Permit , .ry .
OF TIGARD ELECTRICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00008
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/07/2010
. Parcel: 2 S 102 DA00200
Jurisdiction: Tigard
Site address: 8720 SW BURNHAM ST
Subdivision: Lot: 0
Project: City of Tigard
Project Description: Install (1) 200 amp or less panel, and (7) branch circuits.2 /2/10 ADDED (3) branch circuits to
permit.
Owner: FEES
TIGARD, CITY OF Quantity Description Date Amount
13125 SW HALL BLVD
TIGARD, OR 97223 1 ea Services or Feeders - 200 01/07/2010 $100.70
amps or less
PHONE: 7 crt Branch Circuits w /Purchase 01/07/2010 $51.94
Service or Feeder
1 ea 12% State Surcharge - 01/07/2010 $18.32
Contractor: Electrical
OREGON ELECTRIC GROUP 0 ea 12% State Surcharge - 02/02/2010 $2.67
1709 SE 3RD AVE Electrical
PORTLAND, OR 97124 3 crt Branch Circuits w /Purchase 02/02/2010 $22.26
PHONE: 503 - 234 -9900 Service or Feeder
FAX: 503 - 535 -2763
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $195.89
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 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.
' r
Issued By: � 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.
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r,,,,,..:.:-.1,,,. 11V Received ♦ik
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i� Pennrt Nn.;
s c 13125 SW Hall Blvd., Tigard, OR 97223 Uate /By: -- ____- -_ -_ -- ---- �___�_.- -� � ' - r �`
I A 2 n 6 O Plan Review
"• ''' I : 's Phone: 503.639.4171 Fax: 503.598.196W (j I Date /fsy: Other Retina:
r T I G A'll 6 1 Inspection Line: 503.639.4175 Uatc Ready/Byr funs: Sec Paget for
b`, - - __.
. , •..ct; Inter( et: www.tigard- or.gov MY OF T t /1 RD Notified/Method; - - � CO Supplemental information
. ifyP1.; OF i1' n'.911 . • !t' `. J N PLAN REVIEW _ _
❑ New construction " -- ►l Addition /alteration /tx placement 9 1i Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or mnrc ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
_.____ _.__.�_..: -- - _:. - -_ -_• - - less to ground, or enceeds 14.000 ❑ Commercial-use agricultural
1- and 2- family dwelling E Commercial /industrial ❑ Accessory building amps tar all other installations buildings.
❑ Multi- temily ❑ Master builder ❑ Other: ❑ File pump. 0 Installation of 75 KVA or
- - -- JOB SITS INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
__ ___ . O - - - _ _ [] Addition of new mntor load of ❑ "A" "E 1 -2" ,• 1 -9"
Job n 4-1
o.: 81000 11 Job site address: 8720 SW BURNAM ST 100HP or more. occupancy.
`2 ...- _.,� „-.- El Six or more residential units. 0 Recreational vehicle parks.
City /State /ZIP: TIGARLD OR ❑ ileatth -care facilities. 0 Supply voltage for more than
— .- _-- .-_.._ _ _ _ _— --•-- ..__...---- -- - _- °- .-_ -__ —_____ ❑ llvardous locations. 600 volts Will inal.
Suite /bldg. /apt. no.: i Project name: NICHE BUILDING ❑ Service or feeder 600 amps or pore.
_ - - ____.._- ___......_.._. Frio SCHEDULE
Cross street /directions t0 _ job site: tretivrbption _ -- �_,( ty. Gee. 1 _l__ Total 1 ^ _
- " -i-- New residential single- or multi- family dwelling unit.
-__ _ -- Includes attached garage.
• Subdivision: - -- -�- - - - 1 Lot no.: 1,000 so fl. or less _ - 168.54 -_ - 4
--" Ea. add'l 500 sq. 11.. or portion 33.92 1
Tax map /parcel rut.: - Limited energy, residential
" - " - ___ - ._. - __---.___._
DESCRIPTION • OF WORK - . " _ (with above sq. ft.) 67.84 2
Hinged energy, multi- family -
ADD TiiRFF CIRCUITS TO PERMIT # ELC 2010 - 00006 _____ - - 67.84 2
-- .__..____.__. _ - .. - _______ _______ - _ - _______.__ twsidcntial (with above sq. WI
Services or feeders installation, alteration, and/or relocation
_. 2 00 amps or l ess 100.70 2
- ❑ I'ItOPE127i�OWNF.iZ_- __. _ TENANT 201 amps to4UU amps -- ___ --.__- 133.56 2
Name: 401 amps to 600 amps 200.34 2
- ___ ----- _--- _---------------- 601 amps to 1,000 amps 301.04 2
Address: — " - -- ----- - - - __ _. _--__ _ ___
Over 1,000 amps or volts _ _ __552,26 __ 2
City /State /11P' 'Temporary services or feeders installation, alteration, and /or -
relocation
Phone: ( ‘) j Fax: ( ) 200 amps er less 2 59.36 - -- 1
Owner installation: This installation is being made on property that I own whic is not _ 201 amps t o 40 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 - ncw, alteration, or extension, per panel
Owner signature: Date: - - - - --
A. Fee for branch circuits with
❑ APPLICANT. p CONTACT PERSON above service or fccdcr fee,
7.42 2
each branch circuit
Business name: 13. Fee for branch circuits
_- -_ -- . .._ -- -. -. --- - without service or feeder fee
Contact name: - - - -- first branch circuit 56' 18 2
Address: Fact) add'I branch circuit 3 7.42 2 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 µ 2
Business name: OREGON ELECTRIC CROUP Signal circuit(s) or limited-
_ -._ -- energy panel, aitetatiou, or
Address: 1709 SE 3 AVE extension. Describe: Page 2 2
City /State /ZIP: POR'fLAND OR 97214 Each additional inspection over allowable in any of the above
___- _--_---- ._---- __- ___._. _ -.- Per inspection 66.25
Phone: (503) 234 -9900 Fax: (503) 535 -2763 — Inve ligat per hour (1 hr min) 66.25
CCB Lic.: 203 Electrical Lic.: 26 -95C Suprv. Lie.: 4549S industrial plant per hour 78.18
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, rcyu . tY" . C`) ‘3, , 4
- __._.._..__ , ti e ' `� - Subtotal: 22.26
Print name: RICHARD MCELLIO1T Date: 1 - - Plan review (25% of permit tee):
® State surcharge (12% of'permit fix; 2.67 /
Authorized signature: - -13 .s; 3Te " TOTAL PERMIT FEE: 24.93 \//
this permit application expires If a porn is not obtained nitbin 180
Print name: RICHARD MCELLIO fT Date_ 1-29-10 - - -_ days after it has been accepted as complete.
'' Number of inspections allowed per permit.
I ? Building \ Permits'`'?. I.C- PcunitApp.doc 10'01 09 - " - 0. 440- 4615•1"411JU5 COMJW tin
-)
. OF TIGARD
ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: 0 E 1 1.. / C 0 00008
,TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/07/2010
Parcel: 2S102DA00200
Jurisdiction: Tigard
. Site address: 8720 SW BURNHAM ST
Subdivision: Lot: 0
Project: City of Tigard
Project Description: Install (1) amp or less panel, and (7) branch circuits.
•
Owner: FEES
• TIGARD, CITY OF • Quantity Description Date Amount
13125 SW HALL BLVD
TIGARD, OR 97223 1 ea Services or Feeders - 200 01/07/2010 $100.70
amps orless
PHONE: 7 crt Branch Circuits w /Purchase 01/07/2010 $51.94
Service or Feeder
1 ea 12% State Surcharge - 01/07/2010 $18.32
Contractor: Electrical
OREGON ELECTRIC GROUP •
1709 SE 3RD AVE
PORTLAND, OR 97124
PHONE: 503 - 234 -9900
FAX: 503 - 535 -2763
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $170.96
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 1.800.332.2344.
Issued By: A % i J z( 7 Permittee Signature: de 4.7 ip /'L / ( /Ox
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.
Cali 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.
, .
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El eC:trieal Perm it AJnig.istati( • D tyrii .. itx , v , i)T :;, i „„:„_..,,,,,,,,.„....,,....,...,....,..,....,,,,,.,,,,..„.,...„.„:„..„.,,,,,,.,„
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i) Rene ate,/ i 3 ve y, d kj Naiad No.: et 10 (:).4101.47;
irl 1312SW
ic t C;ty of Tigard ad ,
.. ' ...,.: ..1 5: liall:Blvti., Tigaixi , OR 97223
2g .‘ Phone: 5031i:19.4171 Fa x 503.598.19JAN 0 5 2010 PlarrIteview
, .. ateiBy
, Other Penuit:
D:
4... . Inspection Line: 503.639.4175 . DategeadyiBy:
ve-i°,See F age 2 ftw
;.t.tr Internet: www.tigard-on:gov . ,
ITi OF TIGARD Noiifieitimelhod• • _ , Supplemental information
:• :l :::.-:: : '"l : ` ' ‘;::• • •: •' :',:** ) ( T E: '' 0 43.13 4 1EIYINGI " -).1ViT. ST • ••:. : :::: . : . •''':':".• ;: ;!::,', : ': : ." . .'l.'1" :. .:'.:: . :l.'4: -... . 2 1..: ''li"
. • : [3, New cObstruction El Aoitioittiteratioriire*coment Please check all tltal apply (subenit2 sets of writems checked below):
0 Service or feeder 400 amps or more 0 Building over three stones.
''El Demol ition D othcr: where the available fault earrent. 0 Marinas and boatyiu•ds,
:, :l . ......,..... exceeds 10,000 amps al 150 volts' or Eftloating buildings.
r. ' ' :ll: """ ''''' ' " • ' ' "-=•,-,-,' '-' " ' •''' - - - ' - ' ' ''' Is to ground, or exceeds 14,000 0 Commercial-use agricultural
...
0 1- and 2-thrnily dwelling [I Conitnercial/industrial El Accessory building amps ti,tr all other insiantaions. builditi
Li multi-famil [I] Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
1, se derived system.
: S (1 ii;::'(04,..FQ..,R )4...A710....,N'' ,'.A:110N• 0 Addition of new MOW load Of 0 "A", "E" "1-2". "1-3".
job no 81004-100 f •
Job address: 8720 SW BURNHAM ST 10011P or - more. occupancy.
Psis or more residential units. ' 0 Recreational vehicle parks.
•
C il y/State/ZIP: TIGARD OR 0 tit:Mut-Care facilitie,s. 0 Supply voltage fir tsore than
0 Hazardous locations. 600 volts noininal.
Suite/bldg./apt. no I Project 'torte: NICHE BUILI)ING fj Servictt or fecder 600 amps or more.
..,.00
Cross street/directions to job site: 06:40 '------- [ qty. r - 1 'Fetal 1 -- t'
New residential single- or multifamily dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq, ft. of less 168.54 4
--- --- Fa. ndd'I 500 sq ft or portion 33.92 1
l s ax map/parcel no.:
Limited energy, residential
67.84 2
— ----------------- Limited une,rgy, multi
ADD D -- --
NEW PANEL AN D 7 CIRCUITS 67.84 2
_.______ resicientialiwitli above sq. ft.) .
Services or feeders installation, ttlteration, and/or relocation _
__,,,,,, ,,____, _____ _„______ 200 amps or less I 100.70 100,70 •2,
... ,.;.•....,.:: 0.INAN,T..,'„? 201 amps to 400 amps T 2
------
401:amps to 600 amps 200,34. 2
Name; ...
601. amps to 1,000 amps 301.04 2
Address:
Over 1,000 amps 01 volt j j 552,26 2
.
C:ily/Stale/ZIP, Temporary services or feeders installation, alteration. andiot
- relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
--
2
Owner installation: this llation is being tntale on property that 1 own which_ is not 2 01 ' 1- to 400 ' nip - 125,08
intended lir sale, lease, rem, or exchange, according to ORS 447, 449, 670, and 701. 401 ' . alliPs 3 o 599 arnPs 168.54 2
_
'Branch circuits -- new, alteration, or extension, ter aneI
Owner signature: Date: . ,,., ,.., -- -----
....._-...7z....-:- ---- ----.- _________ _ __ A. Fce for lwamh cocoas orth
: '':: "." :•'APPIA(AN11': .: '-..'t.t.ti ::. ... • ."1-.?, '7',.,: '.. ,, (ON I Al : 1 : PERSON:-. ..,, '-':..--,., above service or feeiler fe, 7 51.94
7.42 2
each branch Cirellit — -'-' ---
. : Business name: B. Pee fOr branch circuits
without service or feeder fee,
Contact name: 56.18 2
first'branch circuit
Address: Each add' l branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Lacli manufactured or modular
. • dwelling, service and/or feeder 67.84 2
• Phone: ( ) Fax: : ( ) only 67.84 2
-- .........._, .____ ._....
E . Pump or inigation circle 67.84 2
_
:;t.,:,.: .•77:: :....7; ;::, i:: .::::,.,::: : ;.:77 , ;::; : ' : : : • ; .Si Or ojidinJlighttng --- - 67.84 2
Signal circuit(s) or limited
Business name: OREGON ELECTRIC GROUP —. energy panel, alteration, or
_
Address: 1709 SE 31» AVE extension. Describe: Page 2 2
City/Statc/Z1P: PORTLAND'OR 97214 Each additional inspection over allowl ble in ay n of the above
..,...._ _......,
Perinspeetion 66.25
Phone: (503) 214-9900 I Fa (503) 535-2763 '
, in per hour 0 hr min) 66.25
CCf3 Lie.: 203 I Electrical Lie.: 26-95C Suprv. Lic,: 4549S Industrial plant per hour 78.18
-- __
__ _____ _._______ -- _ ---,.. - -- --- - '''.:: -....:::. EFS
..: . • , , . .
Suprv. ElectriCian signature, requi .
\ L,h,..).L vo-tc sz; (-, c.) ..,) ° , :` 7 , 7- c , `:-.) subtotal: 152.64
)...'),. . ' ' -
Print name: RICHARD MCELUOTT Date: 1-5-09 Plan (25)1 0f permit fee):
, -: ' • „,.......... - ---- - - - --- ..- .-- - -- . -- --State surcharge (12%
Authorized signature: , ' * T?..iA:t':° -k :",..? "f*N cC\ r ‘ Z-d TOTAL PERM11' 1TE: jj..g:71"5 1 -, , n.qb
---
– — --- — . T his permit application expire s if aPermit is not obtained within 180
Print name: RICHARD MCFLuarr [Date: 1-5-09 . -
t clays after it has been,acceptctl as complete.
+ Mather of inspections allowed per permit.
I: \ fillildme•Permitslti/f:-PernlitApp.doc 1 0,0 l!Og WO-4615 lios,cut;441
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