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Permit CITY OF TIGAR® ELECTRICAL PERMIT ` a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00172 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/15/2010 Parcel: 2S112DC01400 Jurisdiction: Tigard Site address: 15865 SW 74TH AVE 105 Subdivision: CREEKVIEW INDUSTRIAL PARK Lot: 4 Project: Cognex Project Description: (2) branch circuits Owner: FEES JDS LLC & Quantity Description Date Amount CRITERION CREEKVIEW LLC, PO BOX 6525 BEAVERTON, OR 97007 2 crt Branch Circuits 04/15/2010 $63.60 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 04/15/2010 $7.63 Electrical Contractor: ALL AMERICAN ELECTRICAL CONTRACTORS PO BOX 1426 GRESHAM, OR 97030 PHONE: 503 - 657 -4351 FAX: 503 -496 -3995 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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. Issued By: ���� r �,� IJGCrle-- Permittee Signature: 647 9-, °/ / C/9-//a/\/ 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. . .c P:t, ' 'f' RO. r' 1 , z' ;1 S+I :I, ` `"hgi'nitiVs11, 1 T Elect cal @C1411t A �ICRtI $ ag74',$� , ^ �'ti . „.4 t , . , 1;,(,) 1. 141:,1 itt�t),�1 ' , 1q 7:0" irlr �^^� -• � � �Y.I�� ` i -, : ' ' L 'r�'�.,' :` 4 r ".�.'.e"f Nearkti14 ' 1 : iYCk.Y.riry L,.f � a 5._ _Li Received �— in Tigard I)ate/li : d Permit No „�C S ,�►l41 � DO /7__ a SW City Of }.gard, 1 4 �Q�Q PlanRevio m I � D Phone : 503.639.x [all IIlvd 17, Ti 1 Pax; 503 .598 �,t Date/13 : Other Permit: ' c.. Unto Ready /By: )uric la e '` ' ” '' "'' °' Inspection line: 503.630.4175 r e CITY OF TIGARD N ulifled/Method: Supplemental I information �+ �:= �'h3'"��'y� Internet: www.tiglud- or.gov pp — TYPE _ PLAN REVIEW . [] IVew constntction Addition /alteration /replacement _ Nose check all that apply (submit 1 seta of plane wfitema checked below): El Service or feeder 400 amps or more ❑ Building over t stories, ❑ Demolition ❑ Other: where the available fault current ❑ Marines and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps al 150 wells or 0 Floating building& lean to groilnd, or exceeds 14,000 0 Commercial-use agriculture' ❑ I - and 2- family dwelling %Commercial /industrial 0 Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other; J ❑Fire pump. ❑ Inslallatiun of 75 KVA ur — ^'^" ^^'" 0 Emer gency system. larger sepatately del ived system JOB SITE INFORMATION AND LOCATION ' ❑Addition of new motor load of ❑ "A ", "0 ", "1.2 ","1 -3 ", no.: Job site address: ( ' e' Six o or morn. R occupancy. Recreational 1oh I - Ysr tJJJ III �� ©Six or more residential unite. ❑ Recrcntional vehicle parks 1 City /StCity/State/ZIP! ��"CC �,/AJ v� � ❑ Health-care fauilifacilities. S u PP Y voltage for more then or, ❑ 8 _1_ dv4 �.. 4.- .__ Y ___. _... ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: 1 0 5" Project name: ❑Service or feeder 600 am p — — �F , c L� L � � a or more. — FEE SCHEDULE Cross street/directions to job site: _Description 1 Qty, 1 P e<. 1 Tet.1 1 ' New residential single- or multi - family dwelling -snit. Includes attached garage. _ Subdivision: 1.01 no.: 1,000 sq. ft. or less 168.54 4 Tax map/parcel no.: Li 500 sq. Q. or a lloo I Limited iced energy, residential — DESCRIPTION OP WORK (with above sq. ft.) 2 — __. -__ ^_ __ 0 20 4 p (� y _ _ Limited energy, multi-family Eno residential (with above s . R 2 , _ 1 Services or feeders Installation, alteration, and/or relocation 200 amps or leas 100.70 2 0 PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2 ---- -- 401 amps to 600 amps 200.34 2 Name; 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 T 201 amps to 400 amps 125,08 2 Owner installation: This installation is being made on property that I own which is not - -- — — intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.5 2 _ Branch circuits — new, alterlalio, or extension, per panel Owner signature: Date: A. Fee for branch circuits with above service or feeder fcc, ❑ APPLICANT — ❑ CONTACT PERSON each branch circuit 7.42 2 Business name: B. Pea for branch circuits without scrvicc or feeder fee, first Contact name: branch circuit 56.18 . 54 , / 2 Each odd' 1 brunch circuit / 7.42 2 , yam. 2 Address: Miscellaneous (service or feeder not Included) — ty City/State/ZIP: /State %LIP: Each manufactured or modular � _�_ _,,, -•__ d we lli ng , ser vice and/or f ee d er 67.84 2 Phone: ( ) Fax :: ( ) Reconnect only 67,84 2 E -mail: Pump or irrigation circle 67.84 2 Signor outline hyping 67.84 2 CONTRACTOR Signal clrcult(s) or limited- energy Business name: A. (� 114 144,er_ i iecacx panel, alteration, or extension. Page 2 2 Each additional Inspection over allowable in no) of the above Address: P.0 r 8O X 1V 2� R Additional inspection (I hr min) M , 66.25/ hr _ 3b Industrial tan _..,, _ . _,__. City/State/ZIP: � � ! � q �D investigation (I hr min) 66.25/ hr 9 p t (1 hr min) 78.18/ hr _"...._ „-,. Phone: (5c, ) trc , ( Fa ( Sa3) ff " 6 . C` Ltspecllons for which no Pee fa " 90.00/ hr ✓ ,specifically listed (h hr min) CCBLic.: 132ejgo [.ilectrieal Lic. ZG- (�Lflf � Lie.: ELEC1RICAL PERMIT FEES Suprv. Electrician signature, required ii, a Subtotal: 6 9 . ( 0'0 lL�: ,. ��"� Plan review (25% of permit fee): — — Print name: D 1 ,1 4 .,. k ( ___ , , v ,4 Date: State surcharge (12% of permit fee): 1 Authorized signature: / TO AI, PERMIT FEE: q / . c ,2 — ^ � �r, , _ �! 4, .m.41 -xc. ,. M This permit application explr a if a permit le not obtained within 180 e . � %v.. M R Date: C/7/3 a daps and a has d per accepted as complete. Print name: e J Number of inspections allowed par permit. Cl aulldhlg \PUmlte\ELC PermitApp, 10/01 /09 440.4615T(1I /05ICOtd/WP Z00 V] 7Nd TO:CZ OTOZ /T0 /TO