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Permit CITY OF TIGARD ELECTRICAL PERMIT II , ` : 2 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00353 T 1G A RD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/14/2010 Parcel: 1 S136DB00201 Jurisdiction: Tigard Site address: 11577 SW PACIFIC HWY Subdivision: Lot: 0 Project: Good Feet Project Description: (5) branch circuits for track lighting Owner: FEES FRED MEYER STORES, INC Quantity Description Date Amount BY NICKEL & COMPANY LLC, STORE #375, PO BOX 35547 5 crt Branch Circuits 07/14/2010 $85.86 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 07/14/2010 $10.30 Electrical Contractor: CHRISTENSON ELECTRIC INC 111 SW COLUMBIA ST, STE 480 PORTLAND, OR 97201 PHONE: 503 - 419 -3300 FAX: 503 -419 -3695 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. / Issued By: Permittee Signature: ©N �����6/ v OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 603.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job slte until completion of the project Approved plans are required on the job site at the time of each inspection. JUL -12 -2010 MON 09:59 AM CHRISTENSON ELECTRIC, INC FAX NO. 95034193695 P. 01/02 Electrical Permit Application ; -) --.4 :; - -,'' , a FOR OFFICE liSE ONLY , - Race City of Tigard lea /B / / y`/n z 4tV Permit Ne.igt aO /0 - if Q 3$ 3 11 ,-- • 13125 SW Hall Blvd., Tigard, OR 97223 1 3 2010 Plan Rcvi 1 Phone; 503,639.4171 Fax: 503,598.1960 JUL put„/By: Other Permit; 'r 1 t.i A t t t) Inspection Line: 503.639.4175 Date Ready/By: 1 � r ® ec Page 2 for ia Internet: www.tigard or.gov � '0( •" '' .. - , Notified/Method: 7f ' , Supplemental tnfarmadon �r. T, I''OF'WO -.. .:2'v- 1.i.: _PEA j 1 IUW i ;•i .• ❑ New constriction @„ ddition/alterfition/replacement Please check nil that apply (submit a, sets of plans whtems chocked below): ❑ Service or feeder 400 nmps or more ❑ Building over three stories. ❑ Demolition -❑ Other: where the available fault current ❑ Marinas and boatyards. ' CATEGORY , OF CONSTRIIC1'1ON' • . • : • exceeds 10,000 amps at 150 volts or ❑ Floating buildings, 0 less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2 family dwelling ' dmmcrcial/industrial ❑ Acccssory building amps for all atherinstnllations. buildings, ❑ Multi - family ❑ ster builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Eanergency system, larger separately derived system. JOB: SITE . INF OfRMATION AND . LOC.A'f;iON, ❑ Addition of now motor load of ❑ "A" "E" "1 -2" "1.3 ". 'I Job site • address: i^ �,/ 1 � , �� �u 100HP or mote, occupancy. Job ftA. ` ,L L ,� , l � t •(. l' n ` ❑ Recreational vehicle parks. //7 ���''' ❑ Six or more res units. t City /State /ZIP: -- \ — \ . 0 f,ly(/r 1 (,h ,� C .77)_-_, ❑ Health-care facilities. ❑ Supply voltage inr more than ❑ Hazardous locations. 600 volts nominal. ' ` n Service or feeder 600 amps or Suite/bldg. /apt, no.: Project name: C �t ?lC\ .A.74.).2(7-.; more. , , . 1 . °SCH . Cross street/directions to job s .. -y L � — ,,71 ttwerintion 1 Qty. 1 Fes 1 'rota[ i - New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no., 1,000 aq. R. or less 168.54 4 En. add'1 500 sq. R. or portion 33,92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DIisCRI TION OF WORK (with above sq.11) -- 1 I Limited energy, multi fatuity 75.00 2 '-tl' d:.- ,(.,? -1'1 n L. residential (with above sq. ft.) Services or feeders installati0a and /or relocation . 200 amps or less 100.70 2 .' ❑ PROPERTY OWNER'' •❑ 1'IGN;4NT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200,34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /er City /State /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 59,36 t 201 amps to 400 amps 125,08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 500 amps 166,54 2 Branch circuits — new, altera1iot1. or extension, per panel Owner signature: _ Date: A. Fee for branch circuits with 0 AJJ LICANT' . , ... ', . . • • I ❑ CON each TACT PERSON above hr an ra c or feeder fee, 7,42 2 clt circuit , 1 k ll. fee f ur branch circuits without Business name: !�(IV1',� �'N1 y1 �. 'VI (�LV 1 tt! r - service ( 1 l i s6 2 56,18 - 1 Contact name: bra circuit —" -- - - Each add'! branch circuit �T 7,42 ` '.4 -1 1 t7 2 Address: Miscellaneous (service or feeder notincludcd) Each manufucturcd or modular 67114 City /State /ZIP: _ dwelling, service and/or feeder _ Phone: ( ) [ - Pax:: ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67,84 2 CONTRACTOR ' Signal circuit(s) or limited -energy • r r an . ne►, �tl 2 tcration, or extension. Paget Business name (, � J A r ' ' t_, ' ' O \ ` l � Each additional inspection over allowable in any nt - the abov AddreSS: ,l, V�.1 C, p( . Lu...6 4. i , , , - -1y 1 , r ' �- -t• . k l Additional inspection (I hr min) 66.25/ 11r l 7 _ � _l•� i_.l . <. � 1. -\ � � Investigation (1 hr min) 66,25/ lir City /State/ZIP: ' 1 \ l: ' } Q. p ( ) _ _. Indu s trial Ian[ 1 hr min 78.18/ hr Mont : ( + ` • �i , t (_ . L .., "� inspections for which no fee 'is 90.00/ hr ( �7,� . I . v 'I 1 specilieotly listed - (%p hr min) 6/ CCB Lie.: • 41.-- � � � Electrical Lice _. t t prv. Lic. �� � F',LGCI'ItICAY PERMIT FEES r ° S 1 1 1 3 1 1 , Electrician signature, required: (MU" # _ (25% Subtotal: ,7 Plan review (25 /a of permit fcc): �� ^ — Date: �� �„ j State surcharge (12% of permit tee }: 1 Print name: V -. i Lam'- "1 ,..- TOTAL PERMIT FEE, 1( kbo Authorized signature; ` � This permit application expirex i[ a Perri[ it net obtained within 18 -. days after it has been accepted It complete. Print name: ,. _ -W Date: - -_ —„ • • Number of iuspecliun. allowed per permit 2� /Ye 7 1lrluiI I nylPcrru ii \I t,C- PennilApp.dcx nom) .. Oar] G 15T(11/051CO�V1VFf.1 / y/� / 6,---5. J I�( t om — - •/ 6'