Permit r w ���� OF TIGARD
ELECTRICAL PERMIT
ill " PERMIT #: ELC2008 -00655
COMMUNITY DEVELOPMENT
=_� DATE ISSUED: 12/1/2008
TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 11380 - 00500
SITE ADDRESS: 08180 SW DURHAM RD ZONING: I -
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: DORADO FILMS
Project Description: TI.
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: SIGNAUPANEL:
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: 3 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:
DURHAM II LLC DICKINSONS ELECTRIC
8100 SW DURHAM RD 8449 SW BARBUR BLVD
TIGARD, OR 97244 PORTLAND, OR 97217
Phone: Contact #: PRI 503 - 246 -3550
FAX 503 - 213 -6049
FEES
Description Date Amount Reg #: ELE 26 -140C
IELPRMT] ELC Permit 12/1/2008 $66.80 LIC 65534
[TAX] 12% State Surchar 12/1/2008 $8.02 SUP 3100S
Total $74.82 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 c..ies of these rules or direct questions to OUNC at 503.246.6699. 32.2344.
Issued By Permittee Signature: � %v
.4- '
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.
Electrical Permit Application ' � , ;°= F F `'FO U ,,, ` , p : , .
City `'
'EI�
.
of t� ' f Received ) 'emit No.: ��C � y C
w - 'J f Ti and g 1 DateBy 01 i cR i / —'- J V��.r L 55
k e ° 13125 SW Hall Blvd., Tigard, OR 97223 p Plan Review J
r , - z 0 M , - :i , . Phone: 503,639.4171 Fax: 503.598.1960 0 20w Date/By: Other Permit:
-M rte) Line: 503.639.4175 Inspection Date Ready /By: Juris: ® See Page 2 for
T C A R Q' p O G
` A I 1ro �;xti 11 t+ Internet: www.tigard- or.gov �{�i 0 '�G M Notified/Method: 7 T?" r ✓ Supplemental Information
►` 1 (311 . P R EVIEW
^ ' TYPE OF, WOR _ ^ 1 NG DN .. . ..
❑ New construction I .LK(1(�ition /alteratio I Please check all that apply (submit 2 sets of plans w /items checked below):
..77 ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ 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„--.M ommercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JO SITE INFORMATION. AND .LOCATION - ❑Emergency system. larger separately derived system.
j ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: g7 ,: Lam L / 1J1 100HP or more. occupancy.
` vvv"���CCCllliii ❑Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: � ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Project Q �r , _ _ ❑ Service or feeder 600 amps or more
Suite/bldg./apt. no.: Pro ect name: r� J � u � (n
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee- 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
- D CRIPTION OF WORK . (with above sq. ft.)
/ r Limited energy, multi - family 75.00 2
/ ` �!r residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ .PROPERTY. OWNER,- .TENANT . 201 amps to 400 amps 106.85 2
Name: /j, , 401 amps to 600 amps 160.60 2
` V � r�s 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 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 amps 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits /
Contact name: without service or feeder fee, 46.85 16 t 62 •
first branch circuit
Address: Each add'I branch circuit 3 6.65 0, et S 2
Miscellaneous ( service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outl lighting 53.40 2
j
Business name: Dl Signal circuit(s) or limited -
�,&, ✓1/f c. ` j energy p
y Z i ! ener panel, alteration, or
J � I extension. Describe: Page 2 2
Address: 6' G,Z 1 .. -yyd ,. gez t L -g /.
City/State/ZIP: ``1, f Each additional inspection over allowable in any of the above
y L � '`/ 1 (--) Per inspection 62.50
Phone: ( t / f �j 2 F ax: (c�,/ `� � l/` Investigation per hour (I hr min) 62.50
, Electrical Lic : f Suprv. Lic.: ,7 Industrial plant per hour 73.75
�>�
CCB Lic.'i _ate •' ! _ p
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require..,i � Subtotal: C0(0 ,i6
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): g, U)-
Authorized signature: TOTAL PERMIT FEE: 7 e{ • 3'L..
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per pennit.
1\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
•
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY_
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1 \ Building \Permits\ELC- PermitApp.doc 03/23/06