Permit • a.
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00229
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/22/2009
Parcel: 2S 102AA02302
Jurisdiction: Tigard
Site address: 12202 SW MAIN_ST��
Subdivision: Lot: 0
Project: Fletchco
Project Description: Install /alter (3) branch circuits. •
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 wo /Purchase Service or
PHONE: 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 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: / Permittee Signature: e� (9 //°GEC �9770N
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: 004 OF 005
Electrical Permit Applicati ECEIV 1 Mil( 1 t:SI 0 \L1
City of Tigard eiiv kl
:"� 3 AY 1 2009 �' •.�� 616 1 3125 S W Hall Blvd., Tigard, OR 9722 Plan Review Other Permit
Phone: 503.639.4171 Fax: 503.598.19 Date/By
1 - i , l � Inspection Line: 503.639.4175 GIB G� Ti(' R D Data y /�' t • ' ® See Page 2 for
Internet: www.tigard Notified/Method: I I Supplemental Information
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❑ New Please check all that apply (submit a sets of plans w /items checked below):
New construction N Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
}, �ti• j- _;- .y - k" w_3:: - amps ❑ Floating vg. =�i.; �� � exceeds at Floatin buildings.
�� -- _ 'r '= ,s : '- ' ' = ° -� ?'°r .. _` r 42 :.,7, less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations, buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
larger separately derived system.
Z€.r�c ,>x:�.� ° v �: P v t r �?i��.- • '�`�`- •�.� -s:�...
n� J E ;'r �� � - lraro,��. i � '.,.� . ,SSv, � �� -� s -a�u� 0 Addition of new motor load of ❑ "A•• , • E „ "1.r.- 1 3
Job no.: L q - 76 Job site address: /220 S �✓ , ''fA /AI 5 T Six R c r eatio n
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: T'/ 6A 2O OR / . 7 2.23 ❑ Healthcare facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: F[ F TG HCU ❑ Service or feeder 600 amps or mote. �
J
_ 0 '
Cross street/directions to job site: F xT ro Po oF� = <<E § }< .. Description Dty. Fm Total •
� New residential single- or multi - family dwelling unit.
frh e A/ A'i ii-y /AkS14 4 e- Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'1500 sq. ft. or portion 33.40 1
I t arc a zs. r . , c -' r Limited energy, residential 75.00 2
'a 7 < s.: 1 T �' i 1 . L }� ,,, - . ^ .. c s•. t • 3 ,' i ti :' (with above sq. tt.)
ENS /�G Y TIQUS T Limited energy, multi - family 75.00 2
Le / e firiNG RI .5T/�0 / T residential (with above sq. It.)
Services or feeders lnstallationolteratlon, and/or relocation
200 amps or less 80.30 2
;1`24 _ � e _ ' .i . 201 amps to 400 amps 106.85 2
Name: FL( PRoPr-Rli - $ LL C 401 ampsl0600amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: / :2.&2_. S G'/ Mq / S 7 Over 1,000 amps or volts 454.65 2
City/State/ZIP: 7-7 6A ,e; G / 0/ / 9 222 3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (R j3? - 2 / 6 y' I Fax: ( ) 200 amps or less . 66.85 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 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 ex tension, r panel
A. Fee for branch circuits with
1_ .
.2, _... -` _:a s�t .c. t `m ` t ti "� above service or feeder fee
�._.._w..._.� ._ 665 2
J j(j dr ` Fee fhor rbran c branch Business name: B. r Fe o barth cicuits
without service or feeder fee, 1 46.85 9' 2
Contact name:
6640 / 9L�'u . - first branch circuit
Address: � � / /y /l . �0 � _ Each add'1 branch circuit 2 6.65 f 3,30 2 2
7� lQ 1 r Miscellaneous (service or feeder not included)
City/State/ZIP: ' #. / 10 •'. J _ Each manufactured or modular 2
f 3 3 . !75 5/ Fax: 3, l 5 j dwelling, service and/or feeder
Phone:
( < ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
� Yae 7.`: .1;:1 3 r�3sr i °_r °�° ` tx z . s?E' ' Sign or outline lighting 53.40 2
� �=- .g .,.- �.:.:; e, � t �: ,,:::-<2- .�, =`�'`� �s� '� .
.... rr'_-._ r:. ��sr�r'. �h., u ���:. r..:. i•. vw: _, t•_.: �• a .=•;- :,- �:,._ �•. `,�'.`,,.rll' - �sv_
Business name: /� Signal circuit(s) or limited-
}(, 4 d Q (t fi^I • C. energy panel, alteration, or
1 /� extension. Describe: Page 2 2
Address: J2.5 A /6 7 n y e n pct
7, ; speed
City/State/ZIP: --3 / i • J '_ I/^t° Each additional inspection over allowable in an of the above
L�
M Per inspection 62.50
Phone: (9 ,)3 . 3 . /7_53 ' 7 Fax: ( lz 0 233 . 7,--5.,5,_a investigation per hour (I hr min) 62.50
CCB Lic.: / / 7 Electrical Lich f , _ 4 Suprv. Lic.: �+ )C 7 .3 Industrial plant per hour 73.75 •
, ieg -41: -_- 1 :lS i :„.127 -s 1J 1 01); A - - ri. t --:,. ; -y-ft ::r==..
Suprv. Electrician signature, ret)uired:
A pfr . . Subtotal: . 60, /g'
Print name: f Date: / � /i g�0 Plan review (25% of permit fee):
• - /= State surcharge (12% of permit fee): 7 , 22
Authorized signature: ��- TOTAL PERMIT FEE: 6 7, 3 7
Print name: 0, La. 1 A 1 r / )& C ,, 1 Date: 5 / /0 y Tbb permit appdays after i I ht bee a n acc ep ted as coo b
not millet within 180
' ,(/ , _ t � days after t u becctmplete.
' Number of inspections allowed per permit.
1:: Building■PnmifIELC•PetmitApp.doc 0503106 440-46t 5T(11105ICOM/WEB