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Permit q CITY OF TIGARD ELECTRICAL PERMIT i • oa COMMUNITY DEVELOPMENT Permit #: ELC2010 -00255 Date Issued: 05/25/2010 T [ GARjJ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S109DA17900 Jurisdiction: TIGARD Site address: 15271 SW SUMMERVIEW DR Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 108 Project: Arlington Heights No. 3 Project Description: Temporary power for sales trailer. Owner: FEES STONEBRIDGE HOMES NW LLC Quantity Description Date Amount 4230 GALEWOOD ST #100 LAKE OSWEGO, OR 97034 1 ea Temp Services or Feeders - 05/25/2010 $59.36 200 amps or less PHONE: 503- 387 -7538 1 ea 12% State Surcharge - 05/25/2010 $7.12 Electrical Contractor: CITY ELECTRIC & SUPPLY CO 22235 SW SCHALTENRAND LN SHERWOOD, OR 97140 PHONE: 971- 404 -1714 FAX: 503 - 625 -3052 Type of Use: COM Class of Work: OTR Type of Const: Occupancy Grp: Total $66.48 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 - = rdanee 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. A NTION: Oregon aw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-'010 through OAR 952- 1- 00. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.66 9 or 1.800.332.2344. Issued - 1 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' derf2 TA 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. Electrical Permit Application . . I • ' , Received /� //����,, City Of Tigard Date/By: 9 .g C . /d )uxfo Permit No.: Etd,..0 O 04 5 n 13125 SW Hall Blvd., Tigard, OR 97223 RECEIVED Plan Review 1 Phone: 503.639.4171 Fax: 503.598.196 Date/By: Other Permit: Inspection Line: 503.639.4175 Date Ready /By: lulls: El Sec Page 2 for TIGARD p . Internet: www.tigard- or.gov MAY 2 5 /010 Notified /Method: Supplemental Information TYPE OF WO.1 PLAN; R ® New construction ❑ Addition /alterat i � F � v Please check all th apply 143 LlIVISI(�N pp Y (submit 2 sets of plans w/items checked below ) ❑ S ervice or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. exceeds 10,000 amps at 150 volts or ❑ Floating buildings. CATEGORY OF CONSTRUCTION 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 pump. ❑ Installation of75 KVA or e y tt load of 1 - . ;JQB Si'LE 11�7FQRMATTpN AND:; LOCATION :; oa o ❑ larger separately y eme s Emergency s ❑ 100 Addition of new motor or more. occupancy. Job no.: Job site address: I j z 7 v ! _ iv - (' J se,..) ❑ Six or more residential units. ❑ Recreational vehicle parks. ❑ Health - care facilities. ❑ Supply voltage for more than City/State/ZIP: Tigard, OR 97223 ❑ Hazardous locations. 600 volts nominal Suite/bldg./apt. no.: Project name: El Service or feeder 600 maps or snore FEE.SCHEDULg.: 't:: Cross street /dire to job site: �e d� �A a Description 1 Qtv• 1 Fee. I Total 1 New residential single- or multi- family dwelling unit �iA (J lat.1 Includes attached garage. Subdivision: Wisesrldge-1-- At' Il Lot no.: 107 1,000 sq. ft. or less 145.15 11n�TA ^ 1.y5__/46---- Ea. add'1 500 sq. ft. or portion 33.40 Tax map /parcel no.: Limited energy, residential 75.00 ' ' DESCRIPTION OF E WORK a ,. H (with above sq. ft.) Limited energy, multi - family 75.00 i M y, Q Li e c a .- Q p residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation P lid._ , i f t t 7 200 amps or less 80.30 l''`, )gttRRQFER'11tAOW,NERti ' , ` : 1�t `1ENAN1C}, " 201 amps to 400 amps 106.85 Name: I1,, 401 amps to 600 amps 160.60 ��Or1C�Ct t� H4+r1�S Alt..) 1-1-(____ 601 amps to 1,000 amps 240.60 Address: 4230 Galewood St., #100 Over 1,000 amps or volts 454.65 City /State /ZIP: Lake Oswego, OR 97035 Temporary services or feeders installation, alteration, and /oi relocation ©� / Phone: (503) 387 -7538 Fax: (503)387 -7615 . 200 amps or less f —6685- /. 2 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 intended for sale, I- or exch. ge, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 Branch circuits — new, alteration, or extension, per panel Owner signature: jig/ Date: 2y itl /I A. Fee for branch circuits with P • ! ..:_ PLTC'A T , ® CONTACT PERSON above service or feeder fee, 6 65 each branch circuit Business name: See Above B. Fee for branch circuits without service or feeder fee, 46.85 Contact name Q first branch circuit L� " ' Each add'l branch circuit 6.65 Address: ...._5a Each Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 dwelling, service and /or feeder Phone: ) wq — q€3--) Fax: : ( ) 3$ - W Reconnect only 66.85 E -mail: vicki@dmhholdingsco.com dmhholdingsco.com Pump or irrigation circle 53.40 ' ': CONTRACTOR'.'::.._. Sign or outline lighting 53.40 Signal cireuit(s) or limited- Business name: City Electric energy panel, alteration, or Address: 55568 SW Schaltenbrand Lane extension. Describe: Page 2 City /State /ZiP: Sherwood, OR 97140 Each additional inspection over allowable in any of the abo - Per inspection 62.50 Phone: (971) 404 -1714 Fax: (503) 625 -3052 Investigation per hour (1 hr niin) 62.50 CCB Lic.: 42422 Electrical Lic.: 26 -289C Suprv. Lic.: 35925 Industrial plant per hour 73.75 ELECTRICAL '�PERMIT?FEES � Suprv. Electrician signature, required: I . Subtotal: 5 - ' Plan review (25% of permit fee): Print name: Chuck Friesen Date: o 1 State surcharge (12% of permit fee): . / Authorized signature: TOTAL PERMIT FEE: 40 ,yc This permit application expires if a permit is not obis urcd within Print name: Date: clays sifter it has been accepted as complete. Number of inspections allowed per permit. 1:\ nuildutg \i'cnniis \ELC- PennilApp.doc 05/23/06 440 461ST(1t /05 /COM/WER