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Permit
• CITY OF TIGARD ELECTRICAL PERMIT . ' ILA COMMUNITY DEVELOPMENT Permit #: ELC2009 -00588 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/02/2009 T`1RD g Parcel: 2S111CC15600 Jurisdiction: Tigard Site address: 10035 SW HIGHLAND DR Subdivision: Lot: 0 Project: Bolton Project Description: Panel change Owner: FEES BOLTON, BETTY J REV LIV TRUST Quantity Description Date Amount 10035 SW HIGHLAND DR TIGARD, OR 97224 1 ea Services or Feeders - 200 11/02/2009 $100.70 amps or less PHONE: 1 ea 12% State Surcharge - 11/02/2009 $12.08 Electrical Contractor: MITCHELL ELECTRIC INC 1775 NW 3RD STREET GRESHAM, OR 97030 PHONE: 503- 307 -9881 FAX: 503- 674 -5855 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 503.246.6699 or 1.800.332.244. Issued By: f) v" _ Perm ittee Signature: 1 t.. ale 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. i : 11/02/2009 09:58 5036745855 MITCHELL ELECTRIC PAGE 02/04 ER . cc I u 9- . 4 �q , i i ° m . o- d ke;, It f� G'� -.1 Electrical Permit Applicat 'a �' ," 'l: - � OW Or1 7 lt•l i ONl: a ` 1P ',"''.. A:h C of Ti and eec 13r. Permit iNo.: jLL t f ' l — COS W � !; tY NOV N0I 0'1.2009 R eec/Bv 13125 SW Hall Blvd.. Tigard, OR 97223 Plan Review Other Permit: : ®: Phone 503.639.4171 Fnx• 501,50 n ere /Bv; l�iT`` OF TiGAR at /By ,tiers: 0 9ecPage Inspection Line: 503,639.4175 Supplemental Information � at,cn g g PL�,NI - RL 'ti ^ t "'et h o d : �d Internet; www.ti acd -or. ov i6'�,�9'' /:° PLAN REVIEW •yl•t OF WORK Please check all that apply (submit k sets of plans w /trams checked bcluw): L.J New construction U Addition /alteration /replacement ❑Service or feeder 400 amps or more ❑ Building over three ❑ Dcmulitiun ❑ Other: where the available fault current stories. exceeds 10,000 amps at 150 volts or ❑ Manners and CATEGORY OF CONSTRUCTION less to ground, or e' cecds 14,000 boatyards. - 7 14 and 2- family dwelling ❑ Commercial /industrial TJ Accessory building amps for all other installations. © Floating buildings. El ❑ Multi- family 17 Master builder ❑ Other: Fire pump. 0 Commercial -use ' 1 JOB SITE INFORMATION AND LOCATION ❑Emergency system. agricultural ❑ of new m otor load of buildings, .lob no.: Job site address. 10035 Highland Drive 10011P or morn. ❑ tnsranatien of 75 — ` ❑s ix or more residential un its. KVA or City /,State Tigard, ❑ Health -cam facilities. ❑ /Z1P: Tid, OR 97x24 larger separately derived system " S rit/bldg. /apt. no.: Project name: ❑ Hazardous locations. 3 ", occupancy. i ❑ Service or feeder 600 ❑ Recreational vehicle Cross street /directions to job site: amps or more. harks. • - I 0 Supply voltage for tore than Subdivision: L no.: 600 volts nominal. Tax map /parcel no.; FEE SCHEDULE - DESCRIPTION OF WORK D rxcriytvn I krx• 1 Fee. 1 Total V " New residential single- or multi - tamily dwelling unit. panel change _ Includes attached garage. 1.000 sq. ft . or lcse 168.54 4 1 . Ea. addl 500 sq. ft, or anion 33.92 1 ❑ PROPERTY OWNER ❑ TENANT limited energy, residential 67.84 2 with above . ft. Name: Limited energy, multi- rAmlly 67.84 2 Address: residential (with above so. 0 •) - ' Services or feeders installation. alteration, and /n relocation City/State/LIP: 1 100.70 200 amps or less 100.70 2 Phone:( ) 1 Fax:( ) Owner installation: Tills Installation is being made uu property that 1 own which is not 201 amps to 400 amps 13y.56 2 idtcnded for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 - 401 amps to 600 amps 200.34 2 ()wrier signature: Date: 601 amps to 1.000 amps 301.04 2 Over 1.000 4111115 or volts 552.26 2 0 APPLICANT 1 0 CONTACT PERSON Temporary services or feeders installation, alteration. and /or Business name: relocation .. a 200 amps or loss ` 59.36 1 Contact name: 201 amps to 400 amts 125.08 2 Address: 401 amps to 599 amps h 168.54 1 — Branch cirvuila - new. alteration, or extension. per panel City /State /ZiP: A.Fec for branch circuits with above service or feeder fee, ; 42 2 - Phone: ( ) I Fax: : ( ) each branch circuit B. Fcc for branch circuits E - mail: without service or feeder fee. 1 CONTRACTOR _ first branch circuit 56.1 R 2 Business name: Mitchell Electric, Inc. Each add'I branch circuit 1 J 7.42 r2 Miscellaneoussservice or feeder not included) Address: 1775 NW 3rd Street Each manufactured or modular 67.54 7 dwellin•, service and /or feeder City /State /ZiP: Gresham, Or 97030 Reconnect only 67.84 2 !bone: (503 ) 307 - 9881 1 Fax: (503 ) 674 -5855 I Q v i Pump or irrigation circle 6:.84 2 f Sign or outline lighting 67.84 _ 2 T CCB Lic.: 173822 41 Electrical Lic.: C244'?I l Via\ Suprv. laic. 51915 y,91'(0 Signal circuit(s) or limited- n �j energy panel, alteration, or Suprv. Electrician signature. required: A, 746- 7Z.CeY extension. Describe: Page 2 2 Print name: Tom R. Mitchell Date; 1 Each additional inspection over allowable in anvor the above Per inspccliun 66.25 Authorized signature: _ investigation per hour (1 hr min) 66.25 Print name: Date: Industrial plant per hour 78.18 ELt;(;1'KIC:AL. PERMIT FEES 1:\ Buildinc \Portnit6\ELC•PermitApp.deo 10 /O1 /0c 440- 4615T(11t05tC0MtwFB CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit ELC2009-00588 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/02/ Parcel: 2S111CC1 CC15600 Jurisdiction: Tigard Site address: 10035 SW HIGHLAND DR Subdivision: Lot: 0 Project: Bolton Project Description: Panel change Owner: FEES BOLTON, BETTY J REV LIV TRUST Quantity Description Date Amount 10035 SW HIGHLAND DR TIGARD, OR 97224 1 ea Services or Feeders - 200 11/02/2009 $100.70 amps or less PHONE: 1 ea 12% State Surcharge - 11/02/2009 $12.08 Electrical Contractor: MITCHELL ELECTRIC INC 1775 NW 3RD STREET GRESHAM, OR 97030 PHONE: 503-307-9881 FAX: 503-674-5855 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 ~m/a]y obtain a copy of the rules or direct questions to OUNC by calling 503..24,6.6699 or 1.800 332.2 44. Issued By: . Permittee Signature: U-YL- a-,aw 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. 11/02/2009 09:58 5036745855 PIITCHELL ELECTPTC PAGE 82/14 FOR OFFICY USE ONIA Electrical Permit A,Pplication Recclvcd ' City of Tigard Pe it vo r,,J&L'7 ~L S 0 'L L J1; ; natnlBv: 13125 -SW Hull Blvd., Tigard; OR 97223 "We Plan Review Other Permit: Phone $03.639.4171 Fnx' 503 599.196¢ ate/Bv - 9 t 4 = '1 -Date Rcad3'/By he tx: BJ 9ez gage 2 for Inspection Line: 503.639.4175 $upplemen"l Information lntcrnet: www.tigard-or.gov * r r;rra fied(Method: PLAN REVIEW 12'rt OF WORK Pleasc cluck all that apply (submit 4 sets of plans wfirerns cl,ceked hcluw); New -construction Addition%altcrati0n/replacement ❑$ervice or feeder 400 amps or more ❑ Building over thm-z ❑ Othere where the available fault current stories. ❑ DCmUliUOuu exceeds 10,000 amps at 150 volts or ❑ Marinas and CATEGORY OF CONSTRUCTION Its* to ground, or cxeeccis 14,000 boatyards. X k and 2-family dwelling Commercial/industrial Acccssory building amps for all other installations. ❑ Floating b6idinEs ❑ Multi-family ❑ Nlastcr builder ❑ Other: Fire pump. Commercial-use ❑Emergency syxtcm. Agricultural JOB SITE INFORMATION AND LOCATiON ❑ buildings. Addition of new motor load of Job no. Job site address: 10035 Highland Drive 10011Pormorc. ❑ lmstallarion ur73 KVA or OR 97224 ❑Slx OL IttefC rC9identlal Ilnlr9. City/State/Zip: Tigard, larger separately derived systen ❑ Health-care facilities. Suitul/bldg.lapt, no.: Project name: ❑ Hazardous locations. 3", occupancy. ❑ Service or feeder 600 ❑ Recreational vehicle Cross street/directions to.job sits: amos or Marc narks. Q Simply vahage ro; more than Subdivision: Lot no.: 600 volts noa+;eal. Tax'map/pltrcel no.: FEE SCHEDULE DESCRIPTION OF WORK Drec tivn Fee. TMAI Nem, residential single- or multi-tamily dwelling unit. panel change Includes attached garage. 1,000 s q. ft. or Icss 168.54 4 ~I La, add'I 500 sq, ft, or ortion 33-92 1 ❑ PROPERTY OWNER l._I TENANT limited energy, residential 8 2 with above . 4 67. . Name: 4 Limited energy, mule-fAmUy 67.84 2 Address: residential with above s q. ft. Serviccs or feeders installation alteration and/or relocRunn C: ity/ Jt0.1:e// I F'; 1 i 00.70 200 amps or less 100.70 2 Phone: ( ) Fax. ( ) Qwner installation: Thus Installation is being made vu piuperty that I own which io not 201 amps to 400 amps 133.56 2 intended for sale, ]case, rent. or exchange, according to ORS 447.449, 670, and 701. 401 amps to 600 amps 200.34 2 Owner signature: _ bate: 601 amps to 1,000 amps 301.04 2 1Ova 1,000 amps or volt, 552.26 iJ APPLICANT L❑ CONTACT PERSON Temporary services or feeders installation, alteration, and/or Business name: relocation 200 nmp3 or less 59.34 l Cotttact name: 201 amps to 400 am $ 125.08 2 Address: 401 am s to 599 amps 168.54 2 Branch cinuila -new, altcratio.+. or extension, per panel City/Stale/Z1P: A. Fcc for branch circuits with above servicc or feeder fee, 7.42 2 f'honc: ( ) rAX:: ( ) each branch circuit E-mail: B. Fcc for branch circuits lvithou t service or feeder fee. $6.18 2 CONTRACTOR first branch circuit Business name: Mitchell Electric, inc. Each add'i branch circuit 7.42 2 Miscellaneous service or feeder not included AddrCAS: 1775 NW 3rd Street Each manufactured or modular 67.94 dwcilin •servicc and/or feeder City/'Stale/ZIP: Gresham, Or 97030 Reconnect onlv 67.84 2 Phone- (503 1307-9881 Fax: (543 ) 67d-5855 ( Iv Pum or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CCB Lic.: 173822 Electrical Lie.: C244 ;11 1 Suprv. Uc-: 51915 who Signal circuit(s) or limited- 1 ~~f'~.,,f energy panel. alteration, or Su}1rv. Electrician signature. required: / ate ' extension. Describe: I'agc 2 2 Print name: Tom R, Mitchell Date: 11102/09 Each additional ine action over aunwable in an of the above i I I Per inspcuivii 66.25 Authorized signature: lnvcsti anon per hour (l hr miN 66.25 Print nsme- Datc: Industrial plant per hour 78.18 ELM YRIUAL PERMIT FILES I \Buildin¢\PonnhF~FI_C•Permi`App des IOMIfbO 4aUabl ST(: I!O:/COh1/WEB