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Permit
/ //// R f v 6) ,v i se+��'Z2. � Ii CITY OF TIGARD ELECTRICAL PERMIT 2 ' COMMUNITY DEVELOPMENT Permit #: ELC2010 -00530 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/28/2010 Parcel: 2S101 CB00200 Jurisdiction: Tigard Site address: 8200 SW HUNZIKER RD Project: SMITH GERIG WESTERN PROPERTIES Subdivision: Lot: 0 Project Description: (1) temporary service. 1/5/11 reprinted permit to upgrade from (1) 200 amp temporary service to (1) 200 amp service. BT. Contractor: JARMER ELECTRIC INC Owner: SMITH GERIG WESTERN PROPERTIES L 5105 SW 45TH AVE #200 PO BOX 930 PORTLAND, OR 97221 WILSONVILLE, OR 97070 PHONE: 503 - 246 -5381 PHONE: FAX: 503 - 244 -8037 FEES Quantity Description Date Amount 1 ea Temp Services or Feeders - 09/28/2010 $59.36 Specifics: 200 amps or less 1 ea 12% State Surcharge - 09/28/2010 $7.12 Type of Use: COM Electrical Class of Work: ALT 41 Electrical Permit 01/05/2011 $41.34 5 12% State Surcharge - 01/05/2011 $4.96 Type of Const: Electrical 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 . by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 throug • 2- 001 -0090. •u i. - • : - - • • - Lions to OUNC by calling 503.2 1 or .800.332.2344. Issued B� _ • �■•••" Permittee Signature: 'f 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. CITY OF TIGARD ELECTRICAL PERMIT .1111 to COMMUNITY DEVELOPMENT Permit #: ELC2010 -00530 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/28/2010 Parcel: 2S101 CB00200 Jurisdiction: Tigard Site address: 8200 SW HUNZIKER RD Subdivision: Lot: 0 Project: SMITH GERIG WESTERN PROPERTIES Project Description: (1) temporary service. Owner: FEES SMITH GERIG WESTERN PROPERTIES L Quantity Description Date Amount PO BOX 930 WILSONVILLE, OR 97070 1 ea Temp Services or Feeders - 09/28/2010 $59.36 200 amps or less PHONE: 1 ea 12% State Surcharge - 09/28/2010 $7.12 Electrical Contractor: JARMER ELECTRIC INC 5105 SW 45TH AVE #200 PORTLAND, OR 97221 PHONE: 503 - 246 -5381 FAX: 503- 244 -8037 Type of Use: COM • Class of Work: ALT Type of Const: Occupancy Grp: Total $66.48 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 -2- 001 -0100. You m: • • .' . • of th= direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. r Issued ay• ate' Permittee Signature: e e.7.2" 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. Electrical Permit Application rolz of l Icr LIT: ()Nix of Tigard c' Date/B ` © Permit No.: --Lc... i (0---005" 13125 SW Hall Blvd., Tigard, OR 9 \\ Plan Review • 0 Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 O Gj �- Date/B TI( AIZD Inspection Line: 503.639.4175 ,p Date Ready/By: rugs: ® See Page 2 for Internet: www.tigard- or.gov c � ,r(Cj O � Notified/Method: Supplemental Information TYPE OF W010.• �1 z c s v AS I PLAN REVIEW El New construction ❑ Addition/alterat,®acement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. El Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: loop or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qtv. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi - family 75.00 2 GA - I „ w r rR 16 (t) ?Or--) residential (with above sq. ft.) ��' M T`" 1 Services or feeders installation, alteration, and/or relocation O("0 cr ;2...e._ 200 amps or less 100.70 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 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 tY relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) _ Ci /State/Z1P: Each manufactured or modular 67.84 2 tY dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E - mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited-energy Business name: panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City /State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18 / hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (Y2 hr min) CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES Subtotal: ' Suprv. Electrician signature, required: Plan review (25% of permit fee): 1_(I , 3 Print name: Date: State surcharge (12% of permit fee): , ( TOTAL PERMIT FEE:t�'-(L f , 'NO Authorized signature: This permit application expires if a permit is not btained within 180 D ate: days after it has been accepted as complete. Print name: 3 eF F C ►(_{. 1 - o�r • Num o inspections allowed per permit. I: \Building\Permits\ELC- PermitApp.doc 07/01/10 4404615T(11/05/C0M/WEB Electrical Permit Application_ RECEIVED , III Ci ty of Tigard IC EC� ' f�, , ,A= Fames.: — eta 10 - • 3c 13125 SW Hall Blvd., Tigard, OR 97223 k - Phone: 503.639.4171 Pax; 503.598.19 P 2 4 2010 .. ;., Otltw Permit: Inspection Liao; 303.639.4175 Date • , , - Tnta= www.tigard- or.8ov (`ITY OF TIGARD N°tli(ed fethatk o VISION (' •• '. . £ MN;•1ttEViiivV • ❑ New construction tr Addition/alteration/replacement Please cheek ended apply (submit a acts of plans w/ieems Matted below): ❑ Demolition j Other: ❑ Service or feeder 400 amps or mote 0 11uild ee over (hum stories. i wham he available iluelt currant D Ma*Inxa and boatyards. .. _ _ ' • e;?Artl); jtbRX Ott toOsiltectioN • otos a 10,000 amps at 150 volts or D Fleeting buildings. ❑ 1- and 2 dwelling ❑ Commci 1al/indnstrial lam to Ste. or arc 10.000 CI Commercial-use a8ricv�rel ❑A ccessory bu ilding carps for all other ioelailadone buildings, ❑ Multi- family ❑ Meste r builder Mi ; O Pin pump. D bawllation of 75 KVA or ring. Cl Emergency totems, larger separately derived want. i Fi A8l1ii 1s6 ?�'A'1`7dP1 CI Addition anew rooter road of C1 °A`. "E ". "1-r, °(-3". Job no.: / II/ ( 1 Job site address: 2-a 5 (9 - -it t 91- / a r 100,11 or more. o�anoy. O � I D Six or mom residential unite. vehicle peeks, City/State/ZIP: / k. rN I J 6714 4/ ?• - . - 3 O Haatth.cara Wheel. 0 Supply Wails air mere Ikon Hearth= tooatlons rile vets ,>omhtat Suito/bldgJapt no.: a I Projcctnamc; s-0,‘ &ctn.. Lt sk•r/ '. sendae erleader600 mops or mon, P Cross stroet/direcdons to Job site: ')1 a�. ' '• • Avretbraoa I[r7311M1::-',ttttoiIIl• _ ,,� New redden*, single- or multi - campy dwelling unit. - - 3ubdivlsion: , �— o!; � �l` t no.: 1, or h garage. 168.54 — 4 Tax map/parcel no.: d 17 i Limited add" ne0 mited aterS . R (sportive 33.92 1 i34 res 67.84 2 . " DESCRiPPYOIY Ole WOR1E • (wickab 1 a re e) UMW residential (with a n.) b 2 Services or *mitre leutalbttton alteratloo, and/or remade 200 camps ctr lass 100.70 J 2 • . U'� : • _ . .1 F b TENANT. 201 maps to 400 amps 133.56 2 Name: 401 snips to 600 amps 200.34 2 Address: 601 amps to 1.000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 eity/StatelZlp: Temporary service, or deer, tastallatloa, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less J 59.36 , l Owner Installations This installation is being made on property that I own which is not 201 aasrpp to 400 elutes 124.08 2 intended for sale, lease. rant, or exchange, according to ORS 447.449.670, and 701. 401 amps to 599 amps j 168.54 2 Omer atgnetut o: Date: Blench sew alteration, or extension, per mad A. Fero Poe branch amain with O AP1R'f i< atlVT' • • • f • •CI 'comma' PEBsoof above service or feeder fbo. ,soh bannali circuit 7.42 2 Business name $, Poo for branch circuits Contact name: without service or *odor Sm. 56.18 2 fink blanch circuit Address: Bade add" brendt circuit 7.42 2 baseelleneune City /s tale /zIP: (jvIn er feeder not lades _ Boob mamftft or modular 67.84 2 Phone: ( ) l p : ( ) dwelli service endim Roder Ram only 67.84 2 E -mail: Pump cr boon circle 67.84 2 • A 80 or outline I% 67.84 2 • Business users: S�gajyy�(L ELa l 1 N C . ei alma) or limited- —' energy panel, Okays kM. or Address: 51 • ) h , • i ac0 axtmssion. Describe: Page 2 2 Cib/State/7.1P: ' .olt:?tA NO O if- CS _ 1 ibaeh addltlnnul taspaetloa over anowebte is of the above x,603 • 534 I Fax: (503 --S03i Portaa 66.25 Investigation per hour (1 hr aria) 1 66.25 _Cal Lie: (f 9„ f I Electrical Lic.: (S . Lic.:40414,G htdussaislplant per hour 78.18 Supre. Electrician signature, required: ..e.,.-- _ of permit e): sam (25% S Print • �f �AQ1Y1� I Da ce: 9 - —/ 6 Plan review (25 Stow surcharge (12% ofpcnnit era)_ 1. / y Authorized signature: TOTAL PERMIT FEE: ( ( _ 'Mb Print name: I Date: parade epplteatioa,spins U a permit b not obtained whale (s0 daps after • bas taxer accepted as eempleee. Imes 100b09 MO 11jt I IDVOOMAYEB ' Member of iaspoerlmu allowed per permit Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\ Building \Pennits\ELC- PertnitApp.doc 07/01/10