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Permit 1 R CITY OF TIGARD ELECTRICAL PERMIT 14 COMMUNITY DEVELOPMENT Permit #: ELC2009 -00587 Date Issued: 10/30/2009 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 T 1G ARD; Parcel: 2S 102DA00200 Jurisdiction: Tigard Site address: 8720 SW BURNHAM ST Subdivision: Lot: 0 Project: Skate Park Restroom Project Description: (4) branch circuits and low voltage for door control. Owner: FEES TIGARD, CITY OF Quantity Description Date Amount 13125 SW HALL BLVD 4 crt Branch Circuits 10/30/2009 $78.44 TIGARD, OR 97223 wo /Purchase Service or PHONE: Feeder 1 ea Signal circuit or Limited 10/30/2009 $67.84 Energy Panel Contractor: 1 ea 12% State Surcharge - 10/30/2009 $17.55 MOUNTAIN F ENTERPRISES INC Electrical 25973 S MOEHNKE LN BEAVERCREEK, OR 97004 PHONE: 503 - 313 -0761 FAX: 503 - 632 -5521 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $163.83 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 503.246.6699 or 1.800.332.2344. Issued By: t la • Permittee Signature: A /9/ / e -77g N Y 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 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. 10/30/2009 08:47 503 - 632 -5521 ALAN FITCH ELECTRIC PAGE 02/04 ir,iectrical Permit Aptlitipii64., r oiz o ril'I: l S11 ONLY City of Tigard 3� " k cetera /C s o 1 ` e ' iv P erm i t No.. 4'O r. 0 . 87 13125 SW Ralf Blvd.,'1'igard -{ t97 33 , - Phone: 503.639.4171 Fax: 50598.1960 1 u - j - I ! „ t Date/13 : '" Other ' 1( P 00 DO !/ - 1 , ,. `I. n Inspection Line: 503.639.41, i( ° . R ate Ready/BY! Ready/BY! Ready/BY! FM El Sat Page 2 for Internet www tigard or.go t ■ 'V l �° ;� i r � ottfied/Metitad Supplententar Inrormanon '� v: ,' ��� ; �,R r " ��� o ;._' * '' '" �� '" r` `� i s r, 1 f" ' . ' �� i '1�, !�11 .r, , � N�� � r 4 i`� f y , 4�� �.i , �, u . ! ra � ,. 4 (� ii',.> 4 ,�,. ,. � � �. ' l y ,,,,hl � ��I w' ti L A f ,.d. 6„, , k i -..�. t" � „ New construction 1:1 Addition/alterationh aremerrt Please check all that apply (submit j sets of plans whtems checksd below): ❑Service or feeder 400 amps or more D 9uitding over three crones. 0 Demolition ❑ Other: where the available fault current ❑ Maxims and boatyards. ii ` ' C AI FOR ,. 01 ( R1Cn . ' ,, ,, , . 'r, exceeds 10,000 amp at 150 volts or ❑ Flmung buildings. w ........._ --- - ' less to ground, or exceeds 14,000 ❑ Commeruial• use agricultural ❑ 1- and 2- family dwelling RComrnercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder El Other: Cl Fire pump. ❑ installation ot75 KVA. or ❑Emergency system. larger separately derived system. .0ri SnZ ::INFO) I'IO1♦ . NH , LO(A'r1014t, '.':; ° ::'! ❑ Addition of new motor load of © "A~ •7E", "1 -2 ", "1..3", r e Job no.: J site address: 2D s '6oi # rTrr/ 1 7�' o i Six or more. Recreational vehicle parks. g P x o o r r more residential colts. 0 1t R�cre I..ityi State /ZIP: ' q - -^ -N ❑ Hoeah -acne cations. facilities. ❑ Supply voltage for more than l Q Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name:5�� .? ,,. a(1 s-r Q service m feeder 600 amps or more. Cross street/directions to job site: ...„,„2_, rien R a n f Fee. I Teal � I" • Nev residential aingie -or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Tax map/parcel t10 - `� Ea add'l 500 sq. ft. or portion 33.92 1 l .— Lt (v abo q. residential 67.84 2 C/ Limited energy, multi- family 67.84 2 N 12 A t((,,.1.{ rrs , 1�1, 1 ' >L- (/ 6,µ ! _ , residential (with above sq. R.) gg Services or feeders installation, alteration, and/or relocatio w i lA1 'l.a...a1 --" t-a Ud 1✓ PpOft' 6 010r1L0 i W 1Y'e, 200 amps or less V-- - -.�� 100.70 2 }' c h'a'ir : o w'w .. 0 '�T$1'��LN � 201 am�s to 400 amps 133.56 2 Name: _ 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps -µ 301.04 2 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 made on property that I own which is not 1..101 snips 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, perpancl Owner signature: Date: A. Fee for branch circuits with CI APPLICANT : ''• :,, . . ', f ' cONT;4itT Pfl4SQN ` above service or feeder fee, d 2 ' ' ` _each branch circuit 7. 2 Business name: B, Fee for branch circuits -� Contact name: without service. or feeder fee 1 56.18 ,l ii 2 first branch circuit_ _ Address: w.., .__ Each add'l branch circuit �. _� Z 7.42 ZZ, 2 -- - -- — •- - - - - -• — Miscellaneous (service or feeder not ineludedl_ City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 6'7.84 + 2 Phone: ( ) Fax : : ( ) Reconnect only _ 67.84 2 E -mail: Pump or irrigation circle 67.84 2 Bus 1' 1 D t�I P` . �jA � 1 1 �fL.}� � ' l circuit(s) t(s or 67.84 2 • s... CONTRACTOR , Sign Business name Signnl circuits) or limited - VL . 1 energy panel, alteration, or . .._ extension. Describe: Page 2 44, it'f 2 Address: LS 1 , frloao w City /State/ZIP: r Each additional inspection over allowable in any of the above V2�C c ` ' Per inspection 66.25 Phone. ( .) t . 6:1,A,, 1 Fax: (S0 51- . g 5 2 - . i / Investigation per hoar (t hr min) 66.25 r CCB Lic : k 5 t C c 2 Electrical I.,-c.: 3 -7,f, 9.- C Suprv. Lic - 51.2_,‘ 5 , In Lliaalitant per hour 78.18 h1 tel Suprv. Electrician signature, required: A� � � . - - - 0t4lt,r F�ltS i . �_ ; �j . � � Subtotal: tip t 277 - Print name: i Date: C� Plan review (25 %of termir tee): P 1� 1 t t-� - - - --._ . J ... _... �� - �� a / State surcharge (12% of permit fee): I �.SS Authorized signature: 1 TOTAL PERMIT FEE; 1A0_ 3 j 1.0/... — ' > ` "'� This permit application expires If a permit is not obtained within 1110 Print name: 1 , .. t . - Date. dad t after it has been accepted as tomplete. ' Number of inspections allowed per permit. 01 3uilding■FvmitiaLC- PermitApp.Qoc 1W01 /09 440-46l Sr( I 3 /0S/C0MWF.A rt CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit ELC2009-00587 • 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/30/2009 Parcel: 2S 102DA00200 Jurisdiction: Tigard Site address: 8720 SW BURNHAM ST Subdivision: Lot: 0 Project: Skate Park Restroom Project Description: (4) branch circuits and low voltage for door control. Owner: FEES TIGARD, CITY OF Quantity Description Date Amount 13125 SW HALL BLVD TIGARD, OR 97223 4 crt Branch Circuits 10/30/2009 $78.44 wo/Purchase Service or PHONE: Feeder 1 ea Signal circuit or Limited 10/30/2009 $67.84 Energy Panel Contractor: 1 ea 12% State Surcharge - 10/30/2009 $17.55 MOUNTAIN F ENTERPRISES INC Electrical 25973 S MOEHNKE LN BEAVERCREEK, OR 97004 PHONE: 503-313-0761 FAX: 503-632-5521 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $163.83 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 taw. 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 503.246.6699 or 1.800.332.2344. Issued By: Permittee Signature: ~~~e Ail 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 603.639.4176 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. 10/30/2009 08:47 503-632-5521 ALAN FITCH ELECTRIC ' Viectrical Permit Anplicat>lan A City of Tigard pt~ra 13125 SW f -WI Blvd.jigard, OR 9722 s~ plan tt new cniuK r~,it~ Ll~' ,UG C"!~ ~n ~j Phone: 503.639.4171 Fax: 503.598.1960 Date 13v: _ 1mpectioo Line: 503.639.4175 Date Raady/13y: Iwi 0 See Page 2 fur Internet: www.tigard-or.gov NotiftecfMethod Supplooental information 1 ~f'~A" 1~V~.~47n ,...,•4.r^^^' J 1 f. i F ~f-':iG 1 ,a 1 0 1 Fi#~~ h^..e;rk er 7 ~.-p rJ KNew construction ❑ Addition/alteration) rc lmxrorw Plmse check all that appl-v {submit 2 sets of plans wlitems che&Ad below): D Service or feeder 400 amps or more Q Building over three stories. ❑ Demolition ❑ Other' whore the available toult current ❑ Magmas and boatyards. exceeds 10,000 amps at 150 Volts of El 1 load pg buildings. CA' loss to ground, or exceeds 14,000 Q Commixatat-uu agriculteral ❑ 1-told 2-Ettnlily dwelling W.oinmercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Mula-family ❑ Master builder _ ❑ Other D Fire pump. d Installation or75 KVA. or S cl`fP)l_11 f Ctfil e111Vk1 LUCA'FIOItE D emw y syslam, larger separately derived system _ ❑ Ad4i n of new motor load of Q "i4" "V, "14'>, "l 3"> Job no Job site address. ~u ,t 100HP or more, occuponGy- Y M 0 Six or more residential units- © Recreational vehicle parks. City/state/ZIP: D Health-ogre facilities. D Supply voltage for more than Cl Hazardous locations. 600 volts r onwial. Suite/bldg./apt. no_: Project narne-.5V Q gCrvi<e pi Fee lcr GOO wUNb or awe. 7 7 77 Want i od. ~.xJ»» Gross street/directions to job szte: >=ra r,~~► Ncw residential aitioe-or multi-family dwelling unit. _ Includes attached garage. Stibdivision: Lot no-: 1,000 set, ft. or less 168.$4 _w 4 / I no-: Ea add') 500 sq. ft, or portion 33.92 1 Tax iliap pie Limited energy, residential ` b)1 00 b1~r vircYWt y It p' ylt ,i'„' with above s . ft. 67,34 2 Limited energy, multi-family 67.94 2 1 residential witb shoes . tt, _ wt Services or feeders bmtallation alteration, and/or relocation ~t - 1. v .,1. V t C*1 caoyty l W 200 amps or Itss 1()0,70 2 JM Uq)C' It'I11} ~Wri Id 0 1'ENAi!4 201 amps to 400 amps u 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address, Over 1,000 amps or volts m 552,26 2 City/State/TIP: Teotpornt y services or feeders installation, alteration, and/or relocation Phone: ( ) Ea-,, ( ) 200 amps or less _ 59.36 1 Owner instulbitiom. This installation is being made on property that i own which is not 201 amps to 400 amps 125.08 2 intended. £or sale, lease, rent, or exchatlge, aeoording to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 _ 2 Branch circuits- new, atteratton or extension c, noel Owner signature: Date: A. Fee for branch circuits with APPIYCAPiT', mm~ above service or feeder five, 'CJNLIiC I P)EIt50N 7.42 2 _ each branch circuit Business name: B, Fce for branch circuits ~ Contact name: Without 5crvia: or fccdor fce, ' 56.18 3,1$ 2 first. branch circuit Address: Each add'l branch circuit W 7.42_ ZZ,1Io 2 Miscellaneous service or (ceder not ineladed~ City/State/ZIP: Eacb manufactured or modular - dwcllin service mid/or feeder 67.84 2 Pllotle: ( ) Fax ( - ) _ Reconnect only - 67.84 2 E-mail: Pump or irrigation circle 67,84 2 v ~~1 _77 Sign or outline lighting 67,94 2 '17 1 Business name KD Signal cirt nit(s) or limited- W 1.>r? _l t- ?C , tN energy pawl, alteration, or Address: extension. Describe: Page 2 2 ' City/State/ZIP: Each additiount inspection aver allt>`vable in art of the above - Per inspection 6625 Phone: ( ) _~1 61-10) ~ .1 8x: ) .1 _Investigation per hour (l hr min) - 66.25 CCB Llc Electrical L c,- C Sul rv. Lie-: lndunir~Hl plain pchotu 78,IR IFjI q52. ~'~~a p 342 5 Suprv. Electrician signature, required Subtotal: 2 - W- Print narne: Date: Plan review (25%oftermir f8e: AL- A 6) -H ~ ~ ~ State surcharge (12% of perrnit fee): ♦t ~ . ~js Authorized signature. 1'Ofk, PERMIT FEF.: Print name: Date: This permit application expires if a perrnit is not obtained within 190 it days; after it has b«. accepted as complete. ` Numlwr or inspections allowed per permit. 11$~IfQinalpermitniFLC-ParmitApy.Qoc w/oVoY 4M-•t~i iT{I3 i'woom/wFn