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Permit r~.0, ?' ELECTRICAL PERMIT i CITY OF TIGARD fit; 1111 e ° PERMIT #: ELC2006 -00680 i COMMUNITY DEVELOPMENT DATE ISSUED: 11/30/2006 � G 503.639.4171 , D 13125 SW Hall Blvd., Tigard, OR 97223 503.639. PARCEL: 2S102AD -03450 SITE ADDRESS: 08777 SW BURNHAM ST ZONING: CBD SUBDIVISION: LOT : JURISDICTION: TIG Project Description: Install (43) retro kits and (1) OC sensor. 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: 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: CITY OF TIGARD WATER BUILDING OREGON ELECTRIC GROUP 13125 SW HALL BLVD. 1010 SE 11TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 639 - 4171 Contact #: FAX 503 - 535 -2763 PRI 503 - 234 -9900 FEES Description Date Amount Reg #: ELE 26 -95C [ELPRMT] ELC Permit 11/30/200( $46.85 LIC 203 [TAX] 8% State Surcharge 11/301200( $3.75 SUP 4460S Total $50.60 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 may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: L 1 19... d Permittee Signature: 0 affiakrat 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. • 20V -29 -2006 03:33PM FROM -OR ELECTRIC SVC 5035352763 T -508 P.001 /002 F -739 t. iec Ilcall remit. ; t p r— ; y - - ' V D " , f F`'� i . .,,,,, i_,.. ,i,,, ..� ix ., . _ Received City of Tigard D , �� /3c , b Permit No.: ' , p •(a "TV 13125 SW Hall Blvd., Tigard, OR 97223 Pion Review / Other Permit; 503.639.4171 Fax: 503.598.19 V 2 2006 fi ., � . , 'R + I ': _ Re r• �, s 1 I, a /I ;y: Mg ® See Page 2 for Inspection Line: 503.639 -4175 CITY O� TIGARD ' Notified/Method: Supplemental InformiIan Intcrncr, www.ci.tigard.or.us t GAND — - 0t i WB1 ION PLAN REVIEW • Please check all that apply: 111 New construction ® Addition /alteration/replacement DService over 225 amps, conun'l ❑Harirdous location ❑ Demolition ❑ Other: ❑Service over 320 amps — rating OBuildng over 10,000 sq. R., CATEGORY OF CONSTRUCTION . . .. of 1- and 2- family dwellings 4 or morn new residential ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Braiding over three stories ❑ Feeders, 400 amps or more ❑ Multi - family 0 Master builder ❑ Other ['Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION ' .. -, - ❑Egress/lightingplan RV park ❑Health -care facility ❑Other' Job no.: 94894 Job site address: 8777 SW BURNHAM STREET Submit 2 sets ofplans with any of the above. City /State /ZIP: TIGARD, OR 97223 The above are not applicable to temporary construction service. • Suite/bldg./apt. no.: Pr ect name: RETRO KITS/WATER BUREAU FEE" SCfiEDTJ o J Desalptlon Qty_ I Foe. Total �� Cross street/directions to job sitc: SW HALL BOULEVARD New residential single or multi - faintly dwelling unit. includes attached garage. _ 1,000 sq. R, or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75,00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular dwelling, service and/or feeder 9090 2 INSTALL (43) RETRO KITS & (1) OC SENSOR Services or feeders installation, alteration, and/or relocatio 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 © PROPERTY OWNER 1 ®TENANT 401 amps to 600 amps 160.60 2 Name: CITY OF TIGARD WATER BUREAU _ 601 amps to 1.000 amps _ 240.60 2 Address: 8777 SW BURNHAM STREET Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City / Suite/ZIP: TIGARD, OR 9 72 23 Temporary services or feeders Instil nstallation, alteration, and/or relocation Phone: (503)639 -4171 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 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 _ 2 Owner signature: - Date: Branch circuits — new, alteration. or extension, per panel ■ ❑ APPLICANT ❑ CONTACT PERSON: `. A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit B. Fcc for branch circuits ' ( o Contact name: _ without service or feeder fcc, 1_ 46.85 L_hA 2 each branch circuit _ ' Address: Each add'1 branch circuit 6 -65 2 City/State/ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) , _ Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- CONTRACTOR :. energy panel, alteration, Of extension. Describe: Page 2 2 Business name: Oregon Electric Group Each additional inspection over allowable in any of the above Address: 1010 SE 11th Ave 6250 Pet inspect _ City/State/ZIP: Portland, OR 97214 _ Investigation per hour (1 hr min) 62.50 Phonc: (503) 234 -9900 I Fax: (503) 535 - 2763 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES"' CCB Lic.: 203 I Electrical Lic.: 266 SN• • .: 4460S Subtotal �i' � r� Suprv_ Electrician signature, required: ,, J i Plan review (25% ofperntit fcc) `C ' State surcharge (8% of permir fee) , I 1 � ~ Print name: 4t e / - /AiAt �t1 ` a I Or. T OTAL P ERMIT p E6 � t `�f' Authorized signature: . / T bls p eratlt applicattnn a :piree If a permit 1S mat obtatnod within 1110 days after It has been accepted as complete Print name: ,' .1 ' 1 '� D • - Fee methodology set by Tri- County Building industry Service Board ' _Sit III/ Number of inspections per permit allowed. I uildi ,5 \PcitlitA ELC- 1'ermitApp.d°e 11103 4404615TI16J021COMIWL•B