Permit . T ..`
CITY OF TIGARD ELECTRICAL PERMIT
N COMMUNITY DEVELOPMENT Permit, #: ELC2010 00029
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639:4171 Date Issued: 01/20/2010
Parcel: 2S101AD02900
Jurisdiction: Tigard
Site address: 12755 SW 69TH AVE 100
Subdivision: WEST PORTLAND HEIGHTS Lot: 31
Project: Legend. Homes
Project Description: Add /alter (5) circuits for TI.
Owner: FEES
TRIANGLE TERRACE, LLC Quantity Description Date Amount
12600 SW 72ND AVE #200
TIGARD, OR 97223 5 crt Branch Circuits 01/20/2010 $85.86
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 01/20/2010 $10.30
Electrical
Contractor:
GARNER ELECTRIC
2920 SE BROOKWOOD AVE A
HILLSBORO, OR 97123
PHONE: 503 - 591 -1320
FAX: 503 - 642 -7925
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $96.16
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 wit 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- 00.10'throu h 0 P '\CtIij \J? 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.
lI
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:
^ CONTRACTORINSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' , p • Date:
LICENSE NO. ^ \ � J
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 tfie'job site at the time of each Inspection.
..AM' i l
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Electrical Permit AppIicatio W Ww.tig Dato / N o - - - a ,- . :' use - v>
rrii • kecetvnd P nrnil No.:
,t i C lty ot " T AN 19 2010 1�etC/kiy! . '(czar �C o
I r ° . is 13125 SW Hall Blvd., T UK 972 Plan Revie
01 i
r o s ; C x Phone 503.639 4171 Tali`. '5 03 54 liv
a cwt ts 4 c 1 TIGAItD Hale 12eady /13y, , rr,�. Q1 See Page ' 2 , for
TIO' "A'R hnpecL[pn Li 503 . 63 9.4175 u Information
, fv. „,r,F,. teme
tut' tlyd,,o gov BUILDING DIVISION
UG , t , @ up n t u
w, ' ,t',r .,:m * n n )psi il )tl,litd/ �4 cth � d ' ). , rpC re.l { } Yt
g ,� r } r �� W . 1 ( ° h.
• ,� °��iit r , , 9r IEl l,zi � r , �x ' ,, , ∎' ' a h, � i Z" l p ,nl ' ' "tM y , , , X t'' all t 1 t p
�; , , , � . . . z S A ? t 11 w , _ F } '',.:i0 , i) I .. t i r. bfcft ,, l }, . � G� t 9 d tB P t a „ Il fl..,. i) Nee ❑ !;
mif geld of fans whiffing chatted below).
❑ New construction X A .ddition/altcratlon/rcplacement ❑ fitirvicc or feeder 400 amps or more Liuildin over three stories,
O thCT: _ , . . eavailable melt current ❑ lvlarinnsa}id boatyards. III Demolition � where 0t
�� , , , m , t trn t �r 6tf fl i : excecds amps iu 150 volts or 0 Mooting bui1c1i1
t Lt O 1- and 2-family }} u Clw � e } l . I Colm I N aI/irid tl m d Accessory I building ,1^� I':� les In ground, ornxcocda 14,000 C1 Com+r iai -use agricultural
�rPlph r 1 l r. ,.I r : ,. "'
amp fur it1other installations. buildings
O ) 'it'c per, D - installation of 75 kVA or
El Multlfaniily ❑;Ivlasterbttildcr ❑ m iargcraeprralaly rein.
� r r r ,, w.Ptt'';" ❑ Emergency syate
lilt , } l � �(f• i r i +,' 'ATV 1L it l Iru I v i 0 1 i f a Y .i ilYi 14 I � l tu d i '4 '' 0 A ddition ofttnw motor IoaJ of ❑ l ar " se separately der : „
•
t Ct,I k ' ,br t i h, . , Ll�uol ^a � ..11.a a42 } i� .t ❑ p Y
`- ■��, !00111'
- or more, oaw anc ,
Job no,: Job site address: S 2- 7.'7 6 �V v �l� 1 T L Y'�I ❑ Six or more residential units. Q Recreational vehicle parts.
. ID Health-care facilities. ❑ Supply voltage . for more than
C ity /State /711?: ®� 4 d 1 -, q (�1 ❑ liazaTilotis 1 „cat i ona, 600 volts nominal..
Suite/b14./apt. nc 00 Project name: p p o ;� m u 1 ( t t 0 Servievor 600 amps or more.
_ . : 91 ' 1 I�i � U � ,l.a 1, . >, i i 3 '� ti 1 00.
One s& street /directions to�ob site; neeeri tlon _ rt8.. T "tat
Nov residential single. or multi - fancily dwelling uott.
Ineludexattached garage.
M _ ,
1,000 sq ft. or Ices 145.16 4
Subdivision; Lot n _ _ Vl
_, - . — Ea add 1500 sy. ft or porti 33,40 1
'fax no Limited energy i esldential 85,00 2
a ti., r: x ` 1Y" E with ab ove a 11)
�x1�. ., 1,,,, S, , py �It 1 W A /� /// ]Nrl 1ypt'VWWdI 1 1
f} i' l ''l M, i r f,9 W�t.l i, V I & i g i j iii 1 Ate I, ,, TI l . ulna , t'�'1i_ „, , �ri l I Q ..
Limited energy multi family 75 -OU 2
FM ' f ( �/' • / / f '/& 0 residential (with above sd. ft.)
• Sei ti ices or 'feeders installation, uiteretion,'antllor relocation
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200 amps or less 80.30 2
l ) l .t p 1, c � }r�'` tte¢ p x w , Ill M } as yt + i 2Ul amps to amps 106,85 2
i v l i ', l ttR'b r 1i, i nUkYd l;, lzr v ;\4 1').;4' s I `C . iiF � t � ��iN a
"�� it _ 401' amps to GUU.`.Ptmps 160.60 2
Name: ,�' 601 amps o 1,000 amps 240.60 2
Address' Over 1,000 amps or volts 454.65
• - � — Temporary services or feeders lnstallatiU[l, alteration, a ndlnr
City /State /ZIP: relocation
Phone ( r[ /920,_. 700 1 Fax: ( ) 0
200 amps or less 66,85 1
C �j��/�/
,) �) KJ6�' 201 am to 400 amps 1 00,30 2
Owner installation: This installation is being made on property that 1 own whin is not 2
133.75
intended tot''salc, lease, rent, Or exchange, according to ORS 447, 449, 670, and 701- 401 amps to 599 amps Owner signature Date: for branch circuits with
� ttrr � A Branch circuits - new alteration or extension, per panel
1 q " ri ., i q t1 fi, !gill s . 4zpr�t flag¢ fi "F r above service of feeder. fee, 2
„ r ,t I ts� ".� I r W ,, rill!' >� , a ' e.} , 1 .' i I1,, , M i ' 1 4n . 'Mid'MI5fr it � } 8:iik' i u ' 6.65 .,
lie ' .t .1 a a l aeraa i. � .cac circuit
Business name: 13. Fee for branch circuits
—. -- without service of feeder fee, l 46.85 „ 2
Contact name: firstbranch circuit �
.-- Each edd circuit -1 a 071.! _
6.65 ' 2
Addrehs: ._ Miscellaneous (service or feeder not Included)
City /State/Z1P: Each manufactured or modular 90.90 2
.— dwelling; service and /or feeder -
Phone: ( ) TFax:: ( )^ -- Reconnect only 66.85 2:
_ Pump ar imgationcircic 53,40 2
� 53;40 2
E-mail: y�yy , C t ( 5 t o outline It hrtn
"V , ," d fr 1 T i IA;, Trt {'. . , vim 4)l�c t)�'tii, , i ;�' t Y� ring( 'A 1 , g 6 .
i1 qj �, 1;1 r j ' 4, Ii I Signal circuit(e) or ltmtted-
Business "Hartle: 6�'�1 r` p riergy:panel, ult5fatinn, or 2
I ext Describe: 2
Address: ,q ��— O[X�f —.: _
( Each additional inspection over allowable In any of the above
City /State/Z1P: 1,C (,_,py-^( a ^� Per inspection 62.50 _
Phone: (5'a' ) .552- Fax - (5 n') (p'�t Z..79 — htviceztlgunon (} hr min) 62.50
Industrial plant per• hour 73.75
CCBLic.: [J Elcctr Su v .Lic.: � " �� " ] ��
121 � �' r • —. (!'i 91' m; r'� r 3ipr S ' " ! "a9` ( ti t '4 .
Subtotal: t o
Suprv, Electrician n signature required: _ u o a ��
,°, _ .. or ,, K i Plan rcviewt(25 %. Of permit tee).
Print name:
T - J ear t - State St ircttnrt a (rl2% of pertrxt fee): f 1I3 .3)
Authoriz,ed signature: — .,
TOTAL PERMIT FEE; 2
This permit applicatiuu expires' if a permit is not obtotoca within is (21 _
Print name; �I !Date: days after It has been. accepted us complete. 1 I W
C Number of inspections allowed per pernut.
Td WdSZ : 20 (N0? 6Z •uBf � S f Z6ZZb9S(aS : 'ON Xlzld 3161321D J3NJb9 : WOdd
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