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Permit 7 /09 tA/JZ a. . A, J / , .� CITY 0 IGAR� ELECTRICAL PERMIT ' -1 : ',- COMMUNITY DEVELOPMENT l Permit #: ELC2009 -00261 1312 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/04/2009 T cA Parcel: 1 S135ACO5000 Jurisdiction: Tigard Site address: 10940 SW 95TH AVE Subdivision: PP1993 -040 Lot: 1 Project: Donahue Project Description: New service panel. 7/6/09, adding a feeder. Owner: FEES BRANING, MITCH Quantity Description Date Amount PO BOX 470 BANKS, OR 97106 1 ea Services or Feeders - 200 06/04/2009 $80.30 amps or less PHONE: 1 ea 12% State Surcharge - 06/04/2009 $9.64 Electrical 1 ea Services or Feeders - 200 07/06/2009 $80.30 Contractor: amps or less WILSONVILLE ELECTRIC INC 10 da 12% State Surcharge - 07/06/2009 $9.64 PO BOX 845 Electrical (manual) WILSONVILLE, OR 97070 PHONE: 503 - 638 -5353 FAX: 503 - 638 -8804 ' Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $179.88 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. ATT TION: Oreg n law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0 10 through OAR 95 .01 a ... You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.234 // / C Issued y: / Permittee Signatur�_J dJIliv • 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. CITY OF TIGARD ELECTRICAL PERMIT s COMMUNITY DEVELOPMENT Permit #: ELC2009 -00261 Date Issued: 06/04/2009 T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 6/04/2 CO5000 Jurisdiction: Tigard Site address: 10940 SW 95TH AVE Subdivision: PP1993 -040 Lot: 1 Project: Project Description: New service panel. Owner: FEES BRANING, MITCH Quantity Description Date Amount PO BOX 470 1 ea Services or Feeders - 200 06/04/2009 $80.30 BANKS, OR 97106 amps or less PHONE: 1 ea 12% State Surcharge - 06/04/2009 $9.64 Electrical Contractor: WILSONVILLE ELECTRIC INC PO BOX 845 • WILSONVILLE, OR 97070 PHONE: 503 - 638 -5353 FAX: 503 - 638 -8804 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $89.94 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 throug AR 9 2- 001 -e100. 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: ` `� I Permittee Signature: e� "' ' �4 C�-77 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'N 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. , i J� I S b C it :. ` av,:. "-zlr >. u F,R,- , t .;� . R , 9;t i ,}�t„ u,r. $€ i t, , ( ' , s 4 FO OF ri< f, I SE ON�1 : , ' i ` W „ „ rwy 1 Electrical Permit Application JUN 0 1 200 ' 14 . City of Tigard DateJB 9,9 I �� /� Permit No.. C�o� '�� 13125 SW Hall Blvd„ Tigard, OR 97 Phone: 503.639.4171 Fax: 503.598W 1 OF TIGARD Iffli.111111111111 Other Permit: . Inspection Line: 503.639.4175 BUILDING DIVISION ' *. - Date Ready /By. .Lvia • BI See Page 2 far Internet:, www.tigard or.gov Notified/rifethud: ' Supplemental Information TYPE OF WORK PLAN REVIEW El New construction rAdditionlalteration /replacement Please check all that apply (submit 2 sets of plans wtitems checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition El Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ID 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 ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", ` I - 2 ", "I - 3 ", 10021P or more. occupancy . Job no.: Q 9 y p :4 - 4 ,.. 5 _ :4 - 4 ,.. 5 �1 Job site address: i / 4 t i ❑ Six or more residential units. ❑Recreational vehicle parks. City /5tatefZlP: — 1 -- t G ID Health-care facilities. l: Supply voltage for mere than E-.1 Hazardous locations. 600 volts nominal. Suite/bldg. apt. no.: Project name: El Sarvi e or feeder 600 amps or awn:. FEE SCHEDULE Cross street/directions to job site: Description I Qiv. I Fee. 1 Total [ • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 _Ea add] 500 sq. ft. or ponion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK with above sq ft.) , Limited energy, multi - family 75.00 2 N iP14.- 5 e--g 1 iY\ _ l C gar , residential (with above sq. ft ) Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 8►0 3 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: M / 7' ieRmv /A/6- 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: y70_ Over 1,000 amps or volts 454.65 j 2 City/State /ZIP: a09-"46,5 ex- 9 . 7/ /f 4 Temporary services or feeders installation, alteration, and /or relocation / Phone: ( ) Fax: ( ) 200 amps or less 66.85 I Owner installation: This installation is being made on property that I own which is not 201 amps to 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 circuits - new, alteration, or extension, p panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 1 2 Miscellaneous (service or feeder not included) City StateiZtP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder Phone: ( ) Fax: , ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 e: 1 d' 1 .( Signal circuit(s) or limited- l3uSin2ss narrl u_Ri..S1=t.i5 � -e C -_7Lr '— energy pane!, alteration, or Q extension. Describe: Page 2 2 Address: p a L a, 49,k Q 9 „ 5 --- City/State /ZIP: , ` /� �} Each additional inspection over allowable in any of the above i l J 1 1,�SD n 1 Vic, t � _ ! -- 7p 7a Per inspection 62.50 Phone: ( $) ,3) , 35-- S3,5 -3 Fax: ( SP 3 ) 6 3 7 r- ,r2P,9 q • Investigation per hour (.l hr min) 62.50 CC B Lic.: Elecal u rr. Lie Industrial plant per four 73.75 \Ol, �� - 3 p 3 S 1�Q1 li p a pi 10 ELECTRICAL PERMIT FEES D Suprv. Electr s requ s9 Subtotal: Ate, a p Print name: � a� ate: 6, Plan review (25% of permit fee): [Jr'>f y � '�� > State surcharge (12 %ofpermit fee): 9 k, ei Authorized signature: 11 TOTAL PERMIT FEE: 5>9 g!, This permit application expires if a permit is not obtained within 130 Print name: Date: days after it has been accepted as complete. Z'd 17088gg9E09 OIjJ 1213 311IANOSIIM e2Z:LO 60 LO unf