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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00399 DEVELOPMENT SERVICES DATE ISSUED: 7/21/2006 '---� 13125 SW Hall Blvd., Tigard, OR 97223 503- 639 -4171 PARCEL: 1S135BB-00100 SITE ADDRESS: 10195 SW CASCADE AVE ZONING: I - P SUBDIVISION: LOT : JURISDICTION: TIG Project Description: Monopole 200 amp service to cell site. 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: 1 W /SERVICE OR FEEDER: 2 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: SUBURBAN PROPANE, LP ADK ELCTRIC, INC. ATTN: CARL J REMMES PO BOX 2676 240 RT 10 W BATTLE GROUND, WA 98604 WHIPPANY, NJ 07981 Phone: Contact #: PRI 360 - 608 -0665 FAX 360- 576 -6975 FEES Description Date Amount Reg #: ELE 37 -934C [ELPRMT] ELC Permit 7/21/2006 $93.60 LIC 148882 [TAX] 8% State Surcharge 7/21/2006 $7.49 SUP 48535 Total $101.09 REQUIRED ITEMS AND REPORTS 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 expire if work is 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 are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: �� , / , `� Permittee Signature: Q - cz.)\ 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'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. Alan Kangas 13603766973 07120/06 11:13A P.001 Electrical Permit Application X + ti ; a _ 1 0,t; UI F. l(E l S1 o 1 ' f t City or Tigard � 1 7 27(/ d i Permit No.: )(- '0)19 13125 SW 11s1I I31vd. Ti _ ( 5 k Plan Review other Pr Permit. Phone: 503.639.4171 Fax:+ 1 . "".• .1960 '` v. + '` DatefEty Inspection t itic: 503.639 -4175 C .4.k. ;; Do ' I i . _ a Ready/By: '� E3 Rte Pale 2 cur Internet; www.Ci- tig4r'd -or. 2 0 2006 NcsifiediMnhwl - SupplonentalInfonoatioo TYPE, p r wo PLAN REVIEW NCW constltitctian \ Li ' •;.1 • ■ ., ; i ... - • .it Please check all that. apply. ❑Se:vioo over 225 amps, come! 011uzardous location 0 D emolition 1 1 v i t 9 {,i ©Service over 320 amps – rating ❑ Iiuildng over 10.000 sq. lt, 'CATEGORY OF CONSTRUCTION :. • - of 1- and 2- family dwellinp 4 or more new residential ❑ 1 and 2 family dwelling 9 Commcreial/industrial ❑ Accessory building El system over 600 yobs nominal units in one structure ❑ Multi- family ❑ Mutt• bnildQ i �.� ` - . dl3uitding over throe stales CI Feeders. 400 npo ut more (]o ccupan t load over 99 persona D Manufactured sinaLleires or .1011 3ITE INFORMJE'L'ION AND LOCATION • ElEgrassiligtanig pan RV park Job no.: nob site nddtt`S`s: p 10,1 5 5, SS j _ y 'b -- ElHcahh -care facility 0016er. ,'- U �- Submit 2 sets of plans with Any of the shove. City/Srate/7,IP: , t) a Tbc above are not applicable to temporary aonatrudion service Suite/bldg./apt. Suite/bldg./apt. no.: Protect name: . L L _ > " +JC or". .. peatlet.. or". rd resat Caim street/directions ,job site:: it bk 1 , i L 7 . . _ ) Ne attached si Xe C : medti- family dwelling nett - � V Q,Q.3 f31i �}/C.. • CO W t' i w Qv\ VL yJ t t t E svbDvh 1.000 a fc netts 145.15 4 Subdivision: Lot Lot no.: Ea add'l 500 sq. ft or portion 33.40 1 -- -- ---. — Limited energy, residential _ 75.00 2 Tax map/parcel n0_: Limited encrRy. non - residential 75.00 2 DESCRII ION j 0>R WORK hack manufactured w ;nodular • 1 • l dwelling manufactured ce und/or feeder 90.90 _ 2 a L Services or feeders lUatiote, alteration, and/or relocation 200 amps or less --. II 80.30 �.11 ' 2 • D ' PROPERTY OWNER • - CI TENANT 201 amps to 400 amps 106.85 mom 2 401 amps to 600 stops 160.60 2 Name: ~ 601 amps to 1000 amps 240.60 2 Address Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State/ZIP: Temporary serwkee or Renters tsKrnatioo, attention, and/or r _ _ _ reloading Phone: ( ) Fax: ( ) 200 taps (*less 66.85 1 Owner installation: This installation is being made on 'property that 1 own which is not 201 ,,, to 400 amps 100.30 ' 2 intended for sale, lease, tent. or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 133.75 2 Owner signature: Date: Baaare tir:aaivr– new, alteration, or esteosion.Far panel 0 n A. Foe for lmlneh cittuite ;ooh 21 APPLICANT II CON iAC? er.RL9on selv.oe or feeder fee. each L 6.65 (S' J' 2 Business name: branch circuit Contact name: 13. Fee for branch circuits r V -- without acnrice or feeder fee, foil branch circuit 4610 2 Adt$atS: Each addl branch circuit 6.65 2 City/State/7TP: Miseeimcom (service or feeder not Included) R Phone: ( ) I Fax: : ( ) enp or irrigation elide 53 -40 2 _ Sign or outline lighting 53.40 2 E -mail: Signal circuits) or limited- CONTRACTOR energy pa ati panel, alteron, or ' extension_ Describe: Page 2 2 Boy name: ' Able_ 5�� n1 N\--C ( J Address: V:st ` LL v tit ...iit%% ��� l \T' E � a r allowable in an of the above Per 62-50 City/St/de/ZIP: l l (J q -s -' 1nve:ai&ation p hour (l hr min) 62.50 u- Phone: ( 3 ( � } - ( '1 ( 5155 F rs �E't ) 51 1 6 - lo�15 Industrial plant per boor 73.75 � 4: F. CTR1CAL Pw.gatrr :Es CCB Lic -: (4 , Eloatrical Lic.: .(_ Sulay. Lie.: SuWoW 4.6 6 6 ( Suprv. Electrician signature, required / �/ " , J , / / Pisa review a wiaw (2 of fee) rr State surcharge (8% of permit fee) L � {� qq Print name:: iv ' ..k i.21 1 • a 'b_1 TOTAL PERMIT FEE 10 I • 01 Authorized signature: / . J. l Thb permit ■ppneatlon ;spires if a permit a not obtained within 100 days after It ban h... •- -.. .. Print name: . 1 , I'• .. 1 A i i ■ I Tate: 1 12, 6 1 D • n. Mee elheaelegt s e t y c, • ' CITY OF TIGARD BUILDING DIVISION ' PERMIT #: ELC2006-00399 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7121/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 _LLI-"Iii INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7 PAGE: 59 SITE ADDRESS: 10195 SW CASCADE AVE CLASS OF WORK: • SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: PSF SUBSTATION DESCRIPTION: Monopole 200 amp s ervice to cc..11 site. OWNER: SUBURBAN PROPANE, LP, PHONE #: CONTRACTOR: ADK ELCTRIC, INC. PHONE #: 360-6080665 Inspection Request Scheduled For: Date: 7/28/2006 Pour Time: . . Code # Inspection Description Confirm # Contact # Message 199 Electrical final 033936-02 360-608-0665 N Corrections/Comments/Instructions: L V S X PASS fl PARTIAL APPROVAL H CANCEL 0 NO ACCESS H FAIL H CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED Inspector: . ...t.cc—k N Ge) t... Date: i 'Ala) Phone #: (503) 718- ILA CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006.00399 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 712//2006 Phone: (503) 639 -4171 '! y J 4 Inspection Requests (24 Hrs.): (503) 639 -4175 s'. "�' I . INSPECTION WORKSHEET FOR DATE: 7/20/2006 TIME: 7 :O1AM PAGE: 60 SITE ADDRESS: 1(1.95 SW CASCADE AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: P SUBSTATION DESCRIPTION: Monopole 200 amp service to cell site. OWNER: SUBURBAN PROPANE, LP, PHONE #: CONTRACTOR: ADK ELCTF2IC, INC. PHONE #: 360.608.0665 Inspection Request Scheduled For: Date: 7/28/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message la Electrical service 033936 -01 360- 608.0665 Y Corrections /Comments /Instructions: PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 1 V CIS �� Dater Z W Phone #: (503) 718- IA N