Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00177
DEVELOPMENT SERVICES DATE ISSUED: 3/27/03
AIiI 13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 1 S135DD -00900
SITE ADDRESS: 11875 SW PACIFIC HWY
SUBDIVISION: HOFFARBER TRACTS NO.2 ZONING. C -G
BLOCK: LOT : 021 JURISDICTION: TIG
Project Description: Partial electrial permit to allow work to start on tenant improvement prior to review and issuance of
E LC2003- 00176.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: • PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
LEFEVER, GEORGE & TAMMY NEW TECH ELECTRIC
11875 SW PACIFIC HWY 6950 NE CAMPUS ST
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: Phone: 503 - 648 - 1900
Reg #: LIC 41868
SUP 2113s
FEES ELE 26 -4I8c
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 3/27/03 $46.85
[TAX] 8% State Tax 3/27/03 $3.75 Elect'l Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work wi : - • • - ccordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for •re than 180 days. 'TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
fo in OAR 952 - 001 -0011 rough OAR • - --0: -0100. You may obtain copies of these rules or direct questions to OUNC at (503) 246 -6699 or
1- :00-332-2344.
By: • al/ � �1 _ g
Iss . • d B I 1,f% � � � �� � / Permit 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 INSTALL /TION ONLY
SIGNATURE OF SUPR. ELEC'N: ...ffdr3v DATE:
LICENSE NO: �� S S
Call 639 -4175 by 7:00pm for an inspection the next business day
66/.
.. ,
r e,,, Electrical Permit iipplication .
• Date received: �f� Permit no.: ' ;1.In -D4 / 7
ra, � � iii
� ( j,,,. ie City of Tigard Pro ect/appl.no.: A lai
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: .Earn Receipt
Phone: (503) 639 -4171 IN
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval:
• TYPE OF PERMIT • •
0.1 & 2 family dwelling or accessory 0 Commi :rcial /industrial 0 Multi -family iiti Tenant improvement
0 New construction ❑ Additic•n/alteration/ eplacement ❑ Other. 0 Partial
- JOB SITE INFORMATION .
• Job address: ; ' • . , 1111 Bldg no.: Suite no.: Tax map /tax lot/account no.:
Lot: Block: Subdivision: /
Project name:Zna-P�Fio - yy►e - 0 4..5 I Descrip lion and location of work on premises, r /-i 47 i?t " t" (// 74--
Estimated date of completion/inspection: Q ,2Q0
CONTRACTOR APPLICATIOi - FEE SCHEDULE '
Job no: Fee Max
Business name: New Tech Electric Description Qty. (ea.) Total no. map
Address: 6950 N E Campus s W a New residential - single or multi-family per
P Way dwellinguniLlnclude: atfadtedgatage-
City: Hillsboro StateOR 21P: 97124 Servkeinduded:
PhoEd33- 648 -1900 Fax6 48 -3131 E -mail: 1000 sq. ft. or less 4
CCB no.: 41868 Elec. bus. lic. no: 26 -418C Each additional 500 sq. ft. or portion thereof
L energy, residential 2
• /metro lic, no.: Limited energy, non 2
3_.2 7 . Each manufactured home or modular dwelling
of supervising a ectrician uired) Date Service and/or feeder 2
p. elect name (print): Z ,1. r ,/ ..- ..,..4, ,_ Li.xnse no:3 . Servicesorfeedees feeders–Installation,
alteration or relocation:
PROPERTY OWNER 200 amps or less 2
--�'`—
Name (punt): T,4e,f i e r T i o e.,5 201 amps to 400 amps , z
Mailing address: , n(�
► ma'� 401 amps to 600 amps 2
•_ y' 601 amps to 1000 amps 2
City: • a/ 22 9 72 Z Over 1000 amps or volts 2
Phone: Fax: E -mail: Reconnectonly 1
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to installation, alteration, orrelocation:
200 amps or less 2
ORS 447, 455, 479, 670, 701.
201 amps to 400 amps 2
Owner's signature: Drte: 401 to 600 amps 2
' ENGINEER- 8raach'circults- new, alteration,
or extension per panel .
Name: A. Fee for branch circuits with purchase of 7
Address: service or feeder fee, each branch circuit / . 2
City: State: .2P: B. Fee for brunch circuits without purchase
Phone: Fax: E-mail: �] of service or feeder fee, first branch circuit: 2
Each additional branch circuit
• PLAN REVIEW (Please check all Ilia IETEMIIIIII Mdse .(Serviceorfeedernotlncladed):
yi Service over 22S amps - commercial 0 Health - care facilit y Each pump or irrigation circle 2
• O Service over 320 amps-rating ofl&2 O Hazardous locaticn Each signoroutlinelighting 2 ,
family dwellings 0 Building over 10, )00 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal mom residential units in one structure alteration, or extension* - 2
O Building over threestories 0 Feeders, 400 amp tormore *Description:
O Occupant load over 99 persons O Manufactured stn mctores or RV park Each additional Inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other: _ inspection I I I l
Submit _ sets of plans with any of the above. investigation fee •
The above are not applicable to temporary consb action service. Other
Permit fee $ ` /6 ;
Not all jurisactioos accept crest cards, please call jwisaction for more Intl mad= I. This perm app •
• O Visa 0 Mas Iv,, , • / 4 , expires if a permit is not obtained Plan review (at — %) $
y State surcharge (8%) 7
Credit - ■ within 180 days after i h as b een � ( ) ••• $ ��
.••�'����' `�I)/
accepted as complete. TOTAL $ D • 6'0
Er _ ''/ --- __ . Trust Account # 41868
Amsaat • 440-4615 (6100/COM)