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Permit
I t I f CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2010 -00316 Date Issued: 06/25/2010 TIGARD'; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102AA00200 Jurisdiction: Tigard Site address: 11920 SW PACIFIC HWY Subdivision: Lot: 0 Project: Mixers Bar & Grill Project Description: (1) 201 - 400 amp service to replace meter base. Owner: FEES TUMAY CORP Quantity Description Date Amount 11920 SW PACIFIC HWY TIGARD, OR 97223 1 ea Services or Feeders - 201 to 06/25/2010 $133.56 400 amps PHONE: 1 ea 12% State Surcharge - 06/25/2010 $16.03 Electrical Contractor: CHERRY CITY ELECTRIC 1596 22ND ST SE SALEM, OR 97302 PHONE: 503 - 566 -5600 FAX: 503 - 540 -8147 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $149.59 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 503.2 or 1.800.332.2344. Issued By: Permittee Signature: �w L e_6 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. CaII 603.639.4175 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. 06/24/2010 08:07 5035408147 CHERRY CITY ELECTRIC PAGE 04 �l1 ' ' iR th � H 1 '.'.'k'''A.,' ,, i ' p a r 0 , t,1 Atk :,, , .. c .__�� L. 1 q tit �i? v Electrical Permit, p�icatio r , ) 11)1 c 111 1( 1 _ ,-,..--,,,::,';;f,;:',",(32 ,, V... t r � t a � � ^i � L i s +I. . `7 , ,. L .. J UN 2 . 4 2010 Pate 2s /e) j;.' - 1'emrr ao/i -DU. ' (, z i +i 'd f: City of Tigard Flare 1t\ r� + m 13125 SW Hall Bivd., Tigard, OR 97223 T� I p � [� 1 W "{ 1 , 1' ime: 503.639.4171 Fax: siasn8.19t° 1 9 1 OF I I G AR D i i . ar Inspection lmr 503.639.4175 0 See Page 2 fir ,,au : Internet: vetvar_tigrrrdor.gov BUILDING DIVMSIO �i% C iu talInformation TYPE OF WORK PLAN REVIEW Mane ® Addition/alUera� se check a0 that apply (submit a seta of plane w/itema checked below): ❑ 0 New construction Service oT feeder 400 imps or more ❑ Building over twee stories. "" CI ❑ � "" wt.. the available !nett cu neat ❑ Marinas and boatyards. K;A �' CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings, _ t�7t less to ground, or exceeds ds 14,000 0 Corra9Aerciai -sae agiculterral 0 1- and 2- family dwelling 0 Commnercialli ndnslrsal ❑ Accessory building amps for all other installations. buildings. Q t-'� multi-�1Y 0 � ❑ Orin primp, ❑ Installation of 7516VA ce Other ©Hlmergemcy system. I:ugzt sellv:tel\ derived system JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load 9f 0 A. "9", "1 -r, "1 - 3", ocoup Job no,: S410311131 Job site address: 11920 Pad& Highway 100 or" ` �y 13 Six or mate residential units. ❑ Rexaeatienal vehicle parks. CitylStatdZIP: Tigard OR 97223 El Health-ease facilities. ❑ Supply voltage for more than 171la.wrdwa location. 600 wits nominal. Suite/bldg. /apt. no Pmject nine: Mixers Bar 0 Service or feeder 600 amps or more WE. .SCRIEDULE Cross street/directions to job site: nexrrence 1 0 1 Fae 1 row 1 . New Teddetat $ tdoka- or multhfarolly deeding fit. T Insindes mKneAed garage Subdivision; 1 Lot no.: 1,000 aq _ or lees 168.54 4 1 Ee. midi S06 rap. - or portion 3392 1 Tax rlatpplparvt1 no.: Limited mangy, residential 67.84 2 DE'icIIrfOl4 OF VP (with above sq. ft) Limited energy, undth amity 67.84 2 Replace meter be nsaidentiel(with above tat 0-) Sea's or feeders to stallallnn. alteration. and/or relocation 200 naps or lets 100.70 2 ❑ PROPFAT OWNER f . . 0 TENANT 201 amps to 400 imps _ 1 133.56 ^ 133.56 2 401 amps to 600 amps 200.34 2 Nam 601 *nun 1n 1,000 amps 301.04 2 Address: Ova 1,000 amps ar wits 55226 2 Temporary services or feeders iartadionan, altermrion, and/or City/Slide/ZIP: relocation Phone: ( ) 200 aaQe err kw 59.36 1_ Owner installation: This in:oil:Aim is being made on propert■• that I own which is not 201 mops ha 400 amps 125.08 2 intended for sale_ lease. rent. or a change. according to ORS 447. -1-19, 67D. and 701. 401 amps to599aeps 168.54 2 Branch circuits — nets. ,eneratioa or eY tesisioa. veer panel (. signature: Date: A. Fee for team* tort* above service or feeder fee, 0 AfI.IcA11T 0 CONTACT PERSON each Mooch 7.42 2 Business name: 1t. )'err for brands circuits wribootr service ar feeds fee, feet 56.18 2 Contact name: Waal circa Bach add'I butch circuit t 7.42 2 Address: Miscellaneous (service or feeder ant included) City/State/ZIP: Each manufactured or modular g, 67.84 2 1 dwelling, service and/or feeder Phone: ( ) J Fax :: ( ) Reconnect only 67.84 2 Pump or irrigation cacle 67.84 2 E-mail: Sipe or airline ligbr+ag 67.84 2 C'ONTRACI OR Signal cireuit(a) or limited-energy 13usiness name: Cherry City Electric Farrel, alteration, \u <ne ton. Page ; 2 rash additional inspection over allowable tin any of the above Address: 1596 22 St SE Additional impaction (I lu min) 66.25/ la Ittneatigali City/State/ZIP: Salem, OR 97302 ° () be 1010 66.25/ t` . io vial pint (] hr min) 78.18/ In Phone: (503) 566 - 5600 Fax (503) 540"8147 1mpectims for wfiich no foe is a 'ilicallc tilted ', In Hein) 90.00t inn i CCB Lie.; 91668 Electrical Lic.: 37 - 620C - Sum, Lit.: 36405 ELECTRICAL PERMIT FEES Subtotal: 133.56 Suprv. Electrician signature, required: . - 1,O . ! �• • . £ i _ "i. e/ Islam rme w (25% of permit flee): Print name: Douglas Haycock I Date: , ' 0 Stele am°fnage (12% of permit foe); 16.03 TOTAL PERMIT FEE: 149.59 Authorized signattlne: Tds prima mailkatiew o>gttres if a pottnit to nat ebteined within 1 go Print name: Dom: dim elle+' it lama bees *mama as cempkte. • Nrznober of inspections allowed per permit its uit41nglregatrslEt e- PerrtotAppdoc 10101/09 44od51Sr(1 r/051CO1MIWg0