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Permit CITY OF TIGARD ELECTRICAL PERMIT 111 q COMMUNITY DEVELOPMENT Permit #: ELC2010 -00715 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2010 Parcel: 2S102DB01000 Jurisdiction: Tigard Site address: 9400 SW HILL ST Project: LOPEZ Subdivision: Lot: 0 Project Description: Panel replacement. Contractor: OAKLEY ELECTRIC INC Owner: LOPEZ, ANDRE J & JANICE R 12042 SE SUNNYSIDE RD STE 500 9400 SW HILL ST CLACKAMAS, OR 97015 TIGARD, OR 97223 PHONE: 503 - 855 -4712 PHONE: FAX: 503 - 855 -4723 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 12/28/2010 $100.70 Specifics: amps or less 1 ea 12% State Surcharge - 12/28/2010 $12.08 Type of Use: SF Electrical 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 _9 001 -0090. You may ob. - . • • • of s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ! — � Permittee Signature: Y 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 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. Elec Perlmlit An FOR OFFICE E'SI. ONLY City of Tigard csotAcossIc) ' Received 0 • Phone: 503.639.4171 Fax: 5 i 13125 SW Hall Blvd., Tigard. `t2 2 '� Date/B Review : �� Permit No.: — , Id - , • \0 ® •ter 71S ; . P' :.966 q ll o- Plan Review • T I G A R L7 Inspection Line: 503.639.4175 o'C P �O D't : Other Permit: Internet: www.tigard -or.gov S AA Date etVMe t ho \\�r ON NotifiedJMehod: El See Paget for Internet: EM Supplemental information TYPE OFWar T ‘ DV ❑ New construction �tion /alter4 �; PLAN REVIEW �2 yAddi ``OO`"' v )aeement Please check all that apply (submit 2 sets of plans Warns checked below): ❑ Demolition O Other: ❑ Service or feeder 400 amps or more where the available fault current ❑ Building over b boatyards. stories. CATEGORY OF CONSTRUCTION exceeds 10,000 ❑ Mums and boatyards. am :4 1 - and 2 - family dwelling 0 Commercial/industrial amps at ISO voles w El Floating buildings. ❑ Accessory b snips for all other installations. buildings. ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA er JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system, Job no.: �/ ID Addition of new motor load of ❑ "A", `g x •1.2 ", "I -3", Job site address: y1 ,/00 SG /7 / i j/ S f-- IOOHP or more. occupancy. City/State/ZIP: ❑Six or more residential units_ 0/Recreational vehicle perks. T ' ur ° ' ey2 0 Health -care facilities. 0 Supply voltage for snore than Suite/bldg./apt no.: Project name: ❑Haardous locations. 600 volts namiaal. ❑ L ,'A Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Dam • lion 117/111NOVIIIIIIMIETIMIN10 New residential single- or multi- family dwelling unit Subdivision: Includes attached garage. Lot no.: 1,000 sq. ft. or less 1111 168.54 _ ILI Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 11111 33.92 IM DESCRIPTION OF WORK Limited e residential III 75 with above • . R. � © Limited energy, multi - family residential with above .. ft. III 75.00 � © 2 00 amps or less RA 100 Services or feeders installation, alteration, and/or relocation IIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIIIIIIIII ❑ PROPERTY OWNER 100.70 /00 Z.- Q ❑TENANT 201 amps to 400 amps 11111 133.56 — 401 amps to 600 amps 1111 200.34 = Address: 601 amps to 1,000 amps MI 301.04 Over 1,000 amps or volts - 552.26 II Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less MO 5936 — 201 amps to 400 amps Owner installation: This installation is being made on property that I own which is not 125.08 _ intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 2 ■� 168.54 �„ Owner signature: Branch circuits - new alteration, or extension , er , • net Date: A. Fee for branch circuits with ❑ APPLICANT =j CONTACT PERSON above service or feeder fee, Business name: each branch circuit 7.42 - � B, Fee for branch circuits WilhO u Contact name: branch circuit feeder fee. firs brach iit Address: Each Each add'I branch circuit I -i l 7.42 _ City/St ress: /Zip: Miscellaneous service or feeder not facts, . Each manufactured or modular III n • service and/or feeder 67 P MI hone: ( ) Reconnect Fax: : ( nect only 11.. 67.84 E - mail: Pump or irrigation circle - 67.84 �© CONTRACTOR Sign or outline lighting � 67.84 © Business name: I Signal circuits) or limited - energy ■ G,�t, �`Y'c i•1/4 �. .• el. alteration, or extension. ea Address: 0 Each additional ins ,action over allowable in an • of the above 4,.1 SE S. ,. • rjc U - • • ■ S �• � ��L, Additional inspection (! hr min) 66,25 / hr _■ Investigation (I hr rain) 1111 66.25/hr �i Phone: ( � � )� t( n l Fnx: ( _ , Industrial plant (1 hr min) 1111 78.18/ hr III �:� ) S 5 I / %) .3 Inspections for which no fee is ■ Electrical Lie.: //)--c..., s• ificall listed ''A hr min) 90.00/ hr • L Suprv. Lic.: 5/ _S ELECTRICAL PERMIT FEES. Suprv. Electrici2. :tu e, required: — _- 7 f " [ 0 ( I 7 Subtotal: • /00, �• Plan review (25% fee): Date: Site surcharge ( % ofpermit fee): Inffarin Authorized signature: �,— TOTAL PERMIT FEE: '• Print name: This permit application expires if a permit is not obtained within 180 J��, i r/ Dote: days after it has been accepted as complete. ( • Number of inspections allowed per permit, S i i - 11_ 6' d L60609L909 oupe 3 i epieo dZ0 :60 01, 9Z tea