Permit v CITY OF TIGARD ELECTRICAL PERMIT
IIII 11 : COMMUNITY DEVELOPMENT Permit #: ELC2009 -00118
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/11/2009
Parcel: 1S135BA02800
Jurisdiction: Tigard
Site address: 10380 SW CASCADE AVE
Subdivision: Lot: 0
Project: Tigard Motorcycle
Project Description: Install (1) 200 amp panel and (4) branch circuits.
Owner: FEES
LANPHERE ENTERPRISES INC Quantity Description Date Amount
ATTN: DOUG MEATH, 12520 SW CANYON RD
BEAVERTON, OR 97005 1 ea Services or Feeders - 200 03/10/2009 $80.30
amps or less
PHONE: 4 crt Branch Circuits w /Purchase 03/10/2009 $26.60
Service or Feeder
1 ea 12% State Surcharge - 03/10/2009 $12.83
Contractor: Electrical
ACCESS ELECTRIC & CONSTRUCTION
2870 SW 170TH AVE SUITE 108
HILLSBORO, OR 97123
PHONE: 503 - 642 -4333
FAX: 503 642 - 9699
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $119.73
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 -0100. 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:
faC11.121,t111111_______ Permittee Signature: ._ '44110 t‘
fi110 S �i� I A
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.
11
03/09/2029 1014 1 ACCESS ELECTRIC PAGE 01/01
. ,-,..-Lv. *'t11 .I. Ca mit ii
\ FOR OFFR"'E (ISE ONLY
N . . ,:. • ' City of Tigard Received 2, t n. „..„
rcrm '
• - 1 : U . A il No.: 1 • ZO09 .00 1 le
, ,..... 13125SW Hall 131Vd., lipid, OR 97223 le- ,
Ili O Plan Review
: ... • Phone: 503.639.4171 Fo; 503,598.1960 Date/B : Other Fcrmil; •
T 1 GA RD 1, 15Peetion Line; 503.639.4175
Dale Readv/By: u • 62 See rage 2 for
Internet: wwwtigard or.gov
Notified/Methodt c supplement.' Informntion
1 • :' :' ''''' ';. i i'', :::.;'':',' :;.::'!:"", t.::;';',;;i:v0i.!.6#.,i,ioAlc,:.;:,:1,::'!H4;.'::.,.:,:';!::.k7i.t \i:1‘,1'!9;',:a.;t:i',',;'1.;:k,;!!: ii!.,'.!6;■'.;;.:'.'.''."''''''ill';:,'''..:',:iitiOt',..11t VIEW • D New constimetion E Add ition/abciation/replacement Please c eek all iht apply (submit 2 sets of plans whiems checked below);
0 Service or feeder 400 amps or more CI Buitdiilg over three stories.
ID Demo' - ti 0 Other:
- where the available fault current El Marinas and boatyards.
.. -,---
: kft.dotkV;:ii**Iltitt.firi::„'.1:i!;,!;1;q':701R:,:',::.,,., ':.'', exceeds 10,000 drop at 130 volts or U Floating buildings,
SS to ground, or exceeds 14,000 El Commercial-use agricultural
n I- and 2-family dwelling Eg Commercial/industrial 0 Accessory building wo f an oilier installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire mime. 1:1 Inctollni ior of 73 KVA ul
-------• • , " 77 " 77 ' 7.. ......'r.„ . .. r 0 Emergency system larger scpamtcfy derived system,
:;Y:l.,....1:;.:1':::/dif;Stit:12401iI4AT1ON r -- i
•,' • ' • • ••,, • ....,•.• • ,,, .. - • : ".,,,, - : .., ••• - • ,•., - ....,• • ,, - ,:..i • •,„,,,,,,.. , „,,•,.: I__, Addition of new motor load of 0 "A" "" "1 "1
Job no.: 7596 Job site address: 10380 SW Cascade Ave 100HP or morc. occupancy.
0 5ix or more residential snit 0 Recreational vehicle parks.
City/S_____
tate/ZIP: Tigard OR
10 Health-care faciliti 0 Supply voltai;e for more than
•---
El FlazardollS locations. r500 volts nominal.
Suite/bldg./apt. no.: Project name: Tigard Motorcycle Li Si..vice or !Cam- 600 !mix.. ul Imre,
' ; : M Y , I ;P : at. i' .' 5'.',:.;; ; : i ' ! : :: : ' ' 2 ,' :i ; f04S.COLVOL1r1 ; A'aSa' . .
Cross street/directions to job site:
Durri.fion M IIIIIIIEttaIMEIMIN ^ _
New residential single- Or multi family dwelling unit.
IIICIlltle, attached garage.
Subdivision:
Lot no.: 1,000 sq. ft. or less 145.15 4
, ,
Pa add'! 500 sq, ft. or portion 33.40 i
Tax map/parcel no •
Limited energy, residential _
2
'',..•': '':':::'.;",.:•:;:.,',','H. :.':[';','!',•,:,',!':i;.!i,:,:.1:,'00'00,,11.6s':::Ot:1,*.iti0;',!.':';'..,.,T1;.';'1aIi',-;0';;A,.,:':i! (with above sq. ft) 75'00
Limited energy, miilti - family --
75.00 2
Install small panel for RV's
residential (with above sq. ft)
.
Services or feeders installa6on, alteration, and/o relocatio
200 amps 01 -""------- i --- R1).:4 0 8030 1
-
Q ':;;1'. 0"!TtivitNt.; 201 amps to 400 amps 106.85 2
Name: Lan phere
_
401 amps to 600 amps 160.60 2
601 amps tp 1,000 amps 240.60 2
Addrees:
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less
- 66.85
—
.30
Owner installation: This installation is being made on property that 1 own whi 201 amps to 400 amps 100 2
ch is not
intended for An I e . 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; Ater panel
Owner signature:
Date:
A. Fee for branch circuits with
i .. • . - :•"- . ,---,:.-• . illll' :•i.i. l! '"" !.i::i i . 'ill'ittrat?..7T.tifl - _4iiiilkli"H:lici"• , "'"'.; . above Nei vice or thcocr fee 4
...::: :. ;;,,.,,...:..., i •i;ii,. 0::Arpme4di.4., i:::ii ,:' ,, ..:,i • ..!7.7.,: ^...".'"'.7711. t...'"7,--.•';•1•,•%•:!'•:'::,:'.,: caii bra, lch circuit ' 6.65 26.60 2
Business name:
13, Fee fOr branch circuits
_ A R 7 ,,,,,
,i7i,h, service or feeder foo,
46.85 2
Contaet name:
; •.:_. , ‘-A A r
first branch circuit
-
Address: , / II %TAW Er, Each add'I branch circuit 6.65 2
MiSeellanenut (aervice or feeder not included)
City/State/ZIP:
Each manufactured or modular
90.90 2
- dwelling, service and/or feeder
Phone: ( ) I Fax: : ( )
Reconnect only 6ts 85 2
—
E-mail:
Pump or irrigation circle 53.40 2
l'.". ",..,:•..:::..'. ::.-::, ., ...:''. .:.• .:' : Sign or outline lighting 53.40 2
Signal eireuit(e) or limited.
Business name: Access Elpeteic & Construction, LLC
energy panel, alteration, or
Address: 2870 SE 75 Ave Suite 108 extension. Describe: Page 2 2
City/State/ZIP: Hillsboro 0 R 97123 — Each additional inspection over allowable in any of the above
Per inspection 62,50
Phone: (503) 642-4333 -
- Fax; (503) 647.9699
Q. 1.
( k 0 Investigation per hour (i hi- min) 62.50 -
CCri Lic.: ■ i 166 Electrical Lie.: C16 7.1.11 I Suprv. Lie.: 4931$ Industrial plant per hour 73.75
Suprv. Electrician signature, required:
fi) ir......._ •',•,.:,.::.:Xii.x.x,:rpgeoiti;;)!;10m.,!;i'.];:..,,:i',1,',,::.
Subtotal:
106.90
mr-lir
Plan review (25% of permit fee):
Print name: Kent Zimmerman Date: 3/6/09
_ State surcharge (12% of permit fee): 12.83
Authorized cignoture:
TOTAL PERMIT FEE: 119.73
_
This permit application expires if a permit is not obtained within 101)
Print name:
Date:
days sifter it has been accepted as complete,
Number 0 impections allowed per permit.
1 :\Rading\Pconds\ELC-PcrolitApp.doc 03/23/06
440.46/3T(11/05/COM/WEB