Permit ., . ' . CITY OF TIGARD ELECTRICAL PERMIT
1 ,1 a COMMUNITY DEVELOPMENT Permit #: ELC2010 00119
T tGAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/12/2010
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Parcel: 2S102CB03400
Jurisdiction: Tigard
Site address: 9870 SW FREWING ST 59
Subdivision: Lot: 0
Project: Cypress Crest
Project Description: Replace (1) 200 amp or less panel.
Owner: FEES
CANTAS LLC Quantity Description Date Amount
4223 GLENCOE AVE STE #A -220
MARINA DEL REY, CA 90292 1 ea Services or Feeders - 200 03/12/2010 $100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 03/12/2010 $12.08
Electrical
Contractor:
ABC ELECTRIC
135 NE 9TH AVE
PORTLAND, OR 97232
PHONE: 503 - 233 -7551
FAX: 503 - 233 -7552
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $112.78
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 throug 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: dbtA). 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' }fin 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.
3/12/2010 10:43 AM FROM: ABC Electric ABC Electric TO: 503- 598 -1960 PAGE: 002 OF 003
Electrical Permit Applicatio ` F OI OFFICE l Sl. ()NIA'
City of Tigard " Y 1 , R `� ""�
Iii . q S W Ha Blvd., Tigard OR 97223 2 Plan Review VACMillirrareirMAI
Phone: : 503.639.4171 Fax: 543.598.19 AR 1 1 G 201 Date/By: Other Permit:
7 I G A R D Inspection Line: 543.639 Date Ready /By ® See Page 2 for
Internet: www.tigard-or.gov y - j N tified/Method Val Supplemental Information
riiY 1,tA r n x�. .,,,/
• `'4.1:7 - 7Mw'ph.s+�-a. ,, i: �. i,. St e TYPE l .� .1 "i .r.,,:. . ` i. _ . PLAl�1 E ' „ 2 { / 1 t•
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /Items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
' r3 tt -r5�N Sethi ORY.';OE CONSTRUCTION ' = exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
' • ' � less to mound, or exceeds 14,000 ❑ Commercial use agriculture!
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
El Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
.. ....;,,- ....�._,1,...;, Emer larger separately derived system.
,fir4h.; t JOB INFORMAT,ION gCAT[QN ,' z ;[' _ i ❑ Addition of cy s new mo load of ❑ " A „ E p „ `l- 2
Job no.: R- 10-228 Job site address: 9870 SW Frewing 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, Oregon 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 59 Project name: Cypress Crest Apartments ❑ Service or feeder 600 amps or more.
. . FEE; SCHED81 .' . . 1 ? 4:.;a: =
Cross street/directions to job site: Description 1 Qty. 1 Fee. ^ 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. 0. or less 168.54 4
Ea. add'I 500 sq. 0. or portion 33.92 1
Tax map /parcel no Limited energy, residential
r rW� I DESoileljOJV (.OF' +WORK ; : r (with above sq. ft.) 67.84 2
Limited energy, multi - family 67.84 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
Panel change 200 amps or less 1 100.70 100.70 2
4 r • . 0 PR , ; r.OWNER• ❑ 1ENANT j ;,, . 201 amps to 400 amps 133.56 2
Di ._�?,.. 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
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I 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, per panel
Owner signature: Date: A. Fee for branch circuits with
v 4 above service or feeder fee,
7A2 2
i' AP)�')F ttf t ., C �. t8 CONTACI eachbranchcircuit
Business name: ABC Electric B. Fee for branch circuits without
service or feeder fec, first 56.18 2
Contact name: Anne branch circuit
Each add'I branch circuit 7.42 2
Address: 135 NE 9 Avenue Miscellaneous (service or feeder not included)
- Ci /State /ZIP: Portland, Oregon 97232 Each manufactured or modular 67.84 2
�' + g dwelling, service and/or feeder
Phone: (503) 233 - 7551 Fax: : (503) 233 - 7552 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: anne @abc electric.net Sign or outline lighting 67.84 2
a..r - r.., .�' r _ . `r CONTRACTOR . .., Signal circuits) or limited energy
Ye Business name: ABC Electric panel, alteration, or extension. Page 2 i 2
i7-- Each additional inspection over allowable in any of the above
Address: 135 NE 9 Avenue Additional inspection (I hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City /State/ZIP: Portland, Oregon 97232 Industrial plant (I hr min) 78.18/ hr
Phone: (503) 233 - 7551 Fax: (503) 233 - 7552 Inspections for which no fee is 90 / hr
specifically listed (/s hr min)
CCB Lic.: 161501 Electrical Lic.: 26 -1226C Suprv. Lic.: 5096S =. ELECTRICAL ,PERIOU,FLE$r': =.: =:; ,;.::. _�.:
Subtotal: 100.70
X Suprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name' Shawn Dunigan Date: 3 -12 -10 State surcharge (12% of permit fee): 12.08 —
TOTAL PERMIT FEE: 112.78
Authorized signature: 1 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Shawn Dunigan Date: 3 -12 -10 • Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.dor 10/01/09 440- 4615T(1 I /OS /COM/WEB