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Permit -. CITY OF TIGAR® ELECTRICAL PERMIT t ,. Permit #: ELC2009 -00605 _ - COMMUNITY DEVELOPMENT RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/10/2009 TIGARD - Parcel: 2S112AD01000 ,. . ?:., Jurisdiction: Tigard Site address: 7007 SW CARDINAL LN 105 Subdivision: Lot: 0 Project: Spec Space Project Description: Install (10) branch circuits. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 10 crt Branch Circuits 11/10/2009 $122.96 wo /Purchase Service or PHONE: 503 - 624 -6300 Feeder 1 ea 12% State Surcharge - 11/10/2009 $14.76 Electrical Contractor: FIVE STAR ELECTRIC, INC. PO BOX 555 BANKS, OR 97106 PHONE: 503 - 324 -0948 FAX: 503 - 324 -0973 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $137.72 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 0 R 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ` /�1 Permittee Signature: Z // or ,/ G% `e47 / / 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 603.639.4175 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. From: 11/06/2009 10:37 #844 P.002/003 r RECEIVED Electrical Permit Applicatio OFFICE USE ONLY IOV 06 6 2009 i Receved City of Tigard Dece / l iQ Q y ,e f PennitN°t/C'aw Do( ©S q 13125 SW Hall Blvd., Tigard, OR 9722 Plan Review / 8 Phone: 503.639.4171 Fax: 503.5981 DataBy: OtherPer /'x , /6c2. Inspection Line: 503.639.4175 CIT OF TIGARD Date Ready /By. Othe �� ® See Page 2 for T I G n R U Internet: wvrw.tigard or BUILDING DIVISION I Notified /Method. 7 l I Supplemental Information _ TYPE OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below) ❑ New construction X Addition/alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Mannas 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 ❑ Emergency system. larger separately derived system • JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ ' A "F °t -2 '1 -3 ", � IooHP or more. occupancy. Job no.: `Utg 1 Job site address: i ::5 - 1 V��■ d( [ ] Six or more residential units. ❑Recreational vehmie parks City/Statc/ZIP: ' — C Lt1 ? j Jj� ❑ Health -care facilities. Supply voltage for more than I t}� �` + ❑ Hazardous locations. 600 volts nominal Suite/bldg. /apt. no.: r Project name: `J L "� P (0 0 ❑ Service or feeder 600 amps or more. — FEE SCHEDULE Cross street/directions to job site: Description J Qty. 1 Fee. 1 Total New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 ' 4 Ea. add'I 500 sq. ft. or portion 1 33.92 1 t Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 67.84 2 t� I� Limited energy, multi - family \ "\' Gt t 67.84 2 t \ b \ 'Z L f On C)( ���,` residential (with above sq. ft.) _ 1 1VU `t Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 ' 2 • ❑ PROPERTY OW NER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 1 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts I 552,26 2 Ci /State /ZIP: Temporary services or feeders installation, alteration, and /or LY - relocation Phone: ( ) Fax: ( ) 200 amps or less I 59.36 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 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 with ❑ APPLICANT ❑ CONTACT PERSON I above service or feeder fee, 7.42 2 each branch circuit Business name: ' B. Fee for branch circuits without service or feeder fee, I 56.18 a 1 g 2 Contact name: first branch circuit Address: Each add'I branch circuit CI 1 7.42 u21,2,1$ 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle ( 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Signal panel. er or limited- Business name: Five Star Electric, Inc. energy panel, alteration. or Address: PO Box 555 extension. Describe: Page 2 2 City /State /ZIP: Banks, OR 97106 Each additional inspection over allowa in any of the above Per inspection 66.25 Phone: (503) 324 -0948 Fax: (503) 324 -0973 Investigation per hour (1 hr min) 66.25 CCB Lic.: 158231 v Electrical Lic,: 34 -665C ✓, prv. Lic.: 4622S './".' Industrial plant per hour 78.18 g ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: '" Subtotal: 2.2 . °� Print name: Royal Stearns Date: i 3b1-09 , Plan review (25% permit fee): J State surcharge (12% of permit fee): 1 A , `, 6, Authorized signature: TOTAL PERMIT FEE: ` `1 - 10.. This permit application expires if a permit is not obtained within 180 Print name: Date: I days after it has been accepted as complete. Number of inspections allowed per permit 1. \ Building \Permra\ELC- PermitApp doe 10 440. 46157(11 /05 /COMAVEB