Permit CITY OF TIGARD ELECTRICAL PERMIT
1 1 1 : COMMUNITY DEVELOPMENT Permit #: ELC2010 -00560
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/12/2010
Parcel: 1 S 134AA02100
Jurisdiction: Tigard
Site address: 10340 SW NIMBUS AVE NB
Subdivision: Lot: 0
Project: MCKESSON CORP
Project Description: (1) branch circuit for security system.
Owner. FEES
ROBINSON, CONSTANCE A & Quantity Description Date Amount
ROBINSON, LYNN ET AL, BY KG INVESTMENT
MGMT, 10240 SW NIMBUS AVE #L3 1 crt Branch Circuits 10/12/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/12/2010 $6.74
Electrical
Contractor:
ALL AMERICAN ELECTRICAL CONTRACTORS
PO BOX 1426
GRESHAM, OR 97030
PHONE: 503 -657 -4351
FAX: 503 -496 -3995
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 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: �[ L/ � Permittee Signature: d" n���'f�` 7/G' "
OWNER INSTALLATION ONLY
The installation is being made on property 1 own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
CaII 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.
Electrical Permit Applicat " C N D
City of Tigard Received / /2 id - Permit Nn.: &LC�O /0 - 0054 0
T 2010 Datc/Ay:
13125 SW Hall Blvd„ 'Tigard, OR 972. 11 i C 1 Plan Review ether Permit ��2 20 / O OOZ�
Phone: 503.639 -4171 Fax: 503,598 -1960 13atn/Br: _ _
Inspection CITY TIGARD I Datn Ready/By: luris/ Si. ® Pant 2 for
I i .: , r u tion Line: 5036394175 CI 1 t OF nMS NniIlied'Metlwd; "l lee S information
Internet: www.tigard-or.gov - - " " --
TYPE Oi' wuRlc PLAN REVIEW
- Please check all that apply (submit sets of plans wlitema checked below):
0 New t onstnlction Addition/alteration/replacement 0 S or feeder 400 amps or more ❑ Building n%er that stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ['Floating buildings,
Toss to ground, ur exceeds 14,000 a Commercial -uses agricultural
❑ 1 - and 2- family dwelling )"' Commereiallindustrial ❑ Accessory building amps for all other installations. buildings.
• Multi - family ❑ Master builder 0 Other: ❑ Fire pump. ❑ Installation of75
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND L 0 Addition anew motor load of ❑ "A ". "E ", t 2 ". "1.3
- 100HP or more. occupancy.
ob n0,: Joh site address//03 y0 5 t to Hi 144 to uE ❑ six or more residential units. ❑ Recreational vehicle parks.
❑ l IeelUt - care facilities. 0 Supply vo f or murn Than
0 1 City /StatdZlP: � _ Q 7 Z 0IGwrdous locations. 600 volts nominal.
‘,11.. .. uite/bldg. /apt. no / V oject ram ' 0 Service or feeder 600 mope or mare.
w /C // ` n _ FELT SCHEDOLE
Cross street/dircctl �c
site: � / C E .S� 0 C 't0" r` e' Tai
-
New residential singk- or multi- ramlly dwelling unit.
air vM f�2 6f�EG ,-02/e, i t!d / / /v In cludes a ttached g arm e.
ec�l �
L ot n o - 1,000 s9. ft. or leas 168.54 4
Subdivision: En. add'I Soo sq. IL or onion 33.92 1
'Fax map /parcel no.: _ Limited energy, residential 79 00 2
DESCRIPTION OF WORK (with above sq. fl.) _ -
Limited energy, multi- family 75.00 2
A I r- e--1/ --CIJ� t
s 4Y=' residential (with above sq. ft.)
"� I Services or feeders instaltatlon ; alteration, and/or relocation
/ 200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ 'I FNAN C 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Natne: 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/or
City / State /71P: reloeado°
200 amps or less 59.36 1
Phone: ( ) fax: ( ) 201 amps to 400 amps ri 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, r panel
Owner signature: Date: A. Fee for branch circuits with
0 CONTACT PERSON above service or feeder tee, 7.42 2
❑ APPLICANT each branch circuit
A. Fee for branch circuits withoor
Business name: service or feeder fee, first 2
_ � 56.18 ,�,��
Contact name: branch circuit
Each add'I branch circuit [
1 7.42 , 2
Address: Miscellaneous servke or fe not included) ._
Each manufactured or modular 67.84 2
City /State/ZIP: dwcllintkservice and/or feeder .
Reconnect only 67.84 2
Phone: ( ) FHX:: ( ) Pump ur irrigation circle 67.84 2
E - mail: Sign or outline lighting _ 67,84 2
CONTRACTOR Signal circuit(.) ur limited- energy
� I ,r�� C panel, alteration, or extension. Page 2 2
Business name: �'. f,/� �����t� L,.e.,` /`j �ONc�' uQ-? Each additional inspection over allowable In any (lithe above
Address: Pt yr t _ - / ( Z-6 . Additional inspection (1 hr min) 66.25/ hr
- Investigation (1 hr min) 66,25 / hr
City /State/ZIP: Y.e. 4 4 . 0 - 703 o Industrial plant (1 hr min) • 78.18/ hr
Phone: (6'o3) 657- y35 f Fax: ( 03) ` ( - 39Qs- Inspections ibrwhich no fee is 90,00/ hr
9DCl'ifrcally listed (% hr min) ,
CB Lic,: i s ys qo Electrical Lic.: 2G C Suprv. Lic.: y7 3 ELEt;TRICAI. PERMIT FEES
/ r Subtotal; 5 G a l b
Suptw. Electrician si tore fe�u cr d: . � A . ,. ` .4.. .....-1.:... 717-071A1 Plan review (25% of perm
ermit fee): �`
Print name: d
w D State surcha (129/e of p enult fee): ( y t/ /
„Aoki . d 9 _ - ' TOTAL PERMIT FEE: Q , R Z.
Authorized signature: / .
' 0 This permit application expires If a permit b not obtained within 180
day/latter it has been accepted es complete.
Print name: G ,,, e1 r , (r d D ate: /0 ' o • Number of inspections allowed per permit,
1. 111uiWinglPermibtELC- PenohApp.doc 07rotn0 440.46157(11ro5/C0MMW11t
zo /6 390 A/e et /L/ co Ai XVd 9T ZZ OTOa /6Z /T0