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Permit n CITY OF TIGARD ELECTRICAL PERMIT 11111 COMMUNITY DEVELOPMENT Permit#: ELC2015 00664 Date Issued: 08/20/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: SEG952 Jurisdiction: Tigard Site address: Project: PGE Subdivision: Lot: Project Description: (1)new 100 amp service for communication cabinet adjacent to 9369 SW Tigard St. Contractor: DESIGN ELECTRIC INC Owner: PO BOX 821616 VANCOUVER,WA 98682 PHONE: 360-885-0058 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/20/2015 $100.70 Specifics:, amps or less 1 ea 12%State Surcharge- 08/20/2015 $12.08 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 952-001-0090. You may obtain a cops or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: �� � 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 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 tho job site at the time of each inspection. 09/17/2014 07: 38AM 3606660323 DESIGN ELECTRIC INC PAGE 01/01 Electrical Permit Application I OR (4)1(II I `I 0\1.1 City of Tigard \10) RDaten3 • ./rJ11 ���i 13125 SW Hall Blvd.,Tigard,OR 97223`' '' f 31 Plan Review Related Permit ft: Phone: 503.718.2439 Fax: 503.596,196 .. Date Inspection Line: .503.639.4175 TV'-) Ready Date/By: Fa See Page 2 for 1 (,,,l:f1 �` p Internet: www.tigard-or.gov J Notified/Method Supplemental Information TYPE OF WORK �-.�t:1- 1,`.-"�e k('N PLAN REVIEW ®New construction ❑Addition/alteratl iTPL1aGek Please cheek all that apply(submit Z sets of plats w/items checked): ❑Demolition ❑Other: ("�■_��� ❑Service or feeder 4(t)amps or more ❑Building over three etorieo. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings, [J 1-and 2-family dwelling CI Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 p commercial-use agicultraal 111 Multi-family ❑Master builder amps for all other installations builalnes. ❑Other: ❑Fire pump. ❑Installation of 150KVA or JOB SITE INFORMATION AND LOCATION 0 Zrnergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address:9369 SW Tigard Street 100HP or more. ❑"A",`E•• "I-2""1-3", ❑Six or more residential units, occupancy- City/State/ZIP:Tigard Oregon 0 vehicle El Health-care facilities. parks. Suite/bldgiapt#: Project name:Astound-Wave Broadband 0 tearanaous locations. D Supply voltage for more than Q Service or feeder 600 amps or more 600 volts nominal. Cross street/directions to job site:Tigard&main FEE SCIIEpItLE nescripnoa I Qtr. 1 E.eh I Tart 1 Ntry residential single-or multi-family dwelling mail. Subdivision: Lot#; Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#:SEC952 Fa,add'l 500 sq.R.or portion 33,92 1 DESCRIPTION OF WORK Limited energy,residential J5.00 2 New 100 amp PGE service with 60amp feed to communication cabinet (with above N.R) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy © See Page 2 ❑ PROPERTY OWNER r ❑ TENANT Services or feeders installation,alteration.and/or relocation Name: 200 amps or less 1 100.70 $100.7 2 Address: 201 amps to 400 amps 133 56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: _ _ relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670.and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date; 401 amps to 599 amps 168.54 2 ® APPLICANT I 0 CONTACT PERSON Branch circuits—new,alteration,or e,tension, r panel A.Fee for branch circuits with Business name:Design Electric Inc above service or feeder fee, 7.42 2 each branch circuit Contact name:Ron Halme B.Fee for branch circuits wruhuru Address:PO box 821616 service or feeder fee,first 56.18 2 branch circuit Ciry/State/ZIP:Vancouver WA 98682 Each add"'branch circuit 742 2 Miscellaneous(service or feeder not included) Phone:(360)852-3961 [Fax: :(360)666-0323 Each manufactured or modular 67.84 2 dwelling service and/or feeder Email:Rhalme@designelectric-us , Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Design Electric Inc sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:PO Box 821616 panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP:Vancouver WA 98682 ..� Each additional inspection over allowable in any of the above Additional inspection(1 hr min) e 66.25/hr Phone:(360)852-3961 f Fax:(360)666-0323 investigation(1 hr min) 90.00/hr Email:Rhalme@designelectric.us Industrial plant(I hr ruin) 78,18/hr Inspections for which no fee is CCB Lic.: 173159 Electrical Lic.: C394 Suprv.Lic.: 5342S ape eificaily listed(h hr min) 90.00i nr ELECTRICAL PERMIT FEES L Suprv-Electrician signature,required: Subtotal: 100.70 Print name: Gary Halme Date: 8/20/2015 ❑Plan Review Required(25%ofpe permit rmit fee)- State surcharge(12%ofpermit foo: 12.08 Authorized signature: TOTAL PERMIT FEE' 112.78 This permit application expires if a permit is not obtained within 180 Print name: Ron Halme Date: 8/20/2015 days after it has been accepted as rAmprete_ • Number of inspccnons allowed per permit 1:tnuilding'Permir l•C_Pernut.4pp_ECR ERE.doe Rc.06117/2015 440.466151111/ORCOMIWER