Permit •
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CITY OF TIGARD ELECTRICAL PERMIT
1 2 ; COMMUNITY DEVELOPMENT Permit #: ELC2010 -00584
Date Issued: 10/21/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S102AA01200
Jurisdiction: Tigard
Site address: 11895 SW GREENBURG RD
Project: Luke -Dorf Inc. Subdivision: Lot: 0
Project Description: Electrical for building A remodel.
3/1/12: REPRINTED permit to include (1) low voltage system.
Contractor: SUNLIGHT ELECTRIC INC Owner: LUKE -DORF INC
2800 NE 65TH AVE SUITE B 11895 SW GREENBURG
VANCOUVER, WA 98661 PORTLAND, OR 97223
PHONE: 360 - 772 -3877 PHONE:
FAX: 360 - 694 -9728
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 201 to 10/21/2010 $133.56
Specifics: 400 amps
45 crt Branch Circuits w /Purchase 10/21/2010 $333.90
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 10/21/2010 $56.10
Electrical
Type of Const: 1 ea Limited Energy 03/01/2012 $75.00
Occupancy Grp: 4 hr Per Hour (1 hr min) 03/01/2012 $265.00
41 Hourly Electrical 12% State 03/01/2012 $40.80
Surcharge
Total $904.36
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 -0090. You • a co • of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued _ _ Permittee Signature: �i' ( /�u•.v/
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 503.839.4175 by 7:00 a.m. for the next available Inspection date.
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.
CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2010 00584
T 1 GARE) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 2S102AA01200
Jurisdiction: Tigard
Site address: 11895 SW GREENBURG RD
Subdivision: Lot: 0
Project: Luke -Dorf Inc.
Project Description: Electrical for building A remodel.
Owner: FEES
LUKE -DORF INC Quantity Description Date Amount
11895 SW GREENBURG
PORTLAND, OR 97223 1 ea Services or Feeders - 201 to 10/21/2010 $133.56
400 amps
PHONE: 45 crt Branch Circuits w /Purchase 10/21/2010 $333.90
Service or Feeder
1 ea 12% State Surcharge - 10/21/2010 $56.10
Contractor: Electrical
SUNLIGHT ELECTRIC INC
2800 NE 65TH AVE SUITE B
VANCOUVER, WA 98661
PHONE: 360 - 772 -3877
FAX: 360 - 694 -9728
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $523.56
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. Yo - ay • . r: - "es • • les or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
_ . t
■
Issued By: [/ Permittee Signature:
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 Anplicati ' \ l E . , r(Ili: of l I, 1.1 is i i\ I.\ City of Tigard Received Date/B . 0 Pen"" No.:
; C
I N / , 13125 SW Hall Blvd., Tigard, OR 9 '101 Plan Review
Phone: 503.639.4171 Fax: 503.598.I960 -'1 2 ® Date/By: Other Permit:. (j e,2. 410 _ o4
i , I w
Inspection Lint:: 503.639.4175 1, Date RcadyIBy: I . W r � i /� ® m See Page 2 for
1
Internet: ww.tigard or. gov r • GARS otitkd/M / ethad: .tl' SuppleeotalInformation
, 7 fi i { 7 r ,i :0 * l :
4. .. r41 F. Print name:
....y.'t!, ._, >=a . ,c. _.' t Lo...:--• , . _ms _ al : ,::r' .. �:...3..44:4h ' 14 :s....:, :
❑ New construction ddition /al -, • „ 1 1!1 tltent = __
; ::1" =1 fir . ' . ' t , ; ¢� 1 : , ` �.. " * .. � , r j
❑ Demolition ❑ Other:
} n n �� E . � Please check all t hat apply (submit 2 sets of plans wftems checked below):
�; ,a ' i j rl':: _ _ _ ;.Y . ,rc, - �„. -I�.' !e .K Y ❑ Service or feeder 400 amps or mote ❑ Building over
three stories.
❑ 1- and 2- family dwelling '4 Commercial/industrial n ❑ Accessory building where the available fault current ❑ Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
❑ Multifamily ❑ Master builder ❑ Other. lass to ground, or exceeds 14,000 ❑ Commercial-use agricultural
5 ` .. } { II . 4 r` u` 1, amps for all other installations. buildings_ • .. - z :: ,._ . .. . k,_. :, .u.. ,. r..•�r_.�.. t_•_....._�aw+c _F.... ? -. .� ' _ - _ � ' ❑ Fin an
f � P P• ❑ Instellatian of 75 K VA or
Job no.: lob site address: ii g,s$ 4 yell , 4 , ❑ Emergency system. larger separately derived system
/ ' / State/ZIP: i ' ❑ Addition of new motor load of ❑
C
m T a - Y I00W or more. occupancy.
u ,4 .4 ' ❑ Six or more residential units. ❑ Recreational whisk parts.
Suite/bldg./apt. no.' Project name: y - 1 • 6 1,f; ❑ Health - care factlitiea. ❑ Supply than
for more tla
/ 13 Hazardous locations. 69D volts nominal.
Cross street/direct , to job ❑ Service or feeder 600 amps or more.
4. -4. _.- ...1,.: _�.. :r..:__: .�� . , �'3 .FiqI .rte F
DeseApioo Qty. hen Teed _ •
Subdivision: l Lot no_:
New residential single- or multi - family dwelling unit
Includes attached garage.
Tex map/parcel no.: 1,000 sq. R. or less 145.15 4
'•: _ t •71 .- u . .: ic_ h.r_ _.� -.d. :1a..?= .;i s ' ` ` ' ;" Ea add'I 500 sq. R. or portion 33.40 1
S l � � Limited energy, residential 75.00 2
.TO L' 4 617 a eta- / G� , • • O (with above sq. ft.)
P Limited energy, multi- family
residential (with above eq. ft.) 75.00 2
,' f n r r ; ; s { iJq x r . 3 Services or feeders installation, alteration, and/or relocation
.: . ...._ , 4 . __ . a3 _ at ._,. E ,2.7. ! 200 am.s m less 80.30 2
Name: k k . f �, v 201 amps to 400 amps III 1 '; IE 11
Address: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
City/State/ZIP: Over 1,000 amps or volts 454.65 ' 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax ( ) relocation
Owner installation: This installation is being made on property that 1 own which is not 200 amps or less 66.85 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps 1006
00 2
Owner signature: Date: 401 amps to 599 amps 133.75 2
t a ' xv ,, t 1, s.: Branch circuits - new, alteration, or extension, r panel
ti '...... F - s _ . :; - ._r. _ : : :�,_ .r,;4nr. s .., - -., - '= A, pc, Sorbranch circuits with
Business name: 44 k., P O be above service r feeder fee, 1,4Z .41C - 2
ab
Contact name: 13. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'l branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: ( )
Each manufacuued or modular 90.90 2
dwelling, service and/or feeder
E-mail: Reconnect only 66.85 2
::.1' ` .kr,a ' 3 ' 51'7 p ump o irrigation circle 53.40 2
/ .n ,.. . �, I,...,?nr < I . a iii 5+1r.. g
Business name: cup, f J l £ l eG4, i iv , C , Sign or outline ligluing 53.40 2
Signal
S� i41� B energy n limited-
al er atio,
Address: or
2,49 �A9 /f/e ` aural, alteration, or
extension. Describe: Page 2 2
City/ State/ZIP: tiix. hr.,n r.,< ve . l vA . 'RC C 1
Each additional inspection over allowable is an of the above
Phone: (6 .Si8 _ 18.0 I Fax: r ' O) (w i f - .9721 Per inspection 62.50
CCB Lic.: i 7,2Sk9 Electrical Lic,: c2 3O 1 Suprv. Lic.: , 0 �s Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
Suprv. Electrician signature, required: .. / i ii ' _Y: - . - - - . . . v.- , d
Print name: Date: ` Subtotal: ' _ .,9 114,7.'46
l�4i - , i1 /�/ /1 £ / f �Q �2 O / hO Plan review (25% of permit foe):
r, State surcharge (8%ofpemtit fee): OQ Y )
, l
Authorized signature: SE R G K f f G O yt, A a /V; h i7t TOTAL PERMIT FEE : [ �� (,4 5 �. /y
I ?BuiidlneermitAFIC- PemdtApp.doe OS/23106 ato - soi r0 vos/CAMIWEa (If' / ?-�r
Electrical Permit ApplicationRECE i ,.„is U, , 1(l: t- SE 0\1.1 '
City of Tigard -- 2_ Permit Ne.: atC I 0 "lb S.--t-4 • 13125 SW Hall Blvd., Tigard,OR 97223 ' - ' 2 012 Plan.
lan Re
eview
Phone: 503.7182439 Fax: 503.598.1 • i - a Date/By: Other Permit
i , 6 :, I: J Inspection Line: 503.639.4175 ' ' 12 4:3 r Dare Ready/By: rudr I RI See Page 2 for
Internet: www.tigard.or.gov CI 0 TIGA� sD Notified/Method: • 7 i4 Supplemental reformation
•
• . TYP on .:w &LD!NG DIVISION:.. . . . ... REy,�w
.
.
❑ New construction Addition/alteration/replacement Please all that apply (submit a sets of plena wluems checked below over ❑ D ❑ et: D vv b ero th o vailabl t� o Marinas
cnox exceeds to ewe amps at ISO volts or OP eating buildings. RY'oF coNSrl
less to ground, or exceeds 14,000 D Commcrcialuse agricultural
❑ 1 - and 2 family dwelling Commercial/industrial ❑ Accessory building amps By all other installations. trading%
❑ Multi family builder s ❑ Other. O Fire pump. O lostallstion of 7S KVA or
JOB SITE INFORMATION AND LOCATION • 0 Emergency
system- tarps separately derived system
�+ l ❑ Addition deem motor lead of "A'. °E", "1-2 ", "1-3 ",
Job no.: I I I (g 94 . Sic/ Gimp -ir iGt /� }71 1:17 rmore occepamy.
tfT f " t ❑ shr or ewe rwadmtial amts O Reareadonal vehicle parks.
�
City/State/ZIP: l i G ` Oils Ith too ihcrliues. O Supply voltage for more than
❑Aamrdoua loesmoos. 600 volts nominal.
Suite/bldg./apt no.: Project name: • O Service or feeder 600 amps or more.
FEE •SGIfEDULE
Cross street/directions to job site: Uexrtadoe • I 04. I Fee. I Tom I •
New residential tingle: or multi- family dwelling unit.
. Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited eaeagy, residential
D ON O P WORK.. (with above sq. 8.) I 75.00 7 2
_ b oy
ve l
�� / - �� et./ t • • L imited ene gy, oral residential (with above sq. R) 7100 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER - j 0 TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
• • 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
• City/State/ZIP: Temporary services or feeders installation, alteration, and/or
_ relocation
Phone: ( ) I Fax: (; ) 200 amps or less 59.36 1
201 stops 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, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: v A. Fee for branch circuits with
❑ APPLICANT ❑CONTACT PERSON above service or fader fey 7,42 2
each ch branch circuit Fee for b Business name: L414,40- V B se vice or ranch ei t hat ith m
- 56.18 2
Contact name: branch circuit
. Each add'! branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included) -
City/State/ZIP:
Bach manufactured or modular 67.84 2
dwelling, service and/or feeder
• Phone: ( ) I Fax : ( ) , Reconnect only 67.84 . 2
Pump or irrigation circle 67.84 2
E -mail: Sign or outline lighting 67.84 2
• Il7 CONTRACTOR /g ; " Signal dreuit(s) or limited-energy
�SA l/1 II t C�[ ei t/1i r�� pane l,alttxetion,orextension.
Business nerae: ` v ( Page 2 2
Each additional inspection aver allowable in any of the above
Address: 2, AO O ��' GS � / f . r1 ir_ Additional inspection (l hr rein) £f 6625/ hr , ( j
City /SfateJZIP: Vac je) C Q !/( I!/ (, • L44 /� . 3! C/ I nd u st i a pa t ( 1 Fr ia) 76 .15/ hr
Phone: c_3(6) j 3-/ 1?_ 7.S'.." Fax: 36'p 32G— .96E Q Inspections for which. no fee is 78.1 lv
specifically listed OS hr rra9 _ 90.001 hr
CCB Lic.: 1 67.49 I ElectricalLic.: CZ 30 I Suprv.Lic.: /7 g ELECTRICAL PERMIT FEES
Suprv. Electrician signature. requirad:e � Subtotal: 3 g o
P lan revuwr (25 %of permit fee): '
Print name: / h 6 - 4 4 1 .-4 ) �" 2 r 7 i : ' Date: 02/ S tate surcharge (12% of permit fee): 40 • gp
Authorized signature: ��r / ( - -- TOTAL PERMIT FEE: 390. g
{� Tis permit appieadan expires if a permit Is not obtained within 180
Print name: V I Date: a has been accepted as complete.
• Nmnbe of
r inspections allowed per permit.
imuikurnaverralvaL6Peteita • 44046151(11/ONCOMIw®
TO: Tigard
F A , FAX NUMBER: (503) 598 -1960
FROM: Yegor S.
Sunlight Electric Inc. FAX NUMBER: 360 - 326 -9660
2800 NE 65th AVE, Suite #B.
INNINIMINI
DATE: .3/1/2012 4:10:44 PM
17 REGARDING:
Permit - additional fee.
Zit/ 9.
iii.fro PHONE NUMBER FOR FOLLOW -UP: 360 - 518 -7589
COMMENTS:
PLEASE ADD THE FEE TO THE PERMIT. RECEIVED
Fax a copy of the receipt to: 360 - 326 -9660.
THANK YOU! FEB 29 2012
CITY OF TIGAs tD
BUILDING DIVISION