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Permit CITY OF TIGARD ELECTRICAL PERMIT 111 : COMMUNITY DEVELOPMENT Permit #: ELC2011 -00320 TI;GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/16/2011 Parcel: 1S126DCO3300 Jurisdiction: Tigard Site address: 9900 SW GREENBURG RD 240 Project: Advantage Dental Subdivision: LEHMANN ACRE TRACT Lot: 4 -5 Project Description: Adding (6) branch circuits for remodel. • Contractor: SEVEN PEAKS ELECTRIC INC Owner: ATHERTON REALTY PARTNERSHIP 62988 NE LAYTON AVE STE 102 2100 S WOLF BEND, OR 97701 DES PLAINES, IL 60018 PHONE: 541- 388 -1465 PHONE: FAX: 541 - 389 -0821 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 06/16/2011 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 06/16/2011 $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 C nter. Tho 4 rules are set forth in OAR 952- 001 -0010 through OA' , -2 -001 -0090. You may o. • °s or .ire estions to OUNC by calling 503.23 . 87 or : 50.3.2.234.. Issued By: yL.fi�i _ _= �/� 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. Jun OS 2011 2:13PM HP LASERJET FAX p. 1 Electrical Permit t Application t City a�'Tigard � � � �.R'a�;• e a 13125 SW Hall Blvd,, Tigard, OR 97223 Jr r PlauB : �� Permit No,. ejf`(!aQ/� . I Phone; 503,718.2439 Fax: 503.598.I960 • - v ' V u P atc -15 l view [ t t' ,n DaM�B : Other Permit: q,, action Line: 503.639 0 e 2 �ll At p Cl�/ /�� Date Ready/13y: 3urfa; $1 9eo Page Z far In f110 Y1V. d - flf t..i o edR•dethed, Info, atian c r wt ......... .1 - i. • :.y�'.., fi ":(l'i yr� :�� "t<:i^ :N' - :: �� Supplemental ' IMF. „ • _.0 tI{,: . : ',I - b' S: >. ': .. . � p ., r' .,, .. , ,. ., .,.. ,,, �; i., - `.r .: : >; :,. s' • : ILWi #'1�:''IE�E;ct'i��';ik'� -; ,._;.:�; " _ ;ti��:r';i;:. ❑ New construction Addition /alteration /re . , , . ,;:.:• .... , �;Yr:,...,; .`` ',_ A�(submit � .,..,..., .. .. (1 Addition/alteration/replacement Please oheok all that apply sets dolma iv/items °ho p eked bclow' ❑ Demolition ❑ Other; ❑ Sor4'ioe or tt3edvr 400 amps or more =i. ^ { where t he nvoilabla fault olurenr Ma " Building o lid three s ee. bo ,:., `. �;:;. ' , �',�, ❑ h as aua boe1yai t �'-r1� .:. .. .,.,, "'.. � Q, fiY:',q�'W,,Ct�ra.�7tiU�iT;it3� ;.:� r ❑ 1- and 2-family dwelling �, , ,;,�� i-.' `,•< ; . �,:.:•.'• - .�:: .)� exceedb 10,000 amps nt 150 volts a CI Floating vglldiege. y elling Commercial/industrial al/industrial ccessory building amps ground, of or exeoeda ❑ buildings. Commercial-0.4e aviculture! I: Multi- farrlil ❑ Master builder other installations, El ❑� i ro pwnp. Installation ' '. ., , .. , u.`_ . T•_:• r!, ' • d1 s :,;c,: a t ❑ mar ono s „tent. A or tl.��rr,, � $ ' { 8 >' y ❑ larger separately B 3 ayat:m. ':, . r �k� r ... ��r ' r ,, I :5.::. :"••, r ' ; .: yti A$ da '1 w.._` .. , ❑ rt on of nets mot load of ❑ "A " u>r•• "] -2" "1.3" Job no Job site address: + — op 4.5 IDOHP or mars ooct one f r E l 61x cr more residential un its. 0 Recreational vehicle parks, • .;, 'i A ,e' i s ❑ 1Nettlt -care facilities. E7 Suppty voltage for more then IL P vice o n to r nOlnlnti• b uitcJbld /n t. no.: a ocvicc or t �edor 600 amps •- ' one. 60 g p Project � or mare. Q roje n D � � 1. . „ . p ' . ,. R. "' name: `/ - D volts ' s�Ia��i[ ri J s to job site. ti ,..: •_'•,..;..: ,.; ,>x T- I4ET1 ,F-: Cross street/direction New residential single - or multi-family dwelling unit. Included attached garage. Subdivision; Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map /parcel no,: Es. add'I 500 sq, ft. or portion 33.92 1 .. , .i , � s:.. - �' + r,_a is= "'` ;'y�`:.'t "' - _ - Llmlted energy, residential , 1 , a '.I .- : l t. °' "•` ,∎ �+41eikt IIfAM,p'��aL.yyr-..4.f f ;. .a, {..:. iil.yai- ` ; :, • . '. tur "'' : -,; i�;,,� ,,, " (with above sq. ftJ 75.00 2 Limited enery, multi family g Adding 6 branch circuits for office remodel 75 00 2 residential (with above sq. ft) Services or feeders installation, alteration, and /or relocation : p RQpl Rr'Y:o v i _ .,. :':; . 2 �. : . r . :: ,. ...., ll � ' ?�s ' , •'' >'.'.': (], . f ; i r . . , 20! =pa to 400 amps 133.56 _ 2 Name: ^ 401 amps 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 — City/State /ZIP; Temporary services or feeders installa alteration, and/or relocation Phone; ( ) I Fax: ( ) 200 amps or less 59,36 ' 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 am ps 125.08 2 intended for sale, [ease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168,54 2 Owner signature: Branch circuits- new, alteration, or extension, per panel Owner ., — branch circuits with t ; a;' : � ,-':; h.: �: ";�;;. , � ��r . IL '�('•'lik�X2�Qh!:'•;..- !.L;:' „: ,;, � 7,42 2 ....,. . �� '• "�� each branch circuit non Abu �r`F { riL? � • � B Pen for iy[Anch circuits wttA'o7rr service Contact name: b i.�'G1rar, l NJ fi hrnchcirc first ]1 1 618 r �� • /g 2 Address: Li 20D0 2... V t C Each nde'1 branch circuit 5 7.42 57. le 2 4 4.• 1V 11ecc11nnco us (service or feeder not Included) City /State/ZIP: 0 % : a V q g 7 R 53 Each manuthotured or modular 7 ! i dwelling, service, and/or feeder 67,84 2 Phone: 6I ) / _ 1,i310 Fax; : ( ) Reconnect only _ 67.84 2 E - mail; or o f circle rr!... .n:,e.,.;:';'r ".i'i;': ; fo- } i Sign o lightin o I'ngc 67 84 2 .,,p QNxI?AE p'7, . Si or g 67.84 2 r ?` '''' `.` •' ; ' Signet circuit($) or limited• energy B usiness name; Seven Peaks Electric Inc _ pond, alt ©ration ar extension, Page 2 2 Address; 62988 NE Layton Ave Ste 102 — Each additional In>Ipcctlon over allowable in any of the abov Additional i s ecttnn (1 hr mic) 66.25/ hr City /State/ZIP: »end, Or 97701 Investigation (I hr min) 66,25/ hr l — Phone: (541) 388 Industrial plant (1 hr min) 78,18/ hr Fax: (541) 389 -08?1 Inspections for which no fee is q ( / 4 y i � t{Q / 'l Electrical Lie.: 9 - 227C e.ecifloall listed 14 In inin CCB Lie,: yI$7 90.00 /hr P &tt �ignLture, required: tt 1 Suprv, Lie.: 4539S V A 7 / '�. � ;;:a �'1:: `. 1'a , �'+,jW � RI ,r��,S:,�'I�lral`r �'� r.::.; 1.:L' Suprv. Electrici ![ equired: , , t , a /O I Plan review Subtotal: ''� ,: . _ ' r, ;;:. Li D tal ' 8 (2,5% of pe rmit fee); Print Warne: Mat'den Madison Date: 6/5/11 State surcharge (12 %ofperrnis fee); //• / Authorized signature: �^ j 4 TOTAL PERMIT r 1;: �� y. V7 `� �'► �I This permit application expires If n permir Is net obtained within 190 days after it hen been Accepted as co mpress, Print name: Maiden Madison Datc; 6/5111 -- • Number of h1 poaiiona allowed per permit, 1: 10u0cIing1Pertnit .vii,c.pcnnhAAp.d t/C,t(ID 440.4diOT I IPoS /C