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Permit C ITY OF T I GA R D ELECTRICAL PERMIT PERMIT #: ELC2006 -10009 ,PFVELOPMENT SERVICES DATE ISSUED: 3/1/2006 = '! 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1S134BC-00200 SITE ADDRESS: 12192 SW SCHOLLS FERRY RD ZONING: C -G SUBDIVISION: GREENWAY TOWN CENTER LOT : JURISDICTION: TIG Project Description: (1) branch circuit for rooftop unit. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /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: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: ELLIOT ASSOCIATES OES LLC 50 SW PINE ST SUITE 200 5285 NE ELAM YOUNG PKWY # A600 PORTLAND, OR 97204 HILLSBORO, OR 97124 Phone: 503 - 972 -7192 Contact #: PRI 503 - 693 -6000 FAX 503 - 693 -8660 FEES Description Date Amount Reg #: ELE 34 - 572C [ELPRMT] ELC Permit 3/31/2006 $46.85 L1C 159395 [TAX] 8% State Surcharge 3/31/2006 $3.75 SUP 45875 Total $50.60 REQUIRED ITEMS AND REPORTS This Permit is issued subject to.the regulations contained in the Tigard Municipal Code, State of OR. Speaalty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if wor!'r`s not started within 180 days of issuance, or if 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 re set f AR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these r r direct questions to OUNC at 503 -246 -6 9 or 1 -80 W Issued y: J // Permittee Signat . 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 IN TALLATION 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. 1 1- L. RECEIVED City of Tigard Received. a I ifi g l. Qto Pasmit No.: to ..- IOW? 13125 SW Hall Blvd, Tigard, OR 97223 2. ( , U 6 Plan Review P , Permit: Phone: 503.639.4171 Fa. 503.598.1960 "" fi : ' I�tc/sY Oter Inspection Line: 503.639.4175 CITY OF T_. k ... !,,, Date Rcady/By: tom: la See Page 2 for Internet: www.ci.tigatdor.us BUILDING DIVISION Notified/Method: n , Supplemental Information . 'i?YY il!P`*!E)10A► .; :.. . - . -:,=';',.:.,;:::.';':': _ '` : P.4N6tEti'tn8 "- ❑ New construction RI Addition /alteration/replacement Please check all that apply ['Service over 225 amps, corran'1 ❑Hazardous location 0 Demolition DC7 DService over 320 amps — rating ©Buildn8 over 10,000 sq. 11.. • C�ATEGOR1 OF ",COPI -rcfif<O1N; ,- of 1- and 2- family dwellings 4 or more new residential DSystem over 600 volts nominal units in one structure 1:3 1 and 2- family dwelling al Commercial/industrial ❑ Accessory . building C Building over three stories ❑Feeders. 400 amps or more ❑ Multi-family ❑Masher builder ❑ Other DOccopanl load over 99 persons ❑Manufactured structures or JOO 3Y1'E INP0',114;l11ON $ND VS;t0lON ❑Egress/lighting plan RV h -ca park r , ❑ Healtre facility 0Other: Job no.: Job site address: /� I f 4.' 5--z1/0//5. fie'- A G Snbntit 2 sets of plaits with any of the above_ 1 City /Sttl1JLII': f+� /, . of The above are not applicable to temporary construction service. . . Suite/bldg. /apt no. :' Project name: 7-Es!Ly { _ Description 1 QtY• ( t- I rota ( •• �\\ I Nett/ residential single- or rmilti- fmrrlly dwelling unit. Cross streetldirections to job site: lJt�CN ti N 5 V1 / Includes attached garage. 1,000 sq. R or less 145.15 4 Subdivision: Lot no_: Ea. adds 500 sq. R. or portion 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no.: Limited enemy, non- residential 75.00 2 DZM.RIP HUN OF ''WORT . . , . Fach manufactured or modular n f i U dwelling service and/or feeder , ,, 90.90 , 2 y+ d` t✓4 /' itl Fv' V - Cr , t. k t T : 6( G'. t GI f Services or feeders installation, alteration, and/or relocation Eot Sa e1 c. 200 amps or ices 80.30 2 I ' iii h� , r` 201 atrrps to 400 amps 106.85 2 1;1 P1i�P Y Cr 1VEli 4TE1!T: ' ...r.''''''' ... , ... . 401 amps to 600 amps 160.60 2 Name: "e3 7re•� Ft; - 4, r; -. e 601 amps to 1,000 amps 240.60 2 j peer 1,000 amps of volts 434.65 2 Address: /2 / 0 5(ri' j c v CJs p /r/ Reammect ont 66.85 2 Y City /State/ZIP: 7 /6 , ,, l „c� a 12 ?j Temporary services or feeders Installation, alteration, and/or _ /� relocation Phone: ( 605) 59 — 850 , I Fax ( ) 200 amps or Is 66.85 1 Owner installation: This installation is being made on property thitt 1 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 600 amps 133.75 2 Owner signature: Date: Branch csremts — new, alteration, or extension. per panel 'p . APPL1.d.Nt 'P ::. O 6 :12!t PER'l0N it Fee for branch circuits with service or feeder fee. each 6.65 2 Business name: branch circuit B. Fee for branch circuits /4 -I S�� Contact name: without service or feeder fee, / 46.85 �/� f/' 2 each branch circuit Address: Each add'l branch circuit 6.65 , 2 City /State /ZIP: lcellimeous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuits) or limited- <.yq]1�1Tt2.a3'?TDR , 2 ` : energy Panel' on, ar extension. Describe: Page 2 Business name: Ord L L G— Each addllionel Inspection over allowable In any of the above Address: 5--__ S N Ye) c, N� ' / v� {s..G�♦ >V r°_ . °y t �ilJ p potion u 62.50 City /State/Z1P: CJ �f'., / 4/ Investigation per hour (1 hr min) 62.50 �i " ` Industrial plant per hour 73.75 Phone: (�3 6 ; -0 t� Fax( t . 3'- ''o EjEciouAl<PFRI<tll; REE8 ,... CCB c /j o . Y .0 2 Suprvv.Lic.: 5/ /) o Subtotal 54,0151/ • '- �,� :. J � / r D 7 Plan review (25 %oFpxmit foe) Suprv. Elec � � Electrical Lic.: + ' � e, required: � .. .r' • 1 �-- 0 / State surcharge (8 %ofpermit fee) _ �' . • Print name G � t,.,1 j' 6/„.. /z. s �� 2/ , / TOTAL PERMIT FEE ��r�'�i P 64 Authorized signature: This permit application expires Wu permit Is not obtained within le days after it has been accepted as complete Print name: Date: g Fee methodology set by Tri- County Building Industry S vice Board ' Number of inspections sax seriph allowed. I'd 0998 - E69 (EDS) aounH RpnC + wtr dBS =t,O 90 ea qa 1