Permit a � ' , CITY OF TIGARD ELECTRICAL PERMIT
1
COMMUNITY DEVELOPMENT Permit #: ELC2009-00299
, Date Issued: 06/19/2009
- [i{; r RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S113AB00800
Jurisdiction: Tigard
Site address: 16135 SW 74TH AVE
Subdivision: FANNO CREEK ACRE TRACTS Lot: 0
Project: NW Ski & Wakesports
Project Description: TI - (10) branch circuits and low voltage for phones & data. Job No. 311490096
Owner: FEES
DUNCAN, JOHN A & JANICE LEE Quantity Description Date Amount
9929 NW UPTON CT
PORTLAND, OR 97229 10 crt Branch Circuits 06/19/2009 $106.70
wo /Purchase Service or
PHONE: Feeder
1 ea Signal circuit or Limited 06/19/2009 $75.00
Energy Panel
Contractor: 1 ea 12% State Surcharge - 06/19/2009 $21.80
IES COMMERCIAL INC Electrical
13970 SW 72ND AVE
PORTLAND, OR 97223
PHONE: 503- 648 -1900
FAX: 503 - 670 -9572
Type of Use: COM
Class of Work: ALT Type of Const: .
Occupancy Grp:
Total $203.50
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: ` _ �� � !. A • 1 i 1 k.' Permittee Signature: Q
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.
Z.
e @6/16/2009 09:43 5036709572 NEW TECH ELECTRIC PAGE 02/03
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Electrical Permit Applicatio'RECEIVED ,. ,
,
, , , oit oimict usu ONIA . . - ,
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'
, City of Tigard 1.4.i,,,, I ( 61 X.,_ Permit No.: gh_e_p.eaF-00?
.,... ti: -.1 " 13125 SW Kali Blvd,. Tgard, evew
igard, OR 97223JUN 1 6 2009 Date/8 !
Plan Ri
: "4 t ' • Other Permit:
. Phone: 502.09.4171 Fax: 503.598.1960
. .. t. Datc/B :
spectio Line: . Date Ready/By: liel See Page 2 for
. ‘
T 1 C.1.A R 1") In n ' 503639A175 CITY OF TIGARD Efflil
. Internet: www.ligard-or.gov
1ILDINGDWISION •otified/Method; ..- Supplemental Information
i 1 i '1''' :"(1 iil ittplot ,',,,q,91niggrp.injigegigiggp mgEtailliDIMPIROMMTMEIMPRESNi,!
0 Ncw construction Addition/alteration/replaccmenl. Please check All that apply (submit seta of plans vilitems checked below);
0 Service or fccdcr 400 amps or more 0 Building over three stories.
0 DemOlition 0 Other: where th e available fault currant 0 Marinas and boatyards.
' VP lirif PlirAirP lir pi:. dile 0 otimittaitge4lioniiill i•8,4qi1;;;w•v:iii!:::; exceeda 10,000 limps at 150 vOlts or 0 nO(IlIng buildingS,
less to ground, or exceeds 14.000 0 Commercial-use agricultural
0 I- and 2-family dwelling .:41 Commercial/industrial 0 Accessary building amps for all other installations. buildings.
El Multi-family El Master builder 0 Other: 0 Flre pump. El Installation of 75 KVA or
,. - :,,wiT 0 Etrnorgcncy system.
figgaltr Mg. Il IR : :.At :, 01 , " t! 4 ;,K.:1010,f."P01 0 Addition of ricvv motor load of lOrgcr ;;Cpnrritcly derived tracm.
Job no.:5\ ri cm cic, Job site address: / 6 / 3 5 5 1 7 9 4 v c 1001TP or more.
0 Six or morc residential units, 0 occupancy.
Recreational \1n1 e pnrks.
City/State/ZIP: T " ' j 0,e-d 0 0., 91 2.-1- C. D Health-care fncillries.
0 Vturtrelenttoentiont. 0 Supply voltage for more than
GOO volts nominal.
SUftibidg./apt. no.; I Project name: Z-s'" c) .-c f. ' '•' e — 0 scrvice OT feeder GOO amps OT more, more, ---. V iil T •
Cross street/directions to job site: O r L ,.... L Description Qty. Fee. l'atol
. . .
LL) ft c()e-e-b_re- New residential single- or uniltl-farnily dwelling Unit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq. ft, or less 145,15 4
Ea. add'I 500 sq. ft. or port ion 33.40 1
Tax map/parcel no.:
Limited energy, residential A- i
Pt I 'l ilidRIRIV j A 'Pr 1 ,gg: gliift.ifi 011011#'.. 1 RiMANWPZIliP.Aiiii'li (with .q- PL) 75.00 2
Limited energy. multi-family
ii e 1 5 , ::--z 4,...., / Lc ti,... . pi ‘4 / 9A.,v t
1 residential (with above gi. et.) 75.00 2
d- Oki 1,.., t-er i ei t co) 44 Services or feeders installation. (Mention. and/or relocation
200 amps Of ICSS 80.30 2
+1 " RAPP"0 1141114 ,4 41 0M i: " "l l' : " 201 nm r° 400 amp i
106.85 2
Name: 4 ac(n c s c .1
' 4, 1;1 1 , ' ,.. :44■3,0,11+ ■.;LrhithLt ,ri.4 MIY, 71, Mi 'tt ti ' ill ' 1,1 '1% 4,6'..1! ,,,b;li ‘t,,,W;' I.E'l i 3{0 1 R'1),,ii^r 10a ' '
401 amps to to 600 amps — 160.60 2
7dirNy■ A - t Le DCA c et ft (5(11 amps i ,000 amps 240.60 2
Address: / C / 7 5 -- m5. 1 ,, 7 17 1L ii- a C Over 1.000 amps or volts 454.65 2
City/State/ZIP: 77, q ,,,c,1 OI ' ,.7 -Z"'-(1 TeMpOrary services or feeders Installation, alteration, and/or
relocation . , .
Phone: ( ) Fax: ( ) 200 amps or less 66.85 — . 1 1
I
Owner installation: This installation is being made on property that town which is not 201 amp, tc, 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670. and 701. 401 amps to 599 amps 133.75 2
Branch vim:nits - new, alteration, or ezttension, pnr_panel
Owner signature; Date: A. Fec for branch circuits Ivith.
.1--
' . • ...g • KA:: i;qi 44!
CI_ NERMINSOIRMIRMIINION VINNI!ilZP,q,MINIPP,„.P.,.;,,,,,k,i1;..;,,,,■,Q above service or feeder fee, 9
---- ,-• each branch circuit
Business name: j_ f" ( d /11 es t c..4 I .. :r - , A C • B. Fee for branch circuits
. without service or fccdcr fcc. /
Contact name: Ce d.6.85 l ' G rc _.
c,, ,-
/ e-, _. t-., C kr K
first branch circuit 2
Address: / 7 , O . 5 i_. - 7 2. A - , - 4 /1`,./ C Bach add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: ? fret -.) a /( 1 '7 2-a-5 Each manufactured or 'nodular
90.90 2
dwelling, service and/Or feeder
Phone: c 5 d ) i; ,9-_/ 1 00 Fax: : (5 3 ) g 76 - 9 5 2-, D
econnect only 66.85 2
.
B-mail: C. • 9 r t
^c..‹.-(1) e..s - Co 7. e'' o /. . Pump or irrigation circle 53.40 2
MINIEVINggititligginAPMION,PirMingiagiPalAMOV:it:;.'';:r, Si °r miriiii° li - 53.40 2
Signal eircuit(s) or limited- CIO
Business name:
energy panel, alteration. or ...7._!:
Address: L'e; 0 5 (d) .7.7,,, ., extension. Describe: 1 ' Page 2 ( - 2
City/State/ZIP: ,....v__., eylurg3ta-e- Each additional inspection over allowable in any of the above
Per inspection 62.50 I
I
Phone: ( c7 / g. .0..K.... ( el c Fax: C't,D3, ( 7O o _ t5 - ( - 7 2.
investigation per hour (1 hr min) 62.50 , 1
./ t..
CCB Lie.: , L.( Electrical Lie.: t% 7 Q... Suprv. Lie.: - 5 ""...S'"..S industrial plant per hour 73,75
— .:
Suprv. Electrician signature, required: Subtotal:
, Plan review (25% orpermit fcc):
Pri • _ nt name: c A Date: ( b 9 0 •
Stale surcharge (I 2% of Fcc): 0 4,4 , sly
Authrid i 44 INI
oze signaiurlr ,willPisn. •
TOTAL PERMIT FEE; 2, 0 3 , 5 0
. AMINO%
;., • , 411111111•Wr'""f .
Date: ../ rt7/0 ?" This acrr Opplienti ex
on pir O
es if sl permfl rs nnt tninerf willAn 180
Print name: 4
days after it has been actepted as complete. .
—
''' Number of inspections allowed per perrni I,
IMItt \ Pcrrcht0.1.C-PerrolrApp,r1oc 05/7,51n6 4(10 5T( 1 I /)5/COMAYM