F or more, occupancy,
City /Sta[e%ZIp: Tigard, OR 97223 - ❑ Six or mom residential units. ❑ Recreation vehidn parka,
0 Health -taro facilities. i] Supply voltage fir more than
Suite/bldg./apt. n0.: - 0 Hazardous locations, 600 volts nominal.
I Project name: Cook Park ❑ Service or fender 600 amps or mom.
- - -
Cross street/directions to job site: FEE SCHEDULE
Dowel ilea
t t . Wee. Tend •
New residential single or multi- family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1.000 sq. ft or less - 145.15 4 -
Tax map /parcel no.: - Fa, add 'i 500 s4.. fti o portion 33.40 1
�_
DESCRIPTION OF WORK - Limited energy, residential
(with above s4.. ft.) 75.00 2
Install power for heater and gas pad per Nick Nissen w) the City of Tigard Limited energy, multi-family
residentiaI (with above so. ft.) 75.00 2
Contact: Shawn Heinige 503 -793 -5706 r Services or feeders Instnllatio altcraiion and/or relocation
❑ PROPERTY OWNER I ❑TENANT.' - 200 amps or leas 80.30 2
201 amps to 400 amps 1 06.85 2
Name: 401 amps to 600 anip 160.60 2
-
Address: 601 amps to 1,000 amps I 240.60 2
Over 1,000 amps or volts I 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less
66.85 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amp 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 signatta e _ Date: Branch circuits - new, alteration. or extension. per panel
- A with
Fee for branch circuits wi
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
Business name: each branch circuit 6.65 2
B. Fee for branch circuits
Contact name: J without service or feeder fee, i 46.85
first branch circuit 46.85 2
- -
lu
Address"
Each add branch circuit 1 6.65 6.65 2
City /StatelZiP: Miscellaneous (service or feeder not included)
Each mmuufacturexi or modular
Phone: ( ) Fes, : ( ) dwellingscrvicc and/or feeder 90.90 2
E- mail:
Reconnect only 66.85 2
Pump or irrigation circle 53.40 2
- CONTRACTOR Sign or outline lighting 53.40 2
Business name: OREGON ELECTRIC GROUP Signal circuits) or limited- -
energy panel, alteration, or
Address: 1010 SE 11 AVE extension. Describe: Paget 2
City/State/ZIP: PORTLAND,
-
OR 97214 Each additional inspection over allowable in an of the above
Phone: (503) 234 - 9900 Fax: (503) 535 - 2763 Per inspection 62.50
Investigation per hour (I hr min) _ 62.50
CCB Lic.: 203 Electrical Lic.: 26 -95C Suprv. Lie.: 49458 industrial plant per hour 73.75
Suprv. Electrician signature, required: C e_ ELECTRICAL PERMIT FEES
yI - Subtotal: 53.50
Print name: RICK MCELLIOTT Date: 02/28/08 Plan review (25% of permit foe): - -
_ State surcharge (12% of permit feet 6.42
Authorized sigma= It ;. ' r TOTAL PERMIT FEE: 59.92
Print name: RICK MCELLIOTT Date: 02/28/08 Thls permit application expires if a permit Is not obtained within 180
days after It fins been accepted us complcce,
• Numbcr of inspeaiona allowed per permit.
1;\ Buiidinr lyetmitseELC- Pomiutpa.doc 05i23f05 44o.aytsT(1 lincoldiwsa
CITY OF
��mn m w^�m� nm���n�n�� -"'
BUILDING DIVISION PERMIT #: ELC20Q8-0117
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: l(312008
Phone: (503) 639-4171
Inspection Requests (24Hmj:(503)63Q'4175 ■
INSPECTION WORKSHEET FOR DATE: 5/1/2000 TIME: 7:O08h4 PAGE: 21
SITE ADDRESS: 17005 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: COOK PARK LOT #: TYPE OF USE:
PROJECT NAME: COOK PARK
DESCRIPTION: Installing (2) branch circuit; for heater and gas pad.
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: OREGON ELECTRIC GRC)UP PHONE #: 583-2349908
Inspection Request Scheduled For: Date: 5/1/2008 Pour Time:
Code # Inspection Description —Confirm # Contact # Message
199 Electrical final 69176'U1 503-849-2331 M
Corrections/Comments/Instructions:
r
•
| PARTIAL APPROVAL CANCEL NO ACCESS
| |-
FAIL ri CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
NI »�»� , °~-^ ���
Inspector: ��" %���K~�� Date 51116 Phone#� (SO3}718' �����m
CITY OF TIGARD
44 •
BUILDING DIVISION PERMIT #: /
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2CQ f.i TIME: 7AM PAGE:
SITE ADDRESS: 7:)Of :42M.) AO: CLASS OF WORK:
SUBDIVISION: CO.PAK LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: 11 PHONE #:
CONTRACTOR: OPI: LZ1 C. C;R: PHONE #:
Inspection Request Scheduled For: Date: /1130i2:;;; Pour Time:
Code # Inspection Description /Confirm # Contact # Message
al
Corrections /Comments/ Instructions:
5 Ko Va*.liva"V -
(JD - k(ton CLisf5 1- • 'ON . 1 i-o3 c14 FotL s IA -
PASS ox PARTIAL APPROVAL [1] CANCEL pi NO ACCESS
FAIL CALL FOR INSPECTION E] ADDITIONAL FEES ASSESSED
4 4,4
Inspector: c7Th L. V.) ul Phone #: (503) 718-
CITY OF TIGARD
E-;
BUILDING DIVISION PERMIT #: E1_G2000 -001 17
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/3/ f008
Phone: (503) 639 -4171 1 .,1.����
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/220008 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 110Q6 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: COOK PARK LOT #: TYPE OF USE:
PROJECT NAME: COOK PARK
DESCRIPTION: Installing (2) branch circuits for heater and gas pad.
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503-234-9900
Inspection Request Scheduled For: Date: 4/2212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
159 Electrical final 068740-01 503 - 8492231 Id
Corrections /Comments /Instructions:
03 - PcubN Acc.' `'o etf S -
o
mAka s v $ P�b AciA by Act. 113 i$Lx)
1 PASS PARTIAL APPROVAL Ill CANCEL I I NO ACCESS
F5' FAIL ACALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Gr c Date: / V ® Phone #: (503) 718- 1)14
CITY OF TIGARD f +
BUILDING DIVISION PERMIT #: Et .C2008-001 '17
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/30008
,,.
Phone: (503) 639 -4171 , �,���
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/16/20013 TIME: 7:00Ai PAGE: :71
SITE ADDRESS: 17005 SW 92ND AVE: CLASS OF WORK:
SUBDIVISION: COOK PARK LOT #: TYPE OF USE:
PROJECT NAME: COOK PARK
DESCRIPTION: Installing (2) branch circuits for heater and gas pad.
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503
Inspection Request Scheduled For: Date: 4/16/2008 Pour Time:
Code # Inspection Description Confirm # • Contact # Message
105 Und mgrou dIslab cover 068464 -01 603 - 849 -2754 N
Corrections /Comments/ Instructions:
•
•
PASS PARTIAL APPROVAL ❑ CANCEL 7 NO ACCESS
F ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: et Phone #: (503) 718- l`
APR -11 -08 12:12 FROM— OREGON ELECTRIC —MAIN 5032349900 T -116 P.002/003 F -240
• ••• �•• •• • • • • ••
• • • • • • • • • • • • • • • • • •
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• • .. .. .. .... P 1 12008
• •
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• • ... BUILDING DiGAR®
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• ••• • • c.UASS D 'J 1 .
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le SEAL-OFF
lISEAL -OFT
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3/4" RIGID CONDUIT
POLYETHYLENE GAS LINE
1' ABOVE IN SHARED
TRENCH
CITY OF ThSARO
Apptieve6 _.
Condltionatly Approved _,. (
PERMI T MI T the T NO . as��Vi d�
P11iI. ��
?ea Latter to Follow (
Attach �y
OFFICE COPY &J. Q_.�a._ ..
DATE s
SINGLE LINE DIAGRADIAGRAM '�` � ` "� ., ��q° -7 ��" t , DRAWN No.
,� ,�> Iti i � ' ( J� + +;► 1 ° �� , DRAWN wa aY CZ= it �
GAS A i1 }' 1. l 1 , ( r 1 i':tl ,, r, t 43
FILE DATE SCALE Immo: 11 Apra .r... s
GA PAD /"�� t∎ , i. ,. (i IZ( �i , ',•tW ?fC� c1p- 1P•\s -11 as- wswse
d ! i 1 El
COOK PARK � .. NUMBER
001,
OFFICE COPY
d08 04:39PM FROM —OR ELECTRIC SVC 5035352763 T -732 P.001 /002 F -511
1, III iud1 r er[n1>C 503.598.1960 y — rr 4 . s rtes arr.1 r�C' i'.,, ' 'Mt1ty R- o +m ^
Fg 11sC�tiO� �, r R y 1.
1 t w 4 ( , , i0.' I 11 tiI , U - -- ' ' ' )k�,P c
City of Tigard l r ■ .� �s?is °'1? F'
I n , rr,
T rte = q 13125 SW Hall Blvd„ Tigard, OR 97223 .{ �" ' ` Permit No.: -.ri yj,
I ` � 50
1639.4171 Phonc: 53.639,4171 FaX: Plan View �u�Ct '
'" °nom t' in ec 5 Line: 5 171 Fax: 5 FEB �p Dates) • Other Permit: ` „, (
71(, , 1 I.1) D 2 8 2008 Date Rend 1B
TIMforta Internet: www,tigard -or.gov Y Y °"' %See Page 2 Tor
Not tiedlMotl,od:
Supplemental Information
TYPE OF WORK TIGARD PLAN REVIEW
New construction ® Addition /a[terati . Is Please check au that apply (submit 2 acts ofplans wiitem chec below);
❑ Demolition Oth ❑ Service or fender400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards,
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
❑ 1- and 2- family dwelling ® Commercial /industrial 0 Accessory building less to ground or exceeds 14,000 ❑ Commercial-use agricultural
❑ Multi - family ❑ Master builder amps for all other installations, buildings,
Q Other' ❑ Fire pump. ❑ installation of 75 KVA or
108 SITE INFORMATION AND LOCATION ❑ Energency system, larger aeparatrly derived 9y3ter
❑ Addition of new motor load of ❑ "'A", °1• "1 "1.3•
Job no.: 70010 -102 Job site address: 17005 SW 92 "d Ave i001-IP or Iron:. occupancy,
O six or more �idential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223
_ ❑ Health - care facilities. 0 Supply voltage 1br mote than
Suite/bldg./apt. /Hpt n0. I Project — — ❑ Hazardous locations, 600 volts nominal.
name: Cook Park ❑ Service or feeder 600 amps or mom.
Cross street/directions to job Site: — FEE SCHEDULE
Dowel , nan t t . rcc_ Tea - 1 •
•
New residential single- or multi- family dwctting unit.
Includes attached garage.
—
T u x divisi p n; — Lot no.: 1.000 sq. 1L or less
4
lax map /parcel no,: - Ea. add•I 500 sq_ ft or portion 33.40 1
DESCRIPTION fON OF WORK Limited energy, residential
with above sq, ft.) 75.00 2
Install power for heater and gas pad per Nick Nissen w) the City of
•
Tigard Limited energy, multi- faanily
residential (with above sq. R) 75.00 2
Contact: Shawn Heinige 503 -793 -5706 Services or feeders Installation alteration and/or relocation
❑ r 200 amps or less _ t t 2
PROPERTY OWNER 0 TENANT 201 turps to 400 slaps
2
Name: 401 amps to 600 amps 160.60 2
—
Address: —._ 601 amps to 1,000 amps 240.60 2
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
66,85 Ell
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 r 100.30 0
intended for sale, lease, rent, or exchange, according to ORS 447,449, 670, and 701. 401
Branch circuits - new. alteration. or extension. .er anel
Owner signature: - Dato: ---- &Fee for branch circuits with
O APPLICANT
❑ CONTACT PERSON above servico or feeder fec,
6.65 2
each branch circuit
Business name:
B. Fee for branch circuits
Contact name: 46.85
first branch circuit
Address:
—
Each addl branch circuit 1 6.65 6.65
— Miscellaneous service or feeder not included
City /State/ZIP:
Each manuesctured or modular
Phone: ( )
Fax:: ( ) a • ,
E - malt: 66,85 ��
Pum or irrigation circle 53.40
CONTRACTOR _ Sign or outline lighting 1111 53.40
II
Business name: ORECON ELECTRIC GROUP Signal circuit(s) or limited -
Address: 1010 SE 11 AVE —
energy panel, alteration, or
extension. Describe: Page 2
City /State/ZIP: PORTLAND, OR 97214 Each additional ins . ection over allowable in an of the above
—
Per inspection Phone: (503) 234 -9900 Fax: (503)535 - 2763 ' t
Investigation ' 62.50
CCB Lic.: 203 Electrical Lic.: 26 - 95C Suprv.. Lie.; 49455 Industrial plant per hour 1111 73.75 -
Suprv. Electrician signature, required: C C.
ELECTRICAL PERMIT FEES
Subtotal: 53.50
Print name: RICK MCELLIOTT Date: 02/28/08 ' emit foe):
Authorized signature: C % ,. S. \ ti\I� surchar permit
_ TOTAL PERMIT FEE: 59.92
Print name: RICK MCELLIOTT Date: 02/28/08 ails Permit application expires If a per mlt !snot obtained within Tao
days after It has ben aoeepted as comptetc,
• Numbcr of inspections allowed per penult.
1 A 3uildina \rermitmELC- PeminAep.doc 05/23/06 d.ioaotsT(11r05 /COmiwrta