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Permit (10) CITY OF TIGARD ELECTRICAL PERMIT Fl I COMMUNITY DEVELOPMENT Permit#: ELC2016-00501 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/27/2016 TfCa�4TT� g Parcel: SEG3746 Jurisdiction: TIGARD Site address: SW NO ADDRESS Project: Frontier Subdivision: Lot: Project Description: (1)200 amp pedestal service&(1)branch circuit in vault for Frontier. Located at 150th&Hawk Ridge Rd. Contractor: INLAND ELECTRIC INC Owner: 360 SE BASELINE HILLSBORO,OR 97123 PHONE: 503-681-4700 PHONE: FAX: 503-681-4738 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 06/27/2016 $100.70 Specifics: amps or less 1 crt Branch Circuits w/Purchase 06/27/2016 $7.42 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 06/27/2016 $12.97 Electrical Type of Const: Occupancy Grp: Total $121.09 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. Yo ••- •stain. opy o ules or direct questions to OUNC by calling 503.232 98 or 1.800.332.23 .�q Issued By: •ermittee 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 the job site at the time of each inspection. Electrical Permit Ap 1.4; : 't 1 tV FOR OFFICE USE ONLY f 1 Received 0 Kelm e CityofTigard Perm": 111 a 13125 SW Hall Blvd.,Tigard, 2 2016 Plan R : i g �!�•' ,05-(:) g U Plan Review Related Permit 8: Phone: 5017182439 Fax: 503.b9B.1460 pate/B Inspection Line: 503.639.4175 t-t c e Ready Date/By: tuns: 0 See Page 2 for T IGAR1 Internet: wwvv.tigard or.g l C y 0F' TIGAcRD NotifiediMethod: Supplemental Information NEIIO�IVISION PL.A1! REVIEW New construction ❑Addition/alteration/replacement Please check al!that apply(submit 2 sets of plans otitems checked). 0 Service or feeder 400 amps or mem 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling Q Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Vlulti-family ❑Master builder Other: 9 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergencysystem. larger separately derived Job#:64 9 5 Job site address: r - 9 Addition of new motor load of system. �► s -- I 10011P or more. ❑"A" "E' City/State/ZIP: f t,t v ax- C31'l/` �'1 aL€t 666' ,rf/n ❑Siz or more residential units. occupancy. J �, r ❑Health-care facilities. ❑Re l'eational vehicle parks. Suite/bldg./apt.#: Project name: 5-1-0),,\-c-e, pp,,s, , ❑Hazardous locations. ❑Supply voltage for more than 4 v t ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: /� FEE SCHEDULE \SQ Yt" /\1t_ kkA. �` r V ,d�� De<eripdon i Qty, I Ears 1 Total I • (,/�V (,,-V., V` New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea add'I 500 sq,ft,or portion 33.92 ] DESCRIPTION.OF WORK Limited energy,residential 'T'_�*( *1 P�1 Ev t J_ IC, (with 0th above sq,ft.) 75.00 2 ��\ L [J. S" �/ Limited energy,mufti-family 75.00 2. sq residential(with above sq.It) Renewable Energy , 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less , 100.70 iQa1 (1 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 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 l intended for sale,lease,rent,or exchange,according to ORS 447,449,670.and 70L 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 1 . 0 APPLICANT • I © CONTACT PERSON Branch circuits new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, r each branch circuit I 7.42 -7 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 5b i8 2 branch cirenit • City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) _ Phone:( ) I Fax::( ) Each manufactured or modular 67.84 2 Email: dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: "..,\G,.6. _.4.C,.. -1-%(-- ' a C.. , Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: ,S C. (J 6 ctist,, t,r,,,,, c.sN- panel,alteration,or extension. ❑ See Page 2 2 City/State(ZIP_ kkA%‘1F.:0QCIO �Vyx, .•^ '.1 I) Each additional inspectonover allowable inany ofthe above � Additional inspection(I hr min) 66.251 hr Phone:(5c)3,) (r%t 4.-r) Q 0 Fax:(63s) GI I L031 Investigation(I hr min) 90.00/hr • Industrial plant(1 hr min) 78.18/hr Email:SOW y 4,.,.st.o.co\ tG‘ti<_,,s, e.,. Inspections for which no fee:s 90.00/hr CCB Lic.:j5\ (,31, Electrical Lic.:94 Sig (✓ Suprv.Lic.: 1. S specifically listed(d hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:�� Subtotal: J a% 12.. Print name: 4..1L.,rypj.s-z\ Date:G'/ft/1(r ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 1,� 17 Authorized signature: TOTAL PERMIT FEE: 1.4,0117w This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. J :'B teildiag\PernetsiE-C_PennitApp EIR_ERE.doc Rev06117/2015 440.46151(11/05!COrr1/wEB P 31I* ts Z.d 99£0109£05 'ONI 01210313 ONV 1N1 8Z17:90 91 91 unf I--: 14943 22 - T 1496Q= FRENCH PRAIRIE 54 CABERNET bRlvE -\ eN 2t 15w o97HTA NO. 2 = —J1s 15 FRENCH PRAIRIE 1497,0 �c1497 s� „398 1 76 �� FOUND 3/ 6ainAs Asnc G1S344 15e194 15172 15146 15098 15064WITH , Al'� scRi®ED ' T+No DI NNEERINc SERVICE " 1 15310 15300 15240 15022 iNscRi®ED Hen R PLAT OF'StJNRJDCE HEIGHTS' Nass•S�� C_7(14_!4__./.,": DOki1 2.5' BASIS ut BEARINGS NO9aTHEAS — N89'52 52' 1318.35' NORTH ES SOt1THEAS• 15458 15411 15321 15339 15277 15265 15223 7 15191 15159 sEcnOd B 41 39 38 TRACT H 15117 ! 15025 — SW THAMES LANE —' — — C. -T— t0 S 15047 r — — SW THAMES � D 149551493' 15452 15420 15378 15360 63 05 156340 15326 157 68 284 15270 1558 15236 1523 8 I 15172 15150 15110 SW SOPHIA �, 15095 3 __---_-_ I • 32 i'; DAVIS TRACT A j 15121 151086 15391 15367 15335 '45 e 1149321° Lor z 47 w 15303 7a 15156 81 BO 7g 15243 ♦ 3t 15138 15407 15261 75 15227 Docwue 15153 St 76 / 15188 2005-, 48 17.00'ROW SW MISSISSIPPI COURT DEDICATIONS TRACT K 15206 �3 15177 15160 6 0i' 15150 0 29 L 49 v1 Sian tn 77 OtR\ 14,92. p o, 15189 I 15192 55 57 TRACT K 40, 15230 \ 5D 15415 15381 yoP �,°�,, 1525228 ® f TRACT t 9 " 27 6 w "'p 51� SEINE 15290 a1 7 I o' v-`-"'- 15075 15045 15015 �! 1 15312 15111 TRACT 0115490 15476 15450 15422 15392 15376 �I= a` \ SW DANUBE DRIVE W'1 14935 15260 i �' to 5t sz • s3 ,a - - - ;c;, , TRACT® r 155220 152041 r 15230 i I y GRAYHA 5 TRACT J- 15233 ,,, ' � 20 15260 15263 j 15250 � '� 8 t6 11 ii 15280 15285 a t7.00 ROrs ®I 17 t 2 v 15270-"" DmlcAnad 14945 I TRACT D "15277 a 15306 15307 h m t9 13 15 10 1 I 1 �� — — — — 15341 15328 15331 !am i TRACT l '3I 15 to- ALor 2 3 ' jJ � l_ nA J i— SW HAWK RIDGE ROAD TRCTE _ds l TRACT L S89'55'53'W 1318.53' s/ V 7RAGT AO iI �I 89 55'b3'E `— DOCUMENT NO. 2090-015175 , h f E�29' — _ `' 1.4990 FOUND 5/8"IRON ROD'PITH YELLnt4 Pt AQTP ran - u...... ', ,� 360 SE.BASELINE ST HILLSBORO OREGON INLAND ELECTRIC 503-681-4700 503-681-4738 INC [website] Fax To: DEBBIE CITY OF TIGARD From: STEVE WORD Fax: 503-598-1960 Pages: 2 Phone: 503-718-2439 Date: June 16,2016 Re: PERMIT FOR FRONTER cc: [Name] X Urgent ❑ For Review ❑Please Comment 0 Please Reply ❑ Please Recycle Comments: PLEASE CALL ME FOR CREDIT CARD NUMBER THANK YOU 'd 99E01,09C09 'oNI 01?110313 17:90 9L 96 unr