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Permit
1 . 4, - -, . OF TIGARD ® ELECTRICAL PERMIT r » , ' Permit #: ELG2010 00331 COMMUNITY DEVELOPMENT 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date issued: 07/02/2010 11G'AF>;D" g Parcel: 2S113AC00103 Jurisdiction: Tigard Site. address: 7216, SW'DU,RHAM'RD, BLDG# P Subdivision: PACTRUST BUSINESS CENTER Lot 0 • Project : WellPartner Project Description: (1)'200 amp panel and (4) branch circuits Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description' Date Amount 15350 SW SEQUOIA'PKWY4 #300 PORTLAND, OR 97224 1 ea Services or Feeders - 200 07/02/2010 $100.70 amps or less PHONE: 503- 624 -6300 4 crt Branch Circuits w /Purchase 07/02/2010 $29.68 Service or Feeder 1 ea 12% State Surcharge - 07/02/2010 $15.65 Contractor: Electrical MILESTONE ELECTRIC 1281 NE 25TH AVE, STE. T HILLSBORO, OR 97124 P I I O NE : 503- 645 -5323 FAX: -503 -690 -4843 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $146.03 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: !`f� Permittee Signature: ( ?"U G � 0' v 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. Electrical Permit A licatio ° ,4A �Y rxAr �� � -a (f gq , r uw an° ���e'����nh(11L�� +)IPI�I� L`�1,�'til` \I1�� �s �9�odS„q p 3r � � r�rl i w �.. G ` _ +':4e .I d'• ° r , P City of Tigard Received • P,trro .,,,. ^ b ,.,, ; Date/By: 7// 0 +mow. i Ete•20 /U -- O 4 13125 SW Hall Blvd.,'Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598,19CL • 1 2010 Dart/By: Other Permit: [ ,,,,°"'00''',,,'5."4'..0 Li . L' Inspection Line; 503 639;4975 Date ReadyBy: luris See pane 2 for Internet. v✓ww.tigard orgov Notified/Method: ' Supplemental Information CITY OFT - Ina O k� 'l�Y.ti.' 4kti¢. 5 %;) $ r + ,;, .�. vt: r .. .�• w, `:�, "„' , , rtw. �a ^.�•l „ a ci:.::r "$. Y, ;1,k'-:'t,i'.c!.,,',, 1 ,,, t. Y : ` „:i % ",, ; ri , l:r 4040 .,u,0 ; rt 11F 1' " ,. a. 4k', lt'?�2.z`,',�, } ;;o °' , Ci�J4 . `'rid! :'g:'' ?<: "" '.I'T<A1�1Z s, "-�'r a ` .A �y�y7 ., j�� A� 1. yy y J y. �.Q :,:,, L J'a •. �.�.. \ \T,. �t � iA�r • , 7 �'�. .. ,.i Y:.� ... 4, .. ...,.. .. J \ '.F i�, 9 T. ,: y:N� tit: .. , ;' Please check all that apply ( bmit 2 sets plans wht w,, ams checked below ❑ construction � Addition/alteration/replacement � �"�' ) ❑ Service or feeder 400 amps or more ❑ Euilding over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards, r j -,v � r, p a, ` i i. , d °'r P a�0§,}S ^ . l e' ' il ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings. r 1,,q.,0'i' „ , *'r r ka,1 1 QiV .. ' ,' • 7CIrU , , d; +a k c ^ 1 (re. p g g less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling cki Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder © Other: ❑ Fire pump. ❑ Installation of 751 VA or i ,,,,,k ;ay„ Ica ;+. ;,,• : rp" M ,. ❑ Emergoncy system. larger separately derived system. b . 1 t `�` lr� ��'�� S:� "� �';S%.c. a.�G'ic ".�k�r';'�?tt�(� , tR ;' &11, J�•talr`1 ' $•. ,9v t; r a L I � .9). . �. �w .•. , •c., r :,:,: ❑ Addition of new motor bad of ❑ , A <, « , 1 - 2 . . « lob no.: lo - Job site address: 7q (� S(A) O ,,, ' �� six or or more. Receation, c} r'a' \� 'RCA s ©Six or more residential units, ❑ Recreational vehicle parks. City /State /ZIP: 1 \ t a 0 ct r 9 7 ❑ Health -care facilities. ❑ Supply voltage for more than " ❑ Hazardous locations 600 volts nominal. Suite/bldg. /apt no.: P Project name: WO ( ' r+ Sentoe or feeder 600 amps or rmore y�y� 'zl`1_° Z, ii f El i .,@ . T ilF� :$ YW 1 4� M y S\ ` >' " "' , Cross street/directions to job site: 1� 1 F r ,." ".."ar' `' pti °n � Qty..) Fit I row 1 " New residential single- or multi - family dwelling unit. Ineludes attached garage. Subdivision; 1 Lot no.: 1.000 sq. ft. or less 168.54 4 .. Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1 r Limited energy, residential r ; ' ' rr� ' 0*\*O I1 1V x4 '`� , '�i., ' , a ' c ' 0 – (with above,sq. ft.) 67.84 2 ( , ( {„ 4 a' .Limited energy. mulu.family s IA'O ' ' � I AAA '"1 G k+ S residential (with above sq. ft.) 67.84 2 Services or feeders installation,, alteration, and /or relocation 200 amps or less t 100.70 1 00 1 70 2 v". ;y r. i s fib rikor ,' I} l ovoi 1' • t u i p '1 , ,. 201 amps to 400 amps 13356 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 Y 2 Address: Over 1.000 arnps or volts 552.26 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) pax; ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits – new, alteration, or extension, per panel Owncr.signature: Date: A. Fee for branch circuits with p,n ql ,: ? . e . { 3 ° �sza r � tFd + 11' a 1 1 I l ,i ,. f ,.� above service or feeder fee, L-I 7.42 ¢-'1 r 6 t/ 2 each branch circuit Business B. Feb for branch circuits without service or feeder fcc, first 56.18 2 Contact name: branch circuit Each add') branch circuit 7.42 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 Pump or irrigation circle 67.84 2 E Sign or outline lighting 67.84 2 `�:s ,;�� � •.,: :,. " . Sr ,, 1:40., 1 Ii4 T�L1, .. , ,,SI:'`iu, s*40., ; >, > � i.' si circuit(s) or limitcd-energy - - — Business name: Mil ' �,�± � panel, alteration, or extension. Page 2 ep con o 2 c5 Each additional ins tiver allowable in any of the shove Address: `}" K Additional inspection (I hr min) 66,25/ hr City/State /ZIP: H H,� —1 1 e,Ltri•I� O 97 1 ` t( Invtstigation(lhrmin) 66,25/hr Industrial plant (1 hr min) 78.18/ hr Phone: (3) Fax; Ins ections for which no fcc is y� " 3/..3 ) 69 lJ t) t�J p 90,00 /<hr specifically listed (S hr mm) ` S cl CB Lie.: 1pLi go Electrical Lic.: – Cr6C. Suplv..,ic.: 2,y 5 ^. ;•051.00! fI O'f0.A 1 1R, 01 4 . 0 ' ctt� . nature, 9 an signature. ��. g required/ • t� � ��� S /D%/� d Plan ltiwicty (25% of permlt Subtotal: � fcc): ' J Print name: '- (/ E 6.,:',"!11.5 l Gt ate: State surcharge (12% of permit fee): S. EsS C 1 TOTAL. PERMIT FEE: + y G, o Q Authorized signature: This permit n pptication expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. a Number of inspections allowed per pennit. t I: Wildinglpermits ELC- PermitApp.doc 10/01/09 440.461ST(11 /05 /COMAVEB ' d lti9L'91 3!)}3;13 auo)s ;1i WdL 6 oloz lilt