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_7255 V DARTMOUTH STREET
CITYO F T I G A R D ELECTRICAL PERMIT _
DEVELOPMENT SERVICES PERMIT; E8/04, (10032
�Y DATE ISSUED: 1/118/x
Ly' JEW13125 SW Hall Blvd.. Tiqard, OR 97223 (503) 639-4171
PARCEL: 1 S136DC-04600
SITE ADDRESS: 07255 SW DARTMOU'T H ST
SUBDIVISION: ZONING: C-G
BLOCK: LOT : JURISDICTION: TIG
Proiect Description: Installation of one branch circuit, install small Hubbel under carper power. Job No. 8371.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDFRS_ MISCELLANEOUS
1000 SF OR LESS: 0 200 amp: PUMP/IRRIGATION:
EACH AQD'L 500SF: 201 400 amp: ,!:N/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR. 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER _ BRANCH CIRCUITS _ _ADD'L INSPECTIONS
0 200 amp: W/SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1�,t W/O SRVC OR FUR: 1 PER HOUR:
401 600 amp: EA ADD'I_ BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: >•=4 RES UNITS: > 600 VOLT NOMINAL:
L Reconnect only: SVC/FDR >= 225 AMPS-
CLASS AREA/SPEC OCC:
Owner: Contractor:
COMMERCIAL. NET LEASE REALTY, I ATLAS ELECTRICAL CONTRA;TORS
455 S ORANGE AVE, STE 700 4403 SE ROETHE RD
ORLANDO, FL 32802 MILWAUKIE, OR 97267
Phone: Ph; .a: 659-2212
Reg #: SUP 25815
LIC 1532_
ELE 3-2-C
FEES -- _ Required Inspections—..------
Type
nspections ______Type By _Date_ Amount_ Receipt _ Wall Cover
PRMT CTR 1/18/01 $40.85 2.720010000( Elect'I Final
5PCT CTR 1/18/01 $3.75 2720010000(
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR Specialty Codes and all other applicable laws
All work will be done in accordance with approved plans This permit will eApire if work is not starred within 180 days of issuance,or rt work is
suspended for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rules a-e set forth in OAP 952-001-001 G through OAR 952-001-OOaO 'i ou may obtain copies of these rules or direct questions to OUNC at(503)
246-1987
PERMITTEE'S SIGNATURE401 -- 1SS4113 BY_�`'–�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intinded for sale, lease, or rent.
OWNER'S SIGNATURE. T. DATE':__-
CONTRACTQR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: = F F– �l - %_�"'L
LICEIN'_` NO:
Call 639-4175 by 7:00pm for an inspectio-i the next business day
Electrical Permit Application
-- ' — Date received://8,0
P
City of -
�, Tigard � roject/appl.no.: Expire date:
Ciryqjt"Tigard Address: 13125 SW Hall 1110,Tigard,OR 97223 Date issued: By: Receiptno.:
Phone: (503) 639-4171
Fax: (503) 598-1960 1. lase file no.: Payment type:
Land use approval: .
1111111 all W Will a
U I &2 family dwelling or accessory 13 Commercial/industrial U Multi-family U Tenant improvement
U New construction U A(I(lition/alteration/replaccr.,,•nl J Other. U Partial
,
Joh address: 7255 SW Dartmouth Rlrl;. no :- Suite no : Tax map/tax lot/account no.:
Lot: Block: Subdivision: ---- --- _
Project name: Corvallis office M fDescription and locaticn of work on premiscs_Install small Hvbbel under car et
Estimated(late of completion/inspection .ower.
1 1
mon"; 8371
Business name: Atlas Electrical Contractors, Inc. ti's"�L°" t1+" ha) lotal nu Insp
E Roethe Road Newresiderdial-sinKkormulti-Tamil)per
Address: dtveW wdt.lnciu�k�etlarlxrl n s
— ng s vas
City: Milwaulcie State:OR ZIP:97267 Service Included:
Phone: 659_2212 ! Fax: -4944 E-mail: 100(1 sq.ft.or less -- t
1532 Each additional 500 sq.ft.or portion thereof
CCB no.: Elco.hos.lie.no: _
!imitedenergy,residential 2
C•it /mc ro lic.no.: 243 2
_ Y_ Limited residential
1/_16/00 Each manufactured home or modular dwelling
tiI nawn of supervising electrician(required)' Date — _Service and/or feeder 2
Sur,elect.name(prini) L I iccnseno :�ervfcesorfeeders–installation,
alwration or relocation:
200 amps or less 2
Name(print): 201 amps to 400 amps _ 2
-- ----
Mailing address: 401 amps to 600 amps 2
601 apps to 1000 amps 2
C'ily: Slate: I.IP: Over'.000 amps or volts –
Phone: Fax: E-mail: Reconnect only 1
Owner installation:The installation is being made on property I own Temporary services orfeeders-
which is not intended for sale,lease,rent,or exchange according to Installation,alleratIon,orrelocation:
ORS 447,455,479,670,701. 200 amps or less -- —^
-- -- 201 amps to 400 amps — _ 2
()wnerl's SI nature: Date: 401 to 600 ams 2
111101H I Branca circuits-new,alteration.
or extension per panel:
Nanle: A Fee for branch circuits with purchase of
%ddres!, service or fa:fer Tae,each branch circuit
City. Stale: ZIP: B. Fee for branch circuits without purchase
– — --
Phone: E-mail: of service or feeder fee,first branch circuit 1 (j,3 2
�I :�� —
FAch additional branch circuit
Ilse.(Serviceorfeedernot included):
U Service over 225 amps-commeroal J Health-care facility Each pump or irrigation circle
U Service over 320 amps-rating of 1&2 U Harardous location Each sign or outline lighting
rarnilydwellings U Building over 10,000 sq,rare feet four or Signal circuittsl or a limited energv panel,
U System over 6W volts nominal more residential units in me structure alteration,or extension* _
O Building over three stories U Feeders.4W amps or nk re •Descri tion
U Occupant load over 99 persons U Manufactured structures e.RV park Each additional Inspection over the aBownbM in any of the above:
U EgressAiphtirgplan U Other _ -- Per inspection --
Submit set%of plans with am of the above. I Investigation fee _
the above are not applicable to temporary construction service. Other
Nnt all jurisdict,%as ace-pt credit cants,please call jurisdiction for more informnuon. Notice:This permit application Permit fee.....................$ 46.85
U Visa U MasterCard expires if a permit is not obtained Plan review(at _ %) $
Credit card number._ —_ __-�L_ within 180 days after it has been State surcharge(8%)....$
Expires accepted as complete. A .......................$
- — p TOTL 0.60
Nuri of olaer u s�iown on credit card
S
--Cardholder signature — --— Amount 44p4615(6/00MM)
Electrical Permit Fees: Limited Energy Fees:
_-------.----------------
Complete Fee Schedule Below: TYPE OF WORK INVOLVED -RESIDENTIAL ONLY
Restricted Energy Fee...................................................... $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total
_ Check Type of Work Involved:
Residential-per unit
1000 sq.ft or Ibis _ $145.15 _ T a ❑ Audio and Stereo Systems
Each additional 500 sq,R.or
portion thereof $33.40 1 Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑
Dwelling Service or Feeder $9090 2 I Garage Door Opener'
Services or Feeders ❑ Heating,Ventilation and Air Conditioning System'
Installation,alteration,or r0ocation
200 amps or less $80.30 _ 2
I 201 amps to 400 amps v $106.85_ 2 ❑ Vacuum Systems'
401 amps to 600 amps $160.60 —_ 2 L�
601 amps to 1000 amps $240,60 _^ 2 l—) Other----
Over 1000 amps or volts $454.65 2
Reconnect only $66.85 2
Tpmporary Services or Feeders TYPE OF WORK INVOLVED -COMMERCIAL ONLY
Fee for each system......................................................... -1 ,.,,
Installation,alteration,or relrx;atiun Y � - �
200 amps or less _ $66.85 2 (SEE OAR 918-260-260)
201 amp3 to 400 amps _ $100.302
401 amps to 600 amps _ $133.75— 2 Check Type of Work Involved:
Over 600 amps to 1000 volts,
see"b"above. ❑ Audio and Stereo Systems
Branch Circuits ❑
New,alteration or extension per panel Boller Controls
a)The fee for branch circuits
with purchase at service or ❑ Clock Systems
feeder lee.
Each branch circuit i $6.65 Data Telecommunication Installation
b)The fee for branch circuits
without purchase ofservlce ❑ Fire Alarm Installation
or feeder fee.
First branch circuit 1 $46.85 $46.85
Each additional branch circuit $6.65 ❑ HVAC
Miscellaneous ❑ Instrumentation
(Service or feeder not included)
Each pump or irrigation circle $5340 ❑
Fact sign or outline lighting _ $53.40 Intercom and Paging Systems
Signal circuit(s)or a limited energy
panel,alteration or extension — $75.00 ❑ Landscape Irrigation Control'
Minor Labels(10) _ $125.00
Each additional Inspection over —i— ❑ Medical
the allowable in any of the above
Per inspection $6250 ❑ Nurse Calls
Per hour _ $62.50 _
In?het $73 75 �� ❑ OutdoorLrndsraoe L Ighttna'
Fees: ❑ Protectiva Signaling
Enter total of above fees s 46.85 ❑ Other _
8%State Surcharge $ 3.75
-- � ---Number of 8y8t1lfiH1
25%Plan Review Fee
See"Plan Review"sectlon on $ ' No licenses are required Lice ses are required for all other Installations
front of application -
--- Fees:
Total Balance Due $ 50.60
Fnter total of above fees $_
❑ Trust Account# 9%State Surcharge S
Total Balance Due S-
is ldsts\formskto-fees.doc 10/09/r`J
UN 1 F 1 ED SEWERAGE AGE34CY OF WASH 1 M.-TON c OM'ry
X 1 2 URE UfV IT fZAT 1 f K>5
'`) flee TOTAL TOTAL
F 1 XTURr- VALUE ,'`. NL *BER NLAMER
BAPT 1 STAY/FONT 4 —
BATH -- TU13/S74J7ER 4
- JACUZ/WHPL 4
CL)-P 1 DOR/VATER ASP 1
D 1 SFMASHER CDMMER 4
-- DOWi ST 7 I
DR 1 W 1 NIG FOUIYTA I,N 1
MOOR DRA 1 N t. 1 NCH 2 ~�
3 INCH 5 _
-' A INCH 6
GA IEUkGE D 1 SPO_SAL
- DOM (TO aft IIF') 16
` COMM (Tv 5 "F-) 32
1 ND (OVF-R 5 HP) 48
OIL SEP (GAS STA) F
- ;TALL 2
S 11K - BAR 2
BRADLEY 5
COF WRC 1 AL 3
- SERVICE 3
WA--4-IM. CLOTHES 6
WATER FJCT 6 —!
VATTOR CSE T 6
LR 1 MAL
Fac valL4- this ten r
EDU - this tenant
Idol. fx value - bid
Rm. E()U - b ldd .�
Sewerit
OATS INSP TOTAL
cG 1' EDU
u1CIS I NESS
PERM I T NJ.
TAX MAP/LOT'
rAUN-ED FROM
73-7.5 P83