Permit CITY OF TIGARD ELECTRICAL PERMIT
2 ' COMMUNITY DEVELOPMENT Permit #: ELC2010 -00580
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 1S136AD06100
Jurisdiction: Tigard
Site address: 11419 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Buster's BBQ
Project Description: (2) branch circuits for relocation of wall.
Owner: FEES
SCHOLIBO, GEORGE E JR & STEPHEN A Quantity Description Date Amount
12241 SW TERWILLIGER BLVD
PORTLAND, OR 97219 2 crt Branch Circuits 10/21/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/21/2010 $7.63
Electrical
Contractor:
BECK ELECTRIC INC
15600 SE FOR MOR CT #B
CLACKAMAS, OR 97015
PHONE: 503 - 656 -7396
FAX: 503 - 656 -4397
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. ATTEN • • =r on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -001' hrough OAR • .1 0 • . 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: / ���-- Permittee Signature: l a✓'m"
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: /e 4 �
LICENSE NO.
CaII 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.
Oct 20 10 02:16p Beck Electric (503) 656 4397 p.2
Electrical Permit Application FOR OFFICE USE ONLY
City of and Received
Ti / Permit No.: f�Ca ^�Q 5
Tigard Date.Bv: 9 X /D
II " 13 :25 SW W Hall Blvd., Tigard, OR 97223 Platt Review
C i Phone: 503 639.4171 Fax: 503.598.1960 Date/Bv: Other Permit:
T I G A R ll
inspection Line: 503.639 4175 Date Ready /By: Juri i II See Pas 2 for
In www.tieard Notified'Method: Supplemental Information
TYPE OF WORK • . PLAN REVIEW •
Please check all that apply (submit 2 sets of plans vv ;items checked below):
El New construction KAdditionialteratiorvreplacement
❑ Service or :Ceder 409 amps or more ❑ Building aver three stones.
❑ Demolition ❑ Other: where Ice avai lable fault current ❑ Marinas ant. boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 apps at 150 volts of ❑ Floating !wilding&
less lo ground, or exceeds 14,030 ❑Co.mmereiaki e:.grictdtural
❑ 1 - and 2- family dwelling ZCommercial!industriai ❑ Accessory building amps for all other i istallanor.s b.tildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 7 5 K VA cr
'JOB SITE IN FORMATION AND LOCATION ❑ system. larger separate/ derived systcn'.,
❑ Addition of now molar load of ❑ "A ", "E "I -'.. "I �° i
`� ,,,/// :00HP et more occupancy. •
Job no.: % 5`t Job site address. ' (4' G 1 Vv , la ( � }-}tai 7 ❑Six or narc residenliai units. ❑ Recreational veaicIe narks. I
. Ci:y!StateiZlP: ci a O 1Z-- 9-122, ❑ Healthcare facilities ❑ Supply voltage ror more than
❑ Hazardous locations. 600 volts ncaniral.
Suite/bldg./apt. no.: Project name: _13,v154w z0. ,eGVL ❑ Service or feeder 600ampscrmere
FEE SCHEDULE
Cross street /directions t0 fob site: Dc.eripo.. I Qtr. I Fcc. 1 Total ' •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot n0.: 1,000 sq. ft. or less — 16853 4
. Ea. add'! 500 sq. ft. or portion 33.92 1
Tax !nap /'parcel no.: Limited energy, residential
DESCRIPTION • OF WORK ' • (with above sq. ft.) 75.00 2
r - (, Limited energy, multi-family 75.00 2
(e,— ro LA-c_ �O CtrGU %3 . - Ge watt l tOoken residen o r feeders above sq. a f t )
JJJ Services o r fee rs i nstallation, alteration, and +or relocation_
t(Y1N•e. d 230 amps or less 100.70 2
❑ PROPERTY OWNER I.. • ❑ TENANT • . 201 apps to 4C0 amps 133.56 2
401 amps :0 6C0 amps 200.34 2
Name:
1 t
601 amps :o 1,000 amps 301.04 2
Address: Over 1,000 amps o- volts 552.26 2
Temporary services or feeders installation, alteration. and/or
City /S:ateJZIP: relocation
Phone: ( ) Fax: ( ) 200 apps or less 59.36 1 1
201 amps to 400 amps 125.08 ' 2
Owner installation: This installation is being made an property that 1 own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670, and 701. 401 amps to 559 amps 168.54 2
I Branch circuits new. alteration, or extension, per panel
Owner signature: Date: A. Fix for branch circuits tvirh
above service or feeder fee,
APPLICANT • . • ' I 0 CONTACT PERSON: - - 7.42
each bran h circuit
t
I Business tame: B. Fee for bra circuits without 1 •
service or feeder fee, first l 56.18 -∎ •.- 2
Contact name: branch circuit
Each add 'I branch circuit l . 7.42 1.9 v
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 6i B4
CityIStateiZIP: dwelling. service aadior feeder
Phone: ( ) Fax: : ( )
Reconnect only I 67.84
Pump or :niga :ion circle 67.84
E -mail: Sign or outline lighting 67.8.
CONTRACTOR Signal circuit(s) or limited-energy •
Business name: � 1� E`�` - 1 ( 1.(. - .2anel, alteration, or extension. Paget
Each additional inspection over allowable in any of the above
Address: 15(000 Se 1-•- f )4- 8 Additional inspection (I hr min) 66.25/ lir
Investigation (1 hr min) 66.25/ lir !
City/State/ZIP: c__\ ac rv%cts 0 ft. °1
Industrial plant (I hr min) 78.13 hr
Phone: (j) 1056 3 Fax: ( 3) LjS(o 439 1 • inspections for which no fee is 90.00( hr
specifically listed (% hr min)
CCB Lic.:2,( � Electrical 1...c. 3 - t^ 1 su Lice :SpZ`f —S ELECTRICAL PERMIT FEES
Subtotal: k toil
Suprv. Electrician signature, required: Plan review 125% of permit feet
Printnante:cjkayVes Bc ,, vl - J Date: SO 7.0 1V State surcharge(l2 %of permit fee): 1.103
On TOTAL PERMIT FEE 1(a Z3
Authorized signature: _ I This hermit application expires if a hermit is not obtained within 181)
days after it has been accepted as complete.
Print name: CA/a( 1p,. in (\l 5 ' Date: 10 12,0 I, V ' Number of inspcctiann,tllo . ved per pemut.
tv9.dldnnvg,Pamfti•Ete•F ' An, doe 07/7111) 4 I /05IC OM/Wes