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Permit l CITY OF TIGARD ELECTRICAL PERMIT •« - '''t- COMMUNITY DEVELOPMENT Permit #: ELC2010 -00663 tr i ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/24/2010 Parcel: 2S 113AB00500 Jurisdiction: Tigard Site address: 16083 SW UPPER BOONES FERRY RD 120 Project: State Farm Subdivision: Lot: 0 Project Description: (7) branch circuits for TI Contractor: LEAR ELECTRIC CO INC Owner: G &S FC LLC PO BOX 573 516 SE MORRISON #100 GRESHAM, OR 97030 PORTLAND, OR 97214 PHONE: 503 -665 -9840 PHONE. FAX: SG� --4lv/ l° -3k/ p FEES Quantity Description Date Amount 7 crt Branch Circuits wo /Purchase 11/24/2010 $100.70 Specifics: Service or Feeder 1 ea 12% State Surcharge - 11/24/2010 $12.08 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 OA 952 -' -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / I , - ' v P erm itt ee Si gna t ure: 0./v /77°, t'' ( e d /L/ // Issued By: i ��� y' 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. 11/23/2010 10:28 5036616389 LEAR ELECTRIC CO INC PAGE 83 Electrical Permit A Matt City of Tigard ReF1/2r 13125 sw Ball Blvd., 75gatd, OR \' 31 0 , Pt tNo.: &�' - dc 7 1 r Phone: 303.6394171 Fax: 503.S98i � D t I B y: ievi f, I�ecttonlrn� 503639.4175 G eCi �nN Da Giber Permit g T . t r b Internet wwwtigard -orgov y ()r `- 1, Non�dl Ott: /i l Supplemental Information k I,Z � `" ,v?itt 4 .�2,_J r2 �FG`Ni i 7'i . �i t'l 1 , -.. ri 1 l! { s4 ,vP ' 'iii- 11 . _ r -e it 7 x^ _ - 0 New construction eg""- c -mx_.� 2. .i ,r..;^�' .' 4 � ' ,.i�, s ���. k r�..,: k i „`;2 11 Addition/al t • ; on/replacement Please c heck all that apply (submit a sets ofpbna Viacom chadxd below): Demolition �� 0 Service or feeder 400 amps or more ❑ Building over Max Karim ��� fit k ` 1 r j l r +� s o `i a �hr7 b1Slu on k sS r where9reataileblefaulteammt t Maniasandboatyards. >,:t , �dd.et' 7ry3§• s" 'rr '�C.:E't ,: < ',lj "�` t Y �` t' �* "'`� ,• t�; �, y,. ��'.' n` u3{ e1� `..t{'n.aiL�.e�.a�loi.�`}`.rT� da QPloatmgLWe, 0 1 - and 2 - family dwelling T1 Commeacial/industrial ❑ Accessory building less m arrwaa, caber installations, ll t ons, ❑ co dings al. egtiouttarsl amos ❑ Mulh family ❑ Master builder u . caber itmfallm3oaa Installation 0_ j�a Z„'� �,, �, a v .,�,. 0 Other: ❑Fire pump. ❑ lnea0adoa of 75 KVA or �;'� s x ° £a L 9 i °r iu)nly3 5[a f }iZ e ' � �,y`c' y y y �} .0 �, ❑EmaB m larger separately ��ye. '.+.:�%y L.:L.^`.1x �v.�i�W,'C.�AMVI .t =`r } u "1 - derived 1-", system. ,A r . ❑Aadi rion mntol• band of ❑ `A " ". "1?', "I 2", °1 -3 ", Job Do.: 1 p_ C j rob site address R U OAS 3 S L J 100i1P ar mo ..p., ..p., l' $a�n es ❑ S;x nr more re. reaiaemcll call ❑ Recreational vehicle parr. City /State/ZIP: 'II • r, .1. cc ' Dma1 oat eciiitica. a al snitC / f s. r r LX volt voltage mate than d& D 1�� ,project Dame a F�rdoas loca tiotx 600 voila nominal. a Service or feeder 600 amps or more. Cross street/. :ra .: ;a '.. - �ti�' r 4'� ° �t :;•id� tf f t! �.a +, '�1�''. +5• `�t�z c :.�s. -, ,"�'.:'� -.. - t �1 1 11 ,,col® New residential single - or multi fanilly dwelling ttnit. Inc tides attached garage Subdivision: Lot no.: 1,000 aq• 1 or less II 168.54 T map/parcel no.; Be. aria' 500 sq. ft. or portiem 33.92 DTs "1S Tax s i ce" f q ? a ° a3 asc �. p YW ^mss- Limited en a�laehz~k �kroil z' 1 t r o a t N e t'' J a' SriY residential �7 -1. '; VL ..i •�"` '' x,I ` Vw ..i�rY''.•r^at S^�'" ill above :. ft 75.00 Lvarted energy, multi -family NS ' ` - (s /� Ct7 e i / C Ce ! � /�' _ � 7 ^/O � v.S.3 G residential (with abovesq. R.) 75.00 2 ,� C/ Services or feeders Installatio alteration, and/or relocation 4 (2) /L / t. 200 amps as less 100.70 2 '"'� �,�V ���1 � i , jr / �'� r r�"r�W;• x, r s � 3�"�irR� y ''�.. Cs �� t ��� •� ��" �'( yr,�.'jz�'�'.;7^0 T� � � t 7'^ ncx -. 7f.�'c'' i t ° a�. D3'!^:i.i &.�.ti .az' "..u3'W^a ;4x1 .t.�,4.:z.�`� T' .W., ;xu' ri-TER RCS., ,., @, ei �r� � a ftc� am 133.56 Name; �M� _ �..�:. i���� gal amps to 400 () � � y . � % a°' alp to 6ao amps 200.34 � © Name; (- //L({/il / 6.01 amps to 1,000 amps 301.04 2 r$ Over 1,000 amps or volts 552.26 2 City/State/ZaF : L Temporary services or feeders installation, alteration, and/or relocation Phone ( ) F ax: ( ) 200 naps or lens 59.36 1 Owner installation: This installation is bang made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, least, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 anon to 599 amps 168.54 2 Owner signets = t , ,,, rt Data A. Fes for branch circuits Mention, er prod RIP -.9✓¢ ; -!,,, t 1, 3�'q` ^• t1 f - ,. "4 rr > - ' 1 i ^471 -. . ✓ y .7 „'F 1 9 �rs $ .r �s { R { 6 h w G I w x above service or feeder bee, uzzi', rt 'S r.. .vc�':._9.„ \� s_ T. '" � 11 enCL h raaC h c txeebt ` / 7442 Ai , - 2 Business Dame: S. Fee for branch circuits wuuhout . Contact Dame: service or seats foe, fast branch circuit 56.18 <6) /' 2 Address: Each add 1 bread circuit 7.42 2 h ikellaneons (service or feeder not included) City/State/ZIP: Each raemniret red or modular dwell . ,_, service and/or $xderc 67.84 2 Phone: ( ) Fax: : ( ) Recenncer onl � "* n t c , na^ Pump w irrlirrigation tlan circle II 67.84 67.84 E-mail: y .nix .,_ 5ar.:. a, rx�c7x , x y i r •1 � 2 r _ Sign of maitre light mg 67.84 � -er� , d4 2G 5d wvy�e �e1.s_4 sigta! circuit(s) or limroa[ oneagy Busime®snam� Lear Electric Co., Inc, panel aUerazion,orexrrmaicm p 2 2 Address: PO Box 573 fir Each additional LDSpe n over allowable in any of the above Additional inspection (1 hr min) 66.25/ In 0 4 1 /State/OP: Gresham, OR 97030 Invc�igationflbtmin) 66.25/1c Industrial plant (1 In min) 78.18/ hr Thom 0 3) 6 6 5 - 9 84 0 Fax: (5 0 3) 6 61- 6 3 8 9 Inspectfooa for which no fee is CCB Lie.: 5 2 2 7 8 Eleciriextl Lin _ 41 : 3 listed hr m 90 QO/ hr � ( ei '2 6 1 C .Sooty, Lie, 8 6 S .e.e.._'' k s"i''air..ai�,w'ja r'+ . : � N,t:P t " ` s.Z y ' t_ �nFM SDprv. Electrician signature, �.. m moor. / � subtend: C t� Pleat review 25 %ofparmit see): Print name: David ford A Date: -- ? - • , y a' ",3 - � S tate surcharge (12% of peatnit fox): Authoti , gnatrtre r ��� TOTAL II RMIT ta . 21 R A rr Prin name;: David Mumf o r • permit application aspires been mantled It .. Obml "" `y „" ' " 'w days alter tt has Date: l 4 3 l • Number of been mantled as �. r / • CO l: UkuldegWermiu∎SLC- PeemirApp 07/01/10 d t a44.4 i3T im5/CODS/Nrel inspections perntit / f�,,y E' '..- J Q �� - � aas 3 �l� ' -/� br 1/5 /e rr