Permit '� �• CITY OF TIGAR® ELECTRICAL PERMIT
i�r�y
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00148
aT t CARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued:
Parcel: 25101 DA00105
Jurisdiction: Tigard
Site address: 13009 SW 68TH PKWY A
Subdivision: HOMESTEAD VILLAGE Lot: 0
Project: Homestead Village
Project Description: Rewire bathroom light switches fro two switch to one switch. All units included in scope of work.
Owner: FEES
BRE /HV PROPERTIES LLC Quantity Description Date Amount
TAX DEPTARTMENT, EXTENDED STAY
HOTELS, 100 DUNBAR ST 1 crt Branch Circuits 04/01/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea Per Inspection 04/01/2010 $66.25
Contractor: 1 ea 12% State Surcharge - 04/01/2010 $14.69
Electrical
STONER ELECTRIC
1904 SE OCHOCO
MILWAUKIE, OR 97222
PHONE: 503 - 462 -6500
FAX: 503 - 659 -4968
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $137.12
Required Items and Reports (Conditions)
This permit is i - • 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 ' accordance wit = .proved 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's ' es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-011-0010 through OAR 952 -0 - 100. Y ay obtain a a copy of the rules or direct questions to OUNC by oath.: 03.2 .6699 or 1.800.332.2344.
•
Issu • By: 2/-'�\ Permittee Signature: ir �i
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' 1 � , �_: /� , f5 �� Date:
LICENSE NO.
can 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.
Mar, 30. 2010 : 49PM No. 2072 P. 1
Electrical Permit A licati D i F r r` (n l(tl ( i / '` 4 ` � 4 N t' v w
�P Q� 1 ., \r: V tai° r, x+ is x K, .-' gv ' ;ai5V13.VtI ,,, ,t.a" Aiii l
City of Tigard Received t
e a 13125 SW Ball Blvd., Tigard, OR 972 MAR 3 0 2010 Date/B : Review sb
' i Il Phone; 503.639.4/71 Fax: 503.598.1960 Dot I y: Other Permit;
r ' ;?y Inspection Lino: 303.639.4175 OF Date Raady/By: hair Z See Page 2 for
�` it'S rai �I + I(�AR i Internet YVwwtigard- or.gov " i, t Notified/Method: Supplemcental
F) In f•t.MM(_ 1'to,lv.lCl'a -
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TYPE OF WORK • PLAN REVIEW
❑ Newconstruction Addition/alteration/replacement please cheek all that apply ( submit1 sets of plans wfnema checked below ):
❑Suvice feeder 400 amps ormore ❑Building over three stories.
❑ Demolition ❑ that: where the available fault current
❑Merittea tired boatyards
CATEGORY OF CONSTRUCTION . exceeds 10,000 mope ut 150 volts or ❑ Floating buildings.
11 1 - and 2 family dwelling (- Commercial/industrial ❑ Accessory building amps for all lo other uw ta � llatio�-000 b al use agricultural
building,.
❑ Multi 0 Master builder 0 Other. ['Fire Punta ❑ installation of 751 (VA or
❑fimergency system. larger separately derived system.
jron SITE INFORMATION AND LOCATION
❑ Addition of new motor ltsrd of ❑ "A ", "E ", "1.2 ". "1 -3 ",
Job no.: 6.3e5 4, /a 1 Job site address: (3 009 Sw t ,& t y 10011P or more. ocwpancy-
❑Sixormoreresideate'units. ❑ Recreetiw®I vehicle parlor.
City /State/ZIP: - ( a Q1' ❑ Healthcare facilities ❑ Supply voltage for more than
r ❑Heaatdoua locations 600 volts nominal
Suito/bldgJapt.no. 4 C Projectname: rp s-y , y , / ?r
m . ❑ Service orfoed600am r ps omo1
Cross street/directions to job site: FEE SCHEDULE
F
� nercriptloo I Sty. I Yea 1 Total l'
, New residential single- or multi- family dwelling unit.
Includes attached garage.
—
Subdivision: I Lot no.: 1,000 aq. R. or leas 168.54 4
Ea. add'I 500 aq.11. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
. DRSCRWI'ION OF WORK • (with above aq. R) 67.84 2
!Q -ti
Re U � � (� r � Limited energy, multi- family
ilRerfrn 4'/ T W� %C _7 7 ,aitice i .,4; /.O residential (With above eq. ft) 67.84 2
/� �1
I Services or feeders installation, alteration, and /or relocafion_
/ j P-_ a eovee; (F /&-S e 11 ' d 7Z ') At-t,- IJ04Jl7 j __ 200 amps or leas 10030 2
11 PROPERTY OWNER + ❑ TENANT • 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps orvolls 552.26 2
City /State/ZIP: Temporary services or feeders Installation, alteration, and /or
relocation
Phone: ( ) i Fax: ( ) 200 amps or leas 59.36 1 1
Owner installations This installation is being made on property that I own which is not 201 amps to 400 amps 125.0 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits— new, alteration, or extension, , er panel
Owner signature: Date:
— A:Pee for blanch circuits with
Q APPLICANT J ❑ CONTACT PERSON . above service or feeder fee,
742 2
oaeh branch circuit ___
Business natne: 13- Fcc for branch circuits
Contao[ name: without service or feeder fee, 1 56.18 �/ ' 18 2
first branch circuit
Address: Each add'l branch circuit 7.42 2
-- Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Phone: dwelling, service and/or feeder
( ) Fax:: ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
- — CONTRACTOR Sign or outline lighting 67.84 2
—
Signal circuit(a) or limited-
y - Business : STONER ELECTRIC, INC. energy panel, alteration, or
Address: 1904 SE OCHOCO extension. Describe: Page 2 2
City/State/ZIP: MILWAUKIE, OREGON 97222 Each additional inapedion over allowable in an of the above
- - — Per inspection / 66.25 406r
Phone: ( 503) 462 -6500 I Fax: (503) 659 -4968 InveaNgalion per hour (1 hr min) 66.25
A CCB :44823 ✓ Electrical Lie.: 26 -122C $uprv,Lic -: 3496S .� Induatrial plant per hour 78.18
s • ' t f 1 . ( } + U ELECTRICAL MINT' FEES —
Suprv. }? nom s requited: m Subtotal: /2.24' 3
Plan review (25% of permit fee);
Print name: MICHAEL FALCONER Date: 3 13 bJs-6 State surcharge (12"6 /�, ofpermit fee }: "�
4, �
Authorized signature: TOTAL PERMIT FEE: /97/
Print Home: I D
This p ermit application expires Ira permit is not obtained within 180
J days after It has bon accepted es complete.
a Nwnbor of irrpeclione allowed per permit.
1.13ui14ie ermiONELCPenirApp.doo10AIA9 440.161.. 11.b7MOM1W2D