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Permit i ,+ CITY OF - �IGAR® ELECTRICAL PERMIT '' COMMUNITY DEVELOPMENT Permit #: ELC2010 00330 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/01/2010 - 1GARD Parcel: 2S104AD04500 Jurisdiction: TIG Site address: 12 SW WALNUT ST Subdivision: Lot: Project: TUALATIN VALLEY FIRE & RESCUE Project Description: Owner: FEES TUALATIN VALLEY FIRE & RESCUE Quantity Description Date Amount 20665 SW BLANTON ST ALOHA, OR 97007 1 crt Branch Circuits 07/01/2010 $56.18 wo /Purchase Service or PHONE: 503 - 649 -8577 Feeder 1 ea 12% State Surcharge - 07/01/2010 $6.74 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 $62.92 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 OA -95 - 01 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Y Issued By: Z(l 'E Permittee Signature: 8 A /7/o /)G / e(9-7 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 503.639.4176 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. T AR B U I LDERS Fax 503:324 0973 Jun 30 2010 02:'30.m P002 003 EleCtl'1CiC� Pe1'II11t A �IC`c�Tr$091 � d . �¢ � " ;.; �,, R�� 1 �„it?� , �.' , �,;. �.� :�� " -•� ", Received p 0 City O�x�gard JUN 3 0 2313 7 , ee �, 'perm/ / '4o 2o —D p �ZC �, ��' 13125 SW Hall'Flvd., Tigard, OR 97x2 P1an. 7vda: I Line: ax: 50 503.639.4175 Other PerrnrtN� /Q, Q 3.5981960 Datel3y . �/ T1(A I sp .4175 UMT " O TI F GARD Date e1 : „ . S e BUILDING DIVISION ; � :: nt,�net: ww�i:tigard- or.gov �� ��I Q T .1: ., .... : rsu, i , ..{,. " �5' s ,r, 1t+�"','Le' s y!.''' , {s s y ' ; ..��� �'y,y{ale f � "?1.;in'r1?'S' !i`E� j, r ,}: r 'r r�} �;"p' k.: t, / n�.> , .,t. l.,.d i, t d BE. , , } 1 { 1!i If t f t'ii q' . . ro I _ i_1 I 'l�El�'1, y ` O 1 4�ryl be� , � l � , � ^ �(t 5� � ilr 1 G �. � EIi�Y �� ,.,i. °�' 2 �3 f _ r• , . v - � . `� z� �,.. � rua � t r te! > � :� �„ � �r>l� t.. W � � �� , w ' „ please check ail that pty(subatiC?`sets of plans w /items checked below); Q IVew cOns[ntctrOtl :dditi0n /alteration /ieplaCernent ❑' Service or fe 00 amps or more 0 Building over three stories. ❑ Demolition Q Other available £a ds u m tiF i " "atS r ; exceeds � 10 000 at 150 tilts or 0 Floating buildings. , A a 1 - 1- a 2 dwelling � - < t 'ommercra)Jl `' s r r r i , , k,: leas to ground, or exceeds 14,000 ❑ Commercial -use agricultural y , • � f•d #�.��� © y � u'ldustri ❑ Accessory building amp fot'all otller,instsllations, buildings. 0 Multi- family ❑Nlastcrblinder 0Other ❑ Fine . pump. ❑ lTtstallationof75KVAor a�• p`Vf4 ..u. � P ' ,� //s�*• I�Is, ;', ❑'Emergency system. larger separately denved,6y6tera 1� �r< "� "i� { r a ��1 ,,IF b �; �`�� ©Ek�iditroa pew motor toad o£ ID "A", 'E , 1_3 i ra occupancy. 100UP or more. Job no Job site address L.. '- ❑ Six or more residential units. ❑ 1Leettational; vehicle twits. its. Ci /State /ZAP: ❑ 1-lealth -care facilities. El Supply voltage formore than ty1� 1 �� l�a7ardous locations. rolls nonxt 600 nal Suite/bldg.apt.. no,: V Project name t ❑ or f ee d er 600 map or m ore L wi :� 13i `r {I,a lt,r ; .1. '71 r ' � i s f i r 1 i' P 151 • ' Cross street directions to job site: 'o rn New residential single- or multi- family dwelling unit - Includes attached garage. Subdivision: - Lot no,: 1,000 5.; It. or less IMI . 168.54 4 Ea. add1 500 sq. ft. or portion 33,92 ..1 /nap /parcel no tt�t .. ;. dr wr . t: K': l l`li' i 'sal • LLimited rgY, residential 67.84 2 Tax �} } , � f a�, t ttii . , i 3� ,4 t� s ., , _ ,'14 ",.� ;-; re dt 1 6:.- ;:° i. t, ;'bk ) '1 •n .x { , . . T'•.r .+..r.• r IE&tE.'':l °'�k V 7' a n Limited erieC gy, multi- £ amity MI 67.84 2' Illa reV` residential fib above i. ft; s or i ederre instaAlataort and/or reloca.tlon 200 amps or less 100:70 2` i' rM 1 l� a � ''i s r �, g . r, �' } ' c 2A1 ann s ta:400 am Ps 133:56 2_ ab. i ra,t lt .`.. . e. aI2 - n a 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000L amps 301.04 a 2 Address: Qver 1,000 amps or volts 552.26 ' 2 W Ted o ary services or feeders installation, alteration, and/or City /StarelZIP. Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is.bein,g made on property that I own which is not 201 arft. to 400'arnps 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, rp r ;, p ancl Owner signature: Date: ----- A. Fee for branch circuits with . t' '` <' 1 p. i fr t t'!i 1.p S4 . s ! :i� -f'i above service or feeder fee : r • r c 111(;i } ll 1 1 1 $., , :a ; �r }, , ,t , z+. , h. - ' r j �s i;i .i. 1l",: .. • ,, ti �l � lA is ` • «,r nti rr 'v k t .. •`•; ', 7.42 '2 . each branch circuit — - te— Business name: 2: Fee for branch circuits + ' without service or feeder fee, 1 56.18 i 3 l 2 ' Contact name; . fi branch circuit Address: Each add.'/ branch circuit 7.42 2 • Misceltaia service or feeder not included City /State/ZIP: - Eaeb manufactured or modular 67.84 2 dwelling, service and/or feeder _ Phone: ( ) Fax: = ( ) Reconnect only 67.84 2 E -mail: Purtrp or irrigation circle _ 67.84 2 wara ,;, 1 P a c°n <. r;` 1� 1 sma rn l I ; w " iRll .: s � � : d ; . , .� ', 1 " � ' ;. ; : S or outlinelighi�ngw 67 :81 Signal etrcuit(s) or limited Business name: Five Star >E;lectrie, Inc- energy panel, alteration, or - extension. D Scriber Page 2 7 Address: PO Box 555 _ City /State/Z1P: Banks, OR 91106 • rack additional ins 4 cation over allowable in an of the above Per ins. oction III 66.25 EMI Phone: ( 503) 324 -0948 Fax: (503) 324 - 0 973 Investigation per hour (lira-an) 66,25 CCB Lic,; 158231 Electrical Lie,: 34 -665C Suprv. Lic.: 4622S Industrial plant ,er llotir 11.11 78,18 r 9iE r P:,7. i vat r tC , , it m Suprv, Electrlciati;signature, required : - Subtotal: ; tt Print name: Royal Stearns Date: Plan review (25% of penult fee): State surcharge (12% of permit fee): , .. 40 AtitlFOri sigctaru2e: TOTAL PERMIT _!E • Print name: Date: nib permit application expires if a permit is not obtawed , pntbia ) days alter it has been accepted as complete. Y/ •" Number of insp =coons allowed per permit. Imuildime mititE.,c- Permitepp•doc two1/09 440- 40,5T(1 /COMMIES