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Permit
• CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2010 -00706 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010 Parcel: 2S112AB00600 Jurisdiction: Tigard Site address: 14101 SW 72ND AVE Project: Westside Moving & Storage Subdivision: Lot: 0 Project Description: (6) branch circuits for lighting upgrade. Contractor: TICE ELECTRIC Owner: TUFFORD, PHYLLIS J TRUSTEE 5405 N. LAGOON AVE. BY VERN TUFFORD PORTLAND, OR 97217 EASTSIDE VAN & STORAGE CO 4836 SE POWELL BLVD PORTLAND, OR 97206 PHONE: 503 - 233 -8801 PHONE: FAX: 503 - 872 -8290 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 12/22/2010 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/22/2010 $11.19 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $104.47 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 -0090. You may obtain a copy of the u4es ordirect questions to OUNC by calling 503.232.1987 or 1.800.332.2344' Issued By: f�.. / / "�.� - 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 the next available inspection date. 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. 1212112010 09:11 Tice Electric TA]()5038728286 P.0021003 • Electrical Permit Application RECEIVED FOR OFFICI? USE ONLY City of Tigard DEC 21 2010 lttcaved M Date/D: 1 - W i t III -, 13125 SW Hall Blvd., Tigard,' OR 97223 Plan Review ' � • Phone: 503.718,2439 Fax: 503.598.19 °t Ins action Li 503.639.4173 lITY OF TIGARD Aare r te • r, jl� i l < BUILDING D NISIO Internet: www.tigard- or.gov ' no aavl �'� ' PaSe1 for /, pp lemeata l Info rmatiotl . T ox ' '.v w ❑ New construction 0 Addition /alteration /replabement Please check all hat ap. : . .mit 1 sets of plans w /items oheoked below): Q Demolition Li Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories. where 11ta available fault current I: Marinas and boatyards, 1 -an 2-family dwelling Co mrc al /ind 0� l e n � to ground g 1o.nd r exceeds s 1 vol 4,00t or 0 Com ma ai a -use a. agricultural - � � -- Icaa to , or excees 10 ❑ Commeroi agricultural E] y g ® ustrial ❑ Accessory building amps for all other installations, buildings. ❑ Multi - family Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or A ❑ Emergency system, larger separately derived system. >� 1, 1rE 01il�ir'TIOr Al I t Caelf l lV 0 Addition of now motor load of ❑ "A" "E" "1 -2" "1 -3" Job no.: 5.4213 Job site address: 14101 SW 72" Avenue 10014? or more. occupancy. CI or more residential units. EI Recreational vehicle perks. City /State/ZIP: Portland, OR 97224 © Health -care facilities. ❑ Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg, /apt. no.: Project name: Westslde Moving & Storage _ ❑ Servloa or feeder 600 amps or more, • job site: lliMe1� Cross street/directions to J Description . I Qty, I Fee. I nisi 1 R New residential single- or multi- family dwelling unit. _ Includes attached garage, Subdivision: I Lot no.: 1,000 sq. ft, or less 168.54 4 Ea. add'/ 500 sq. ft, or portion 33,92 1 Tax map /parcel no,: Limited energy, residential 73.00 2 0 % 0 ..` O WO_ lilt (with above sci, ft,) Limited energy, multi - ,family Lighting upgrade includng removal and installation of strip fixtures and wall residential (with above sq. ft,) 75.00 2 Services or feeders installation alteration, and/or relocation packs 200 amps or less 100,70 2 0 112AI diStg# I 0 1t1 t 201 amps to 400 amps 133.56 2 Name: - 401 amps to 600 amps • 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City /State /ZIP: Temporary services or feeders Installation, alteration, and/or relocatlua Phone: ( ) I pa;t; ( ) 20o amps or less 59.76 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 Hraach circuits— new, alteration, or extension, per panel Owner signature: - Date: A. Fee for branch circuits with U Ao ` "' abice or feeder fcc, ' � ! each ove bran oirouit 7.42 2 Business name: B. Fee for branch circuits wtthour / service or feeder fee, first 56.18 , 2 Contact name: branch circuit Each add'I branch circuit 5- 7.42 9, Ja 2 Address: Miscellaneous (service or feeder not included) Each menufhctured or modular City /State/ZIP; dwellin :. service and/or feeder 67.84 2 Phone: ( ) I Fax: ; ( ) Reconnect only 67.84 • 2 E-mail: - Pump or Irrigation circle 67,84 2 t ., -..... Sign or outline lighting 67.84 2 �.4 _ Signal eirouit(s) or limited- energy Business name: Tice Electric Company panel, alteration, or extension, Page 2 2 Each additional Inspection over allowable in any of the abov Address: 5405 N Lagoon Avenue Additional inspection (I hr min) 66,25/ hr • City/State/ZIP: Portland, OR 97217 Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: (503) 233 - 8801 I Fax: (503) 872 -8290 Inspections for which no fee is 90.00/ hr specifically listed (14 hr min CCB Lie.: 166 Electrical Lic.: 26 -126C Suprv, Lic,: 3651S v ;$, ' T ,1ES Subtotal: , Suprv. Electrician signature, required: �� , J P lan review (25% o permit fee): � --- Print name: Doug Johnson Date: State surcharge (12% of permit fee): //, /9 Authorized signature: TOTAL PERMIT FEE: / �/, v p A . We permit application expires If a permit is not obtained within 180 Print name; Doug Johnson Date: days after it has been accepted as complete. Number of inspections al lowed per permit. t: Bulld ingtpmmlta111LC- PermltA0p.doo 07/01/10 440.4315T(11/01/COM/w[ea