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Permit CITY OF TIGARD ELECTRICAL PERMIT 71 r n Permit #: ELC2011 -00704 COMMUNITY DEVELOPMENT TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/15/2011 Parcel: 2S111AD10000 Jurisdiction: Tigard Site address: 8710 SW REILING ST Project: Fannie Mae Subdivision: SCHECKLA PARK ESTATES Lot: 59 Project Description: Reconnect only. Contractor: Owner: FANNIE MAE /BEN COFFEE 9635 SW PIER PARK PL PORTLAND, OR 97203 PHONE: PHONE: 503 - 320 -7847 FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 12/15/2011 $67.84 Specifics: 1 ea 12% State Surcharge - 12/15/2011 $8.14 Electrical Type of Use: SF Class of Work: OTR Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports (Conditions) This permit is ' --nPd 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 ' accordant ith 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. TENTION: Oreg law r es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -00 -0010 through OAR 9 -0 -0090. Y u may obtain a copy of the rules or direct questions to OUNC by calli ..•..K 32. 987 or 1.800.332.23• • . ■ Issu d By: t/i^4.42A....,(0, Permittee Signature. �� ii� %LVr / �� 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. 12/15/11 01:45PM PST -> City of Tigard Permits 5035981960 Pg 1/2 • pl4g ) Permit Application V� 1.0 i 1 t 11 Ili t 1 ,i`ia%; l: N.ce City of Ti and � 1 � � O '*\ NTA JJ Permit leo.: tV -et) , 13125 SW Ha1I Blvd,,'I'igard, *, � a Pllom: 503 Pax. Rl + ' :.1960 ►„ 1 1 , ,, , , Inspection Line: 503.639.417 ..,1 G `t�. Di R ndylgy: his: El See Page 2 der intemat: www.tigerd- or,aov X, 'S1 �� N ad /Method: Su, , temente; information O " ..Gw PLAN REVIEI New construction ❑Addition /alt - , , • , - •ement Please ohock ell that apply (submit 3 errs of plans w/dams checked :law): El Service or feeder 400 aim* or more ❑ Bending over threw atones. ❑ Demolition ► i Other: 12.e. -tyyl h 1e C - i 0 Y) I where the available theft currant El Marinas and boatyards, ,.. • ' :: '.CA'tEGf tV • OF 'CONSTRECTION : ' exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -rue agriaultunrt re I - and 2- family dwelling (21 Commercial/industrial ❑ Accessory building amps tar all other uutaltatlone. buildings. 0 Multi-faiTli1 ❑ .Master builder 0 Other: Olin pump. ❑ Installation of 71 KvA or ...> Mil INFORMATION APR') LOCATION Q P,mergeocy system. larger separately derived system. ❑ A./Ail o motor load of ❑ "A ", '•P" "1.2 "1.3 Job no.: Job site address: '3 '1 I () S I e . , &I ,0011.P pr mom, occupancy. Q Six or more residential units. ❑ ROCroadmal vehicLa prim City /State /ZIP: t CA (Ca k ❑ Health earo faoititiea, 0 Supply voltage ter more Hiatt CI Hwsudoua locations, 600 volts nominal. Suite/bldg. /apt, no.: Project name: 0 Service or feeder (100 amps or more. Cross street/directions to job site 44 ' / FEE 6GIIEDULE: I 61 w e ' sew 100. ti- I_41z1- ' 1 „_ Toll _ T ''g F5111 New residential single- or multi-tangly dwelling unit, fi t R. t Includes attached garage. Subdivision: - ' he C. k. .. F'ck ( ',onto.: 1 ,000 eq, ft. or Tess 168.34 4 La. add'? 500 sq. ft. or portion 33..92 I Tax map/parcel no.: , r Limited energy, residential 75.00 . . . ,., ..rl} POTION OP `WORK. ' . .: ..: ,, (with eb9vo sq. ftA Limited energy, multi - family ;e 76.00 Ill .COYIne t Cry-1 - L. L.0 C. k FOX cQ , residential with above : ft Services or feeders installation alteration and/or relocation 200 amps or less ME 100.70 nom 201 amp to 400 amps 133.56 P�tl�'pl�Ii'1'Y'..`ovVHii;x ; : ©'r'tNANt' •: ,. � MEM 401 amps to 600 amps � 200.34 MOB! Name: ` • QY dl Y'I r"1 l�' GI 601 amps l0 1,000 amps 301.04 El Address: .3S N ? 1 ' r Par k (' I s Over 1,000 amps or volts 552.26 2 City/State/ZIP: (+ a G�" 1 �- a 7a Temporary services or feeders Installation, alteration, and/or at relocation Phonc: (SO ) ZU O- Pax: (3)3 ) 33 L _ 2 3 200 amps or less 59,36 _ 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not - intended for sale, lease n t, or exc.. , according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Owner signature: Branch circaita - new, alteration, or extension, . erpanel /� 1f Date: / 2 /r ZD l A. Pec for branch circuits trtth above service or feeder fee, 'El APPLICANT : ►�: •CONTACT. PERSON.. :,... 742 2 each branch circuit fl. Fee for branch circuihl without f ^- service or f001107 t first 56.1R Contact name: , ,r-, lam. , r . branch cimutr Each MITI branch circuit 7.42 Address: 9 ( A.) - 0 l - .r Pa ( {� t� ( Miscellaneous (service or feeder not Each manufaohucd ormodulat City /State/ZIP: pc,- (. rt d [l. 2_0 dwcliint- serviceand/orfeeder Phone: ( .b3) 7 20 :•---1 F- LI Fax:: (9) 3) —z - & ltewnnectonly I 67,84 iiiiii Pump or irrigation circle 67,64 E -mail: Sign or outline lighting rang II 67, 84 111111 CONTRACTOR . -. Signal citcuit(s) or limited-energy Business name: .anal altered() or extension Pa , 2 ._ - ..__ Each additional inspectinn over allowable in any or the above Address: Addi inspec (1 hr min) 66,25/ hr City/State/ZIP: Investigation (I hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone; ( ) 011111.11.111111MI Inspections for which no the Is 90 ,00/ h EMMIIIII _iflcall. listed 14 hr min) Electrical Lic.: Suprv. Lie: ELECTRICAL PERMIT FEES • Subtotal: 1G'1, $ Suprv. Electrician signature, required: Plan review (25% of permit fee); by State surcharge (12% of poi mit fee); '$ . 1 Authorized signature; TOTAL PERMIT FEE: 15, This 'limit application expires it a permit in not obtained width 180 /� days after It leas been +rcepted an complete. (/ • Number of mspoceionsr sllowed per permit. I :1BuildlntTemib114,C PamiIApp.doe 07/71/10 440.461STYl iiusicx)OAIWPB