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Permit a ii . ,.. q CITY OF TIGARD ELECTRICAL PERMIT Is COMMUNITY DEVELOPMENT Permit #: ELC2009 -00625 i GARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/19/2009 T Parcel: 2S102AB01001 Jurisdiction: Tigard Site address: 11950 SW Lincoln AVE Subdivision: Lot: 0 Project: Monroe Square Project Description: Add /alter (1) branch circuit for walkway lighting. Owner: FEES SERES Quantity Description Date Amount 4175 SW GREENLEAF DR PORTLAND, OR 97221 1 crt Branch Circuits 11/19/2009 $56.18 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 11/19/2009 $6.74 Electrical Contractor: SQUIRES ELECTRIC PO BOX 16851 PORTLAND, OR 97292 PHONE: 503 - 252 -1609 FAX: 503 - 253 -5831 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 thro gh 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: -anauu 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' nn Date: LICENSE NO. `� Call 503.639.4175 by 7:00 a.m. for an Inspection that business day. Thls 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. • 1 Electrical Permit Application t r,E� �`' ' ° f- < k' _ : *: , � p ` i v i ,Nl x 1 I . ' ' s y F kwOFf O�LIs a „L phi ..°;' City of Tigard Re • �., ''i.' ' ° 13125 SW Hall Blvd., Tigard OR 97223 plan Review , i F t Phone: 503.639.4171 Fax: 503,598 -1960 NOV 1 2009 t»te/B _ Other Permit: rte: Inspection Line: 503.639.4175 Date Rwdy/By. rd see Page 2 for T�lcu Internet: wwwtiprd -or.gov CITY OF T1GAR U Notificd/Mahad: EMI supplemental information Imo " . ✓,nee - 7:471 ,�- : w'"':;: 4 7 p � . , i �" 'nS' roA A�= � 'fie a 7:* - X �b !: y �q t` ^ P yly�'�IRNki?:f Ji. . y --,�•�p q'l,", 'y`n .0_A 1 Ra 34 + ' ' „ J ' . h 4„ x z q?` 9� v : < _ l ' f tr . . " ;, `)f: r't �i�.,i,rr�'trk �'^ �, �ee�k^ ��, E.: � .�. ��t'���''i.e. .. � X+:.r , u u i � r �R�',e ..., IS'�`�.,.i'1���:a_'�l...Ft,� .... ..�..,, s'� .. - ❑ New construction /1 Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w/lretns checked below): 0 Service or feeder a(X) amps or more 0 Building over three stories. ❑ Demolition ❑ Other; where the available fault current 0 Marinas and boatyards. -, rrr " "� p F f r 1 g ” »A kV-We-47W exceeds 10,000 amps at 150 volts or El Floating building. " Less to gmtmd, or exceeds 14,000 ❑ Co,nmert dal - a aericrih+ral • ❑ 1- and 2- family dwelling P'l Commercial/industrial ❑ Accessory building amps for all other installations. buildings. • ❑ Multi family ❑ Master builder 0 Other: [(Fire ptmmp. 0 installation of 75 KVA or `'re" �' � t ., "° ''7 t p ❑ Emergency system. larger separately derived sy' em. 3 " 1 ,-- 12 r , . . � "f r t ,..v_ f 't . s . s e - ' �uu .•,,; : !M ❑ Additirno of new motor load of ❑ "A'. "E", - 1-2", ..1.3 ", Job n0.: Job site address: / ( /� 1001 or morc. occupancy. �( ( 4 L� , I Yt Il - t) £- ❑ Six or more residential units. ❑ Recreational vehicle parks, ■ City /State/Z i /� - r D i 0Hr:tlth.care facilities. ❑ Supply voltage for mom than ❑ Hazardous locations 600 volts nominal. Suite/bldg./apt. no.: Project name: 1 ❑ Service or feeder 600 amps or more s 07 cr Cross street/directions to job site: �. ji 0 y) t ccrip n c is ..; ,; l ../ , 4 1 ... M.-.' al a � �y� 1 kt I Total I • . , New residential single - or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq_ ft. or less 168.54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limitcd energy, residential P.,' k . ��a rF:{�,vf i , 67.84 2 'ra y,'. . R ..t� , • , v ':�'�?;. -.1 � ...,..,ia - ,,.. gf i �S, .�Y i�!'.%' ` ��° ire; (w ith above e.. ft_ n Limited enemy, multi - family III 67.84 III Oc.L; 1 i r l._ t residential (with abbe sq, lt) Services or feeders installation. alteration, and/or relocation 200 amps or less 100.70 2 , ? M 77 c , •.7 l ,' J , r',; v _ `, r 201 amps to 400 amps MI 133.56 � Name: f 401 amps to 600 amps IM 200.34 © 601 amps to 1,000 amps 1.1 301.04 1E1 Address: Over 1,000 amps or volts 552.26 2 • City /State/ZiP_ Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being rnade 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 extension, , r panel Owner sigttattirc: D A. Fee for branch circuits with • : . 4r. -gi' � ; ti ? p " 1 , ,' "?r ! ,y. ,r " ii ;; 4. a rr W :4, t above service or feeder fee. 7.42 2 Cash branch circuit Business name: B. Fec for branch circuits without service or feeder fec, 1 5618 � • / 2 Contact name: first branch circuit - RF • Address: Each add'l branch circuit 7.42 2 — Miscellaneous (service or feeder not included) City /State /ZIP: • mach manufactured or modular 67.84 2 dwellintg, service and/or fender Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E -mail Pump or irrigation circle 67,84 lj .a c., ;;. .J'," u tit'= -a- yr • , ra� r 9. '. . ...t.� S outline lighting 67.84 �'::. ,I E. '. ,a. ` r :anu s?:; y Ir ; 5-' . ..,, y47 : .'" a rt Or O Signal circuits) or limited- Business name: •‘6 1 u r e E-- 1 c t l — r energy panel, alteration. or Address: -- FL x 1 (.p , j 1 extension. Describe: Page 2 City /State /ZIP C 1 u ._ Each additional ins t ection over allowable in any of the above Per inspection MI 66.25 MINIM Phone: ( ) ,.' Fax: ( ) � 2 -e, '5 gt3 i Investigation per hour (1 br min) - 66.25 - CCB Lie,:1 J am-- /) Electrical I,ic.; idt t C Suprv. Lie.: g 0, 16 inrt9du,_st�rial plant per hour I tt ^ 541:) .:.,. r w .~ '. f . .' '. Y:.•':!":. ;: &P: "+ t+, ' Suprv_ Electrician signature, requir� _ Subtotal: � Plan review (25% of permit fee): Print name: E :1TJ t,t.t re Date: / � g in State surcha roe (12% of permit fee): MOM Authorized signature: TOTAL PERMIT FEE: NEM This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. - • Number of allowed per permit. f \8uildimlPeon is E"CC- PecmitAai 4oc 101109 � " i � e . Z00 /300 d EZ6E# �‘ 13 S3EiI V 1E89E93E0g ZE 9I SOOZ /81./1.1.