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Permit r „ CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2009 -00444 TA GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/02/2009 Parcel: 2S113AC00103 Jurisdiction: Tigard Site address: 7236 SW DURHAM RD, STE# 500 Subdivision: Lot: 0 Project: St. Jude Medical Project Description: (3) branch circuits to relocate fork lift charger outlet. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount 15350 SW SEQUOIA PKWY #300 PORTLAND, OR 97224 3 crt Branch Circuits 09/02/2009 $60 15 wo /Purchase Service or PHONE 503- 624 -6300 Feeder 1 ea 12% State Surcharge - 09/02/2009 $7 22 Electrical Contractor: IES COMMERCIAL INC 16135 SW 74TH AVE TIGARD, OR 97224 PHONE. 503- 648 -1900 FAX: 503 - 670 -9572 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $67.37 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 wit 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 -00 -0100 You may obtain a copy of the rules or direct questions to OUNC by calling 503 246 6699 or 1 800 332 2344 i Issued By: ' / / Permittee Signature: eN z 2 e 7 Z .A9 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. 08/#27/2009 13:29 5036709572 Ft NEW TECH ELECTRIC PAGE 01/02 � I - }�;leztrica� Permit ,A,pplicatio ( ll��. ,„ `' d - „ UOR Ol' FICE USE ONLY r� Acco;vcd City of Tigard �p 7 PcrmitNO,:/ City o Hall 131vd„ Tigard, OR 97223 AUG 2 a 2009 Tint a ° 9 "054. G'L�avv9' D�f''�/y S Plan Review C .. Phone: 501639,4171 Fax; 503,598.1960 lha /l y; Other Permit: CITY F•t S i 6 lkD inspection Line' 503.639.4175 CITY 4e"t, #�, T IGAR Daic Rcsdy/By: � rtrr 4 ^ / � Sre Pnte 2 for • Internet” www tigard- or. gov i :, nf Nocd /ivtotho I: / G Supplemental information r I' i� `ka K1! 7.h " "i ir , 1 {f 1 pf '"..,);]:1' r rk �m (r ' �1 r �r� S ��f�YgY ��V� err r � �t g�IY' � +��v� Ig''.V'. )7 ' li�l� {U.t!�AAt�r A' A'CIY, ' "A ''tWlIIi(� ( i i C wa1 1�1�!' ., 'l ' t ° 'i !; .t l p' ' ��ifr? ,; j ; r iLI 1Mdlit tuJ t�kf��R } � v, INE4'A�lf� t'^li l { .' ''r. ,1 . In Now oonslruclion in ddition /alteration /replacernont Please check nil that apply (submit 2 sots of plans w /;term checked below). ❑ service or fccdcr 400 amps nr mom ❑ Building over three Stories, ❑ Demolition ❑ Other: where the available fault Current 9 Marinas and boatyards. r na . ' , Y � a,, :,n,, .r+ G cxccedc 10,000 amps at 150 volts or ❑ I buildings !t' Y �'�' AL 'j,i', i o " 1/02 � a niffeiffiFii@i�� i tad r's< Ni? 'I P 8 '�n � , . k1 s a :., 6. �16a x r nrr7�mMa, r,e, r r, x,ue�t,Y , arr,,,,i. i!a fir, a less lo ground, or exceeds 14,000 ❑ Commercial -use agricultural El 1- and 2- family dwelling W'ommercial /industrial ❑ Accessory building amps for all other installations bnildintsy• ❑ Multi- family 0 Master builder ❑ Other: ❑ Fire pump, ❑ Installation of 75 KVA or iii _ W:' , „ l l f r 1 „ I 9 > mer s larger separately derived system, `! i, yl^ ''i.a;hINII��4nxtwfelr,uwN�f i.� 4' iii S'�' "�"{'°' I i rkri9 -�ii 7i� ❑Addnlonofnewtmotor ❑.,A,. „F., „1_Z„.<1_g'. nn1 '�,Ra�ra r,�:a�aarki�Erita r11{ r�i'rrtt,.J, �,n�ra,,u,6r 1 rr'PY IlM Il Job no.: 3_05112 lob site address: '7 k 5 i J/ ,4i� or © six o A 100 o Of more occupancy. Rec more reettllal units. ❑ Recreational vehicle parka. City (State /ZIP: 1 'r^, ? a __ ii 0 4 9 7^'9_,2 4 ❑ Health -care factn ❑ 000 v norm oa r more than w�'+�- ❑ Hazardous locations, Suite/bldg. /apt, no,: OD Project name:,57 jr ,,e. Nei) pt t- ` Service or feeder 600 amps or more, � q f � ¢ p 1 �� I ii E � f �i �;iYt'rlr �9l h� llf : '' �� Eva 7' 9 I h'11�p! &� i lli &41 Cross st'rcctJdirections 10 job site: Deyeripiion I QV. I Fee. YAMS New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: ' Lot no,: 1,000 sq, ft. or teas 145.15 4 Tax map /parcel no.: Pa- add'I 500 sq. R. or portion 33.40 I y1q 6i Limited energy, residential 75.00 2 ,..li ., ' '� I.IS�,ti� . l! �i�.'� � yµ . 8 �, ! ,.an 7A& « ,j�tt. (�uk",n ' ' : .0 , r, l w .' 6 bl E'I � )5 flip' ' all'j� i r r ri�i � (with above sq ft) � '��Mt�v, A. i. ,,, 'r(� �ih „' ;?' �` f r ' ^rw +l��t�i`r �"'� ' / Limited energy, multi- family 75.00 00 2 Re c' -1 0 ti( L.; tl 1'r ” ,.-' co � residential (with above sq. ft.) -_ Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 r401, `' r VERS )BuG� ��y {1I i u �rj6'� 4 � ';, ; �Vy ;Ypt "°�`��1YY1r,��yl�,r��pry�g�6 P 201 amps to 400 amps 146 RS 2 SGf 4' @tlm,�� dttfi glut 1rc Ai�%i 114, l'I Y1 Pi { 1 4 ,,i PrGintV4,Rry i„d,�Pnd'I;m u_ Name: 401 amps t o 600 am . 160.60 2 — 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454,65 2 ,iy/ State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 66,85 1 Owner installation: This instal,ltktion is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, (case, rent. or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 i ahlrc: Date; Branch circuits — new alteration. Or extension, per panel Owner signature: _ i g A. Fee for branch circuits with th E l ; �', , „ I "liM'M�`1� 1 'il ii{i 61I�(ti1i�1 g'i I �� I � { jk' !";,t� ° y f '#`' .,�JN i ;s: N x above service or feeder fcc, N' 1 t ^,� �m1rn„ r » 1� ��,„ "�wr„v- „rli1�� Lei ,�� each branch circuit 61.65 2 Business name: 13, Fee for branch circuits f Contact name: itvithor t service or feeder fcc, L 46.85 t `$” 2 first branch circuit r Address: Each add'l branch circuit ° 6 .65 y 2 - - Miscellaneous (service or feedernot included) City /State /ZIP: Each manufactured or modular 90.90 2 Phone: dwelling, service and /or feeder ( ) Fox! ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53,40 2 r �. 4 .F 1 + 1 L x.' R J 4" G r,Y6 r t I , p,�r�� n,� r,, r n Sig” or outline lighting 53.40 2 , ,IN k ,l ''1't Vi' 1'i • fll�r M` i k 4 ILM i Tv,, � � v l ,)� i3r �l.! 1; kl 11r I d a ', ° ut'.l �, . , Ibr ld,l� � '# r s�3 � rt� � , � �(, Ctl� �s �i�� Signal circuit(4) or limited- Business name: .. G Eta ea%fir - 4 4 energy panel, alteration, or Address: /” / 3. 1 � ( ,d a ✓ 7 ,4. e— extension Describe: Page 2 2 tpjs City /State /ZIP g �/ "� Each additional inapeetitirf over allowable in any of the shove Per inspection 62 -50 Phone; ($p 3) 6 yp --/9'®Q 11; ¢x: (i ) 4 7 - rs'-7 Investigation per hour (I hr nun) 62,50 CC13 Lie.: i 1 1 c ?Electrical Lie.: e 4y�9' Suprv, L.ic, 44a.S Industrial plant per hour 7175 s� d f wtillbClW �r�iu�!� II' , � " ��` ' tG �� A v it� r t ' ' � ""a ° �i��'��t31v��1� K `� � � .. ' .�� 'l' :'; � +� , u ;n�':',I�II`� e Suprv. Electrician signature, required: Subtotal: -- �� / �eJ 7 3 Plan review (25% of permit fee), nt name: ut� " / / C ��p�f� ,t70 : r ` State surcharge (12% of permit fcc) 7 a: Authorized signature: TOTAL PERMIT FEE. Print name: This permit a pplicati,m capir if a permit is not obtai c within 180 1�arC: days after It has been accepted as COmple , ��pp n " Number of inspections allowed per pormil. n 1, 1nuilding\Permits \ELC- PcrmitApp tan 05/25/06 440 4515T(11 /oS /COMM/1k ` �' .'3 ■ s!!