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Permit CITY OF TIGARD ELECTRICAL PERMIT �r V s f;. COMMUNITY DEVELOPMENT Permit #: ELC2010 -00396 .:TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/30/2010 Parcel: 2S110DD90571 Jurisdiction: Tigard Site address: 10840 SW MEADOWBROOK DR 57 Subdivision: Lot: 0 Project: Jamison Project Description: Panel change. Owner: FEES JAMISON, CHESTER GROVE & COLETTE Quantity Description Date Amount 6503 SW ORCHID ST PORTLAND, OR 97223 1 ea Services or Feeders - 200 07/30/2010 $100.70 amps or less PHONE: 1 ea 12% State Surcharge - 07/30/2010 $12.08 Electrical Contractor: ROSS ELECTRIC INC 2870 SE 75TH AVE #203 HILLSBORO, OR 97123 PHONE: 503 - 642 -2800 FAX: 503- 642 -5815 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 ma obtain a copy of= r direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ! _ f Permittee Signature: •oao. 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. 07/28/2010 18:33 5036425815 ROSS ELECTRIC INC PAGE 02/02 CEIVE Electrical Permit Application ! JtR ill h, r > ,r • ()NIT C of Tigard JUL. 2 9 ]reserved Daio (c) Permit No.: a 13125 $W Nall Blvd., Tigard, OR 97223 Pte r'? 4 ;; , Phone: 503.639.4172 . Fax: 503.598. MY OF TIGAR D Date& : Other Permit: T , ( „$ .1 ', 1) Inspection Line: 503 "639 "4175 BUILDING DIVISION Date Ready/By: ,aidr M Sec Page 2 kr Internet. www "tigard- or,gov Notifsed/Method: ! su [-.t -I 4 " Pi>temantal Intbrmodon i, ) eY 1ie' .n .0 0 fd6 f - i d ! 9 t ., a ' ,, / / z t:;°,i'4,..1..n. " \ r,. ,'.,.. nJ •.: . ..ji I ;.... .,r (. [ ,,r /..,;.:,;,,/,', 1 ., r/, r... . .. El New construction 51 Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wfitems oheeke belo 0 service or fheder 400 am ps or more C3 Building over truce atoriw. ❑ Demolition ❑Other: where the available lb ult current q Marinas end'boatyarda. ? �' ' � . . s k .9 ; �f a ;. , t , r . - r n exceeds 1 0,000 amps at 190 volts or ❑ Float building g t . a , r . ,....K. ar ., .y.f � ,.,.:., ...- . � �..,.<:, ,. .c. �,,. ., , . :,, ., ,:. . ` -,, .., :. ,,. . ,a:; less to ground, or 14.000 l] Commercial -use filf dwelling agricultural l- and 2-family g ❑ ComtnereiaVindustrial ❑Accessory building amps for all other installations. buildings, ❑ Multi- family 0 Master builder ❑ Other 0 Fire pump ❑ Installation of 75 KVA or ! . ` - t i , .. am •r z 4 k 4 . , v r - 7 7 � 0 Emergency system. larger separately derived s d . . r1 i n ! d % n..v a I-1 Q y$flR1 . 1' . ,..w.......rr,: ' � ,. ` ,1EI h 5 ,< DAddition of now motor load of 1 Job no.; Job site address:l O S �t b r k Q . 1001•11 aectt (] Six or more residential units. D lteoronal vehicle parks. City /State /ZIP: r () 4e,.. -7 ., r Health ra O Supply l f, voltage R re mo than H ar Suite/bldg. /apt "no. L; 3 )t_t,.! 1Z Sernce feeder COO maps or mote �/ ) >`aL a `! Cross strcet/dirvctions t u t Site: id I 1. . . t !S 1.4� i IC Q _,• brt,ak of. onE� 'rota] t..* New residential single- or multi- family dwelling unit. Includes attached garage, Subdivision: Lot no.: G 1,000 sq. ft. or less 168.54 4 Ea. add9 500 sq. ft. or portion 33.92 1 Tax map/parcel no f i= e -. mac", D e a! t l.r s. . t � r- P ^ L io • t z r 51 a / residential 67.84 2 Limited energy, ;I _ (with shov Limited energy, multi - family y residentialn above sq. R.) 67.84 2 Services or feeders iastallatio , alteration and/or relocation I yIy'' 200 amps or leas • MI 100.70 r . g ni L l4i,4 ♦. , / S J�... ;, t 1 } I ts . 201 amps 10400 amps : »,,. .i ,... .r,.,I.. .. ,,,�. »' , ,., , ,.,rl ,w ��_ -f� .., _,. ., ,." 133.56 Name: Chet. �CL 1(h s S W. 401 amps to 600 amps 200,34 1 601 amps to 1,000 amps 301.04 Address: o a - W OR.c . 1 Over 1,000 amps or volts 552.26 City/State/ZIP: ?01-41 w,1 0A Temporary services or feeders installation, alteration, and/or relocation . Phone: (( ) .7 -,_CA 3%1 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 Owner Signature: Date: french circuits— new, alteration, or extension ! er . anel A Fee for branch circuits fee, cuits Eli 7 IJ 7 "' ` / ' . t , . I l ., 1 {' / r f , t � 1 1 ( 7.42 sho serV = or feeder iSC.HS.+v1l Y -. � "t ..u vn ,I:. ... . s. . i . .n .. ..1 o- . e [ r. �1 " .. /... .n. 1, ,. ... each branch circuit Business name. B. Fee for branch circuits without service or Ibeder fee, Contact name' first branch circuit 5618 2 Address: Each add'I breach circuit 7.42 2 Miscellaneous (service or feeder not include. City/State/ZIP: Each menufitetrred or modular 67.84 11111111 Phone ( ) Fax ( ) dwelli :, service and/or feeder Email ?u Reconnect r in1getion eiirclle 1 ,, [!nr x k r ! i ; r r J ." ..;::1 ..... ...:.:, Sign or outline lighting 111.1 67 111111.© Business name: Ross Electric, Inc Signal eir«a t s) or lhnitcd energy panel, alteration, or Address: 2870 SE 75 Ave, # 203 extension. Describe: Page 2 2 City/State/ZIP: kllllsboro, Or 97123 Each additional ins ' ection over allowable In ; , of the above Per inspection 11 66.25 11.1111 Phone: (503) 642 -2800 Fax: (503) 642 -5815 Investigation per hour (1 hr min) 66.25 CCB Lic.: 157891 Electrical Lie.: 34 -436C Suprv. Lk: 42328 Industrial plant .er hour 78,18 ,� /y� )~katrician signature, required: Suprv. Subtotal: ,1117/MMII Print name: Stephen Ross Date: 2/8/2010 Plan review (25% of permit foe): State surcharge (12% of permit fee): i e Authorized signature: TOTAL PERMIT FEE : -75, Print name: Date: This permit application expires if a permit is not obtained —75, itbin 180 Bays OUT It has been accepted es complete. • Number of inspections allowed per panne. 1 1Bpildin Tarmiteter_C•PermhApp. 10/01/09 44O- 415I5r(II,o,COMWell di 1/1-j M Ililt/