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Permit . CITY OF TIGARD ELECTRICAL PERMIT is COMMUNITY DEVELOPMENT Permit #: ELC2013 -00286 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/22/2013 Parcel: 2S113AB00300 Jurisdiction: Tigard Site address: 16037 SW UPPER BOONES FERRY RD 100 Project: Simpson Property Group Subdivision: FANNO CREEK ACRE TRACTS Lot: 38 Project Description: (4) branch circuits for TI. Contractor: STEELE ELECTRIC LLC Owner: OREGON STATE BAR, THE 716 ROXE DR 16037 SW UPPER BOONES FERRY RD FOREST GROVE, OR 97116 TIGARD, OR 97224 PHONE: 503 - 332 -1280 PHONE: 503 -620 -0222 FAX: 503 - 372 -6448 FEES Quantity Description Date Amount 4 crt Branch Circuits wo /Purchase 05/22/2013 $78.44 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/22/2013 $9.41 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 0 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. `.t Issued By: Perrnittee Signature: o/c/ ,70:73z/c4-7-7-6-, 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 603.639.4176 by 7:00 a.m. for the next available Inspection date. 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. 05/20/2013 13:42 5033726448 Steele Electric #0930 P. 001/002 Electrical Permit .Applica A !J EC IV E D FOR OFFICE USE ONLY City of Tigard IN ig 2O 3 .i 11 Received /Mir Nog' 20 S-00 13125 SW Hall Blvd., Tigard. OR 9722M AY 2 O Dane/8 : Permit { Plan Review Other P ere ( 0/3-000 93 Phone: 503.639.4171 Fax: 503.598.1960 Elate/By. Ti GA R U Inspection Line: 503.639.4175 � IGA C ITY ®F Date ReadyBy 7 gl ^ Pam 2 for Internet www.ti -org • I ► , V I i vsION Notified/Method: ! S uppl4 , nCatal lnf o rm atiou OtefS . 'K' A't` s f ..?. ^ r A re'V " 4 +A . 4 A k t ° +! •"' - . "v <.�]'. gq .m•.v . �. :�" ' '' %ci y .a"a ^ � ,�. ii ;V � � � s � �5. .o . , eve �,` c �� ; ' =� _- .1L J"' n. .,� 1 � 1� .,. :.., ... .. ,... S�i" �Q' m� . ❑ New construction lin Addition/alteration/replacement Please check all that apply (submit g sets of plans w /items checked below): El Dea101ition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories. -g •ger -r,- u where the available fault current ❑ Mamas and boatyards. S*. � 4 r i -- i � � t 1t tt ,5 9 c c , a & 1F� r e Y&2 ..A mat ✓ �°vg' =Cab 10,000 at 150 'MILS or Fl oating buildings. ❑ 1 - and 2 fealty dwdli g COSnmercial/industr l iii ? ~ Irk less to ground, or exaxds 14,000 ❑ Com ial -ose a g ricul tural Accessory building amps far all other insertions, ❑ Multi ❑ Master Oth er OM= um buildings. aster builder ,-. } 1a © pump. ❑Installation of 75 KVA or v>i 14W �V $7,:. fi e >., a C IS � y ; c "� . , , as . 0 Emergency system. separately deli i< ,,}� y'rµ vox, w r i . K } li l.. i'� i:t .,. . :, �.; o nor'ib Y ved system. a a t,wewrscr.l uar�, ,...r..4 ❑ Addition of new motor load of ❑ "A ^, "E", "l.2", ^1 - Job no.. Job site address: I U U s. 1001W or more. OC Opancy. "' r`� ❑ Six or more residential units. ❑ Rem/clonal vehicle parks, City /State/ZIP: 'F' \ , ( „ 1 _ 4 .-1 _ D D 22 c v . P.. . ❑ Health -care facilities. in Supply voltage for more than _ l� Cl Hazardous locations. 600 volts nominal. Suite/bldg/apt. no.: i u D Project name: S , ay.., D ru. • 0 Service or feeder 600 amps or more, Cross street/directions to job site: '4F"; ^, �? . 3 9-;I:4 75: r , .a75 . t ': 00•. Pa. Taw • New residential single- or multi family dwelling unit. _ Includes attached garage. Subdivision: { Lot no.: 1,000 sq. ft. or less _ 168.54 MIN 4 Tax map /parcel no.: Ea. add'] 500 sq. R, of portion 33.92 i tr ti D w 77 -� ' , fi t - d t S t;®; r �x !w ! w Limited energy, residential . f t aGal � xr.' ,, �.... * .. , ':w.d .: o - . , 1 ± i s S;f S ..i. v ry 3 with above . ft 75.1)0 e Limited encrgyy, multi family III T 2 (�i,. v ,v v. rw residential (with above � • - R 73.00 2 Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 <w•-. ;t +�ua ;I i �y�.• .xr ” v,, + .+ f: l'k. ^` 201 am tp 400 am •��. , ;.��": °_- �'s�da�- wc: ""�' .':t.:'r� ^, ;.�.'�- 1•'.x .,v dl! r; ' 'X �� +..a p5 P 133 Name: 401 amps to 600 amps 200.34 2 -- . 601 amps to 1,000 amps 301.04 2 Address: Over 1.000 amps or volts 55226 2 City/StaLe/Zlp: Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 20 _ 1 amps to 400 amps E25.o8 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Owner signature: Branch circuits - new alteration, or extension, . - r • • del A,1 nat rev -, ; , c � ,, Date A. Fee for branch circuits with ' ? rt :y; a a 0 � : h e ' ! .; above service or feeder fee, " " j ^ each branch circuit 2 Business name: B. Fee for branch circuits withora service or feeder fee, fast Contact name: branch circuit 2 Address: Each 'l branch 7.42 :2 Miscellaneous service or feeder not included City/State/, EP: Each manufactured or modular III 67.84 2 d Mkt • service and/or feeder Phone: ( ) Fax: • ( ) Reconnect only • E mall Pump or irrigation circle 67.84 r �, 67.84 2 'Sy� y." ^�..,;�'� -. 1..... J..,.be w ti% ' S d. $ � t,,:wr:.: '�w --fit ' " + , y "' t ..... rye ,,. . y Si or ou tli ne lighting 2 1 �_'� 4 ': I ` e =' ... t tr- * Signal circuit(s) or liarited- energy Egli Business name: S 4. — z,... t/_ •. .el, alteration. or extension. - 2 Address; Each additional inspection over allowable in any of the above 2 l 6 Q -. v-? Additional inspection (I hr min) 66.25/ hr City /State/ZIP: ..- (} Investigation (1 hr min) 66.23/ hr - Fir S 6 r e C et t .lo lnril — ¢trial ptarrt (1 hr min) 78.18/ hr one: ( Z c 1 `l i heath listed hr min (�� 3 - t 2 • Fax: (j� 3) • • -- - ens for which no fee is �. hr 11 CCB Lic_: vc ( l Electrical Lim: L Su rv. Lic.: , Suprv. Electrician signature, red: ?� required: _ Subtotal: "'"�� Plant review (25% of permit foc): - Print name: Q r� S Z Date: c i ze, i ` 3 State surcharge (12% of permit fee): Authorized signature: TOTAL PER MIT FBE ; g -�iC �/ "'�- -- _� _ This permit application expire!, if a permit is not obtained within 180 '7 Print name: Date: days after it has been accepted as complete • Number of invections allowed per permit / E 07/01/10 44 0.4615T(11/051CO ip von