Permit o CITY OF TIGARD ELECTRICAL PERMIT
.111 ss •• COMMUNITY DEVELOPMENT Permit #: ELC2010 00583
T [GAR 1) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 2S102AA01400
Jurisdiction: Tigard
Site address: 8925 SW CENTER ST
Subdivision: Lot: 0
Project: Luke -Dorf Inc
Project Description: Electrical for building B remodel.
Owner: FEES
LUKE -DORF INC Quantity Description Date Amount
10313 SW 69TH AVE
TIGARD, OR 97223 1 ea Services or Feeders - 201 to 10/21/2010 $133.56
400 amps
PHONE: 503- 726 -3700 45 crt Branch Circuits w /Purchase 10/21/2010 $333.90
Service or Feeder
1 ea 12% State Surcharge - 10/21/2010 $56.10
Contractor: Electrical
SUNLIGHT ELECTRIC INC
2800 NE 65TH AVE SUITE B
VANCOUVER, WA 98661
PHONE: 360 - 772 -3877
FAX: 360 -694 -9728
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $523.56
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 0 952- 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. s.
Issued By � _ Permittee Signature:
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.
!tl 11 Electrical Permit Application � roll o r r l< i s 1 s i: c, • 1.1
Ph City of Tigard 0 DatetB : 10 i Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 OC, \ � v
Phone: 503.639.4171 Face 503.598.1960 5 ►' Other Permit: S /
1 c , I c i , Inspection Line: 503.639.4175 Qn 1\ , : ® Page see Pa 2 for .
Internet wvAv tigard-or.gov G` .r . ' , , ■ souute teatal Information
' { 3 } 1 r J - Z 1 Tr N ,- . i �tZ! Print name: •
.
a .ut r, , -
. . ill !,. , . 4 :.'l:xC;QI - tom t t sl C_ , :45 i' - - 3 � _ - x - . •
.❑ New construction • ddition /alteration/replacement
El Demolition ❑Other Ytt .��. -. r f ; , .,, __t' t: ' , '} 7
a } �„ . _ Please check eft that apply (submit 2 sets of .-
f Lr { -t ti _., . v nn � j plans Sodding ve checked st below):
nf.... S..,., .,. _,;. �_ �.,.c.. ? --, . �• r, ....r a... ..w:...a . k �� ..n r,,. L .,,J�, i4 ❑ ^ xrvice or feeder 400 amps or mote ❑ Sodding over three stones.
❑ 1 - and 2 family dwelling Commercial /industrial ❑ Accessory building where the available fault current ❑ Marinas and boatyards.
exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
❑ Multifamily ❑ Master builder ❑ Other less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
,• , r f n - E a 1:5 r'� 4, "* amps for all other installations. buildings.
..e _:: aT -' .. ...... _ ..Y . .' a. C ;u.. ,,Ili - C]Fite
Job no.: Job site address 1C A r r _ ❑ Emergency sys tem. ❑ large separately of 75 K VA or
t I ' g. separately derived system.
�
'�� Cdr `
City/State/ZIP: ❑Addition of new motor bad of ❑ "A" E 1 2^ "I -3
_� -. „ , l/ ` I OOHP or more. occupancy.
AMA A I _ Elwin. H
❑ x or more residential nits. ❑ Recreational vefirt .
SuSuite/bldg./apt Suite/bldg./apt no : Project name: ❑ Health -core facilities. s. ❑ Supply voltage more than
for more than
Cross street/direct' : , t. site: / - -' , ❑ Hazardous locations 600 volts nominal.
❑ Service or reed. 600 amps or more.
ra .a
Subdivision: Lot no.: New residential single- or multi - family dwelling unit.
Includes attached garage.
Tax map /per 1,000 sq. ft. orless 145.15 4
r , M 4 „ ' . „ ` . - '” Ea add'I 500 sq. ft or portion 33.40
�: . < <� k _ ? 1
d -.._ Limited energy, residential
/e I / 75.00 2
0917 i.- �� 1.+ r octal at. 0I ovoid; i -1; e4 (wish above sq. R.)
Limned energy, multi - family 75.00 2
residential (with above sq. ft.)
1 ` : fI { i H} .� + v rr a ,. Services ar feeders installation, alteration, and/or relocation
.. ...: _..: _: . . . , _:, , ,t, ,.._
,- :,,,,,,L4- a,c * .rw� a .,_ 200 amps or less 80.30
Name: k D0 0 • 201 amps to 400 amps 1 12✓S0E /2- 2 . i . s — r e
Address: 401 amps to 600 amps 160.8e 2
601 amps to 1,000 amps 240.60 2
City/ State/ZIP: Over 1 ,000 amps or volts 1 454.65 2
Phone: ( • ) Fax: ( ) Temporary services or feeders installation, alteration, and/or
relocation
Owner installation: This installation is being made on property that I own which is not 200 amps or less l 66.85 I 1 -
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 20I amps to 400 amps I 10030 I 2
Owner signature: Date: 401 amps to 599 amps 133.75 l 2
.; ' a ` r , , .v' Branch circuits - new, alteration, or extension, p panel
_ ._ .:.. _ A. Fee for branch circuits with
Business name: Lkhe Poi. above service or feeder fee, 7/42 1 3319 2
each branch circuit
Contact name: B. Fee fbr branch circuits
without service or feeder fey
Address: first branch circuit 46.85 2
Each add'1 branch circuit 6.65 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Each manuthctined or modular 90.90 2
dwelling, service and/or feeder
E-mail:
Reconnect only 66.85 2
4 a y , . N a o- 5 '+'g u - Pump or irrigation circle
53
_._._.. ,..._ � ::_t•:.r _. �u.a.�4�_ -is �`,atr • _.. P gm� .40 2
Business name: 5u N 1 i g f e G41� % G y c, Sign or outline lighting 53.40 2
n c SA energy p a ne l, al cr t limited- o or
Address: L �� /(/ J � B crurgy panel, alteration, or
p Q extension. Describe: Page 2 2
City /State/ZIP: Vm hGe u V B WA . . eS e 6 o I
i �t� s/ o - / Each additional inspection over allowable in any of the above
i
Phone: O Fax: tAQ) CV! - 9 72B Per inspection 62.50
CCB Lic.: f 713''19 I Electrical Lic.: C 2 3 O Suprv. Lic.: 1 7 r 3 S Investigation per hour (I hr min) 62.50
/ Industrial plant per hour 73.75
Suprv. Electrician signature, required: /,4 },� Ol i 1 3 x,11 1, : kTe_: _. _ ,.. j ' -E '' , -_
al
Print name: ri ,52 1- - � e/1 Date: 1 rj /Z 4 Plan review (25% ° of pen nit Subtot feej: : Sy, 9i 4(07,`l4,
State s u r c h a r g e %of SS ‘ - I J
Authorized signature: Ss R G N£i C C 14s A R tte; 'Cif; TOTAL PERMIT FEE: $57 ( /
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