Loading...
Permit • : ELECTRICAL PERMIT O , F T - 'COMMUNITY DEVELOPMENT Permit #: ELC20:10 -00338 13125 S W Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/06/2010 � rI GAR1 }„ Parcel: 2 S 101 DA01200 Jurisdiction: Tigard Site address: 7165 SW FIR LP 100 Subdivision: Lot: 0 Project: Alternative Services Project Description: (4) branch circuits for TI • Owner:, FEES AMERICAN PROPERTY MANAGEMENT Quantity 'Description Date Amount 2154 NE, BROADWAY, STE 200 PORTLAND, OR 97232 4 crt Branch Circuits 07/06/2010 $78.44 wo /Purchase. Service or PHONE: 503 - 284 -2147 Feeder 1 ea 12% State Surcharge - 07/06/2010 $9.41 Electrical Contractor: CONDUIT ELECTRIC 19461 SW 89TH AVE TUALATIN, OR 97062 PHONE: 503- 692 -1428 FAX: 503 - 692 -3652 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: • Total $87.85 • 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 lissuance, 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 B � Permittee Signature: i OWNER INSTALLATION ONLY The installation' is being made on property I own which is not intended for sale, lease or rent. OWNER'SrSIGNATURE 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. ,From:CONDUIT ELECTRIC �p c 03692, 652 07/01/2010 12:56 #277 P.0021002 . EF,. ! p L- - • ,Electrical Perm Applicat '' JUL 0 1 2010 FOR of I I F 1SF OYI.1,1 F gt t City of Tigard (! T O _ Received Permit N g ' � d 13125 SW Hall Blvd., Tigard, OR 9 2'hh ! r OF lrAFiD Date /13y: & ,20/6, -c5o3 8 0 Y p 0 ®i t�'n DIVISION Pl an Review V �� // S Phone: 503.639:4171 Fax 503.59 9 DIVISION Date /By: OthepPermii4`(� J/© 9.11( A R n, Inspection Line: 503.639A 175 Date Ready /By:" funs El See Page for a 0 ^,t5t: r V I nternet: www,tigard- or.gov Notifed/Method: f 71(3 Supplemental Information TYPE OF WORK PLAN REVIEW . New construction Addition /alteration /replacement Please check all that apply (submit 2 sets 'of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three siones. ❑ Demolition 0 Other: where the available fault current ❑ Marinas and boatyards. ' CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural . E 1 2 family dwelling . Comtnercial /industrial ❑ Accessory building amps for all other installations. • buildings [ family Q Master builder ❑ Other: ❑Fire pump. ❑ Installation of 'IS KVA or ' JOB -SITE INFORMATION AND LOCATION � ❑ Emergency dd Addition of new m larger "E", "1 -ely derived system. El Addition of new motor load of ❑ "A ", "E ", "1.2 ", "1 -3 ", Job no.: "3 l I I Job site address: I 7-( co 5 5 . "./V , F tc (—a () I 00HP or more. occupancy: ❑ ❑ x or more residential units. Recreational vehicle parks. /state /ZIP: t y'y ' ty � 3 ❑ Health -care facilities- ❑ Supply voltage for more than Ci o c� t - C. "7 T Z • 1 _ /(/ r ❑Hazardous locations 600 volts nominal. Suite bldg. /apt. no.: 47 Project name: ' �--r�' 9-- /(�t- ,Sf ❑ Service or feeder 600 amps FEE SCHE3 Cross:atreeUdtrecfions to J or more. i /J ct L W - . � job site: �' , . ,� Description p 1 Qty. .1 � l rent 1 Fer I O 0 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'I 500 sq. ft. ar portion 33.92 i 1 Tax map /parcel no.: Litnited energy, residential 1 1 DESCRIPTION OF WORK (with above sq. ft) 67 2 Qsa - -(- i`--- -e$.. 4 (l L l )_, Limited eid energy, multi-family sg fl _, residential (with above� sq . fl,) 67.84 { 2 Services or feeders installation,.alteration, and/or-relocation � 200 amps or less_ 100.70 2 W] PROPERTY OWNER © TENANT 201 amps to 400 amps 133.56 2 n , mot 401 amps to 600 amps • 200.34 ?. Name:. {' I ._ ` - 601 amps to 1,000 amps 301.04 2 Address: /� ( v 5 + 4 / Over 1,000 amps or volts 552.26 1 2 Temporary services or feeders installation, alteration, and /o City /State / "L1P: SYL t`� +?�" t� fit ‘7 1 2 ? j Z 1 relocation Phone: (5 2- `'/ 1 Z s Fax: ( ) 200 amps or less 59.36 1i 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, lease, rent, or exchange,according to ORS 447, 449, 670, and 701. 401 amps to 599 amps I 168.54 2 Branch circuits - new, alteration, or extension, .er panel Owner signature: Date: A. Fee for branch circuits with , 0 APPLICANT 1 0 CONTACT PERSON above service or feeder fee: each branch circuit 7'42 2 Business name: B. Fee for branch circuits without service or feeder fee, / Contact name: first branch circuit / 56.18 . 2 Address: Each add'I branch circuit 3 7.42 2Z 7_S-- Each — — , Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular 1 l dwelling, service and/or feeder 67'84 2 Phone: ( ) i Fax: : ( ) Reconnect only - 67.84 2 E -mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Signal circuit(s) or Limited - 1 Conduit Electric energy panel, alteration, or Address: extension. Describe: Page 2 2 19461 SW 89th Ave , , City /State /ZIP: TUa l dt 1 n , OR 97062 Each additional inspection over allowable in any of the above I Per inspection 66.25 hone: (5 0 3) 6 9 2 - 4 2 8 Fax: (503) ),.6,,92-3652 Invest per hour (I hr min) 66.25 C Lic.: 1 0 9 6 6 9 ectrical Lic.: 26-905C1 - S uprv. Lic.: 4501 S industr plant per hour 78.18 ELECTRICAL PERMIT FEES Suprv.-Electrician signature, required: ' / Subtotal: 1 13/ J ' Print name: Y I Date: 4 J t / ( , - Plan review (25% of permit fee): ------ (}3 A Y 1 P' PAY P T Slate surcharge (12% of permit fee): Ci Y/ .7_71 i Authorized signature: tr t TOTAL PERMIT FEE- ?jl +/ 11 This permit application expires if a permit is not obtained »ithin 180 Print name. -ems- _. C '.K Date: - / t / (`� days after it has been accepted as complete. • Number of inspections allowed per permit 1 ^,awlding',Permit5',5LC Permi;App.dor IO'O1r0t 440- 4615T(I 1'05:COM-WFlt