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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00122 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/04/2011 Parcel: 2S101AA00101 Jurisdiction: Tigard Site address: 12000 SW 66TH AVE Project: Landmark Ford Lincoln Mercury Subdivision: Lot: 0 Project Description: Replacing all parking lot fixtures. Contractor: E C COMPANY Owner: CORLISS, JAMES L & CORA K PO BOX 10286 LEASE TO: FORD LEASING PORTLAND, OR 97296 DEVELOPMENT CO PO BOX 23970 TIGARD, OR 97281 PHONE: 503 - 224 -3511 PHONE: FAX: 503 - 295 -3012 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 03/04/2011 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 03/04/2011 $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 rules or direct questions to OUNC by calling 50 ; 1987 or 1.800.332.2344. Issued _ - - Permittee Signature: i 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. Mar, 3. 2011 3:40PM No, 9035 P. 1 Electrical Permit Application . 111: I i. t- (E- I 't. t) N, I City of Tigard N_____ NINE E25 SW hall Blvd., Tigard, OR 97223 11 '-= --- : �W� Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: i ,_ F: n Inspection Line: 503,639,4175 Date Ready/13y: Mil RI See Page 2 for Internet www.tigard- or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wrtems cLeciccd below)! ❑ Service or feeder 400 amps or more El Budding over three stories, ❑ Demolition El Other: where the available fault current ❑ Mantras 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 E Commercialindustrial ❑ Accessory building amps for all other installations. buildings- ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installatiao of 7S KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ['Addition of new motor load of ❑ •'A" "E" "1 - 2' "1 - 3y Job no- `14151 Job site address: 1, 2 0 0 0 SW 6 6th ave. Six or or more. occupancy ❑ Su w or residential mots. ❑ Recreational vehicle perks. City/State/ZIP: Tigard, OR 97224 ❑ Health -care faclitica. ❑ Supply voltage for more than ® Hazardous locations. 600 volts nominal. Suite /bldg, /apt..no.: Project name: Landmark Ford © Service or feeder 600 amps ormote FEE SCHEDULE Cross street/directions to job site: nexuptiou I on• 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 Tax map/parcel no.: Ea add'1500 sq. ft. or portion 33.92 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) _ - Limited energy, multi- family 75.00 2 Replace all parking lot pole light fixtures residential(withabovesq.R) Services or feeders installation aad/ar relocation 200 amps or less 100.70 2 ® PROPERTY OWNER l ❑ TENANT 201 amps to 400 amps 133,56 2 401 amps to 600 amps , 2 Name: Landmark Ford, Inc - 601 amps to 1,000 amps 301.04 2 Address; Over 1,000 amps or volts 552.26 , 2 Temporary services or feeders installation, alteration, and/or City/State /ZIP: relocation _ Phone: ( ) Fax: ( ) 200 amps or less .. 59.36 1 Owner installation: This installation is being made on property that I own which is not tot amps to 400 amps 125.08 2 rent, or exchange, 401 amps to 399 amps 168.54 2 intended for sale, lease, ge, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with :: APPLICANT T 0 CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: EC Company B. Fee for branch circuits without servke or ffbeder fee, first 1 56.18 56.18 2 Contact name: Kathy Kelley branch - Each ndd't branch circuit 5 7.42 37.10 2 Address: PO Box 10 2 8 6 Miscellaneous (service or feeder not included) Each manufactured or modular City /State/ZIP: Portland, OR 97296 dwelling, service andror feeder 67-84 2 Phone: ( 0 3) 224-3513. I Fax:: (5 0 3) 295-3012 Reconnect only 67.84 2 E -mail: kathyk @e - c - co . corn Pump or irrigation circle 67 2 CONTRACTOR Sign or outline lighting 67.84 2 • Signal circuit(s) or limited- energy Business name: EC Company per. alteration, m extension Page 2 _ 2 Each additional inspection over allowable in any of the above Address: PO Box 1028 6 Additional inspection (1 hr min) ' 66,25/ hr Investigation (1 hr min) 66.25/ hr • City/Statc/ZIP: Portland, OR 97296 - - Indu-strial plant (1 hr min) 78.18/ 1rr Phone; (5 0 3) 224 - 3 511 Fax: (5 0 3) 295-3012 Inspections for which no fee is s li sted min) 90.00/ hr CCB Lic,: 49737 Electrical L. • ; 6- - Suprv. Lie.: ELECTRICAL PERMIT FEES otal: 93.28 Suprv. Electrician signature, required: e 3 Plan review (25% of perm fcc ): r - Print name: Ron Co f fman 1 Date; 3/01/2011 State surcharge (12% of permit fee): 11.19 r TOTAL PERMIT FEE: 104 . 4 7 Authorized Signatu This permit � pe application acplrca if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Andrea Stinger Da: 3 / 0 3 / 2 011 • Number of inspections allowed per permit. 1: 1Bui ldiaaTetrtits1ELC- PermitAoo.doe 07/01/10 440d615T(It /05/COM/wEa