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Permit 511 CITY OF TIGARD ELECTRICAL PERMIT Per COMMUNITY DEVELOPMENT Permit #: ELC2009 -00228 T t G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/21/2009 Parcel: 1S126BC01506 Jurisdiction: Tigard Site address: 9020 SW WASHINGTON SQUARE RD 400 _ Subdivision: - Lot: 0 Project: NEC Project Description: Install /alter (1) branch circuit. Owner: FEES WISCO REAL ESTATE EQUITY Quantity Description Date Amount FUND I LTD PARTNERSHIP, BY WYSE INVESTMENT SRVS CO, 1501 SW TAYLOR ST 1 crt Branch Circuits 05/21/2009 $46.85 PHONE: wo /Purchase Service or Feeder 1 ea 12% State Surcharge - 05/21/2009 $5.62 Contractor: Electncal E TECH ELECTRIC 3350 NW ASHLAND DR BEAVERTON, OR 97006 PHONE. 971- 570 -9298 FAX: 503 - 690 -9185 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $52.47 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 da s 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 Notificati enter. Th•se rules are set forth in OAR 952- 001 -0010 throug OA 952- 001 -0100 You may obtain a copy of the rules or direct questions to OU by calling 503 6.6699 r 1 a I. .:2344 Issued By: C o , ( 1 Permittee Signatur . / ru n 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. , E1 � ect rical Permit Application RECEIVE 1 FOR OFFICE USE ONLY City of Tigard Received MAY 21 2009 Plan Review . ■ ) ' _ _ 6� `��_�� 111111 ° 1 3125 SW Hall Blvd ,Tigard, OR 97223 Plan Review C Phone 503 639 4171 Fax 503 598 1960 Date/By Other Permit TIGAKD Inspection Line 503 CITYOFTIGARD DateReadyBy 1 riS ® See Page 2 for Internet www tigard -or gov BUILDING DIVISIO Notified/Method IG) Supplemental Information TYPE OF WORK ' ' PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below) ❑ New construction "ddition /alteration /replacement / ❑ Service or feeder 400 amps or more ❑ Building over three stories ID Demolition ❑ Other. where the available fault current ❑ Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ,ommercial /industrial ❑ Accessory building amps for all other installations buildings ❑ Multi- family ❑ Master builder ❑ Other ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION p ❑ Emergency system larger separately derived system El �f k/ I�Fr f^�� Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ", Job no.. Job site address / OZ 0 .5 q q /� � S or more occupancy V ❑ix o or r more residential units ❑ Recreational vehicle parks. City/State /ZIP. / ❑ Health -care facilities. ❑ Supply voltage for more than ©� ❑ Hazardous locations 600 volts nominal Suite /bldg /apt no • 4.00 Project name ON L /o/l ^ /'j p o Sw -/ El Service or feeder 600 amps or more • - /!/ FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no • 1,000 sq ft or less 145 15 4 Ea. add'I 500 sq ft or portion 33 40 1 Tax map /parcel no.• Limited energy, residential 75 00 2 DESCRIPTION OF WORK (with above sq ft) _ 77 Limited energy, multi - family 75 00 2 4 ( �/ /M19 residential (with above sq ft ) Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2 Name: 401 amps to 600 amps 160 60 2 601 amps to 1,000 amps 240 60 2 Address Over 1,000 amps or volts 454 65 2 City/State /ZIP. Temporary services or feeders installation, alteration, and /or relocation Phone ( ) Fax. ( ) 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 599 amps 133 75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date. A Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6 65 2 Business name. B Fee for branch circuits without service or feeder fee, Contact name: 46 85 2 first branch circuit Address: Each add'I branch circuit 6 65 2 Miscellaneous (service or feeder not included) City /State /ZIP. Each manufactured or modular 90 90 2 Phone: ( ) F ( ) dwelling, service and /or feeder Reconnect only 66 85 2 E -mail: Pump or irrigation circle 53 40 2 CONTRACTOR Sign or outline lighting 53 40 2 Signal circuit(s) or limited - Business name: G = rr-ee, 5 c - C energy panel, alteration, or Address.-?-3,5-0 J ? / � ` � si � l tA� i, / extension Describe Page 2 2 City /State /ZIP: p��- v" , 7 ao 4, Each additional inspection over allowable in any of the above Phone q `7 / J _ 9'2 Q Fax ( 1/ 3) 6 5 0 - � / - Per Investinga 62 50 U ( U gation lon per hour (I hr min) 62 50 CCB Lic • /S�S36 Electrical Lic . Supry Lic. OT, Industrial plant per hour 73 75 r ELECTRICAL PERMIT FEES Supry Electrician signature, require@ - L - Subtotal Print name N/ C2 XI f L - Date • 2 /_ O 5 Plan review (25% of permit fee) c� /4,1 i State surcharge (12% of permit fee) Authorized signature: TOTAL PERMIT FEE. ` Q • ( 47 This permit application expires if a permit is nut obtained within 180 Print name' Date' days after it has been accepted as complete. Number of inspections allowed per permit i \Building\Permits\ELC- PermnApp doe 05/23/06 440- 4615T(I 1 /05 /COM/WEB Electrical Permit Application - City of Tigard ❑ Other , • • Page 2 - Supplemental Information Total number of commercial systems: LIMITED ENERGY PERMIT FEES: No licenses are required. Licenses are requir for all other installations RESIDENTIAL WORK ONLY: Fee for all residential systems $75.00 combined Check Type of Work Involved: ❑ Audio and Stereo Systems'' ❑ Burglar Alarm ❑ Garage Door Opener'' ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 - 309 -0000) Check Type of Work Involved: ❑ A udio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ D ata Telecommunication Installation n F ire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control** f l Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling 1 \Bu ldmg\Permos\ELC- PermiiApp doc 03/23/06