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Permit
, ., ::', CITY OF TIGARD ELECTRICAL PERMIT ilL COMMUNITY DEVELOPMENT Permit #: ELC2010 -00318 Date Issued: 06/25/2010 GAD 13125 SW Hall Blvd Tigard OR 97223 503 ,, . Parcel: 1S134AD06202 Jurisdiction: Tigard • Site address: 10500 SW NIMBUS AVE T Subdivision: Lot: 0 Project: Solid Rock Fellowship Project Description: (5) branch circuits and (1) data telecommunications for child care check -in area Owner: FEES ROBINSON, CONSTANCE A & ROBINSON, Quantity Description Date Amount LYNN ET AL BY KG INVESTMENT MGMT, 10240 SW 5 crt Branch Circuits 06/25/2010 $85.86 wo /Purchase Service or PHONE: Feeder 1 ea Signal circuit or Limited 06/25/2010 $67.84 Energy Panel Contractor: 1 ea 12% State Surcharge - 06/25/2010 $18.44 SHAW WEST CO Electrical PO BOX 1427 TUALATIN, OR 97062 PHONE: 503 - 682 -3939 FAX: 503 - 682 -3723 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: • Total $172.14 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OA 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling s y 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: ,/ V !/�/ / C `¢�O ,, / " OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. CaII 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept In a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. JUN /25/2010/FRI 09:19 AM P. 003 Electrical Permit A licatiO CEWED `` r. � ; , ` R Orrlf l� tip ii`liv]s�� , ` *�'" Anc"� r _. ; ,e4:mtde.�.,.5 ,,,ttis , a 21s . ,s a n' sr . ' R P City of Tigard Dete/B tO17ZS / Permit No. ELL ' a0 /0 .- 00 3i/ � c ° 13125 SW Hall Blvd., Tigard, OR 9722 U N 2 5 2010 y. Plan Reviem Other Permit II: Phone: 503.639.4171 Fax: 503,59$.1960 DeteBy: w f Inspection Line: 503.639.4175 y ' ' "�� CI TY OF TIGARD Da te t2ead B y : Jurla: T,IGAIt.D p Notified/Method: Supplemental Information �t Et Sea Page 7 for S u .im.•. a�+ Internet www.tigard-or.gov 7• w DIVISION _ 7 ;r � ;, y� ti - I] l ,lTift 1trtf0',Y$'5 i'-' � t r :I ??M � IS!!g`l t 1'AF.i > Y Z E ❑ New construction 8 Addition/alteration/replacement Please check all that apply (submit a sets of plans w/Items checked below); El or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current 10 Marinas and boatyards. t fi i r'' Yy ' 1 1 i i ' ' - 7, - ' ; r ' , ,0 exceeds 10,000 amps at 150 volts or ❑ Floating buildings, 'k �i)i : ,1 �+. , T tr � -. , 11 �, o� !� yy 0�l ra n "� 15 , b)GII1 , r - . �. 1.,.:.. � __w _ ,- , ..�__ .- ..- ._,... -,. _ _ •- •- • • -' - loss f0 ground, or exceeds 14,000 ❑ Commerotel -use agriculturot ❑ 1- and 2- family dwelling © Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multifamily ❑ Master builder ID Other: ❑ Fire pump. 13 Installation of 75 KVA or r W "-N ttII � � , , rr ❑ Emergency system. larger separately derived system. ry j� ,, �' , ` "`,t ` , , i 0 I 01 011.0 10h ,/ 9 tn /v 91 41 . . .4�1Zr Dl �1 .... .4, ` ..t'l in Addition of new motor load of „A.., "E", ,. 1 -2 •`1 -3 '_ < ! a...... 7 tf 91 �. 1 l � 11 ; )A t �S�t f9. I' c t Job no.: �, Job site address: 2. ?/ / i00HP ormore : occupancy. 1 " ' I10 Six or more residential units. Q Raoreational vehicle parks. City/Staten?! 70.& Z / A ❑ Health -care facilities. ❑ Supply voltage for more than o Hazardous locations 600 volts nominal ..++' ❑ Se rvice or f eeder 600 amps or more p Suite/bldg, /apt. no.: . / Project Warne: ,_ jecc,E. „, _ ,.. M Cross street/directions to job site: a - Ic iel / / -6-1-1 - 01 0 1 - D.cripIn ow Fee. Thai - New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 - Ha. add'/ 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential ti .. r^ {-^. y ?,s,`s�,S` � P"'r8 �"T 67.84 2 ' J '' 7%' , ; L. »a ° r �� fI6-j r4 p J OT ∎ 6 �f,11- 7:4,•. S .i : t''4 :?17 k� =s Z .{^... Z with above: ft - Limited energy, multi - family ■ 67.84 2 :I ♦ t:Y9 /ems GM/ [. i) e-,41-(---1‘.- - /1- residential with above , .. ft, Services or feeders Installation, alteration, and /or relocation 200 amps or less 100.70 2 iF "j .. ' igi ., i .: a ',: ` ,, 1 I` , S_.:'0'1_1.ii.1 0 Lg �'"�` 3-,'..`.� 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 lass 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 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, der panel Owner signature: Date: A, Fee for branch circuits with z- Ar "$� ' N _ x 4 { ' r M "7 ti ` 7f s r , above service er feeder fee, t 3 1. 'k3 t s ,V,,' ,, , '"k ' ;J��.: lr1 tr rnlll , 1, 7Tt a l each branch circuit 7.42 2 Business name: B Fee for branch circuits without service or feeder fee, first / 56 -18 •.-/ - 2 branch circuit Qc� Contact name: •�r�y - ._ r Each add'1 branch circuit M' 7.42 6i�© Address: Miscellaneous (service or feeder not included) Each manufactured or modular 67 84 2 City /State/ZIP: dwellin:, service and/or tbeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 - Pump or irrigation circle _ II 67.84 2 E f Sign or outline lighting 67.84 2 .! r ,. , t , 5 '.M1 : L ,J� , 10 .2,70 tiC 1 �1,0 1`._.,� , J.._ .. z f' ...F; <'w . 1.. : �T.�i.��:.2. , . ., . , . ~ �. 4.)1., s...h.A..._,_l ....:... .!f �= .�.- ..- w-- ._. .�. �._ Signal circuit(s) or limited-energy J 8 panel, alteration, or extension / Paje 2 rv7 2 Business name: .. - A s a i 6694.1s Each additional ina.ection over allowable in an of the above Address: t5 , 5 4 t 2 - Additional inspection (1 hr min) _ 66.25/ hr MOM investigation (1 hr min) - 66.25/ hr �E City/State/ZIP: (... t Q� -2._ Industrial plant (1 hr min) _ 78.18/ hr • Phone: (.51) &, - 9 3 4 Fax: ( ,f) t, -372-8 Inspections for which no fee is ■ 90.00/ hr . s.ecificatl listed /: hr mm CB Lic.: 6,3 Electrical Lie. :„34---7s .1 Suprv. Lie.: SS 11-x•„ ..y IlR A .t ,1197'✓ i,,077 is ..::;a 2f.,s.:' �1M %!Rift %�� //II Plan I�' °- Si 1 uprv- Electrici: r t y. attire. -gutted: IC Pla review (25% of permit fee): Ill Print name/244444o ...5 � Date: [ _2 .1� S tate surcharge (12% of permit fee): • 4 / TOTAL PERMIT FBE: Authorized signature: 4 This permit application expires if a permit is not obtained within 180 /` days after k has been accepted as complete. fil Print name: t / / ) G_.. ` Date: • 6 - •- - _ - • Numbor of Inspeotions allowed per permit. I:u 3ullding \Perm1UWLC- PermitApp.do° 10/01/09 440461310l/05/COM/WBB JUN /25/2010/FRI 09.19 AM P. 004 Electrical Permit Applicatio - - City of Tigard - Page 2 - Supplemental fnformatiL LIMITED ENERGY PERMIT FEES: Fee for ,ate residential s combined........ $67.84 Check Type of Work Involved; ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum. Systems* ❑ Other: 1'Xl/P1 I .4.n1}''t"'7 0 tae _ ° v $ ` c y n Fee for each commercial $67.84 system (SF:F. OAR 918- 309 -0000) Check Type of Work Involved; ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ 9 Systems rel Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Conttol* ❑ Medical ❑ Nurse Calls El Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations 1•TultdinglPermitaLGPecmitApp . dot 10/01/09