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Permit CITY OF TIGARD ELECTRICAL PERMIT � COMMUNITY DEVELOPMENT Permit #: ELC2011 -00544 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Date Issued: 10/04/2011 Parcel: 25101 BC00201 Jurisdiction: Tigard Site address: 8255 SW HUNZIKER RD 103 Project: RGIS Subdivision: Lot: Project Description: Electrical for TI Contractor: RELIANT ELECTRIC OF OREGON LLC Owner: JOHANSON TRANSPORTATION SERVICE 20200 SE OLDENBURG LN 5583 E OLIVE AVE SANDY, OR 97055 FRESNO, CA 93727 PHONE 503 - 701 -4562 PHONE. FAX: 503 - 668 -4190 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 10/04/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 10/04/2011 $7.63 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 ma • • - - ..y of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344 Issued _ Permittee Signature: / ,,. /�wv,2■•... 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. Oct.03.2011 08:34 AM Reliatakvtpf Orego 5036684190 PAGE. 2/ 2 Ftc Electrical Permit Application OCT 0 3 2011 h i t tn.! i {' l,,I.0...1. i , . City of Tigard ,... 13125 SW Roll Blvd., Tigard, OR 97223 CITY OF TIGAfi� f' v I n pec 5 Sax: 503.598.196 DNISI I� Other Permit: r • i , !� — � ` , . , ! ' ! ..; •� !: F > Intarmct w Inspectictl Lir►c: 503.639.4175 1<11/!f ww.titx!Sd -gm TYPE OF WORK PLAN REVIEW © New construction ddition/alte iation/replacement Plain clack au ea reply (arUnit a eats of plena wiinms checked below)! 0 M 0 ere the avallahte comae atmaa over Sumo stories. O Demolition 0 Other: oh sad boelyarda. -.- CATEGORY OF CONS RUC13O =cola 10.000 amps at ISO warts 4r A Floating buildings. less vi grand, or exceeds 14,o00 0 Comm....6 use agricultural 0 I- and 2- family dwelling , 'Commercial/(ndustnal 0 Accessory building save for aa War inualbtiorr9. bnldiop. O Multi. family 0 Master builder 0 Other 0 Fire mop, 0 tmxell tion of 75 KVA or JOB SI INFORMATION AND LOCATION a Addition er' �,r separately derived C� � `1 �,e�� O ofrowmotartoadof Q "A °. '6". ° t- 2 ". "13", Job no.: 11- 115/-ti Job site address: 2.. 65 , t ) rt {'1� 1 ke aootlPar mace icy 1I Six ar more midst tea. ) Rc aaatiooal %chicle parka. City/State/ZIP: Ti e ii v 0 Hceltlaan: fIscilitiat. 0 Suppb voltage for morn tLsn C5 Haraidow Iacffiam. 600 vows nominal. ui ldg /apt no.: Project name : / V. >q1 �7 0 savioa or Powder 600 amps or mom . . FEE 9C 1ULE Cross street/directions to job site: ue .1„i*t I Qtr- I ear L ew.t I • . New residential single -or gardti-inoiily dwe tiaa, salt. Iaelndes attached garage. 1 000 ft. or lase 168.54 4 Subdivision: j Lot no sq' - ,- �� En. add'l 500 so. ft oc portion 33.92 1 Tax map/parcel no.: Limited anew, tial DESCRIPTION OF WORK (with above scull) .._ 75.R0 2 Lied energy. multi-famil 75.00 2 I /g n ti tA ? �Q1 C. i V 4e. . 1 '! Y n -) Limited iat (.. abowc44-R) I,l_, 2 t 0 ' en et, "+ - VX-p O Veat,e- i14- Se 0 amps or rails s iastaWrroa_*lar. , t sacra, relocation 1 xoas�psa'teas ton -7o ` 2 0 PROPERTY OWNER ( 0 TENANT 201 amps to 400 amps W 1 33-56 2 401 amps to 600 21 200.3 2 Name: 601 singe to 1,000 amps .- 301.04 2 Address: Over 1.000 wogs or volts 55216 2 City/StatrlZlP: Temporary services or feeders installatioe, alts ation, and/or Phone: ( ) [Fax: ( ) 200 amps or lei 59.36 1 Owner Installation; This installation is being made on property that I own which is not - � 20t gmgpa to 400 amps 1 25.08 2 Intended Pm. sale, lease, rent, or exchange, according to ORS 447,449, 670, and 701. 401 amps to 599 n1n n 16834 2 13rarcfl eiresu*s- new aheredos, or extensions o�Cr panel Owner 3igtlatllre: _ .. _ .. - A. Fee tar Mooch ciryni� with a AlPPucANf' 1 . . C] cwNTAci' PERSON shove service or titeder fee, 7,42 2 �p ( � n Q r ` each ham& circuit Micah* $1lsiness rlarne: C /n� �r� �+� IT - � � J L 4 / 7 ) I .� I 1 B Fee 6x-branch fi 5618 r ) D 2 Contact name: 1l (< yrt 414 Y - 1'Yl v i��yn eac hoot aunt j add'1 ibranch circuit f 7.42 2 Address: 2O . 2_00 t tae l , ( , f Lectk_e_ Miscellaneous (service or fear trot {minded) C IStateIZ1P: /��,Q /•'� comb m or modular T L��'"""" l/ r� 1 C/ dwelling, service and/or feeder 67.84 2 Phone: ( 9 ) ) . . 4 - 2 g o Fax:: 0•?, C 7 b --' ( (V Reconnect only .._ 67.84 2 pomp ar irrigation chyle 67,84 2 E-mail: / / , Fi •1 A,, n 11--) sip as outline lighting 67.84 s'%! . • CTOR Signal n) or ti Business name: _ panel, alteration, or extension. _ Pale 2 2 Each additional Inspection ever allew*ble in a"y of the abov Address: Additional inspection (1 hr min) 66.25/ hr I City/State/ZIP: -‘ / Invtatigim (1 la min) 66,23/ hr /1 A I l ■ ... hndamttiat plant (1 is min) 78.18/ hr Phone: ( ) ... -' , l / 'Sr. ' ( f / ". bmpet4aua Dm which no fee is -- - specifically hated (K hr tin) 9D -00/ 10 CCB Lie.: I / ,. 1 2., Electrical Lie.: 1 i Su io■ - - ..s1sl ELECTRICAL; PERMIT FEES Suprv. Electrician signature, required � t& .�. ! ., MIME $tt1u L (® r . � i! _ .. ,�, Plan review (25% of permit lite)• hi nt name: arl t .. , .. \ . • '- j �I1 '�.!-I Dale: -r ✓ i f State (12%ofpermitfy ) 7 ¢. . - p F TOTAL PERMIT FEE: 7 / .' A1Authorized sI a hil c:: ` ' �1.( /r - l � 4 ,�'y.� 1 Ma pawn epelication micas it s hook is not wined within 180 or alter Print name: ` y SC `(.j Yl 1 r a- i i `j f�! a hi 'paw: J0,-3_ i , • tea of i os per a t. as ca.,Mete i 5.. dmnW nnnit. BLGPamvAw.dcn 07101110 4 0- 4613,(11,05 COMl WE9