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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2008 -00295 COMMUNITY DEVELOPMENT DATE ISSUED: 5/27/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136CA-90222 SITE ADDRESS: 10900 SW 76TH PL 22 ZONING: R - SUBDIVISION: TIGARD WOODS CONDOMINIUMS LOT : 022 JURISDICTION: TIG PROJECT: ORI Project Description: Installing (2) branch circuits. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 1 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC: Owner: Contractor: JEFF ORI HILLSBORO ELECTRIC 10900 SW 76TH PL 22 21185 NW EVERGREEN PKWY #110 TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: 503 - 403 - 4477 Contact #: PRI 503 - 439 -9666 FAX 503 - 601 -3680 FEES Description Date Amount Reg #: ELE 34 -499C [ELPRMT] ELC Permit 5/27/2008 $53.50 LIC 134481 [TAXI 12% State Surchar 5/27/2008 $6.42 SUP 4941 S Total $59.92 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: ' 'erm Signature: �( _ —_ �Y�% //6/> G7,/lj 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'N: 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. 05- 23 -'08 14:40 FROM- Hillsboro Electric 503 - 601 -3680 T -637 P002/002 F -453 ElecfricalTermit Aualication . . 1-(m Of I Ilsll i i tl \I 1 _ ° r f4 NN . City Tigard C D V i thr 3 l.E �'-'!.� nNo.: r - ' 13125 SW W Dail Blvd:, Tigard, OR 972 Plan Review Phone: 503.639.4171 Fax 503.598.19 15 " q 0 OQ� ) v: Other xq Pe n: MSC. 7C,(/g. �, I' tt :11('1) Inspection Linc: 503.639.4175 t, h p� p ° Date ReadyBy: Juna : • + l I See Page 2 for Internet; www.tigard- or.gov i V t .ti4 / ( Supplemental Information TYPE E OF WORT{ cc(N (' ' 0 `101 PLAN REVIEW ❑ New construction Sall Atldition/altcratilBpl 1L � it l' please check an that apply (submit j sets of plans w/ite checited below): ❑ Service or feeder 400 amps or more 0 Building over r three stories. ❑ Demolition ❑ Other: 1 � w where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buiidingg, less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi-family ID Master builder ❑ Other: ❑ Pire pump. ❑ lnstallatioe of 75 KVA or ' • •30B SITE. INFORMATION, AND LOCATION ❑ Emergency system, larger separately derived system, • ❑ Addition of new motor load of ❑ "A^ "B" "I -2 , "1 -3 ", Job no.: 1 1 Job site address: Q \ 0 S l , ) 1 V� IixHP or more. occupancy. ❑ J1l° ❑ Six or more residential units, Recreational vehicle parks, City /Stslte /ZIP: r 4 41 / - - J CI Health-cans facilities. ❑ Supply voltage for more than h • [1 Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: /1„--- U ► Project name: 1 ❑ Service or feeder 600 amps or more, FEE SCHEDULE • Cross street/directions to job site: • De°uipUoo 14tr. 1 Men 1 TWA 1 • ' • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 13a, add ° 1 500 sq. ft. or portion 33 -40 1 Tax trap /parcclo.: _ Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 AIL' energy, multi - family (*' residential, (with uboW r N. ft.) 75.00 2 Services or 'Ceders installation and/or relocation _ PROPERTY OWNER 1 amps amps — - 200 amps or less 80.30 2 Q TENANT 201 to 400 106 -85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 • 2 • Address' Over 1,000 amps or volts 454.65 2 City /Statc/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps - 100.30 2 intended for sale, l ease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2 Owner signature: Dam: Branch circuits - new, alteration, or extension, per panel , • - A. Fcc for branch circuits with • © APPLICANT • 0 CONTACT PERSON • above service or feeder fee, each branch circuit 6.65 2 Business name: B. Fee for branch circuits Contact name: without service or feeder fees, 1 46 -85 46 6 za 2 first branch circuit Address: Each add'I branch circuit 1 6.65 (f�, (03 2 —' Miscellaneous (service or feeder riot included) City/State/ZIP: Each tartan ctured or modular 2 90.90 Phone: ( ) Fax: : ( ) dwelling, service and/or feeder Reconnect only 66.85 2 _ E -mail: Pump or irrigation circle 53.40 2 ' . CONTRACTOR . Sign or outline lighting 53.40 2 Business name: HILLSBORO ELECTRIC, LLC Signal p a ne l , al e r t i on ,ed- r panel, alteration, or Address: #110 NW EVERGREEN PKWY extension. Describe: Page 2 2 21185 City /State/ZIP: HILLSBORO, OR 97124 Each additional inspection over allowable in any of the above Per inspection 62.50 phone: (5 0 3 439 Fax: ( 5 0 3 investigation per hour (t hr min) 62.50 CO3 Lic.: 134481 , Electrical Lic.: 3 4 - 4 9 9 C 'Suprv. Lic.: 4 9 41 S Industrial plant per hour 73.75 - Supt's. Electrician signature reqired: � - ELECTRICAL PERMIT FEES 4I - ...;•e-:, * Subtotal: � � Print name: JOEY V T TACCO ' Date: MI 011 Plan review (25% of permit fee): State surcharge (12% of permit fee): ( 0 . 4.2. Authorized signature: TOTAL PERMIT PEE; C j e , C I 2- This permit application expires if is permit is not obtalueedd wii iu 160 Print name: Date days after it has been accepted $9 Complete. Number of inspections allowed per permit. I:\ auilding%Pemtiu\aLC- PamitApp.doc 05/23/06 440461ST(i1 /05 /COM/WEB CITY OF �*nN m ��w— ��n���m�m�� BUILDING DIVISION ` ~�~,"~~~°""�~° ~��°"~°"~,"~ ~ ~ PERMIT #: ELC2008'00295 13125SVV Hall B|vd.. Tigard, ORA7223 DATE ISSUED: 5/27Y2008 Phone: (5O3) S3A'4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 6/4/2008 TIME: 7:01AkN PAGE: 30 SITE ADDRESS: 10900 SW 76TH PL 22 CLASS OF WORK: SUBDIVISION: TIGARC) WOODS CONDOMINIUMS LOT #: 022 TYPE OF USE: PROJECT NAME: ORI DESCRIPTION: Installing (2) branch circuits, OWNER: ORI, JEFF PHONE #: 503-403-4477 CONTRACTOR: H|LLSBQRQELE(TR|C PHONE #: 503-439-9666 Inspection Request Scheduled For: Date: 0/4/2008 Pour Time: Code # Inspection Description ' Contact # Message 199 Bmchinm|final 070813-01 503-538-2953 ~` Y Corrections/Comments/Instructions: 0 &x |r /�\ \ PAS • PARTIAL 111 CANCEL �� NO ACCESS _ fl CALL FOR INSPECTION ADDITIONAL FEES ASSESSED wJ �� �� � n�~ �.»�' �r� Inspector: »��—� �^����l ��^ Date: � -� `� � Phone #: (503) 718- 141-1,