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Permit
i' fly OF T I GA R D �� PERMIT #: ELC2002 -26001 i. DEVELOPMENT Ip SERVICES ) 639 -4171 DATE ISSUED: 10/1/02 PARCEL: 2 S 110 D C -02200 SITE ADDRESS: 15570 SW PACIFIC HWY SUBDIVISION: WILLOW BROOK FARM ZONING: C -G BLOCK: LOT : 011 JURISDICTION: TIG Project Description: Installation of (3) branch circuits for beverage bar. 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: 2 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: TIGARD, CENTER LP STONER ELECTRIC 9777 WILSHIRE BLVD #609 1904 SE OCHOCO STREET BEVERLY HILL, CA 90212 MILWAUKIE, OR 97222 Phone: Phone: 503 - 462 -6500 Reg #: ELE 26 -122C FEES Required Inspections Description Date Amount Rough -in [ ELPRMT] ELC Permit 9/27/02 $60.15 Elea! Final [ELPRMT] ELC Permit 9/30/02 $0.00 [TAX] 8% State Tax 9/27/02 $4.81 (additional fees not listed here) Total $64.96 This Permit is issued subject to the regulations contained in the Tigard Munidpal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at (503) 246 .6699 or 1- 800 - 332 -2344. Issued By: Permit Signature: f - %C' 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 639 -4175 by 7:00pm for an inspection the next business day 09/23/02 MON 12:39 FAX 5036594968 THE STONER GROUP a001 Electrical Permit A.p li- ti_ ara il iar i4Lm . Date received: 9 ©p ?�- Permit no.:624 200 2'264 4 ,�,j;1t:�'�i City of Tigard '1 ` Projcct/appl_no.: Expirc date: City of Address: 13125 SW hall Blvd, Tig )R29 02 D issued: Sy -� Receipt no. Phone: (503) 639 -4171 Fax (503) 598 -1960 ��� ` . P ' � - Case - ' .o .. Payment type: Land use approval: 7"" - - - \,g TYPE OF PERMIT O I & 2 family dwelling or accessory Commercial/industrial 0 Multi- family 0 Tenant improvement ' ❑ New construction ddition/alteration/replacement 0 Other: O Partial . JOB SITE INFORMATION Y - % • address ", --,5 717 - 5 , , Bldg. no_: Suite no.: Tax map/tax lot/account no.: • t Block Subdivision: Li Project name :,,,./.y I/7 r Description and location of work on remis _Q l/ Estimated date of completion/inspection: I P) ('ONTRACTR O APPLIC,ITION ,.,... . ,.,__ ._ ry — , _ TEE,- C:h SFDU!E..,_L.. -- _____ ._- k) , 1 ' ' ob no: S zs s Fee Max d . = usiness name: S— n, wale - �� a Pb� Qty. (c) Total no_ [asp New t+esideotbal -angle ormulti-family per a Address: 1 9e4 dx.hattfl dwelling wdc.Indade unacied ' 3 City: M $ LU PtseJE I State:o. .I ZIP 9'72.x2.. Serticemcludcd: Phonel A...LEA_LSDa I Fax:/al I E-mail: 1000 so. ft. or less 4 Each additional 500 sq. ft_ or portion thereof CCB no.: 4. 445es , 4120 0 N I Elec_ bus. lic. no: 2,4.--1 LZ, e , p� City /metro 'c. no.: y(N/ ( /0101/0.3 - Limited energy, tmdw a 2 Limited energy. non-residential WI I " 9,4,46 . Each manufactured home or modular dwelling Signature of supervising electrician r- uired) pate a , i Service and/or feeder 2 Snp. elect name (prinU_ �[ i _ ' lea/ - _ License �; Services orfeedett:— Installation, alteration or relocation: . PROPERTY OWNER 200 amps or less , 2 ' Name (print): 201 amps to 400 amps 2 Mailing address: ao 1 amps to 600 amps 2 601 amps to 1400 amps 2, City: I State: I ZIP: Over 1000 amps or volts • 2 Phone: I Fax: I E - mail: Reoonnectonly ' t Owner installation: The installation is being made on property I own °ran' genic" °rfeedcrs which is not intended for sale, lease, rent, or exchange according to °01, iOj ' t1Om ORS 447.455, 479, 670, 701. 200 or less 2 201 amps to 400 amps 2 Owner's signature: Date: 401 to 600 amps 2 B ranch dranits - new, alteratio n, or extension per pact: Name: A. Fee for branch circuits with purchase of Address: • service or feeder fee, each branch circuit 2 City: I State: E-mail: ZIP: B. Fee for branch circuits without purchase Phone: Fax . E -mail' of service or feeder fez, first branch circuit: I %. . � 2 Each additional branch circuit: 7 , 4 / S a l PLAN REVIEW (Please check all that apply) Mlle • (Service or fader not inclnded): - O Service over225 amps commercial O itealth-carefacility Each pump or irrigation circle 2 O Service over 320 amps - rating of led CI I lazard us location Each sign or outline lighting 2 family dwellings 0 Building over 10,000 square fact four or Signal circuit(s) or a limited energy panel. O System over 600 volts nominal mote residential units in one structure alteration. or extension* 2 O Building over thneestories 0 Feeders, 400 amps or mote •Description: o Occupant load over 99 persons Cl Manufactured structures or RV party Each addttiooal Inspection over the allowable In any of the :Worm O F$ss/lightingplan Cl Other. -- Per inspection I I I I Submit sets of plans with any of the above. Investigation fee The above are not applicable to temporary construction service. Other , Not an.0Mo:4ctiarc =ors credit cards. please can Jurisdiction for more infasmation. Notice: This permit application Permit fee $ l . / 0 , O Visa Q MasterCard expires if a permit is not obtained' Plan review (at %) $ O F Credit samba: I I within 180 days after it has been State surcharge (8%) $ t 6 it ca - expires TOTAL accepted as complete. T OTA )l. $ to if. 9 Name of andlidder as .Lowe on credit card _ S Cordbolder algoatene Amomr 4404615 (6100/COML f?'' lY