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Permit CITY OF TIGARD ELECTRICAL PERMIT ss COMMUNITY DEVELOPMENT Permit #: ELC2010 00502 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/15/2010 Parcel: 2S113AB00500 Jurisdiction: Tigard Site address: 16083 SW UPPER BOONES FERRY RD 130 Subdivision: Lot: 0 Project: State Farm Project Description: Electrical for TI. Owner: FEES G &S FC LLC Quantity Description Date Amount 16850 SW UPPER BOONES FERRY RD SUITE A 76 crt Branch Circuits 09/15/2010 $612.68 wo /Purchase Service or PHONE: 503 - 639 -0108 Feeder 1 ea 12% State Surcharge - 09/15/2010 $73.52 Electrical Contractor: LEAR ELECTRIC CO INC PO BOX 573 GRESHAM, OR 97030 PHONE: 503 - 665 -9840 FAX: Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $686.20 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 52- 001 -0100 apybf th rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Perm ittee Signature: — Ll 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. 09/14/2010 11:59 5036616389 LEAR ELECTRIC CO INC PAGE 02 c3 Qc, # . Electrical Permit Aaaiica !l� 1i c , rc 1 r c , : ' A G . wa � 125 Han F OR 97223 1 3 • Y s�i i ts-- _ to 'f _- Phone: 503.639A171 Fax 809598.1960 1 s D oat Other Permit i Lin 503.639A175 5 � ` �, Q � / - 6 I B for LuanEf: rs. • � • construction .' Addidodal Q New construction lacement Please iesird* asp* Odmit l sets aeons aAOeme ehemme below): 0 Santee or Seeder 400 amp ormote 0 Building orerewesmaies. 0 Demolition 0 Other mkt* the available than= at Madams tad boeeymde. 6 } -' ,, ,...j , r ,, • ` : . r L ,: i =rob 10.000 amps et 150 Or O Pberhogba4�. • ,�.;,r'X :._' ?� ' r ` . ... �.� _� "1�.� S� ''.11 _� ai.. _fi r,.,.= _,....v ..' 'ed less Wound, or exceeds 14,000 O Commadakee *Wane 0 and 2 - fami dwweiing ■: 'at O Accessory building asp trail weber isamlladona bates El Multi • Master builder 0Other: 015repump. 0benaetlonot75KVAor r. :T .F,.` -t`> - .;v; "? -':5, — = Y:: - �i r�AV 1 C.T:7- E st `u y a O yiys n. d131/6m. 4 i . z _ . a i''_ . ; : 1 . .s .. ' !, r 4; v : v r Additicnahaew tooter load of O •A . "g ; 1 r •q 3 ■ Job n°-: 1 0_ 1 Job site address t (Qp$ 3 Sl4.) i ,:. 43.. : 0 Sic or m e r' asldeelol gain. O Reerestiorm1 vehicle paths. City/State/ZIP: T( our, 011eaif>rame . 0Sooplyvole far mare 0 9 7aa �! err. o Einattdon loemiots. 600 volts aaa ieaL Suite/bldg./apt. no I 0 Project name 0 8etviee or feeder 600 or mesa Cross seroeddbections to job site i[' d i ^.d i New reeldeodial time- or coniti-findly dwelling snit Wades attached garage. Subdivision: 7 Lot tom: 1,000:. 8• or less MN lam _ Q Pa add'/ S00 sq. S orpottion 33.92 � r J , ; >;- ; -.•,r I r' ' : l .. ti 7 y � y , j� ; : :,� � ., l ���� t. above -. $dCOnal III 75�1i — Limited energy, nwhi. 75100 — A T • 0 • 110 L., send' above • ft. Services or feeders • • • .... atteratio and/or rdocadon 200 or less — 100.70 — .2 .. „:. . _ , ,.: ?..,,,,__. . 1 . . ,_ _,..'..�! , L!v.,e,,, n_. __, .. ' � Z...:_._c...:.4: n1 to 400 =Pt 133 56 — 401 amps to 600 amps — 200.34 — Names 601 to 1,000 mops — 301.04 in Address: Over 1030 amps or volts - 552.26 _ Temporary servkes or fen � feeders lnOattOn, dteradon, and/or GSry/StatelI.iP: Phone ( ) Fax: ( ) 200 amps or less — 5936 1E1 Owner : This installation is being made on property that I own which is not 201 .. to 400 amps 12508 intended for sale, lease, rent, or exchange, acceding to ORS 447, 449, 670, and 701. 401 amps to 599 soapy 16654 . Hranehebealts— . or ., . .. Owner signature Date A. Fee inbranch chwhsw et r -. ! ::! r c ^ �sr- a : } j r'- - S ti 'J c .; above aawiceor (iced' f c 7 .,, .r• d, [ r !.._� .. ___�..., *�.u... _:._.s` €. ..�:.. �..�:�.. . � � .._� .�., _� aeeh6em�cicGtit I 7 . 42 -© Business & Feo tear Wanda chalks without same cc theder �� II 56.18 r f Contact name Bach breech chuck add'1 blench dseott ETA 7012 E © Address: MB ins service ar thederr not - - aty/StatwZtP: Each • • •Fee ii 67.84 © Phone ( ) Fact:: ( ) Rego:wax only INN 67.84 — Pomp or Wiestl0a circle Ilo 67.84 —© r - , _ .. 2 Sign oraatline g MI 6 . 8 El �..aM iw.. ..a. 7x.1. _.,.3r .a`'L: :1: �f, ;:.,•s�,_.r..,�- phi: ,Z.. .. .. .. ....._ Signal dredge) or '. � e Bu ssname: Lear Electric Co . , Inc. Each additional . • - • over allowable In . ., of the above Andreae PO Box 573 Additional impemnn (1 hr — 66.25/ br —■ �Y Gresham, OR 97030 ln'- •... Ionia) 66 (125/hr _� lodos�a, pant (1 bratin) — 78.18/br _■ P( 503 ) 665 -9840 Faz:(503) 661 -6389 .;F - 90.o0/br —. CCB Liu: 52278 Electriccal Uc. :2 6 41 411 C 1, °__ ' ` `:, - ;3 : .. 'V.:r � :.Y _ ' " i, � __ _ ' j.r_ _'� Sobtotak Sum. Electrician aig U —em u.+/ "' IMIIIIIIR:rT-;i_rM;T:B?- see � Pret a G .. David Mumford Date — 10 State sumhnge(12%of putt fee): �� 1 It' �!�� TOTAL PERMIT FEE: '�•• J� • T his permit ap empires no penultto not dhteafed vdalmo 180 days after Printaeana David Mumford Y. Q -f .. • Mother of u allowed per y re /. 07101/10 as646Isr(11/at Ceada BB