Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: ELC2010 -00023
T 6GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/15/2010
Parcel: 2S110BA03600
Jurisdiction: Tigard
Site address: 11615 SW CLOUD CT
Subdivision: Lot: 0
Project: Koenen
Project Description: Add /alter (2) branch circuits to add can lights in kitchen and add outlets in second floor bath.
Owner: FEES
KOENEN, MARKS & SHANNON Quantity Description Date Amount
11615 SW CLOUD CT
T,IGARD, OR 97224 2 crt Branch Circuits 01/15/2010 $63.60
wo /Purchase Service or
PHONE: 503 - 624 -7960 Feeder
1 ea 12% State Surcharge - 01/15/2010 $7.63
Electrical
•
Contractor:
VAST ELECTRIC
1525 SEATTLE SLEW DR. SE
SALEM, OR 97301
PHONE: 503 - 566 -7274
FAX: 503 - 585 -8828
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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. Alf 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 thr ugh 'AR 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: AA _� , ` ` , 1 ! �' Permittee Signature: Aop,
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 ofieach!inspection.
•
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit ELR2010-00023
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9677 SW WASHINGTON SQUARE DR C05
Subdivision: Lot: 0
Project: Aeropostale
Project Description: Sound system
FEES
Owner:
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #0 Restricted Energy Permit 02/03/2010 $67.84
CARLSBAD, CA 92008 12% State Surcharge - Electrical 02/03/2010 $8.14
PHONE:
Contractor:
JUSTICE COMMUNICATION CO
3337 SE HAWTHORNE BLVD
PORTLAND, OR 97214
PHONE: 503-232-6163
FAX: 503-232-6902
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: Y Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: N Instrumentation: N Total $75.98
Intercom/Paging: N Landscape/Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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..22344.
issued By: z ZAAL~- - Permittee Signature: e~ 19AP Z, ~Z7 77e
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 603.639.4176 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.
( " x is it r i X11: E ih Two a yY 'u90R0 4 .eYafi n.,#, d�Y +. ,' p n a lit ttt tr 1 irr t Otkt'" "' j
E lectrical Permit Application c (� q �� , i l u ' � ��F o FFIC � SE�o r I v . i1 � " n :� r l�,� 1:: ._
�� , ��" 4 . . i9''f'+ mdNO'Z nPO'� �'vrSw - OR ..e �1Vv;e".•itYuEo3E''ua�ln,9t07 i t';�,,�,i�P. fir , �I�twl '.l(u4'�h..�.,�e
REE iew Permit No : ' 1C D. , rO OO S
T312SW HaBvTigard OR 97223 P ; � 'I O
• a C • Phone: ,503.639 :4171. Fax: 503.598.1960 Date/By: Other Permit:
'f I G A K D inspection Line: 503.639.4175 Date Ready/By. furls: El See Page 2,,for
Internet: www tigard- Or.gov Notified Method; r.� Supplemental Information
T .PE OF `.. .: f -,
❑ -WORK 'PLAN' REVIEW : u •
New Construction Addition /alteration/replacement Please checkalkthat apply (submit 2 sets of plans w/items checked beloW).
El Service or feeder 400 amps ❑ Building over three stories.
❑ ,Demolition ❑Other: where the available fault;eurrent ❑ Marinas and boatyards.
• . " F ' - _ � . I " exceeds 10;000 amps •at 1'50 volts or ❑ Floating buildings.
�� ' .CATEG 'O CONSTRUCTION . . . , -,
Tess to ground, or exceeds 14,000 ❑ Commercial -use agricultural
land 2- family dwelling 0 ❑ Accessory building amps for all other installations. buildings.
. ' ❑ Multi :family ❑ Master builder ' ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
' JOB' S ITE IN •AND', ' ?' o- ❑Em
ergency system. large: ' "derived system.
• ❑ Addition of new motor load of ❑ "A» `fE `1 -2» , "1 =3
f 700HP or more. occupancy.
Job no.: Job site address: L C, 5 S (1 C6c 1id 1 ❑ Six or more residential units. ❑,Recre parks.
City /State /ZIP: 1 13 V t !� ,7 P (R ❑ Health -care facilities. ❑Suppl voltage,for,more than
❑ Hazardous locations 600 volts,nominal.
Suite /bldg. /apt. no.: Project name: �1-, cf vi eerier 600 amps or more.
Vt ❑ Service or f
° :FEE ;SCHEDULE-:
Cross.street/directions to job 'site: Description 1 Qtv 1 Fee. 1 Total 1 " •
New residenti single- or multi-family dwelling unit.
Includes. attached garage.
Subdivision: Lot no.: 1,000 sq. ft, or less 168.54 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
Limited energy, residential
DESCRIPTION' OF W.,ORI{ (with above sq. ft:)
7 84 '
/ / r ( 1('' Limited energy, multi - family 67.84 2
,(9r � 'r�cr'SSec ) c-c i- IC i i'l I- cj"j G c) CO a , ( e7 i 47 residential (with above sq. ft.)
(�j j- / Services or feeders installation, alteration, and/or relocation
• >^ �`tiC 1 ` T 200 amps o less 100.70 2
`; `'. ❑ PROPERTY OWNER . • • . `® T ENANT' r 201 amps to 400. 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 /ZIP: Temporary services or feeders installation, alteration, and /or
relocation .
Phone: ( ) Fax: ( ) 200 amps or less .59.36 1
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: ❑7 CONTACT ' above service or feeder fee,
eachbraneh "circuit 7:42 2
Business name: B..Fee for - branch circuits
Contact name: without service or feeder fee,
first branch 'circuit 56.18 D , i 2
Each add'I branch circuit f 7.42 7, 2
Address:' Miscellaneous (service or feeder not included)
City/State /ZIP.: • Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: ( ) Fax..'( ) Reconnect - only 67.84 2
• E -mail: • Pump or irrigation circle 67.84 2
'• •`' • CONTRACTOR ' -•',' rw; , , - Sign_or.,outline; lighting 6784 2
Business name: } , Signal circuit(s) or limited
- -r i / (r. i e?i tc Ii.c: energy_panel, alteration, or
r extension. Describe: Page 2 2
c 5 �F(.t.� Or. 5
City/State/ZIP:- i t r (r) . G 7 j'� ' %
Address: l '7 a � 1 � ?c�. �� � .Each additional inspection over allowable in any of the
Per inspection, 66.25
Phone :( 3) 5 -. e ? i1 Fax: ( Q3) SYS- (fp? investigation per hour (1 hr min) 66:25
CCB Lic.: 1.7s-6--3 Q Electrical Llc'.; j' Suprv. Lic.: j` � Industrial plant per hour 78.18
/ . _ELECTRICAL ?PERMIT:; FEES
Suprv. Electrician signature, required: / Subtotal to ' ,
Print name: - J IB V .., a ,.e �' A_Q D ate: 1 . �5 1C Plan cha (
' V Statesurcharge (12/oof permit fee): 9, &3
Authorized signature: TOT-AL PERMIT FEE: -7/ „..2.1
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
r (+" � * Number of inspections allowed per permit.
C vvv"� \ Building \Permits\ELC- PermitApp.doc 10/01/09 1 a 7e•O . — V X / O7 440- 4615T(11/05/COM /WEB
77/1 V •
Electrical Permit Application City of Tigard
Page . 2 = Supplemental Information
LIMITED ENERGY PERMIT FEES:
AESIDE 0,JAL.VoRK "ONLY;
Fee for alLresidential systems 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:
COMME'R M.. WORK ONLY
m .r
Fee for each commercial $67.84
system -
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Sy
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
. I
❑ HVAC •
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ N urse Calls '
❑ Outdoor Landscape Lighting* •
❑ P rotective Signaling -•
❑ Other
Total number of "cbmmercial
•
' *No.licenses are required'.. Licenses are required •
for all other installations ! ~
I:\ Building \Permits\ELC- PermitApp.doc 10/01/09