Loading...
Permit q CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2009 -00213 Date Issued: 05/12/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111BB01500 Jurisdiction: Tigard Site address: 10362 SW MCDONALD ST Subdivision: Lot: 0 Project: Washington County Detox Center Project Description: Install /alter (3) branch circuits for ADA restroom. Owner: FEES WASHINGTON COUNTY Quantity Description Date Amount FACILITES MGMT, 169 N FIRST AVE MS42 3 crt Branch Circuits 05/12/2009 $60.15 HILLSBORO, OR 97124 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 05/12/2009 $7.22 Contractor: Electrical MILESTONE INVESTMENT CO INC 1800 NW 169TH PL. SUITE B700 BEAVERTON, OR 97006 PHONE: 503 - 645 -5323 FAX: 503- 690 -4843 Type of Use: Class of Work: 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 thro •;' 952-00J:0100. You may obtain a cop y of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: • J.. _ I . _0 :■ ' . ' , Permittee Signature: 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. May. 7, 2009 3:24PM Milestone Electric ,-).y,; p 1 11 CA14 I LA 1 ; Llectrical Permit Application p ^ I roc:oF'FICF i-'SF.0\1.1 City of Tigard ►+ � • i r► e eecei 1;5.'1 - Gq PmmitNa.: El t700 �' a' 13125 SW Ilan RM., Tigard, OR 97 0 e) fi 73 p • `7e,o Phone: 503.639.4171 Fax: 503.598.1962 ■ A v O 7 2009 1a Other Permit MH1 TIC :l !. D Inspection Line: 503.639.4175 . We iteadgriBy: .hair is SeePape a ter Internet: wavw.tigard or.gov ; NotifiedfAdethert t C.) 1 Sopplementa la!rurnartien !,,, OFTIGA� t, ; TYPE OF w M DIVISION -`, <..�'w'. . _._ P lease che all that (submit Set Ot=gia s•wfttems:cheelced below t D New construction /�Addition/alt ; • , p ecemeent 400 amps m >` f/ C3 Service or feeder WO a or more [Mudding over three stories. Q Dem olition 0 Other where the available fault current Ct Marinas and boatyards, ;;IA;....',.':::!,:: CATEGORY OF CONS'T'RUCTION us>�eeds r0,000 amps at 130 volts or ['Floating buildings. less to ground, or exceeds 14,000 C} Commercial-use agricultural . (D 1- and 2- family dwelling Commercial/industrial 0 Accessory building amps for all other installations. buildings. Multi- family Master builder 0 Other: ! ! UFirc pump. 0Installation of 75 K'V'A or JOB S ITE INFORMATION AND LOCATION D AM- Edo noy system. larger separately 1- system. • , ... DAM tion of new rotor load of 13"A"„ "EV••', , ""1_2 2"", , "1_3°. , • Job no.: 1 t Job site address: .5 Six or or mace, occupancy. l ( �� �! (. 3/3' ( . ��,t�' ! p Six or more residential units. 13 Recreational vehicle garb, ' �, alth-care fact7ities. El Supply voltage for more than . City/State/ZIP: 77 0 � ( q� ./ y 7 x C3llarardous locations. 600 volts nominal. Suite/bldgJapt no.: ' Project name: X- el r I amps or more. "' t ` �� E]Savice ar !coder 600 a ., . :..S .:S CI3li1I' � .... Cross street/directions to job site: "9 na ,dot W [. Q4 i ice ' '.,', Toed New residential single- or multi laml1y dwelling unit. includes. attached garage. Subdivision: Lot na.: ' : 1,000 sq, ft, or less i 145.15: 4 , 'Ea, add't 500 sq. it or portion i , 33.40 1 Tax map/parcel no.: . ^ i l `; '' ; •, y � y( ��� , :; ; energy. res 75.00 11i , \;,> �:. ::. O1B' p .. (with above � ..I . r u ^' 'r�. t A I n •1µm: r .�;4.' .. , Limited energy multi- family 75.00 ilk I. C P o o -a ,� r , , 4iA 3 S- IAt ' i f / q• ) * • � res ide ntial with above s ft. � '. IN Services or feeders installation; alteration, and/or relocation ' 200 amps or less 80.30 2 .:: , R.O .; (3 Tit* F : 201 amps to ps !4 " a pI][1:T1( ';'..;• 400 am 106.85 i 2 Name N. � 1 1 , 1 : i 401 amps t0 600 amps ' 160.60. ; 2 (;f � Q b il, ‘i4 4-e tt (,J D IA ' J 4 1 i 601 amps to 1,000 amps i 240.60 i ! 2 Address: A. Af ✓ : Over 1,000 amps or volts 454.65 2 - City /State/ZIP: / / �p , / ; Temporary services. or feeders installation, alteration, and/or / /.S rG Dr CJ P � � � G •1 + relocation Phone: 3 b ,f 4b 74' 1! Fax: ( ) : 200 amps or icss 66.85 1 Owner insta[l'atiotr: This installation is being made on property that I own which is not • ; 201 amps to 400 amps 10030 2 intended for sale, lease, rent, or exchange, according to ORS 447. 449, 670. and 701. . . 401 amps to 599 amps j 133.75 ; 2 • Branch circuits- new, alteration, or. extension, . r pane[ Owner signature: Date: ' A, tee for branch circuits with- i :`•`; i '.: ;;;-.;' .:. fl tPPticANZ';;.'i ` ,• , . [.. CoN1 tCr PEllso I' :',:i :; .... above service or feeder fee, . each branch circuit 6.65 2 Business name: , 13 :, Fee for branch circuits. without service or feeder fee, '! ' Contact name: fast branch circuit ; I 46.85 : 2 ' Address: ! Each add'I branch circuit ! Z, 6.65 1 ;, ! 2 ' Mlscelbuseons (service or feeder not included) ? City /State/ZIP: : Each ma©nfacnuad on morhsiar dwelling . service and/or feeder 90.90 Z Phone: ( ) [ Fax:: ( ) Reconnect only 66.85 Z E- mail: [, ,rt , Pump of irrigation circle 53.40 ; 2 . ,:.00�1 ibitAC'?OTt 'r it tr IS'= ' I r - Sign outline lighting . 53.40 j ' 2 • 1usiness name IfeF.c.,iey Signair ciscoit(s) or'united , elt i'7 energypanel, alteration or i Address: h _ extension Describe: Page 2 2 City/State/ZIP: ,/yry /e f s� /1 9 7 �/ � . Each additional inspection over allowable in any of the above 1 ::. Ph one: , j� !"�- /'�, 7 3//V IO ; p inspection 6 2.50 01/ z . Fes: (5 �� d - ' �': 3 i Investigat per hour (1 hr m in) 62 ', CCB Lic.: g q R 0 Elcchical Lic- 3(,�..L, ;IC , Suprv. Lic.: �.,/ /: 9 al plant per our • 73.75 1 t • 1 E! •� 1. 1 • IT - 1 b • 1 • to ' ., .• Industri , 'EIE.IECTR1CAL PEIR l ` ';:.� Suprv_ ectncian signature, required: Cr�'x r a Subtotal: . _ w , Print Warne Plan review (25% of permit fix): �iU`llllA7Yt..d A. r L / Rate: - �.. 4 State surcharge (12% of permit fee): : 7, 2.. t • Authorized signature; . . TOTAL PERMIT PER (g, 7, 34, Print name: • Date: ni. permit appMeatioe expfsesira permit i nee ebkoned sada ISO daxsafe it has ken aoeeptaearenmpkee. • !lumbar of inspections allowed per permit. r \noildionn.rmiter c PertnitApp doe 05/23/06 440.4615T(1 UM/COM/WEB CP 7. 7