Permit ELECTRICAL PERMIT
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CITY OF TIGARD
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` a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00280
T FGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/10/2010
Parcel: 1S134AA02100
Jurisdiction: Tigard
Site address: 10340 SW NIMBUS AVE ND
Subdivision: Lot: 0
Project: AT &T Exchange Center
Project Description: Temporary power.
Owner: FEES
ROBINSON, CONSTANCE A & Quantity Description Date Amount
ROBINSON, LYNN ET AL, BY KG INVESTMENT
MGMT, 10240 SW NIMBUS AVE #L3 1 ea Temp Services or Feeders - 06/10/2010 $59.36
200 amps or less
PHONE: 1 ea 12% State Surcharge - 06/10/2010 $7.12
Electrical
Contractor:
MCCOY ELECTRIC CO INC
2014 SE 9TH AVE
PORTLAND, OR 97214
PHONE: 503 - 234 -7521
FAX: 503- 234 -9473
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $66.48
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 aeepy oflrTe - s or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 7- ■11Ir — lisoci AOP 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.
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.
Jun. 8. 2010 ':20PM McCoy Electric Co. No. 9459 P. 1
Electrical rermlr Application FOR OFFICE USE ONLY
City g of Tigard Received
' _i I •
DalelB : jfy Pem»l
Il
/ u 13125 SW Hall Blvd., Tigard, OR 97223 9 + < _ ; 4 Plan lte
Phone: 503.639.4171 Fax: 50 Date/By: Other !knoll:
T I G n It n Inspection line: 503,639.4175 E + Daie Ready/By: lurk: - is Sce Page 2 for
Internet: wwlv.ligard- or.gov ° Notified/Method: 7TCp Supplemental information
-_'=.--.::'. 'YPE 01? , ri_:, 1: = ::c_ - . _. T.. -s — PLATT Il<FYIE�{
3�' Ple ase check all that apply (submit 2, sets of plans w /items checked below ) :
1_1 New construct ❑ dd t1 a, ,� P
�^ « f — ❑ Service or feeder 400 amps or more ❑ Building o�rr three dories,
flDemolition Other: f eM C9en8Ga where the available fault current ❑ Marinas and boatyards.
Cp1 7 . 0 �M, 4_M..11)N ' t ;j�:fi?,I. exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 LI Commercial -use agricultural
❑ 1 - and 2 family dwelling ) Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other Fire pump. ❑ Installation of 75 KVA or
F.. - .— ❑ E merg cnc s y s tem.
larger
.- �::_- :_ —:::_� �:��_- - : --- �° — 8 delvedsysrem.
- _:..�._: � �= 7NFORNiATI01�I ANA- T6P
tk '�. . .... -� - . _... �. - .. - -. - _ r' ' :..-: ❑ Addition of new motor. load of 0
l ,} 100HP or snore. occupancy_
Job no.: 3 If d Job site Address: (a `f 0 sly NI'� . 0 us � I� ❑ Six or more residential traits. ❑ Recreational vehicle parks.
City/State /ZIP
' 1 1 Q ❑Heath care facilities. ❑ Supply voltage For more than
1 4 4 i e , ( (P . Q 72 Z. 0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no. :' t ) Project name: 4 , ❑ Service or feeder 600 amps or more.
.:. • -' —:= : ¥5SC',IILDULE �� :. �v ?
Cross street/directions to job site: '7j o `I 0%S -r tfr [rnI k_ T aesertanon 1 of . 1 Fee. 1 'foal 1 •
// �^ 1 �` New residential single or multi- family dwelling unit.
(s c. I 06 ALi4∎he .r_c C/ ;
eA F ti i includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. add'l 500 sq, ft. or portion 33.92 1
Limited energy, residential
P1:9
—�� � -, ; DESGR1PTCp x: td � 1 , , �.. . 7. a 2
—" l �e L (with above sq. R.)
nergy,mu lti- fam
e rk � y r 112h r (y Ca n "6 s ' l �o l e ° WP1 •f yehahz-. � a � e A r vi citcde eso rl ee d ersins ily ll tt.) 67.84 2
ri / / V � Services or feeders installatim► and/Or relocation
200 amps or less 100.70 2
_ 0i ►b . t x F u _ a 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301,04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP:
relocation
Phone: ( ) I Fax: ( ) 200 amps or less ( 5936 ' .1 !u 1
Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 1 25,08 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 new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits u•irh
r' 0ArP1.CCAh".�- _ -- ,!! CONTACT P) :RSF, above service or der , 7.42 2
._. _ 1 . „_. _. each branch circuit
Business name: Ai � ' B, Fee for branch circuits without
T e F ` r Ct . service or fccdcr fee, Fist
Contact name branch circuit 56.18 2
`,-°' Each add'l branch circuit 7A2 2
Address: 2 O I q , � - t 7 e e µ_ Miscellaneous (service or feeder not included)
/State/Z1P: p ( > act manufactured or modular 67.84 2
Ci
tY f e, E rf e n,,/ C" e A n 9 7 2.( dwelling, service and/or feeder
I Fax: ; Reconnect only 67.84 2
Phone:
(co 3) 2J y 7 s 2 ( ( oo) z y 9. y72 •
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
— _
r '` COPtT O l 1 __T_, = °-__ r .
- - �- =_- ' --• - Signal circuit(s) or limited
Bu siness name. / 14 C /' E C c : t r panel, alteration, or extension. Page 2 r L G � 0 Each additional inspection over allowable in any of the above
Address: r 21 a 6 G e__ Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/hr _
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00/ hr
� seeciflcaI1y listed hr m
Cal Lic_: ( Electrical Lie.: 1 - Su rv. Lic. :a rl " =: . ��':;EI,EGa S
I jJ I i0', / t; Subtotal: . S
Suprv_ Electricia g i e, required: y He Plan review (25 %ofpermit fcc): r\ r
Print name: Ja n.R k lig, I �/ Date: 6/ Slate surcharge (12% of permit fcc): 1 7 r
TOTAL PERMIT FEE: C rte.
Authorized signature: This permit application expires an permit is hol obtained within 180
days after it has been accepted as complete.
Print name Date: '' Number of inspections allowed per permit.
I: 111u16igg \PermltsTLC- Perr14App. 10'01109 410.4615T(11/05/CO\MM'E0