Permit . ' CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 -00234
t C .
� I; Date Issued: 05/12/2010
TIGARD! 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101 CB00500
Jurisdiction: TIGARD
Site address: 12670 SW HALL BLVD, BLDG# 2
Subdivision: Lot: 0
Project: Apex Industries
Project Description: (5) branch circuits for lighting retrofit
Owner: FEES
TCTPI LLC Quantity Description Date Amount
25977 SW CANYON CREEK RD #J 5 crt Branch Circuits 05/12/2010 $85.86
WILSONVILLE, OR 97070 wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 05/12/2010 $10.30
Electrical
Contractor:
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 $96.16
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 OPrR 9 2-001 -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:
xf Permlttee Signature: �� 'L/ L�a
7�
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.
May, 11, 2010 1:16PM No. 2660 P. 1
Electrical Permit Appl><cati E CEIVED FOIi tirrlc!r li5r ONLY
City oI'Tigard MAY 1 1 2010 Received C
1 AI . J 13125 SW Hall Blvd., Tigard. OR 97223 Plan Review
I Phone: 503.639.4171 Fax: 503.59t 1 F TiGAR>i�
9 O Datei ; Giber Permit;
f rt:All lr
inspection Line: 5O3.639.4175 VIS I OR� Dala ReaeyBy: la SeePage
Internet: www.ti ardor, B BUILDING DI
ov Nolifted/Method: EWA Supplemenrallnformation
: n a-- . - .. V .... . ;1, s TYPE..0,;Y17,0 ue c ,- ,. .' . _. ... 0jati`c EVIEW ," r.. :
o New construction ,,' Additiorl/alteration/replacement Please check all that apply (submit z seta of plane tv /items checked below);
❑ Service or feeder 400 amps or more ❑ Building over lhree stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards,
. , -. 'r" �` €p' ? oxcecds 10,000 amps at 150 volts or ❑ Floating buildings,
CATEGORY O , ; ;y � � less to ground. or exceeds 14.000 ❑ Commerciel•use agricultural
❑ 1- and 2- family dwelling iti Commercial/industrial 0 Accessory building maps for all other installations. buildings.
❑ Multi-family 0 Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA or
❑ Emergenty system. larger separately derived system.
,0 :7;$ I. +Q tSR O.i , Nb LOCATION .. ,,'•' 9 Addition of new molar load of ❑ "A „ • •'E , • • "1 -2 , '1 -3
Yob no.: � i/, Job site address: /247b .574) '' //--' 1001 ormpre. occupancy.
/ [] Sixor moro resideniial tails. ❑ RoerealionR vehicle pale
City /State/Z1Pr e v ,p4 ❑ Health•care flu:Hides. ❑Supply voltage for more 'ban
❑ Harardous locations. 600 volts nominal.
Suite/bidg. /opt. no.: 902_ I Project name: 474-k 4, D4's r E ['Service or feeder 600 amps or more.
Cross slreet/directions to job site: Description 1 Qrv. Fe.. 1 r 1 •
New residential single or multi - fancily dwelling unit.
Includes attached garage,
Subdivision: I Lot no.: 1,000 sq. ft. or loss 168.54 4
Tax map /parcel no.: Ira. add'I 500 sq. ft. or portion 33.92 1
Limited energy, residential 67 -84 2
d '- '- ;C 41 5 "�DO Oiff,T101.V OF WORK %:v a icji :. _.�a'r (with abovo sq. li.)
Limited energy, multi- family 67.84 2
jN,STr¢L. 4 14 Acj K I'E ~ 4 /46 'ergo 7 - residential (with above co, R.) _
Services or feeders installation, alteration, and /or relocation
_ 200 ahlps or less 100.70 2
ti y "1 f` ? A q�vl k: :. I q rJ'13rQ,o ? ' ' . 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 or volts 552.26 2
City /State/ZIP: Temporary services or feeders Insfnllnllott, alteration, and /or
relocation
Phone: ( ) Fax; ( ) 200 amps or less 59.36 1 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, 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 ex tension, per panel
Owner signature: Date:
_ A. Fee for branch circuits tt•rrh
17114t,� tQ ti:I te:-•l' I; ,,"0 CONTA I' .p p 1'h : above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: a rrhour service or feeder fee f 56.18 51.1? 2
first branch circuit
Address: Each add'l branch circuit si 7.42 29. (vg 2
Miscellaneous (service or feeder not Included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) I Fox ' ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
ft `„ : Y . ;'.CONTRACTOR ':41 M : = ;y _.,,t- Signor outline lighting 67.84 2
Busiitess name: STONER ELECTRIC, INC. e limited-
energy panel, allemtton, or
Address: 1904 SE OCHOCO extension. Describe: Page 2 2
City /Stalc/ZIP: M I LWAUKI E, OREGON 97222 Each additional inspection over allowable In any of the above
Perinspection 66.25
Phone: ( 503) 462 -6500 Fax: (503) 659 -4968 I nvestigation perhour(1h 66.25
:.CCB Lic.: 44823 Electrical Lic.: 26 -122C Suprv. Lie.: 3496S Industrial plant per hour 78.18
U t'.,,Fieetc. :'ELgCTIII CA L ` .PE RM1t:Z'EP '<° f ..1:7.'
Supra. Electrician signature, required: m „.I Subtotal: 85 grr,
Print name! MICHAEL FALCONER Date; 6/41 /w Plan review (25 %ofpennit fee):
State surcharge (12% of permit fee): /e0 • 3 O
Authorized signature: TOTAL PERMIT FEE: 96 , /(o
This permit appllcallon expires if a permit is not obtained within 190
Print name: Date: days after it hes been accepted as complete.
• Number of inspections allowed per permit.
LlflizildingtPemmiis 'PLC- PerrmiLApp.doc 10/01/09 440 46I5T(11 /05 /COMMrEn