Permit CITY OF TIGARD ELECTRICAL PERMIT
II
COMMUNITY DEVELOPMENT Permit #: ELC2010 00427
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/19/2010
Parcel: 1S 134AA01800
Jurisdiction: Tigard
Site address: 10180 SW NIMBUS AVE J3
Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project: EID PASSPORT
Project Description: (16) branch circuits for moving sub -panel and installing new lights for TI
Owner: FEES
ROBINSON, CONSTANCE A & Quantity Description Date Amount
ROBINSON, LYNN ET AL, BY KG INVESTMENT
MGMT, 10240 SW NIMBUS AVE #L3 16 crt Branch Circuits 08/19/2010 $167.48
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/19/2010 $20.10
Electrical
Contractor:
ALL AMERICAN ELECTRICAL CONTRACTORS
PO BOX 1426
GRESHAM, OR 97030
PHONE: 503 - 657 -4351
FAX: 503 - 496 - 3995
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $187.58
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 -00. 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: �
Y� C)/ �P� � %
Permittee Signature: C)/ L / e \/
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.
Electrical Permit Applica F C ; F ' i ' ° �( ;! i '<rlt OI I'Ic I !1E ( > \I ■
114 City of Tigard AUG 1 2 010 R cciv4 47 /f //P f ='/ Permit No.: ��p�p — pp ya7
• 13125 SW Hall Blvd., Tigard, OR 972 Plan Review �, , O.9��n -00/(;PO
503,639.4171 Fax: 503.598.1960 pater Other Pcnnt 4 o2 V
'� rt ��) h Date ResdyBy: lur 65 See f
es Pe 2 far
Internet: www.tigard- or.gov
t 1 r hvpectionLine:503.639.4175 CIFY T;(-p4,�j 65 See P ag e2 f ar ormition
, , y t Notified/Method:
BIM P�11� r,1�/IClnt
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plain w /items checked below):
❑ Ncw construction Ea Addition/alteratiotJreplecement 0 Service or feeder 400 amps at more 0 Building over three stories.
_ Q Demolition ❑ Other: where the available fbult current a Marinas and boatyards.
CATEGORY OF CONSTRUCTION �. exceeds 10,000 amps at 150 volts or 0 Floating buildings,
less to ground, or exceeds 14,000 0 Commercial -use aliricultursl
o 1 and 2 family dwelling gl Commercial/industrial r Accessory building amps for all other installations. buildings,
O r-^t Multi ❑ Master builder Other' ❑ Fire pump. i� Installation of 75 KVA or
L I y 0 0 Emergency system. larger separately derived system
JOB SITE INFORMATION AND LOCATION , 0 Addition of new motor load of 0 "A ", "B", "1-2", "1.3"
10014P nr more. occupancy.
Job no.: Job site address: 01 t S , W `a ._45_pA►Ml - . ❑ Six or more residential units. 0 Recreational vehicle parks.
itylStnte/LIP:
0 Healthcare facilities. 0 Supply voltage for more thin
0 :Hazardous locations. 600 volts nominal.
_. j__ ___ apt. no.: . .3 Project name:
0 service or feeder 600 amps or mars
_ FEE SCHEDULE
Cross street/directions to job site: . DaUNnpoa 1 Qtr I Pm _J To$et J •
New residealial single- or multi- Ihmily dwelling unit.
Includes attached garage. .
Subdivision:
L Lot no,: 1.000 sq, ft, or less 168.54 4
Ea. add'I 500 sq. ft or portion 33.92 1
Tax map/parcel no.: Limited energy. residential 75.00 2
DESCRIPTION OF WORK with above su. 0.)
Limited energy, multi- family 75.00 2
_h/1011ZNt Ste a residentialwhh above 9. ft)
�, ` j c� Services or feeders installation, alteration, and/or relocation
iii-set. t i b.4 -c i c i s ( 200 amps or less 1 100.70 2
0 PROPER'T'Y OWNER J 0 TENANT 201 amps to 400 amps I 133,56 2
401 amps to 600 amps 200,34 2
Name: ' .
- . .. . 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 I 2
--"" Temporary services or feeders installation, alteration, and/o
City/State/ZIP: relocation
200 amps or less 59.36 1
Phone: ( ) ( ) 201 amps to 400 amps 125.08 2
Owner Installation: This installation is being made on property that I own which Is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rcpt, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits – new, alteration, or extension, er panel
Owner signature: Date: „_ A. Fee for branch circuits with
above serv ice or feeder fee, 7.42 2
Q APPLICANT ❑ CONTACT PERSON each branch circuit
B. Pee for blanch circuits without
Business name: service or fader fee. first
branch circuit ( 56.18 6%, .1 $ 2
Contact name:
Each add'1 branch circuit ( s 7.42 i l l .3Q 2
Address: MIsceIaneoaa (service or feeder not included)
Each menutbctured or modular 67.84 2
City /State /Z1P: dwelling, service and/or feeder
Phone: ( ) I Fax:: ( ) - Reconnect only 67.84 2
.. Pump or irrigation circle 67,84 2
P, -mail: Sign or Dollars lighting 67.84 2
_ CONTRACTOR Signal eircuit(s) or limited-energy
Business name: a t L. cofi v-h''t0 ( pane alter orextrnaion Page 2 2
to ($ ) (J' I -(� t Each addit Inspection over altowabie In any of the above
Address: p. Q , 8 'l t-{ Z , I_ -- Additional inspection (1 hr min) 66.25/ hr
tnvegtigation (1 hr min) 66.25/ hr
City/State/ZIP: ( y 0,� 6,/, & K_ �� O In dustrial plant (1 hr min) 78.181 hr
Phone: (150.3) • s — S Fax: (co3) (f qt; - 3 /9 Inspections for which no fee is 90.00/ hr
specifically listed 04 hr min)
.6v CCB Lic.: 1 S 2 • •, t7 Electrical Lit.: Z(, -girl L Suprv. Lic.: t', fi f ELECTRICAL PERMIT FEES 5ut � � , �^
tel:
Suprv. Electrician signature, required; ■ • ` Plan review (25 %ofpermit fee):
Print name: D. VV► A , tc L,; cod V h„tig Date: 8 / /1 //p State surcharge (12% of permit fee): 204_10
TOTAL PERMIT NEE: 8-1,5'0 -T
Authorized signature: ,,.� This permit applicatioe expires i f a perm is not obtained within 180
V t days after It ha bees accepted a complete.
Print name: �-�p i t/ r r Date; 8 is 10 ' Number of inspections allowed per permit.
a f
I .lauitdin &Permia\ELC- PamhAppdoe 07/01/10 44046151(1 I/0S/ OMIWttR
ZOOZ1 IVA 1 :Z0 OTOZ /80/50