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Permit CITY OF - UGAR® ELECTRICAL PERMIT ` , ? COMMUNITY DEVELOPMENT Permit #: ELC2010 00320 + 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/29/2010 �li Parcel: 2S101AA08700 . Jurisdiction: Tigard Site address: 12511 SW 68TH AVE Subdivision: WEST PORTLAND HEIGHTS Lot: 29 Project: HPNORTHWEST Project Description: (2) branch circuits and low voltage for data. Owner: FEES BEVELAND BUILDING LLC Quantity Description Date Amount 4740 SW LOWELL CT PORTLAND, OR 97221 1 crt Branch Circuits w /Purchase 06/29/2010 $7.42 Service or Feeder PHONE: 1 crt Branch Circuits 06/29/2010 $56.18 wo /Purchase Service or Feeder Contractor: 1 ea Signal circuit or Limited 06/29/2010 $67.84 • • CANBY ELECTRIC INC Energy Panel 790 S IVY ST 1 ea 12% State Surcharge - 06/29/2010 $15.77 CANBY, OR 97013 Electrical PHONE: 503 - 266 -7878 FAX: 503- 266 -5543 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $147.21 . 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 -00 through OAR 952 -001 -0100. • •• - •• i a co, • • - es or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. , Issued By: A:.t.�_ '....al- -- ii01111A1t11111111/ Perm ittee Signature: -/ .46 ��/ 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. Ca11,503.639.4175 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. --- — .. ... r saves re i i.;; Yi K qua, w u•^a ire , ' . p 9 ,J , i4� 1 :ni' 71A1,,. t, ::al t mi�f�i s " :. k� iii �� �^ uW' SIN 1 :r� h +ihtit tMl-�ul,� a �I�'li , 6,::.,:. ; a:.,•0P , Ire ' ' ') City of Tigard • Reeeived "TAM P ura ' N® �� f d . 13125 Half Blvd.,' T OR 9722 Pla R ' .. d d is . ` I� Phone 503.639.4'17) ; • ,r +J / Other Permit; w Fax 3t t � Other Data Ready/Br. au: see Pagel for lu i i ° � r Inspection Line; 503 639.4 ' Costa Ry: Fri.: 8 �.�,, - • ` interact: www:tiga d.or,go Nou d/Mettted: pp information TYPE U ■ s. ;a PLA1`f IZWt,` , r.i , S; ', • A1Cw construction Additiott/atterat ' ' c where the f ec d ebl 0ault o r or © Marinas and over three rds, 1 ) ry 7 P `" t,\ ❑ Servtco of f ecd¢r 400 Ytnpa or more 1:1 Building over three stories: . u Demolition _ Other: CIO I . • CATEGORY @ � 1R UCf QN .. • c co iti.000 amps at 150 volts in In floating buildings.., ' less to ground, or exwudn_14,000 ❑ Commeroinl• se agricultural , 0 1- and.2- family dwelling 123 Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑Multi - family 1:1 Mastcr builder 0 Other: IJ Fira pump. ❑ Installation of 75 KVA o f . JOB SITE INFORMA•I1ON AND LOCATION . . , ❑ largsrseparatatydenvedsyate. © Addition o f new motor load of q "A ", "E" " I -2 ", "1-3" Job no.: I Job site address: J q / 100HPor more. oopam y. --- -, . ! L S I : � J�P" eu ❑ six or more residential units. (:1 Recreational vehicle parks.. , City /State/Z1P. r, ./r ❑ Hiialth- arc facilities. �Hazard4tt8looa ions, ❑Supply voltage for more than _ �` " T.. M „ 600 volts nominal :' Sulte/bldg. /apl C�. nth: V Project name: /4 , I v • . , 0Scrvlce or feeder 600 amps or more- Cross.street/directions to job site: Description I kJ. F._ F._ > Tatar ' New residentiat single- or mule- family dwelling unit. - .. ,._..__— Iaetui c ,attathed garage. Subdivision: Lot no.: , sq. 168.54 4 TrOi map /parcel do -: • Ea. add'I 500.sq. ft, or portion 33.92 1 Limited energy, residential DESCRIPTION ' OF WORK f :' ' (with above ad. ft.) 67.84 2 . — . L imited energy, multi-family 67,84 • 2 In . 0 rE, < Y ,d ... .i 4.,,,..` residential ( aboveaq, tt,) , • l. �_ , �± Services or feeders installation alteration, and/or relocation - lGw - i:� 200 amps 'or' less 100.70 2 0 PROPERTY OWNER _ ❑ TENANT 201 amps to400 amps 133.56 2 • Natnc: 401 amps to 600 amps 1 200.34 .2 • ' _.- -- -- — 601 amps to 1,000 amps 301.04 2 Address: Over-1,000 amps or volts 552.26 .; City /State /ZIP: Temporary services or feeders installation, alteration, and/or ', T .,.,.- .,,.._._ __- - relocation Phone: ( ) Fax: ( ) 200 reaps or toss 59.36 I Owner installation: This installation is being made on property that 1 own which, is,not 201 amps to 400 amps 125.08 2 intended for sale, Icilse, rent, or exchange, according to ORS 447, 449;670. and 701. 401 amps to-599 amps 168.54 2 : Owners: ' gn stare: _ Date: Branch circuits - new alteration or extension . cr • • ucl' - ---: _ - A. Fee for brunch circuitsi"vith 0 APPLICANT C ONTACT'PERSON above service or feeder fee, 7 2 each branch circuit B name: _ B. Fee for branch circuits - - 1 56.18 Coarser 'name: without gervtce u i feeder fee, first brand: eucutt 2 ' Address: • Each add'I branch circuit 1-1. 7.42 .f 1 2 Misceliauedus (service or feeder not included), City /State/ZIP: • t ach'nlanui'actured. modular - -' - - --- dwelling, service and/or feeder 67,84 Z Phone: ) Fax::( ) . ; Itcconnt t :only 67.84 2 E= mail : Pump of irrigation circle 67.84 2 CONTRACTOR Si_ or outline; lighting 67.84 2 - ^ - Signal circuit(S) or limited- BaSin /Mine: int ,., 1 "il t n'5 C _. c, , „R^ .energy panel, alteration, or Address: C ` -- ii S extension, Describe: I Page 2 1 2 • City/State/ZIP: e " - id L3 Each additional ins ectiop n (Par allow a ble in any of the above - - Ter ins eerie/ 66 25 6u5 Z C4, qv 5,3 ZG> — 55 - q3 Investigation per, hour (I hr man) 1 66 25 GCB Lic. 2 67 i i Lie.: – � � Suprv. Lic.: Z (Z 5 ndustriahplant par haw L 78 18 1 t ' , E Fd:CTR t c A L PE&TMTI".PEPSIlirt' • Suprv, Electrician signature, required: ' /Q '"" 5ubtotnl: -01-(4,,:// ° - Plan review (25% of erinit fee), Print name: / r �' �p t Date: _ _.. -,. .__ • iJ �I�/> -- - State sin chaigc ( 12'/o of permit tee): Authorized signature: ri'1•Al. PERMIT FEE. j ki --i Thia' e aplr e y it n permit u not obtained within 180 1 Prliit name: + / Date: ' days after i t ba tsre.n nece pled Yr Comptete- P .. (- /� J • 11 / 05 _ . .. « • Number 6Y inspections nitOWtxl per pri end. 1.uhpiding1Permits•kl . n,rt:�pt tlo, uugl, - J 4 -0G35'f(I I /OS /COtNWi:B I Ed WH02:60 al;0i✓ 8E 'unf 217SS99E2OS : '0N 3NOHd ONI OIa10013 AHNUO : woad