Permit CITY OF TIGARD ELECTRICAL PERMIT
Permit
a : COMMUNITY DEVELOPMENT #: ELC2009 -00233
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/22/2009
Parcel: 2S102AA02302
Jurisdiction: Tigard
Site address: 12200 SW MAIN ST
Subdivision: Lot: 0
Project: Fletchco
Project Description: Install (3) branch circuits for energy trust lighting retrofit
Owner: FEES
B -B -B- PROPERTIES Quantity Description Date Amount
C/O FLETCHCO PROPERTIES LLC, BY 3 crt Branch Circuits 05/22/2009 $60.15
JEFFREY B FLETCHER, 2065 FAIR OAKS CT
Feeder
Service or
PHONE: 503 - 639 -2169
Feeder
1 ea 12% State Surcharge - 05/22/2009 $7.22
Contractor: Electrical
ABC ELECTRIC
135 NE 9TH AVE
PORTLAND, OR 97232
PHONE: 503 - 233 -7551
FAX: 503- 233 -7552
•
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 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 R 952 -00 - 00. 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: Permittee Signature: QN ,- / /'•/C,49-no
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'N 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.
. 5/18/2009 3:01 PM FROM: ABC Electric ABC Electric TO: 5035981960 PAGE: 003 OF 005
.t - •
Electrical Permit ApplicatiRECEI V Et) „Olt OFFICE 1,st: ()NIA'
City of Tigard e Z ; Permi
IN
NAY 1 8 2009 Received ��B : - / a/ .
13125 SW Hall Blvd., Tigard, OR 9722 Plan Review
Phone: 503.639.4171 Fax: 503.598. p : Other Permit:
1 ti A I; D Inspection Line: 503.639.4175 CITY OF TIGARD Da Ready/By; See Page 2 for
Intmmt: www.tigard- or.gov : UILDING DIVISION N° "fied�"t"� Supplemental Information
-_ sr tt •r F "• ..^" I r °4 yn - - G; - xT,a •• si:r , eu rr.:`,re. _ < ;,. : - �?77 - C: �[ s ` r
31•-`_ n L�'sa - 4't A i` a ' '' = t' �Yy ,- i 1 ...� j { L•_ as 4 .."e t S �' . . 1 :_ -- 1 e - _
�••..`�i FE �� �a.�'�ZL�i:C1� v � ' . -� G1r }i�3',� .....¢i:M. ]i'1"{ti R �. S ._° �s��^�.G _
El New construction ® Addition /alteration/replacement Please check all that apply (submit 3 rep of plans w /items checked below):
❑ Demolition ❑ Other ❑ Service or feeder 400 amps or more ❑ Building over three stones.
where the available fault current ❑ Marinas and boatyards.
:" -"'- '= ' zi` n'aa: 1
_ 7 1 .; -• tip - • s�t�: :--tank" ; ;r. sY'� •-
� a - .} , - ` p _ �'- {. J,� 1 �` tp Q e. - ' .�:_g_ a , exceeds 10,000 amps etl50volrsor ❑Floating buildings.
' � ' , :i. 19 . : °' X J` 1 M"' "' less to ground, or exceeds 14,000 ❑ Commercial -me agricultural
❑ 1- and 2- family dwelling Si Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
• ,_ �r -. 7`: tLe= r' :;3 ; v i 4 r �+_ } - ❑ Emergency system. larger separately derived system.
• ..3 _1: 3 rs r ..e. 3 ; '•.r , - ri ` :i��_' _ *tr _ ? s . 'a . 'dr . x s - oii ❑ Addition of new motor load of ❑ , .A E ., .. 2 „ 1 . 3 .,
Job no.: L -04 - 76 Job site address: /2 2e 0 S t,,,, MA //V S 100 or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks
City/ State/Z)P: ] / 6A R h / (1v • 7 7 2..23 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Ft f l C IGLU ❑ Service or feeder n 600 amps or more
1Y REARigETI15
Cross street/directions to job site: /(/FA T ro ?OS% OFF/ LE De olation s Qty. Fee. Total •
New residential single- or multi - family dwelling unit.
�4 .f1 7" includes attached garage.
Subdivision: f Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential
O =. aL Lry, a .� - - T r a .c i I. ['- , �^ ,s•*v, ,J lrx.ri_`. .- r 7 { •v ?.• , , 75.00 2
F•� ..-.3. 1. r 1.? 1,. __. r -A. . 1 _v l 3 r ' 1 - } v ° ,. _' � : 5 .. ,. !'. (with above aq. ft-)
Limited energy, multi-family 75.00 2
FNF/ ?6 Y T 115 % L. t ,' /1,7N6 Rl - "7 F / T residential (with above sq. R) -
Services or feeders installation and/or relocation
200 amps or less 80.30 2
�� K3 n ` ¢
--_ -� - �-,» V ): A fi de~ w c.. � r. , �ri:�a { .r 4C.,. 201 amps to 400 amps 106.85 2
Name: F' L (' TC NCO P Ro Pr- g17 LL 401 amps to 600 amps 160.60 2
, 601 amps to 1,000 amps 240.60 2
Address: / = 2 (;) I 5 L :/ /-1,4 /'✓/ s":1 Over 1,000 amps or volts 454.65 2
City/State/ZIP: ,`-/ C 1,72 L' / e k / 9 7 7 2 3 Temporary services or feeders installation, alteration, and/or
_ relocation
Phone: ( ) '3 ? - 2 / 6 I Fax: ( ) 200 amps or less ` . 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps I 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps ( 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, r panel
_ A. Fee for branch circuits with
' Fs : t ..ta,1r ' w.. r:: : a-Pi. t h . -st .,1; t >c t ?. !.:F above service or feeder fee, 6.65 2
Cfr� C Fee b
branch circuit
Business name: B. Fee for branch ch ci rcuits
� without service or feeder fee, i 46.85 q - 2
Contact name:
6k.) (J%v � . 2. first branch circuit
Address: ,43,5 �� ' y L, ld a , , Each add'I branch circuit 2 6.65 13,7() 2
G t_ Miscellaneous (service or feeder not included)
7 !I/
City/State/ZIP: viand _ Or 4'7�3a Each manufactured or modular 90.90 2
_/ _ dwelling, service and/or feeder - Phone: ( x„33 .,75b I Fax: : ( X 7.9 3. 75 Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
- -,�$ f ` ti s " ham} r - C .,r. : - ,r
1. -E '' '` ti- • ' f: tt-xd . a Sign or outline lighting 53.40 2
<.>3:w _4.. *h^a,., 1. � t
;r.:•fsi��...... - : _ _ ,_S 3_ � a .z.aer3. , y � d• -�.� :.
Business name: Q/; r Signal circuit(s) or limited-
J �. r / ('i I G energy panel, alteration, or
Address: 13./5- ,( /�� o 9/ kV") , extension. Describe: Page2 2
City/ State/ZIP: / -_,2,,te
te „„p p` u ( - re (v 9 _ Each additional inspection over allowable in an of the above
Cri rn l _ 5 _ Per inspection 62.50
Phone: (ID 23 .j , 17,S.."---/ I Fax: t (/ d) :)33 . 752 Investigation per hour(1 br min) 62.50
CCB Lic.: /6,,.'577/ Electrical Lich tel Suprv.Lic.:,5Z)9'6.7 .6 Industrial plant per hour ,. .7 5
Je v X 41 � 1` 4 s era _7 /F. '^t '"v:. 73 :. : ' : a f: ,;;', -
Suprv. Electrician signature, required: L Subtotal: c ; . . 1 /-
• Print name: t ?G /A )Ai ` / �.i Date: 5 / C� Plan review (25 %ofpermit fee):
State surcharge (12% of permit fee): 7 , 22
Authorized signature: -- y-_ _ _---- TOTAL PERMIT FEE: 4 7, 3 7
a r4i�_/ /7r` �zr p� J Date: J / C G, This permit application expires if a is not obtained within ISO name: d
/ g / days after It has s been n accepted as complete
• Number of inspectieos allowed per permit.
I: 'Building mPermas \ELC.PermitApp.doc 05/23/06 440.46157(11/05/COM/wES