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Permit CITY OF TIGARD ELECTRICAL PERMIT 1 11- COMMUNITY DEVELOPMENT Permit #: ELC2010 00639 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/10/2010 Parcel: 1 S 135CA00307 Jurisdiction: Tigard Site address: 9655 SW NORTH DAKOTA ST 24 Project: TAMARYN APARTMENTS Subdivision: Lot: 0 Project Description: Remove and replace meter for siding repair. Contractor: STONER ELECTRIC Owner: KOLS KILROY CANYON LP ET AL 1904 SE OCHOCO BY AFFINITY PROPERTY MANAGEMENT MILWAUKIE, OR 97222 INC ATTN: RUSS PETERSON 421 SW 6TH AVE #905 PORTLAND, OR 97204 PHONE: 503 - 462 -6500 PHONE: FAX: 503 - 659 -4968 FEES Quantity Description Date Amount 1 ea Reconnect Only 11/10/2010 $67.84 Specifics: 1 ea 12% State Surcharge - 11/10/2010 $8.14 Electrical Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and at other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through 952- 001 -0090. You m a e rules or direct questions to OUNC by calling 503.23�or 1.800.3 2.2344. Issued By: �/ %��!i ? %�� Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Nov, 9. 2010 2:38PM Ston c �;p No, 455 P. . 1.3„, /1 /7 /t Electrical PermitA»Dlicatio 1.'4 f► 1 f si�: uv NOV 9 2010 City Of Tigard . -, gOrd DeteBy*. 1 /1 / 0 PermdNa . ct'.f-- j 10 / `( - r 13125 SW Hell Blvd., Tigard, OR -�y OF TIGARD ��� tiew g Pho ne! 503.6 39.4171 Pax 503.59$ � g Olherl?amil; Inap. ..'Y tionlin 503.639,4175 BUILDING DIVISIOP' ago r e2 for r RI %RU �1 d.: a SeePe C< Internet: www.ligard- or.gov Noti lecAfethod_ Supplemental Information TYPE 01 WORK :' PLAN . REVIEW , ©Newconstnlotion Addition /alteration/replacenunt B �l�t epply(su ;ta oe plans wlaemsel,dC4below): ❑ Service or feeder 400 amps or more ❑Building over three stories ❑ Dcmol i tion ❑ Other. - where the available fault current ❑Marinas and boatyards. CA r. IRY OF CONSTRUCTION owcscd810.000 amps at150 volts or ❑lrlaatlnoboildireys. less to gmmd, or c ccoeht 14,000 ❑ CCaowar:id rue agricultural Q1- and 2-family dwelling i :4 Commeroial/iindustrial El Accessory building amps for all other installations. buildings. Multi- family [I Master milder Q Other. °Firepuml- ❑Inatalletion JOB SITE INFORMATION 'AND LOCATION : ElEmaguny system. larger separately derived syst ❑ Additionof newmotor icudof ❑ "A ", , "1 -2", "1.3 /� 5f�'f� . /�` ` �T!'! A 1001-11 or more_ occupancy. Yob no.: t�'1 Job site addross :91 s oR71/ s ❑3ixor more xeaiderniafunits. ❑ Recreational vehicle parka City/State/ZIP A727 97Z � ❑Healthcarefacilitiea ❑ Supply vdtegelarmomthan / ❑Haardous ]ocatwna 600 voltsnamaraL Suiteibld. a..no - Zd.. Projeot name: ' „ ,4 "gal -- ©Scrvico oreocder600 amps arname. FEE SCB DULE ., Cross si c Vdircctions to job Rite: Dwalruoo IOK 1 apt 1 Tout 1 • New residential single- or multi - family dwelling unit. Includes attached garage Subdivision: Lot no_: 1.000 sq. R or leas 168.54 4 - Ea. add' l 500 aq. fl. or portion 33.92 1 Tex map/paroel no.: . ited meow, residential _ Lim gy 500 2 DESCRIPTION,. OR WORK . - , :...... (with above sq. fl.) - . — Limited energy, multi- family 75.00 2 r?cvt+to ✓G iPc t c _ ' 144 "T > �� - D/ /1.16 il /e residential (with above sq, A,) -- Services or feeders lnatallattolheration, and/or relocation 200 amps or leas 100.70 2 • 0 PROP 7." Y °Whi (t . I 0 TENANT 201 amps to 400 amps 133,56 2 Nave: 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 Temporary services or feeders installation, alteration, and /o City /State/ZIP; relocation Phono: ( ) 1 Fax: ( ) 200 amp-: at 155s - 59.36 1 201 amps W 400 amp 125.08 2 Owner Installation: This installation is being made on property that I own which is not intended for salo, lease, rant, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168,54 2 Branch circuits -. new, allerallou, or extension, per panel Owner signature: Date: A. Fee for branch circuits ,.•it). "' above eviee or feeder fee, . ❑ APPLICANT . I' . , ,0 CONTACT ' S a ON each brooch circuit 7_42 2 l3usineas name: B_ Feeforbranch circuits without 1 service or feeder fcc, fast Contact name: branch circuit 56 -18 2 - Bach add' 1 branch circuit 7.42 2 Address' Miscellaneous (service or feeder not included) City /StIIfB�Zlp' Bach manufactured or modular 67Sq 2 4005114, A51^0.105 and/or fogdex Phone: ( ) Fax:: ( ) Reconnect only / 67.84 4,7_ 64 2 E-mail : el a. u) re we »CO r irrigation ghdny 6194 2 Pump o Sign outline li COP7fRACTO$ signs/ eireuit(a)ar /united -energy Business name: STONER ELECTRIC, INC. _aned alteration, or axterasiem - Paget 2 _ .. Each additional Inspection over allowahte In any of the abov Address: 1904 SE OCHOCO Additional inspection (I hr min) 66.x5 / hr Investigation (lhrmin) 66.25/ hr City/State/2.1P: OR 97222 1P: Industrial plant (1 hr min) 711.1 Phone: ( 503 _ I Pax: (503) 659 -4968 impections for which no fee is 90.00/ hr speeilbcaly listed (S$ hr min) CCE I ic.: 44823 I Electri al Lie.: 26 -122C 1 Suprv- Lio. _ 34965 ELECTRICAL PERICT Suprv. Electrician signature, required: /ti-`C ,LL-..........,, a Subtotal: 4, ' ma review (25% of peitfee): , ' W Print name: MICHAEL FALCONER 1 pate: ///9// 0 State surcharge (12% of permit fee)! gy,/ 1 11 Authorized signature: TOTAL PERMIT FPR: 7 ' Z This permit application expires ifs permit is 508 • . .earl' days after It lea been accepted ea compr.' Print name: Date; . Number of impactions allowed per permit. 1140444taVandtt\Bl,CPcneMtp4x crhotrl 44 LOSCOMAVIIB Nov.10. 2010 12:43PM Stoner Electric Group Q 9a + 10 , • Np\J 10 2.014 Community Development pF TIGNRD • 7 l �r n. • Request for Permit Action W P ING DIV ISION TO: CITY OF TIGARD Building Division Services Coordinator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Pax: 503.59$.1960 www,tigard- or.gov FROM ❑ Owner ❑ Applicant ® Contractor n City Staff (check one) REFUND OR Name: STONER ELECTRIC, INC. INVOICE TO: (Business or Individual) Mailing Address: 1904 SE OCHOCO City /State /Zip: MILWAUI <IE, OR 97222 Phone No.: 503 - 462 - 6500 PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (i); ® CANCEL PERMIT APPLICATION. ® REFUND PERMIT FEES (attach receipt, if available). ❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). rmit #: ELC2010 -00639 Site Address or Parcel #: 9655 SW NORTH DAKOTA, #24 • ® ' ti I?> ofect Name: TAIvIARYN APARTMENTS * ' Subdivision .Name: Lot #: r EXPLANATION: CANCEL PERMIT - JOB CANCELED Signature: �ur..,, ,- Date: 11/10/10 DENNIS WHITCOMB Print Name: ltrfund Policy 1. The Director or Building Official may authorize the refund of: a) any fcc which was erroneously paid or collected. b) not more than 80% of the Land use application fee when an application is withdrawn or canceled before a ny review effort has been expended. c) not more than 80% of the land use application fee for issued permit:•. d) not more than s0% of the building plan review fec when an application is canceled before any plant review effort has been expended. e) not more than 80% of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be re turned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE USE ONLY • Rte to Sys Admin: Date / - / - to 13 O ' Rte to Bldg Admin: Date By Refund. Processed: Date ////%/0 /0 By j , Invoice Processed: Date By Peimit Canceled: Date /V / fin By 4r, arcel Tag lidded: Date By _ µ Receipt # Date / Method Amount $ I:\ Building \Forms \LtcgPermicAction.doc Rev 07/26/07