Permit � � 'n' CITY OF TIGAR® ELECTRICAL PERMIT
tr ,'a_ COMMUNITY DEVELOPMENT Permit n: ELC2010-00143
'TIG'ARD;, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/31/2010
Parcel: 2S 1128804000
Jurisdiction: Tigard
Site address: 14500 SW HALL BLVD 102
Subdivision: Lot: 0
Project: Edgewood Manor
Project Description: (1) service and (11) branch circuits for laundry room alterations.
Owner: FEES
D'ORAZIO INVESTMENTS, LLC & Quantity Description Date Amount
HFR INVESTMENTS I, LLC, 4500
BEACONSFIELD CT 1 ea Services or Feeders - 200 03/31/2010 $100.70
amps or less
PHONE: 11 crt Branch Circuits w /Purchase 03/31/2010 $81.62
Service or Feeder
1 ea 12% State Surcharge - 03/31/2010 $21.88
Contractor: Electrical
TIMBERLINE ELECTRICAL CONTRACTORS 182 da Investigation Fee (Equals 03/31/2010 $182.32
PO BOX 918 Permit Fee)
LAKE OSWEGO, OR 97034 1 ea Investigation 12% 03/31/2010 $21.88
PHONE: 503 -459 -4089 Surcharge
FAX: 503 - 254 -4227
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $408.40
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 0 952- 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. , /
Issued By: G � J Permittee Signature: d/V /7 4/ C' / O V
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.
97223
E��c Permit Application °,i r, n, ` h : ' ;"4` `r"- 1 j w , .�
i b. n c k LM11s r�.6 �E," _ 1 f
NV, City of Tigard au ermit rro.:�° -L 0%0 �D13/% j
• r � 13125 SW Hall Blvd., Tigard, OIL MAR. 2 6 2010 » Y / '/ ; -
- "- `f ` r Pho 503.639.4171 Fax 503.598.1960 D : P �P /
/� r � o -- oQn V/
t i f y ` , i,� - Inapecdon lane: 503.639.4175 1 r�+ O t - 1 , (. A D Da r Read a�;/ 4/ 0 See Pogo 2 for
Internet: www.tigard-or.gov BL111_01 17 OR/ ginN N / e(7 Supplemental Intermitter'
u J s .2 Sy �' o`r 1`c7t �•*x " ^' i �w,r�' y2 '�•,... ?"!v+ f7: S r >•A'')� t- i?" rt R3` 2 v Z t
`+" -N i x! ,s 5 i , . a a - A S 5 t , a / ,r y Sk '+ , - ; v,. t z ut y . i t 1 • ti ,v a•. .. .'v-... r.i.... r . .r.. . .,.. , 4 1 , ,..,t.; . r a. 5 -:, ; L .. , - 4 . .5 a'� . . 4 : : $00 .., v4�n : ., _3v. :,,x, -, . .,:43 . ,. a,. t.. a % it , e; ,,,, .,,, ... 2.2 0 N ew construction II: Addi ins an that apply (submit eats o wfi oama eloea be
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
where the available fault current ❑Marinas and
,� ' ;', j s .. r '', 4t. X 1•' -,-T 3 Z b t x dt 'aFt ss 3• Satr:r d ✓ '
= ; , - e;. :, . 4 . � . . _ v __c . .;.i , ,. ..,:, --,: cu ,. 1 d.ae.." -Zi:S .tit - exceeds 10,000 ground. or xcea, 14.000 or ❑ Flaeti acia
n . 5 Less to Bro. und m exceeds 14.000 ❑ Commercial use agricuhwul
0 1- and 2-family dwelling I. Comznei'Cia]/indust'17a1 ❑ Accessory building maps for all other matallationa buildings.
❑ Multi-frail • Master builder ❑ Other ❑ Fire pu q �,� ❑ Installation of 75 fK
1 F 1� }' t SJ�Y - { 1e r K 5 y J 7f 4 S4' Fyr+ "� T 1� /" 3 Y Fp 'i .0 E Emergenc s larger separately derived system.
ti . z + . ?�+ :( . tQ: d J
', . <<` .. ,14 ,;..:; ;' .,. ,+ :..., t .. . _
., r .,:. . m, ' :,,n.ao K. .. Y xE t 3K' . _.,:. ,, -. CI Addition of new motor load of ❑ "A ". S ", "1 -Z "l3 ".
Job M.: Jr% site address: 1L `M , C tt'3► r . 100HP or more. occupancy.
1:1 si or mom residential units. ❑ Recreational vehicle parks.
City/State/ -T: ! ' e ek Cl - 9 9. (1 ❑ Health -care facilities.
CI Supply voltage for more than
FF ❑ Hazardous locations 600 volts nominal
Suite/bldgJapt no.: l6._ at../p01.41
( Project name: ❑ Service or feeder 600 am ar ps mote
Cross street/directions to job site: EA GC Gtr o 0.6 /1'/o s 4r <. ti i i:..,_ ,G' . .. .1 w 4 f :,Wk. . T ` -t ;; DescrIption Qty. roc
New reatdential single- or multi-family dwelling ®it.
Includes attached garage.
Subdivision: J Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add't 500 sq. ft or portion 33.92 1
Tax map/parcel no.: _
t 4s. r E r n c r y r t. Z r L q . � y Limited energy, re 67.8 2 ff
_. ... t +. <.. �. .u< . < : : , : : . ... _ . . . :,.r .. c - ti. - ,.: . i s,-. _ w .:4 7'.., � , • , . si ...,..tie'? rt energy, y, o 4
A f c. * • W i „ ! � n ,,, , fn S ` lam e s porgy, (with a s i
/`t+ � ,.�LCI cJ • residential (with a sq. a) 67.84 2
CO 1/6 77 % T L i • R Op/`, maces or feeders installation, alteration, end/or relocation
200 amps or less ' 100.70 /tJ. '715 2
'+, % r i', ,1 . A A +f„ ? ti 1 jit a 201 amps to 400 amps 133.56 2
'e-+'/ a, . .r <r ..'_ >.i ,:., `.: a �.,1._. k 4 s.- 1�•."�i �'Y Ui�.sr_ tu , ..�- !� ✓...v... ....,i. .n$ 24_,
Name: 401 amps to 600 amps 200.34 2
Address: 5 f5 601 amps to amps 301.04 2
Over 1,000 amps mps or volts 552.26 2
City/State/ZIP: Temporary services or feeders i stallation, atterattao, and/or
relocation
Phone: ( ) ' Fax: ( ) 200 maps or less 59.36 I 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, hinge, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch dremts - new, alteration, or extension, per panel
Owner . Date A. Fee for branch circuits with
s + 4,,, r eT ,r.s f .:1 r . ..,7.7.y ; -, , , , ,`:=;;74`;'.. " r ' n4 rf above service or feeder fe 6
., :ii. . . . . .i.. . u . . .. �'.,�.w._b,K.• 2c.�� ,.£A ,__. ._,4.. . _r cd.. ta;,?2 e ' ,� 7.42 2
Business name: Fee branch circuit
B. Fco for branch circuits
Contact. name: � jQQ � y v without service or feeder fee, 56.18 2
"` " first branch circuit
Address: Each add'l branch circuit f 7.42 2
Miscellaneous paervtce or feeder not Included)
City/State/ZIP: F- h manufactured or modular 67.84 2
dwelling, service and/or feeder
Phony: ( ) I Fes" ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
..:: �rv...t' .1T... -h.... , v .4<..... [ d 1....w.:... R.,.~v)w :e24. :_ - .a. ' ; 3 S . ; 4 Sign Or mane lighting 67.84 2
Business one: ►,.. exi ' , f !)' -'r ik pt t 3 e circuits) or Iimite
vv� "J''6(,.•..v l.,(1TNisV'zi- .4�^ -� eaer , alteration,or
Address: Po E,I V R LS extension. Describe: Page 2 2
CityPikeicPEP: H`4 we6,0 oz. C 7 0301 Fork additional inspection over allowable in any of the above
hone: Per inspection 66.25
1 ' ho
)' 9 -if O I " • Fa ( ) 0 14 -- 4 � investi per hour (1 hr min) 66.25
CCB Lic.: 16 b 6'� 7 Electrical p : e.6 -,- ii i a ' ' ` prv. Lic.: a Industrial plant per hour 7818
5 ..L� ..3u. < . ?. .. _.. . . , S Y. � ,5:
S EleCtTiCimi si ?. : •
Subtotal: t • . f .
Print name: , ► i g : Plan review (25% of permit See): pp
�� J,r...:�,:� � !L' State surcharge (12% of permit fee): v • D
Autborizt d signature: f fAr TOTAL PERMIT FEE: il :%
Tbb pergat application expires if a peeink is not obtained �
within 184
Print name: P C 6 .. Date: 0/96/f t) days after B has boon accepted as compkta t/
mglPa�Nlgl CPm�tAppdao 10/0009 440.4615T(11/O5/(JOM/WEB
a Number of inapeetiona allowed per Parrett 9 6 , 0
�� !`l r, ,,41, � /! V E T i 1 6-417-70 A/ fT� A
11Smld O %/ 2 � ? 1 f /
ZO0/Z00Z XVd £ OTOZ /9Z /£0