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Permit CITY OF TIGARD ELECTRICAL PERMIT 11111 a ..," COMMUNITY DEVELOPMENT Permit #: ELC2009 -00513 T f G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/02/2009 Parcel: 2S112DD01400 Jurisdiction: Tigard Site address: 15686 SW SEQUOIA PKWY Subdivision: Lot: 0 Project: Courtyard By Marriott Project Description: Add /alter (21) branch circuits for lobby renovation. Owner: FEES PACIFIC REALTY ASSOCIATES Quantity Description Date Amount PO BOX 58990 SEATTLE, WA 98138 21 crt Branch Circuits 10/02/2009 $179.85 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 10/02/2009 $21.58 Electrical Contractor: JARMER ELECTRIC INC 5105 SW 45TH AVE #200 PORTLAND, OR 97221 PHONE: 503 - 246 -5381 FAX: 503 - 244 -8037 • Type of Use: COM • Class of Work: ALT Type of Const: Occupancy Grp: Total $201.43 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: q13-1016P C ._ 1 I j7/ 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' � • � 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. ,Le rical Permit AppliRECREIVED roil order usE ON I.1 City of Tigard SEP 3 0 2009 Received 14 Pens* No.: e( oe ., 00 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 /4. - " .. \ Other Pernik: Q . 00 ( 1 , Inspection Line: 503.639.4175 CITY OF TIG ' ° --� ° , I � Date/B : P2O0 Internet: g Date Ready/By: lirral ® See Page 2 for BUILDING DIVI i ' Notified/Method: Supplemental Information • TYPE OF WORK PLAN REVIEW ' ❑ New construction .n Addition/alteration /replacement Please check all that apply: ❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ['Hazardous location ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential ❑ 1- and 2 - family dwelling $ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure ['Building over three stories OFeeders, 400 amps or more ❑ Multi- family 0 Master builder 0 Other: JOB SITE INFORMATION AND LOCATION DOccupant load over 99 persons ❑RVof k lured structures or ['Egress/lighting plan par Job no.: R 7 ? f I Job site address: ,r4 1%G ,lk, S uo1,¢ 19.eit#1 ❑Health-care facility ❑Other Submit 2 sets of plans with any of the above. City/State/ZIP: The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: I Project name: % FEE• SCHEDULE {l�IQ ..v 1 4 -ty� /� 5 Deeerlpdon I Qty. I Fee. I Total I •• Cross street/directions to job site: New residential single- or multi-family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: I Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular �t? /PiNpV�? -'�Q A - ) Services service and/or feeder _ 90.90 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 • ❑ : PRO PERTY OWNER. I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 Name:. 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City / State/ZIP: Reconnect only 66.85 2 Temporary services or feeders installation, alteration, and/or Phone: ( ) I Fax: ( ) relocation 200 amps or less 66.85 I 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel • . ❑ APPLICANT I ❑ - CONTACT PERSON A. Fee for branch circuits with service Business name: or feeder fee, each 6.65 2 branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, / 46.85 ! �� 2 Address: each branch circuit Each add'l branch circuit 2 6.65 / 33 4) 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- CONTRACTOR energy panel, alteration, or Business name: .4 M E. 2 , extension. Describe: Page 2 2 7A. Address: S/ a �W Y ("1"--- , Sr e_ 10 0 Each additional inspection over allowable in any of the above Per inspection 62.50 City/State/ZIP: /O0-2 i i.-,4- A.I 4 © 2 9 7 2 2 / Investigation per hour (I hr nun) 62.50 Phone: (S53 2. I./ Co ° (c3 6 I Fax: (.503) 2 - eo 3 7 Industrial plant per hour 73.75 "ELECTRICAL . PERMIT FEES* CCB Lic.: (p 9 2 y Electrical Lic.: 2?o / 41 2i- Suprv. Lic.: 1 /O 1/y5 Subtotal /17y Vs Suprv. Electrician signature, required: /' G.--.,..,_ Plan review (25% of permit fee) Print name: j -z 4 2 T %hi Al e ate: 9 -2 g_ 69 State surcharge ($ fpermit fee) 2/ OE TOTAL PERMIT FEE 20/ y2 Authorized signature: k - C � P .4 ' This permit application expires If a permit Is not obtained within ISO 1- \ L } days after It has been accepted as complete Print name: d CO \- \ ✓1 c) o \ N tM I Date: q _a 0` , 00k • Fee methodology set by Tri Building Industry Service Board •• Number of inspections per pemit allowed i:\ BuildingTermitACLGPermitApp .doc 12/03 440.4615T(10/02/COM/WEB