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Permit CITY OF TIGARD ��j /��� ELECTRICAL PERMIT !,:. ---.--,,,,'. 11 9/74;2//10 7 COMMUNITY DEVELOPMENT Permit #: ELC2010 -00185 T R 1GAD! 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/20/2010 Parcel: 2S 110BC00900 Jurisdiction: Tigard Site address: 12475 SW BULL MOUNTAIN RD Subdivision: Lot: 0 Project: Tigard Reservoir Improvement Project Description: Temporary service for reservoir improvements project. 4/22/2010: ADD (1) 200 amp temp service. Owner: FEES TIGARD WATER DISTRICT Quantity Description Date Amount 8777 SW BURNHAM ST, PO BOX 23000 TIGARD, OR 97223 5 crt Branch Circuits w /Purchase 04/20/2010 $37.10 Service or Feeder PHONE: 1 ea 12% State Surcharge - 04/20/2010 $11.58 Electrical 1 ea Temp Services or Feeders - 04/20/2010 $59.36 Contractor: 200 amps or less BENTON ELECTRIC INC 1 ea Temp Services or Feeders - 04/22/2010 $59.36 34037 EXCOR ROAD SW 200 amps or less ALBANY, OR 97321 0 ea 12% State Surcharge - 04/22/2010 $7.12 PHONE: 541 - 967 -1244 Electrical FAX: 541 - 967 -8257 Type of Use: COM Class of Work: NEW Type of Const: Occupancy Grp: Total $174.52 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- 001 001 �, You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or or 1.800.332.2344.. / Issued By: ' aii� r� C '� v _- Permittee Signature: /✓ /9 /1 "/ 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 503.639.4176 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. il lit `,, _ CITY OF TIGARD ELECTRICAL PERMIT °' COMMUNITY DEVELOPMENT Permit #: ELC2010 -00185 131 25 Hall and OR 97223 503.639.4171 Date Issued: 04/20/2010 ILG A, SW Hll Blvd., Tigard Parcel: 2S110BC00900 Jurisdiction: Tigard Site address: 12475 SW BULL MOUNTAIN RD Subdivision: Lot: 0 Project: Tigard Reservoir Improvement Project Description: Temporary service for reservoir improvements project Owner: FEES TIGARD WATER DISTRICT Quantity Description Date Amount 8777 SW BURNHAM ST, PO BOX 23000 TIGARD, OR 97223 5 crt Branch Circuits w /Purchase 04/20/2010 $37.10 Service or Feeder PHONE: 1 ea 12% State Surcharge - 04/20/2010 $11.58 Electrical 1 ea Temp Services or Feeders - 04/20/2010 $59.36 Contractor: 200 amps or less BENTON ELECTRIC INC 34037 EXCOR ROAD SW ALBANY, OR 97321 PHONE: 541 - 967 -1244 FAX: 541 -967 -8257 Type of Use: COM Class of Work: NEW Type of Const: Occupancy Grp: Total $108.04 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 of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Y Issued By: k �+' L __ Permittee Signature: —. 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. APR -20 -2010 10: 13A FROM: i I Cale /.. /Z/1 -1CH/ * • TO 15835981960 P.1/2 Electrical Permit Application ,� a,+y�, 1>k� y 1 cgl�,e.►,_1�'1 lc f c�sl 9N1.,, 4 V r " r , t*: 7 tWL�k1.4 ` r* Ia�.lti: V c TJ�'.`th ri �rl ! '1 , ... di u1_. 44 iriuk. a.S 4 M(rt N { + {,,, i 0 2010 Received Date/By. ved Permit No.: lD U()/ AO 1 fix Cdty of Tigard APR 2 , ,• `� d 11 ' 13125 SW Hall Blvd., Tigard, OR A7223 Plan Review Other Permit: { ..a ' a Phone: 503.639 4171 Fax: 5O: 1T d OF TIGARD DateBv: iRIJ11GIA Ins action Line: 503.639.417 Date Ready /By: mils. 10 Sec Page 2 for p BUILDING DIVISION Notified/Method: Supplemental Information as «u as .7.M rtl Internet. www.tigard•or.gov _ ; I ‘....4..1. i ', 1'I SII "') j -� y, ��;il I 1l it I I i � ri y l f l i�lly , P. r : tin i41(I ; . • 111 4, tJ11i �u lo 6) 1 h ) h , , hr I I 1� , d ,. ..11 ,: :cl ...��Jh.dll�._.0f.J t� _.��+. I !�. �....r � ,,..: ® New construction ❑ Addition /alteration /replacement Please check all That apply (submit 3 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over throe stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. r. r yin ' w r (41 , r' .r^ ,, 1 'r i, ' r.. q exceeds 10,000 amps at 150 volts or (] Floating buildings. I .•, ii (r }\IIIlIt1bXA11.i �nh i s lulr.fw�ltlabul;ul ti(a).iti ..,,. ','P w ' less to ground, or exceeds 14.000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi family ❑ Master builder ❑ Other: ❑ Fire primp. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. I ' r ' b d O n9l'�n '( C l n AlYi . n l I t} L( a� t , ii'l a r i 1'"r �I ❑ Addition of new motor load of ❑ t a 1 , :., .,r. ,.'IJ II ' , liil' nw _... . , ..., y �T..; . ;. - 1! L.f. .,..,.t ..,,:;1..!:,...,:'....,-;;;11).1, 6 1:, 1 . IDOFiP or more. occupancy. Job no.: Job site address: 12475 SW Bull Mountain Road ❑ Six or more residential units ❑ Recreational vehicle parks. ❑ Health -care facilities. 0 Supply voltage for more than City/State/ZIP: Tigard, OR 97223 ❑ hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: ( Project name: Tigard Reservoir Improveme n f- Service or feeder 600 maps or more Cross street/directions to job site: oe,criptlon Qty. rea, Total New residential single- or multl- family dwelling unit. Includes attached garage. Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4 Ea add'I 500 sq ft. or ponion 33.92 Tax map /parcel no.: Limited energy, residential 67.84 2 y37 YC ' 1P,.: I.. ..- . . * :r]s �i - i�1''/ ��� '+ r.,l .1 ,;;:iii- N I i I (with above sq. lti - . C , N Limited energy, multi- family 67.84 2 temporary service for reservoir improvements project residential (with above sq ft.)_ _ Services or feeders tnstallation and /or relocation 200 amps or less 100.70 2 " s1 tit (o `lr @./kt w r r , t] ."ilau t t i (' ti a i 201 maps to 400 amps 133.56 2 I j, I l _ L i ril � 1 {i , .. �� . ,...... _.�� e ' i� �, ,.a ._. �.�, ,. i ..l 2 '..: � ' N •• 401 amps to 600 amps 200,34 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or ,. .:;ity/State /ZIP: relocation 200 amps nr less 1 1 59.36 59.36 I Phone: ( ) Fax: ( ) 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits- new, alteration, or extension, firer panel Owner signature: Date: A, Fee for branch circuits with } I ` r , 3' above service or feeder fee, 5 7 42 37.10 2 i is s 1l iltilvillliltt's'�)illt :vs :? . 11 f",.� il,. ( to) . U�� � t i +lr (t ni !'_ �! each branch circuit 0. Fee for branch circuits without Business name: service or feeder fee, first 56.18 2 branch circuit Contact name: Each add'l branch circuit 7.42 2 Address: Miscellaneous (service nr feeder not included) Each manufactured or modular 67.84 2 City/State /ZIP: dwelling, service and/or feeder Reconnect only 67.84 2 ) Fax: ' ( ) Phone: ( Pump or irrigation circle 67.84 2 E-mail: yd /', 11 j } ' la . �rf` Sign anel altem{ion or extension. ne lighting 67.84 2 !� : ' ,, , ,Allot l„,,iplS -it I0uQWa'ii; l_Ya, lr ,il_ .,.ii .u: Signalcucuit(s)orlimited-energy r 1 1 (1 Pa e 2 ...._. . _. . _ - � Business name: Benton Electric, Inc, Each additional inspection over allowable in any of the above_ Additional inspection (I hr min) 66,25/hr Address: 34037 Excor Road SW Investigation (I hr min) 66.25/ hr City/State/ZIP: Albany, OR 97321 Industrial plant (I hr min) 78.18/hr I Fax; (541) 967 -8257 inspections for which no fee is 90.00/hr Phone: (541) 967 -1244 s.ecificall listed (% hr min t/C13 Lic.: 4213 02 -' ( " J 1 Electrical ic.: 22 1\ f Suprv. Lic.: 2067S 1 Subtotal: 96.46 f • Suprv. Electrician signature, required: Plan review (25% of permit fee): D a e: 04/19/10 State surcharge (12% of permit fee): J '.5 1 1.57 i ;int name: Gerald O. Sheffield 1 TOTAL PERMIT FEE: 107.97 Pr n me signature: 'this permit application expires if o permit is not obtained within 18 1 days after It has been accepted as complete. I d8-. 0 1 Date: • Number of inspections allowed per permit , Print name: 440- 4615T(I itosicOM/wOn 11B u i1 d in r m l r slE LC -Perini l A DD doe 10101109 i fTh y e Sy /--- X4 9- /a yy w#-Eiv ,ssucii.