Loading...
Permit AE- I / , vTJL � 7?J ,9-A/s Lo Ad/ //0 G 7'9 — / /51i o 4 ELECTRICAL PERMIT CITY OF TIGARD ` 2 . .: COMMUNITY DEVELOPMENT Permit #: ELC2009 -00670 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/22/2009 TIGARD; Parcel: 1 S126DCO5000 Jurisdiction: TIGARD Site address: 9385 SW LOCUST ST, BLDG# 1 Subdivision: Lot: 0 Project: Fisher Chiropractic Project Description: Install (1) 200 amp or less service, and add /alter (8) branch circuits. 1/5/09 ADD limited energy for data telecommunications. Owner: FEES TSE INVESTMENTS LLC Quantity Description Date Amount PO BOX 1754 1 ea Services or Feeders - 200 12/22/2009 $100.70 LAKE OSWEGO, OR 97035 amps or less PHONE: 8 crt Branch Circuits w /Purchase 12/22/2009 $59.36 Service or Feeder 1 ea 12% State Surcharge - 12/22/2009 $19.21 Contractor: Electrical NORTHSIDE ELECTRIC 1 ea Plan Review Electricial 12/29/2009 $40.02 PO BOX 12323 1 ea Limited Energy 01/05/2010 $67.84 SALEM, OR 97309 0 ea 12% State Surcharge - 01/05/2010 $8.14 PHONE: 503 - 585 -4879 Electrical FAX: 503 -364 -0248 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $295.27 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Y Issued By: Permittee Signature: 0A/ a // - /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. CaII 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. 1A ?/04 /1009 /SUI" 08:14 AM NOATHSIDE ELECTRIC FAX No, 503- 364 -0248 F. 001 Electrical Permit ApplicationRECEIVED . : • • ;�oit Oi+•tf1CL,uSL ONLY , . . • City of Tigard Received t ,:!7t . 'r Date/B • : . >� Jr, �V 1• Permit No. / • 13125 SW Hall Blvd., Tigard, OR 97223 JAN 0 4 2 'o ,ELC ■o1Q �� �� Plan Rev Phone: 503.639.4171 Fax: 503,598.1960 Date/B : Other Permit: TI CARD Inspection Line: 503.639.4175 .CITY OF TIGA pate Notified/Method: RI Sce Page 2 for Internet: www.nga d or. ov Supplemental Information • _ ISION Noti fie etbod: g , • r ikt y ^: ;` � Yy _ r � y K - .B V •r N 4 y- f . . j,...,� o . 7'� t w �-1 Please check all that apply (submit 2 sets of , r' { ` . �l�, wf �-0 t 5',. i� �. t '9.W' 'u- +. �s1 .gtO,' ' N 0 .fi' rS - ., , r ,.. �:.�a. t'� 3,'• irn r�i %:y. n.. a . •. o ..:-�+ � .../n .•.�S ..- fr(s �y. P��7:i !"b, ! � ., . ..... .,. J „: Fi vC : •. , t7 _11 ❑ New construction Addition /alteration /rt placement plans tvfitems chucked below): ti ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Othert where the available fault current ❑ Marinas and heat-yards, •` "T - ^ ' ,rr rL .. •nth a • 9 ,s. ryr r ss • P r L 0i; m s a,7, r exeeeds,li m s.at.150vot or „© ] 4 ,ltui din s S,a ,.`'�r2i1lLL l g..it ca$!: z=..v^'i ,dt=''rC S;a, 1 -4 ,r.N . 'd t a . ' .�a ''''”' . c' " ': ' . h '' x �, P. r: , ,y I 0 •.. ?tfi B r v V '' n ; - - feg ;'•io gtbtmd, or ex -eat f 4,000 - . ' ©CdininBr`cIn( use a6me11ltural • ?�' ^ ❑ 1- and 2- family dwelling ii Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Insrallatia : of 75 KVA or >t : G :52 ' ;'d° j" ic, h • t: rt _ rj �::'''''''' ❑ Emergency system. larger separately derived system. arc ,JOB S,.. INIfQR1V .........3 . ,t.. , .a.,r, � 0 of -- -._3_.� . ,_�K �...t._:�_ ... _y b „�_. � �_ ..,.,�_„ t , } ., y m,.r t , : •.,, ,a ...� , � �y_d,....._r_t_�.l��� - rtew motor load of ❑ Job no. \`L-• Job site address: CViCis S J C,7s'\` 100HP or more. occupancy. \ ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: 7 \ 1ii 1 m i r p` • ❑ Health-care facilities. ❑ Supply voltage for more than • ` ✓ a '� - ❑ B.zardous locations, 600 volts nominal. Suite/bldg. /apt. no.: Project name: CI Service or feeder 600 amps or more. Cross StreeUdirections to job site: M ` •�� ` �•” .EE; SC1EDULE ,'- . , ; ,w ...', J n+errrption Qtr. I Fee. 1 'rotnl — New residential single- or multi - family dwelling unit. Includes attached garage, Subdivision: [Lot no.: 1,000 sq. @. or less 168.54 I 4 Ea. add'I 500 sq. ft, or portion 33.92 1 Tax map /parcel no • a,- n r s F Limited energy, residential � , yj. 'r m r a :ilk r r 'iSt,K# tr '()�' n � '3 5 n t t ".X + x�µ ^kt a a, (with above sq. ft.) 67.84 2 1�' ,, w. �Hr'- y.ria�_r.<•'�'d - .., _ J • lt�k,'!�;'. ° ., ,, ...r -. ki • \ r - j * �.` C Limited energy, multi- family e, residential (with above so. ft.) 67.84 2 ` P1rriq\p s 3 \ (,(_.l'�`- - s` Q.EJ° V Services or feeders installation, alteration, and /or relocation it. •71. �qt7 'W c � }} (nit 4111 �(l 0 - 1b 200 amps or less 100.70 2 , - h '. l,. 2 .10. r c�rFt.^.1' , ef'M :. �'91L C Sa'5rr `` "V'r l,. N 1' X t ® ."` 5i r ry 7 �. d I t., ,, so.N,., r......,..�s ,., ?? 1 . r. 201 ,amps to 400 amps I 133.56 2 Name: 40t amps to 600 amps 200.34 2 - 601 amps to 1,000 amps 301.04 2 ' Address: Over 1,000 amps Or volts 552.26 12 _ity/State /ZIP: . Temporary services or feeders Installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less _µ _ 59.36 1 • Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 1 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with t )"j.i5.r"`1B3 i L ORi '.' jt` iiii I : 0A 'l At P 4„ " i ' ; ,,? , above service or feeder fee, 7.42 2 each branch circuit Business Warne: • B. Fee for branch circuits without service or feeder fee, Contact name: 56.18 2 first branch circuit • Address: Bach add'I branch circuit 7.42 2 -. - Miscellaneous fservicc or feeder not included) I City /State/ZIP: Each manufactured or modular dwelling, service and /or feeder Phone, ( ) Fax; 67.84 2 � ( ) Reconnect only 67.84 2 E -mail: Pump or irrigation circle 67.84 2 S. RA.t7FOR 1, 9� .'o .J -. �i. , .r.. . s ... ? y . .. NT � c ' + ,> t } y Sign or outline lighting 67.88 2 Business Warne: Signal circuit(s) or limited - G energy panel, alteration, or . n att � �� Address:' Ec) ` , extension, Describe: Page_ ' lV City / State/ZIP:l i R1 l 1 Y /'ti Each additional inspection over allowable in any of the above Phone: ) �► ♦ F �•,.� Per inspection 66.25 ��. a x: ( .t/J) Y T a Investigation per hour (1 hr min) 66.25 _ Iv CCB Lic.: - Electrical Lio.: Qr -.1 uprv. Lic.: 2$ r Industrial plant per hour 78.18 '': ElitCTRYC T A'ERN ,1TE5' ,,:. Suprv. Electrician signature, required: ��µY /0/0///r 1 Subtotal: tp'� l ttntname: Date: Plan review (25% of permit fee): - ,l r - — State surcharge (12% of pennit fee): ' ,1 Authorized signature , � /� TOTAL PERMIT FEE: I'� ( � d � ~� J This permit application expires if a permit is not obtained within 18U � ' ` 1'1 "lilt name: Dale: days after it has been accepted as complete • Number of inspections allowed per permit. 1'. gulf anyU'crmite\ELGPermitAOp.doc 1 0/01 /09 44O-4I STr tmtrnnanvca / / (O , C.,, - 4 JiN/04/9009/SIIN 08:14 AM NORTHSIDE ELECTRIC FAX No, 503 P. 001 ..- ' Electrical Permit Application - City of Tigard El C - 7_0q -- 66( ----- Page-2 - Supplemental Information —_- LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined $67.84 _ ____Check_Tne_of_Work_Inv_olved:_______________ . . - ,.r.46.4,1,,,,xr...,,,- - ,7,roca.64r, ..C C••,,,,;,■:•...:.•.1-dttor,,,,,,....4,CA^. i'aMn< Li fl Audio and Stereo Systems* 0 Burglar Alarm 7 Garage Door Opener* n Heating, Ventilation and Air Conditioning System* 0 Vacuum Systems* 0 Other: ,-, eiiglaitjalA179031iVaiWiRii7577.F iti:TE7= ! Fee for each commercial $67.84 system (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems ri Boiler Controls 7 Clock Systems X _ Data Telecommunication Installation O Fire Alarm Installation n HVAC 0 Instrumentation . n . Intercom and Paging Systems , ---- LI --Landscape-Irrigation Control* --- — n Medical E Nurse Calls n Outdoor Landscape Lighting* 111 Protective Signaling r-i ethel Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:11kildinipermits1ELC-PermitApp.doc 10/01/09 .t � ''�r '' - CITY OF TIGARD ELECTRICAL PERMIT ig il ` a °,: COMMUNITY DEVELOPMENT Permit #: ELC2009-00670 l ' Date Issued: 12/22/2009 T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S126DCO5000 Jurisdiction: TIGARD Site address: 9385 SW LOCUST ST, BLDG# 1 Subdivision: Lot: 0 Project: Fisher Chiropractic Project Description: Owner: FEES TSE INVESTMENTS LLC Quantity Description Date Amount PO BOX 1754 LAKE OSWEGO, OR 97035 1 ea Services or Feeders - 200 12/22/2009 $100.70 amps or less PHONE: 8 crt Branch Circuits w /Purchase 12/22/2009 $59.36 Service or Feeder 1 ea 12% State Surcharge - 12/22/2009 $19.21 Contractor: Electrical NORTHSIDE ELECTRIC PO BOX 12323 SALEM, OR 97309 PHONE: 503 - 585 -4879 FAX: 503 - 364 -0248 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $179.27 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. r Issued By: . Permittee Signature: eA r/ 90 04: /C' 0 �/ 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 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. Dim /21. /2008 /Sui�l 08: �� P,���i NOI�THSIDE ELECTRIC P. 001 F AX No 603 - 364 - 0248 ' Electrical Permit Application RECEIVED FOR OFFICE USE ONLY City of Tigard Received , A ry Date/B : c,2 4' 1;9 % Permit 7',I le go 09 "..176 ) . 1312e SW Hall Blvd, Tigard, 97223 E C 2 1 2009 plan Review Other Pennit� �G ©� � /! c?C.!� /� A Phone: 503,639.4171 Fax: 50303 .598.19b I}at./B : Si T IGARD Inspection Line: 503.639.4175 Data Ready/By: lur El See Page 2 for Internet: www.tigard -nr.gov Rr CITY OF TIGARD� � Notified/M thed: j / it Supplemental Information • ,. ' '.T,X ' P ok : 1�L1 \k:1 : � 0I 1`, - N• RE W ❑ New construction Addition /alteration /replacement Please check all that apply (,ubmit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more 0 Building over three stories. ❑ Demolition Other: where the available fault current ❑ Marinas and boatyards. (�t i7�07. 7•TJPv"1�.10:14 C; iEli ,::> 774i,.c `. 10 amps 0 F d _ „ _„ „,,,, v, „- „,,N„N; .. m ,^ G0 r r r' . exceeds 10.000 at 150 volts or . loa_�n nil in ”' less to ground, Or exceeds 14,000 0 Commercial -use agricultural ❑ 1- and 2- family dwelling X Commercial /industrial ❑ Accessory budding amps fbr all other installations. buildings. ❑ Multi-family ❑ Master builder ❑ Other ❑ Fire pump, ❑ Installation of 75 KVA or JOB 5 - —r""• 0 Emergency system. larger separately derived system, • TTF 1(1VVFORM TION c1kD � 0 X7:101\ © Addition of new motor toad of Job no. :9)114 Job site address: 100Hp or more, occupancy, S� ❑Six or more residential units ❑ Recreational vehicle parks. City /State /ZIP: \ v(} d t � c ❑ Health -care facilities. ❑ Supply voltage for more than Y ❑ IIazardous locations. 600 volts nominal. 4 Suite /bld.g,/apt. no.: Project name: ❑ Service or feeder 600 amps or more. I FEE' SCR'EDULE Cross street/directions to job site: Description Or). PCs. TOM New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 1 Tax map /parcel no.: - Limited energy, residential __ 'DESCRIPTION. OF w,0I 1' f r t ,' • ": (with above sq. 8.) 67.84 • 2 t �� Limited energy, multi- family C,�•'�S �r v ) ) —1 -Q 0 (. o . -13)L—. residential (with above sq. ft.) _ 1 67.84 Services or feeders installation, alteration, and /or relocation '' 0 A-. J WI A. k Q— 200 amps or less 1 100.70 jta i/i' k;ROFERTY •OWNER , ` - 1 .3 , . 1 it r 1. ,l T1t1VAN;T + r 't ! 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 amps 200.34 1 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City /State /ZIP: 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 201 amps to 400 amps 125.08 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: Date: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits With 0 APPLIC v .1 ,.'. " r ,. ti ❑ . •CON'I;AC7T r itSO ' above service or feeder fee, Cic 742 3� 2 each branch circuit ' - -- -Business -name: -- - E. Fee for _ ircuits '-' -- - .__ �. / -'- .—' - without service or feeder fee, Contact name: 56.18 ! 2 first branch circuit . • Address: 1 Each add'l branch circuit 7.42 2 )4iscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or [nodular dwellinc service and/or feeder 67.84 2 Phone: ( ) Fax: : _µ_ ( ) X Reconnect only 67.84 __ 2 E -mail: Pump or irrigation circle 67,84 2 ' ` • CO ti ?Ca'OR : • , Sign or outline lighting 67.84 2 ✓ Y Business name: . t ``� � 1c,..1 F� � � Signal circuit(s) or limited - � energy panel, alteration, or Address: T.�_--x a^ , 1 @' extension. Describe: Page 2 2 City /State /ZIP: U Ann OR_ C t ` Each additional inspection Over allowable in any of the above 1 Per inspection 6625 • • Phone: ,e,.) lo _ I • Fax: ( t.) • .1 di , , Investigation per hour (1 hr min) 66.25 � -GCB-Li • - '°• er - l;lactr-I,1 -b .: • - - i --p ry -L- y Su p te- . - ITS - - Industrial- plant - per -hour — 7.8 -1.8 • D om! • - - ` ELECTRICAL PER vIIT FEES S Suprv, Electrician signature, required: It io 10 Subtotal: R1 Plan review (25% of permit zee); Print name: 1 c .„ , le Date: & l /t I State surcharge (12% of permit fee) ;C I a', Authorized signature: i I TOTAL, PERMIT FEE: `, u al 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. 1: lnuildingWennits \ELC- PermitApp.dos 10/01/0 440 I/05 /COMAS