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Permit CITY OF TIGARD ELECTRICAL PERMIT I: COMMUNITY DEVELOPMENT Permit #: ELC2010 -00315 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/25/2010 Parcel: 2S102AA00100 Jurisdiction: Tigard Site address: 12005 SW HALL BLVD Subdivision: Lot: 0 Project: PGE Meter Services Project Description: (1) 200 amp service to replace meter base. Owner: FEES YOO, KYOUNG -HEE & JAEUK Quantity Description Date Amount 17613 OAK MEADOW LN LAKE OSWEGO, OR 97034 1 ea Services or Feeders - 200 06/25/2010 $100.70 amps or less PHONE: 1 ea 12% State Surcharge - 06/25/2010 $12.08 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 $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 through R 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: !/ Permittee Signature: 071 / �� ' 7 V 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. 06/24/2010 08:07 5035408147 CHERRY CITY ELECTRIC PAGE 02 -0 �a tfi �at. Ira �o �aa'1 re1"a 1d�� Electrical PtermitAp®9ica E. � V � r ���, �( A,� 1 1)RZ I)l,� ) R�d, l�5i � (1.��� ir� l , S w�, '`Y 5 1 - '�� . �7u .d.,; @n,�da. ∎ �I�61L tS1iiiY YA 1 $ kM � J .§2,ir� r ., w�, "-. �,5 ; ,� t , �, ✓ r,� �,N ", City Of Tigard Sta �d • Z to .II i ,20 /a . 0 d sks r� w w 2 . 2 • I •er se ]'omit N., * ( ®u , 13125 SW Hall Blvd, Tigard, OR a Phone: 503.639.4171 Fax: 503.598.1960 SHITMINIMIN "thr Dams 01 Vi Inspection Line: 503.639,4175 www. It Bic.,, CITY OF I IG ` s � err sez per :roe _au r "r ttetedt: ti err -guri un n I N ,D M V i SO Supplemental Llformatloe c TYPE OF WORK PLAN REV EW ❑ New construction ® Adchtlon /alteratiall/lepiactnrlent Please aleck all that apply (submit 2 seta of plains vacant checked below): 0 Service or feeder 400 amps or more 0 Building over throe stories. ❑ Demolition 0 Other: where the available fault current 0 Marinas and boatyards. Ct.Tll4 ORS OF CON■NSTfIJC'FION avrceedc 10,000 amps at 150 volts or 0 Floating buildings. less to grnand, a exceeds 14,00(1 0 Conmeercial•use agricultural CI 1- and 2- family dwelling Q Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master bull ❑ Other Urn" pump. ❑ lr>ataflatirn of 75 KVA or O 3magency system lirgrr setxrately droved ..vv.ktn JOB 8i11'E INFORMATION AND LOCATION ❑ Addition clam tr o or load of Job no.: S410311131 Job site address: 12095 SW Hall 1(1(1riP w mom. oeoupaocy _ ❑ Six or more nende tial mats. ❑ Recreational vehicle parks City/State/ZIP: Tigard OR 97223 ❑ health-care facilities. 0 supply voltage for more than _..,,„„ CI Hazardous locations, 600 volts nominal. Suite/bidg.lapt. no.: Project name: PGE Meter Services ❑ Service or feeder 600 amps or more. '- " FEE SC'ILLDtTLE Cross street/directions to job site: t)eaat?oan Qtr. Fee- rail "" New residential single- or sandli4innsily dwellhig emit. - lad :ides attached garage. Subdivision: Lot no.: 1,000 eq. R. or lees 168.54 4 w- -• Ea. add'/ 500 sq. ft. or portion 33.92 1 Tax no.: limited energy. reaidemial 67.84 2 DESCRIPTION OF WORK (with above sq. ft) , Limited aacrer, smith- faatil) 67.84 2 Replace meter base nisideol ai (.tilt above os ft.) . ')mitts or treaters installation. alteration. tuid/or relocation 200 Amps oe less 1 100.70 100.70 2 ❑ PROPERTY OWNER I 0 TENANT , 201 amps to 400 amps 133.56 2 Name: 401 amps to 600 snips 20034 2 _ _ 601 aims to l 000 amps 301.04 2 Amass: Over 1,000 ampa or volts 552.26 2 City/State/ZIP: Temporary services installation, alteration, or Feeders installatio alteration, and/or Phone: ( ) ! Fax: ( ) 2011 amps or less 59.36 I 701 amps to 400 amps 125.08 2 - Own installation: This installation is being made on properh that I own which is not --- intended for sale. lease, rent, or exchange, according to ORS - 7. 449. 670, and 71(1. 401 amps to 599 amps 168.54 2 Branch circuits ^- new. »petition. or esteudion. r and Owner st gontike: pair: A. Fee fix branch circuits with © APPLICANT " 0 CONTACT PERSON above service or feeder fee, 7.42 2 each beau& circuit Business name: B. Fee for broach circuits ,n r!>ow - - aarvieo or feeder tee fail 56.18 2 Contact name: branch ea°uit Each tdd'I branch circuit 7.42 2 Address: I►tIsertlapeaui ser+ice or treater not iacltaded) City/State/ZIP: /Stale/ZIP: Each maawfactoued Of modular 67.84 2 Y dwelling, service and/or feeder Phone: ( ) Fax : ( ) ° °°et or1 _ 67.84 2 E - Pump or irrigation circle 67.84 2 Sign or canine tighriag 67.84 2 ('ONTRACTOIt Signal .:irrait(a) or limited -t exrgv Business name: Cherry City Electric pawl• alteration. rM cdension. Paps ._, Each addllioetd Iaspectloa over allowable In env of the ahoy Address: 1596 22 St SE Additional inspection (1 hr m in) 66.25/ hr City /State/ZIP: Salem, OR 9731)2 hem aiga*ica (1 lie min) 66 hr ^ ..m-.....,, Itdanrial pled (1 hr min) 78.18/ hr Phone: (503) 566 Fax: (503) 5404147 inspections for which no too is — `� specifically lhard ( _ hr aiiu ■ 90.00 / M CCI3 l,ic,: 91668 Electrical Lic.; 37-620C Supty- l ic.: 36405 i r E L PERT►IIT FEE.$ Suprv. Electrician signature, required: 1 sr 100.70 Plan review (25% of permit fee) Print name: Douglas Haycock --1 Date: 6/24/I t! State surcharge (12% of permit fee): 12.08 Authorized signature: 'DOTAL PERMrI' FEE: 112.78 r/ - µm Tats poamit apg6eatlao aupteoe It a parent ie not obtained within 180 days an, it h®a been accepted our complete. Print name: Date: 1 • Number of inspections allowed per perms 1\ Building \Pam rermstApp.Anc 10lo]ro9 440.4615T(11ro5/COM/Wtil3