Permit ;PIF.:;:7,,, OF TIGAR® ELECTRICAL PERMIT
q
4 ` is - COMMUNITY DEVELOPMENT Permit #: ELC2010 -00288
T1GARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/15/2010
Parcel: 2S111DB03800
Jurisdiction: Tigard
Site address: 9190 SW SUMMERFIELD CT
Subdivision: Lot: 0
Project: Swank
Project Description: Panel and (13) branch circuits.
Owner: FEES
SWANK, BEN I AND HELEN A Quantity Description Date Amount
6900 SW 153RD AVE
BEAVERTON, OR 97007 1 ea Services or Feeders - 200 06/15/2010 $100.70
amps or less
PHONE: 13 crt Branch Circuits w /Purchase 06/15/2010 $96.46
Service or Feeder
1 ea 12% State Surcharge - 06/15/2010 $23.66
Contractor: Electrical
LA LONDE ELECTRIC LLC
PO BOX 2220
ESTACADA, OR 97023
PHONE: 503 - 969 -8491
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $220.82
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 ac . • - • - ith 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. NTION: Oregon - re.. es ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fort in OAR
952 -o .1-0010 through OAR 952 -001 . 00. You may .btain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.234
I sued By: ■ /` � . /emu - ' 1 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.
�. •' , CITY OF TIGAR ELECTRICAL PERMIT
■ .' a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00228
T 1 GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/11/2010
Parcel: 2S102AA00200
Jurisdiction: Tigard
Site address: 11920 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Mixers Bar & Grill
Project Description: Sign lighting for relocated sign.
Owner: FEES
TUMAY CORP Q uantity Description Date Amount
11920 SW PACIFIC HWY
TIGARD, OR 97223 1 ea Sign or Outline Lighting 05/11/2010 $67.84
PHONE: 1 ea 12% State Surcharge - 05/11/2010 $8.14
Electrical
Contractor:
ABLE SIGN CO
2007 SE POWELL BLVD
PORTLAND, OR 97202
PHONE: 503 - 232 -6430
FAX: 503 - 235 -3530
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $75.98
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 503.246.6. I: or 1.800.332.2344.
--ow
Issued B 1 � - &11.....0-"..ff..,. .. Permittee Signature: - /�- .. A .. .. /'��
OWNER INSTALLATION ONLY
The installation is being made on property 1 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.
' i . 4 a _: v r 7 I' x i
Electrical Permit Application , �� — ° .- . l c)w� , e l i z� � 0.
City Of Tigard Date /B (� I ,� Permit No.: ( 2y' ���
' ° 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
® Phone: 503.639.4171 Fax: 503.598.1960 DateB : Other Permit:
I I t. A It f) ' Inspection Line: 503.639.4175 Date Ready/By: Ions: Ed See Page 2 for
... .._ .: Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction %Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ 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 ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
c i / IooHP or more. occupancy.
Job no.: Job site address:
Itl 90 �W .fMNMKt f it CT ❑ Six or more residential units. ❑ Recreational vehicle parks.
Cit /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
y / e O � �� 223
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: I Project name: ,q. NV, ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qtr. 1 Fee. 1 Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
67.84 2
'DESCRIPTION OF WORK . (with above sq. ft.)
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less r 100.70 2
• ❑ PROPERTY OWNER I • ❑ TENANT 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: ( ) Fax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
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 with
[r APPLICANT I ❑ CONTACT PERSON above service or feeder fee, I 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: r2 ..L. -e_ L.D -JP A-- branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: /State /ZIP: Each manufactured or modular 67.84 2
tY dwelling, service and/or feeder
Phone: (C ) '3 4c. � / Fax: : ( ) Reconnect only 67.84 2
- Pump or irrigation circle 67.84 2
E mail: 'a rt,• !_.,o,a,,tie,e_/zeTx t C: , C.O...r- Sign or outline lighting 67.84 2
CONTRACTOR ' Signal circuit(s) or limited- energy
panel, alteration, or extension. Page 2 2
Business name: LA Ln,D_e_ 64c,c, 1 N t C
Each additional inspection over allowable in any of the above
Address: . 7 o 7Z2C�
Additional inspection (1 hr min) 66.25/ hr
Z
City/State /ZIP: E Investigation (1 hr min) 66.25/ hr
T� ('GA_ Industrial plant (1 hr min) 78.18/ hr
Phone: (.5o ) I g c. _ggC I Fax: ( 44 Inspections for which no fee is 90.00 / hr
specifically listed (%z. hr min)
") CCB Lic.: l ?Y£5q Electrical Lic.: G 2 —7 G Suprv. Lic.: z 72_ S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 0 1 /1 io0t f� Subtotal: �
( , /.-) A / G e xi Plan review (25% of permit fee):
Print name: gir' ( Nom/ Date: G _/ ,1 /U State surcharge (12% of permit fee): 2 '3 . L e
�� �r TOTAL PERMIT FEE: 2 ,
Authorized signat i.er- This permit application expires if a permit is not obtained within 180
L days after it has been accepted as complete.
Print name: '� 1 wc.. L A j�,..., y,-4- Date: G / 5-- -/U Number of inspections allowed per permit.
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N� Received �
a City Of Tigard n� 2 Date/B ff � Permit No.: /i I 41 "06 :4
13125 SW Hall Blvd., Tigard, OR 97223 MA Plan Review
• C Phone: 503.639.4171 Fax: 503.598.1960 D Other Permit:
I' 1 L A It I ,' Inspection Line: 503.639.4175 �0 OF ThGARp ate/13
'Or0 Date ifi ReadyBy: ® See Page 2 for
Internet: www.tigard - or.gov pu ILDING D \I 1 S Note Supplemental Information
YPE OF WORK PLAN REVIEW
❑ New construction dition/alteration /replac men[ �/� Please check all that apply (submit 2 sets of plans w /items checked below):
y�q�� ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Other: Y l ' b il-C L� / � i e e where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION (1 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 ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' JOB SITE INFORMATION AND LOCATION - ❑ Emergency system. larger separately derived system. A
❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "I - ",
Job no.: Job site address: r t' /o2Q .d G4 - Six or or more. occupancy.
GL' GGv��'��` ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: r l c 9�3 ❑ Health -care facilities. ❑ Supply voltage for more than
� V
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: z-x Description 1 Qty. 1 Fee. 1 Total 1 •
'` �( New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
•
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
/ _ 200 amps or less 100.70 2
E
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
�
401 amps to 600 amps 200.34 2
Name: 1, am
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: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
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 with
❑ APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: 46 /e �� -,,, B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: (` �� � a.� branch circuit
� 0CJ Y 5 £ Each add'I branch circuit 7.42 2
Address: C(� /� Miscellaneous (service or feeder not included)
Cit City/State/ZIP: 7,..2 Each manufactured and/or d/ r modular
Y �� ( � - dwelling, service and/or feeder 67.84 2
• Phone: (� l �v /) Fax: ; (5 )� O Reconnect only 67.84 2
(� � �� � Pump or irrigation circle 67.84 2
E -mail: /y '- IVe 5 (rj' rs • C 4"--)2( S ign or outline lighting 67.84 2
CO TRACTOR Signal circuit(s) or limited - energy
• Business name: J - panel, alteration, or extension. Page 2 2
D � � ���L`� Each additional inspection over allowable in any of the above
Address: - -----D6 , 7 ( — �s`j,29ell Additional inspection (1 hr min) 66.25/hr
Investigation (1 hr min) 66.25/ hr
City /State /ZIP: P L (/ ' ", 7i? 77 2 < d< Industrial plant (1 hr min) 78.18 / hr
Phone: (_,-- ) � (o / (} Fax: (52;:)7) I C it Inspections for which no fee is 90.00/ hr
J specifically listed (%, hr min)
CCB Lic.: (--9 Y i Electrical Lic.: . 7 Z'y S l f Suprv. Lic.: ELECTRICAL PERMIT FEES . .
Subtotal:
Suprv. Electrician signature, required:
^ / Plan review (25% of permit fee):
Print name: 1 V� e....)/`
..�i / ` r ' c (.� C rr 6 v -R Date: I. —/ � -� �/ State surcharge (12% of permit fee):
A . TOTAL PERMIT FEE:
Authorized signature: —/ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: G e)./
Date: * Number of inspections allowed per permit.
I:\Building\Permits\ELC- PermitApp.doc 10/01/09 A fll `� A40ti(rtbI1 /05(COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
I RESIDENTIAL WORK ONLY: • —_ _ -_ — -
Fee for all residential systems combined $67.84
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener* P
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY: •
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC N
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: \Building\Permits\ELC- PermitApp.doc 10/01/09