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Permit ri r r CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00386 Date Issued: 07/13/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112DD00300 Jurisdiction: Tigard Site address: 15900 SW 72ND AVE Project: Pacific Convenience & Fuels Subdivision: Lot: 0 Project Description: (12) branch circuits (adding and removing) Contractor: WHISKEY HILL ELECTRIC INC Owner: PACIFIC CONVENIENCE & FUELS PO BOX 206 2603 CAMINO RAMON STE 350 HUBBARD, OR 97032 SAN RAMON, CA 94583 PHONE: 503 - 981 -4640 PHONE. FAX: 503 - 981 -4643 FEES Quantity Description Date Amount 12 crt Branch Circuits wo /Purchase 07/13/2011 $137.80 Specifics: Service or Feeder 1 ea 12% State Surcharge - 07/13/2011 $16.54 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $154.34 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 S. R 952 -I61 -0010. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �� - / Permittee Signature: ON 19; / c./'Ce9-77v ".. 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. 07/12/2011 07:46 5039814643 WHISKEY HILL ELECTRI PAGE 02/02 Electrical Permit AppliC t� E+JD FOR QVVT USE ONLY p City of Tigard , Permit Nn 14L t � �� ?4 (Q , n 13125 SW Hall 131vd., Tigard, OR 977.7 jL 1 2011 Plan Review ` '�� C Phone: 503.639.4171 Pax; 503,598. t1 pa1e /13 Other o t0 — Q T I C A R IJ Inspection blue: 503.639.4175 �r�.� },�^ pill R D Date Rcr,dy /Byt ,IL EI See Pone 2 for interact: WWw.tig:lyd CI 1 OF l lvl' NntiFic 7 7 Supplemental tnformntinn .. a I 11 ..,,:,. . ,...;.,.,� . -, ,,,,,;, ,,,, ; ,,; , n' . ,, rr,,.n' ... . Rn n. r: ,' � - „ °r; :,,,a•�i, 'r, �, ',r o +'y'ra,:,� :�'7tU(I'Itli : grJ G;,;� , ,�, i .,,, d 1•T'. , ,h„ iJ..,, d R �. „ � ,L,,.: li'.% . ,,,,li':1,I h p, h 1 J .I.. uY.,, '.',rr , l aav i. ,,, .1. r: •, 7. ,n,;;..,'. ,�, ,.;; ,1i1„ I I t ` , i. rl':i. ,1,,,, t .(,� 1' `�a`�1%Y'I"',,,,,,Il, ,,,(, ,I ,i;:,l,t. ,........ �i�, ...,.1.11.. ,..:..,.','.... ,..h :. . ... , ....,+, r o r ,s' , ., ;; „', r i r.,, „. , li 'f!� .: . isT,'. I ,,,,,,..,. , ,,,, ;, { il, ; I t•.',' i' r �,,, . , il, ,.,,,,,,1 i, I, „r ua1,,;',;; +�1i11:'; ,,,�,, �, „r „Fr•1 „d,,,li!il'If� „�,l�:l�! ,tr, ,',,;'1!i , El New construction Addis n /al t ! ❑ casechcc I � s or I Ir repiace meat Please k all that apply (submit Z� sets Of plans lv /iletn$ checked hClnw); / c Service or foccler 400 amps or more 0 Building over throe stories. E Demolition El Other: where the ;iv:dlnhlc faun curt ❑ Marinas nod boatynrds. . . ..;.,:,, ;,. •, ii,;:,.i1;i,. !; ' r A , !j : : i;1i17 ih'i r llig :'I,!{'i,;liil'•� l'1 % x 0,(0Q $ v or 1 Ina11n ' buildings, •r;;, .;;;'l' ..I.,l'i..1'1 .,: Y.,t1 if Y ►1J fit 44 1 , ,.. ,., ,,','I, exceeds I OampantI 0 i nt:: o u t. ! ,i i:i; ,;d':;lr., ,,. „', y i ..... + „ I'lk„ ) yl ,, {t�r,,,,a,(;r >IIIIJ ' � >��' » less to ground, or exceeds 1 4,000 ©COmrnCrCiaLnPC ni:rieubvrnl j] 1- and 2- family dwelling Commercial/industrial ❑ Accessory building amps rorail other installations. buildings. 0 Multi- family Master builder 0 Other; © Fire pump, ❑ lnslallation of 75 KVA or :i' l: i ;' iii ,, '; , 'u r, r r,r , , ' ; , r;; ❑ 1 .,,,cnc :, Impel. saparalely darlved s ysicm. ” r.y ; ,, ;: i' ".':iliil,'' ! ti�t: g `iLiil }l ,{ I 04 14 I �, ' ,u�l' IC .1 .11• Q' i 11' i 1)' ' , $!i';1!,, ;,+,� ! • • i "" ! I , . 111 ,.1 V 12''1,', , rl,t ■ (,.'' fir _ ❑ Arltlil' t' new motor loud of ❑ "A'', "17:”, , .1.2 " " : ",'.: :!: ''' tom( .,... -.�... _, _ ` 4�l�' .':.'.-. 1.:' J;::•. , �1s:t'.ML�A'.i.:�:'A::..f:.tl A:, :A 1 r.nr''i:11i4, r ,,�.�,. p r. ,� "" � iOOHP or more. r. ,lob no.: - Job site address r r -- 7 , .� != „ — + �/~ / /�J (/L��l �� _ T�y. r :si or more ro un ❑ Recreational vehicle parks City /State /71P: lo ! . 1111 th -care 0lcilitics. I] Supply voltage for thorc limo ic y 0 I �t P c _ , F , � ,r.: - lazmeious Intone s, 600 volts nominal. Su /bldg. /apt. no.: Project n6.mc; '' ra , W W F �;i 't ❑Scrvicc or feeder 600 amps or room. ,��l�t -I ;Op 1 ''I {' !iWli, It „gF � f'1gPw.y ,PP,',', 1' � 'i!i°; ! ;(;',c 'I:j J ;' , !; �l.,l: + i1.i i! li!1 {)Iiiii if i ;ill 11 L ,.,. . �, y J, .,5' , ;,' i1il��Ili'. V'12''I, {t( i(,I {1111i� Gross strcet/directions to job site: nreariptinn Qty, ” 11'n,.. total --- ' ""”— New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: i Lot no,: .000 sq. fl. or less - -,__ I68,54 4 --- w. Ea. add'l 500 sq, 0, or portion 33.92 1 'i ma /parcel no.: !nap I limited cncr residential A.v. 75.00 2 r ?: , ;? ;,. . ni ; r�illl ;il;,1,.,11:,,;llpd''; ' "i1, �. s r ', i ;,�'.11,'r r; . '' i ;!;+ �,, ' , ; ,,,, ', , i , 1:. ;1rr aUal;;I; , l. :- , I [1; hov sq, ft '1': with �i t 1.,1 I J I,� 'l a ,Il + , 0 1 1 d h,.,i + tll . , {l 4ldrill' {L Il withaerfe eny, mtt11,•famfly — ,h:i.Li a- :.a.L.h J;-- 1.aa h lul • - -dd/ - e /fi //1 t (7 r rgl i/ t 5- resident: pi ith ahovc 9 . Il,) - 75'00 2 G� L= - w • J Services or feeders installation, alteration, and/or relocation 200 amps or ICSS 100,70 2 i" i`, , ';1}r , r r,; t ;'ii 1,1 , I' ∎ ', >i i t(i fI ' 1 }i iii , 20 1 amps to400 a 131.$6 2 `;:.,..�1� 1 K:,;(!� y l� y hi 3 + lih> 11 ):i i t ' ,1,,: 1i 1 , li, I )1�' p' , , ,,. I l f r r r ,', — -,u.:.... H, 401 amps to 600 amps 200,34 2 Name: 601 amps to 1.000 amps 301.04 2 Address: • Over 1,000 amps or volts 5.52,2 2 ” Temporary services or feeders installation, alteration, and /or (sty /State /71P: relocation - Phone: ( ) lox: ( ) 200 amps or Ie35 V 59,36 - - ^ � 1 M 201 amps to 400 amps 125.08 2 OW ner installation: 'Phis installation is being made on property that. I own which is not 401 amps to 599 amps 168.54 2 intended for solo, lease, rent. or exchongo, according to ORS 447, 449, 670, and 701. — Branch circuits - new, alteration, or extension, per panel Owner signature: Date; A Poe for branch circuits with each : „ l{ii; ", t : ; ,' ! ;,iv4 4' i'F,t k il'n; ",1. „ q r - 7,42 2 above service o feeder foe, , .:i;ia;',',;. :n,: l�rrL`t '' ,,, i , i'1'1II!? ',;r,`$ 'tr; ., i :;,it' i lfe6 f•iilkiti(i§ i' iir i'I'I' r., ,. T I,. j ,jl :it.: , • ....,-;! .., ..,.,......:p,.....E : ,.t; .1,:.,'u, i , 111„ 1, ,,1 1 ,.. di . .l l , t , _:..._ M t.,.,..:, .,;.. "'C z. 1,.,, � branch circuit Rosiness name; B, Fee for branch circuits wlhoto �" . — ____ � — - - .. : -1 ,..-- -- acry cc or feeder fee, first. _t �^ ^ branch 56.18 jj /s. 2 Contact name; ch circuit .... _ . . -- Each add'I branch circuit. 1 7,4 aL6a 2 Address: Miscellaneous (service or feeder not included) Ca en manufactured or modular City/State/7,1P: dwcltinp„ service and /or feeder 67.84 2 Phone; ( ) Fax:: ( ) Reconnect only 67.84 2 y-- -- -y--”- Pump or irrigation circle 67,84 2 T 67 4 2 -mail: , :,...., ,,'. I;'.. ; : •.,,hn5.,,; ,. 'i;R'1 , 1, ,,;, yt 5;i "ir:' I!i,,lr. .' ; : -,, ✓: IY h'i a ;;':;ii.li iui'?'. , • ; i )ll l ` i..,;, ,r,:4 „r'i.� �;i 1; ,1,r i . Sign or outline lighting ng , u.{ � tnc s l �.. � , _. ' ,....,..,, I � r� 1 ,,, 1 4; ( ;1l`asW hlia!,,l i Signal cifcui or limited-energy , r, Business .h / /:. / • P a ne l . a lt cra li nn, o r c xt c c i Pap 2 2 illr (? Each additional inspection over allowable in any of the above Address: � � M Additional inspection (I hr min) 66.25/ hr ('sty /StatC /7.,IP; LL In pint (I I lirmi 66.25 /lir_ _ _, , V j.� � Industrial plant (I hr min) 78,18 / hr P11c1n _ - C y 1 � t 1X; ( '/ � � Inspections for which no fee is ' -- wC/ T T lY I191 in 90 00/ hr �I / C;�: I3 I,IC.: / ��� ��'' I',ieetrical pc,: s 7 1 - Lic.. J l "rl i� ' I spccifical ,f' 1 '� i; ? 11V , yiiVi';"il 6S' r + ,Y 1L1/ l•i i I ' I' }'1i, 1) (ra�a',iit� r.�, I'1,i�ir,1 1,'. �'';.• I,nr;;�' {':,,' Ji'1; , I , l _ q -� subtotal: - , Su �rv. Electrician si t a required: f� �r�/�� __ flan review (25% of permit. fee): Prins.nite / / /4 �� �s + Date; / '' State surehttrge(12 " /"of permit fi e) C '" TOTAL PERMIT FEE: fs .• 5- :/✓ Atttilori7ed .signature; This permit application expires if n permit is not obtained within 180 " Y days a fter it has been accepted as complete. Print name: Date: . Number of inspcclions allowed per permit l., nf, itilina \ Permit MC- rcrrnitA rip if ac uvmno 4411- 4(51:Tt11 /nswomoWtt)