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Permit irk CITY OF TIGARD ELECTRICAL PERMIT 2 -; COMMUNITY DEVELOPMENT Permit #: ELC2010 -00436 T [ G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/24/2010 Parcel: 1S136DD00900 Jurisdiction: Tigard Site address: 6830 SW ATLANTA ST 100 Subdivision: HAINES CROSSING II Lot: 0 Project: BrokerTec Project Description: Electrical for TI. Owner: FEES ATLANTA STREET LLC Quantity Description Date Amount 15400 SW BOONES FERRY RD LAKE OSWEGO, OR 97035 2 crt Branch Circuits 08/24/2010 $63.60 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 08/24/2010 $7.63 Electrical Contractor: DEXHEIMER ELECTRIC INC 9844 SE EMPIRE CT CLACKAMAS, OR 97015 PHONE: 503 - 786 -0886 FAX: 503- 786 -2040 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 • . - 1 - or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. , r Issued By < «- - Permittee Signature: 1.41E _ — =o.. r 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. 3 ry .ii Electrical Permit Auulic ( l I '. ; I Iti a b(_-.( I'Itiv L City of Tigard and Received 13125 SW Hall Blvd., 'iigard, OR 97223 AUG 2 4 2 0 n "tee I MI 0 el/ tit Pem No.: v 10 j 6 ' PlnnR e view . Phonc: SO3.639.4171 Pax: S01.S98.1960 �-- ( f+I , g . I1h . Da teiB ; Other Remit. Cl, / },p i • i • '7 • Inspection Line: 507,639.4175 7 r I "oc. :` r�. . I Data Ready/By: ®s 'u i t Z for Internet: 'www.ei.tigard.or.us ; 1 l L '. " . --•.• "' Notified(Methad, Supplemental information 1 '.j y :� •5� P y ' ...d lei.1;. �^(y tsa�, � gy j yl4.. -. �y rxiog y � mi ri5.`, y.. 4 ,104,0 . v. , ,,t1 y, , � a, t � f: A1N ,,,. ..�.c,iilmr,�1t4l8�.MJ4"."::!_4 Y m r � ,, ti•I r N � ISS .e; O'�.YIitM^c�� ril#FN ,�c.rA or -i," ❑ New construction Addition/alteration/replacement Please cheek all that apply: 0 Demolition Other: ©Service over 225 amps, comm'l []Hazardous location , , �st , 4 e t , i n,r r r !„ , , i p{� a � - �, i ❑S over 320 arms - rating ❑ 13uildn over 10,000 c 0 , r l a4 c- ' r1"` 1 : iy 'r � t�ryy ��, 4 8 rl ' ���t, t_ , , - ` r..�. ` t "'r ° �8.'�t �!. " � '! �`�„� i I ! , �? ;;%s<4, ,� V "� �' �la� �{?x�?'7!'13t� �,� .11 of 1 -and 2- family dwellings 4 or more new residential ❑ 1• and 2•family dwelling -371.conlmerciallindustrial ❑ Accessory building ❑System over 600 volts nominal units in one scrooge [] .Multi family ❑ Master builder ❑Other: UBuilding over three stories ❑Feeders, 400 amps or more ri ����,?? 1� t T, r � / q y, ©Occupant load over 99 persons ❑Manuthcturcd structures or . . ?'f < ,. I. '�31 .5s. k.1 , 1�.e full' O iy *- + T �!:� i i'l'l :i v . . t T 0Egrw5nighting plan RV park Job no,: Job site address: DHealth -care facility DOther• +� R� Submit 2 sets of plane with any of the above. City /State/ZIP: 1 r • - A " , The above are not applicable to temporary construction .service Sui •ldg. /apt no.. • , Project name: .L ...._,. .� Description I Qry. I Om,- i Tot•I Cross strcet/dirccti0ns to job site: New residential single- or multi - family dwelling unit. Includes attached ga 1,000 sq. ft. or less t 145.15 4 Subdivision: Lot no.: E. add'1500 sq, ft. or portion . 33.40 1 Limited energy, residential 75.00 2 Tax map /parcel no Limited energy, non - residential 75.00 2 ! , ; 1 lam it r` a f• „ if. iitu ' ^r2/ f F R,4 _ 1 , 9 N r l F,. Fi .. r �., , ?' f,; rf- :- .b l,. � d;1jK!E�c.. ' ?: n , tiRp¢_ 'n+ ,,, ,.„ 1.i... „, i. w Bach manufactured or modular dwelling, service and /or feeder , 90.90 2 Eri mimmiiimmini Services or feeders installation, alteration, and/or relocatio 200 amps or less 80.30 2 _ . :' ' .. , � ' - 1 } 1 4 i�''d� tl /q, j} ti tl, !! r N i Q»' r l y ' r at ) r u l . .� , ' ' 4 1 . � r -, 11- r r i 201 amps to 400 a 5 106.85 2 .a r fr " p M ~ ... , } .. , r, , , ii .,,tl. ' l . ! 7: i ∎:1 ! a ± l6V.! 401 amps to 600 ems 160,60 2 Name: Got amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 R econnect only 66.85 2 Temporary services or feeders Inataltation, alteration, and/or rciocatton Phone: ( ) 200 amps or less I 66.85 1 i 1 Owner installation: This installation is being made on property that I own which is not ' 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: _ - nate: Branch circuits - new, alteration, or extension, per panel f a,. i` �K. v ' ,� , - �" ttY I ('i - r '�6'.; A . Fee for branch circuits with I � i .t - i�Il �y"'S� ( hit ., 1 � i t '•t �. 1 �1 i t�rt , u'.�fF i{� ��,fN�+,fr r, : Y each i I ,tl.!.,.a '��Tr rl r rba, ,. dP, c ..DI .,�.. • -7,.. A, �.,...,: F. .. service or feeds fee, ea 6.65 2 Business name: branch circuit B, Pee for branch circuits Contact name: without service or feeder fcc, each branch circuit 46.85 iiC•9$ 2 Address: Each add'l branch circuit _ f. 6:65 (r:SIt 2 Miscellaneous (service, nr feeder not Included) Phone: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53 40 2 Signal eircuit(s) or hmitcd- F , i ll ' i , u d Ifya �''i 1 ii 7. %. �trn∎ 1. fi Ent �i' ,i ll 5� f • t�yllr�r 1 ]t, ' 11 energy panel, alteration, or 'tJ r,4 (. 1.,: I _I �I., as r r extension. Describe: Page 2 2 Business none: `I at '" 1, ec..A-4 _ ` Ylj C^- Address; r - /^' t� Cm Euctt additional Inspection over anew able In any of the above Per inspection 62.50 City / State/ZIP: , L C,, k A 1q. I a - / AS Investigation per hour (1 ter min) 02.50 " ('" G Fax ( - �Q Industrial plant per hour 73.75 Phone: ct: ) f. , ,rW r:,; i'., �.: �xirAt, d, l�itt1'? �l'; th�� `i.��l?�N,li;ri)4+��wr ` °,.J' IMMTIMMII Electrical Lic.: 4: 94.3 , i Suprv. Lie.: - - /4.5` Subtotal IG, -41 43, (to • Suprv. Electrician signature, required: \ I A * Plan review (25% of permit fee) - - Print name; • r Are: •• S tate surcharge of permit fcc) '70 (e- / )0 rZ 1 1 VL a • ^ . • TOTAL PERMIT FEE Authorized signature: TLi parm app. 11.11 eap er a permit to not red within 180 days alter It ass been accepted as complete 7 � Print name; Date: • Fee methodology set by Tri- County Building lndustry Service Board °• Number of inspections per permit allowed. i:'BUikliniP ennibl2LC-PurmitApp.doc 12/03 440.4G157(1 !Wan 2,2'd 096186S£0S :01 0f70298L2OS 13 d3WI3HX30 :WOLIJ LO :21 OTO2- 22 -Jfld