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Permit CITY OF TIGARD ELECTRICAL PERMIT el COMMUNITY DEVELOPMENT Permit #: ELC2011 -00142 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/18/2011 Parcel: 1 S126DCO3300 Jurisdiction: Tigard Site address: 9900 SW GREENBURG RD 110 Project: Wells Fargo Subdivision: Lot: 0 Project Description: Electrical for TI. Contractor: RELIANT ELECTRIC OF OREGON LLC Owner: ATHERTON REALTY PARTNERSHIP 20200 SE OLDENBURG LN 2100 S WOLF SANDY, OR 97055 DES PLAINES, IL 60018 PHONE: 503 - 701 - 4562 PHONE: FAX: 503 - 668 -4190 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 03/18/2011 $63.60 Specifics:, Service or Feeder 1 ea 12% State Surcharge - 03/18/2011 $7.63 Type of Use: COM Electrical 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. 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 O:' 952- 001 -0090. You may nhtain a -nr oft - r es • ect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: J - Permittee Signature: 'I 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. Electrical Permit Application FOR OFFICE l.5 h o N L V II City of . 4 PetmitNo__ ; , i _ di / ' 13125 SW Hall Blvd_, Tigard, OR 97223 , AR 18 2 011 Plan Revi C Other Permit C a'0 1 - I. Phone: 503.639.4171 Fax: 503.598.196 1htrlB _ l' I C A !t I) Inspection Lane~ 503.639.4175 Date Rtady/By: tact H See Pape 2 for Internet www.tigard- or.gov Notifed/Medwd: 14 Supplemental Information j TYPE OF WORK PLAN REVIEW • El New construction "Addition/alteration/replacement Please check all that apply (submit 2 seta ofplans whizzes checked below): ❑ Demolition [� Other: D Service or feeder 400 amps or more ❑ Banding over three stories. where the available Sank mascot [3 Marinas sad boatyards. C A T E e . ' Y OF C O N S T R U C T I O N exceeds 10,000 ampsaa 150 robs or ❑ Fleeting buRdiass. lass to ground, or exceeds 14,400 ❑ Commercial-use a ❑ 1- and 2- family dwelling II'. Commercial/elf-Instill L7 Accessary building amps for all other installations. buildings. ❑ Multi- family ■ Master builder ❑ Other: C3 Fare stamp. ❑ la~ailatioa of 75 KVA or ©Emagawy JOB SITE INFORMATION AND LOCATION new system. larger motor load of ❑ A ", "EE , "I l ", " � -} ©Addd'euuon ad'new °1 -3 ", Job no.: Job site address q / t / j - ',�� Z �L� t Of mere. C3 Sac ix or a more residential units ❑ Recreational vehicle parks. City/State/ZIP: TT G y a4,-{ () �, ❑ xestth - care facilities. ❑sappy voltage famore than f I P.pejeet>txrat _- i t L El 11a�aa r: locations. 600 volts nominal. SuiSuite/bldg./apt no.: t V . 0 Service or feeder 600 amps or more. Cross street/directions to job site: �!►^` F, . �� FEE SCHEDULE tv 1 Fee i Tow i • New residential single- or ntalti- family dwelling unit. Includes attached garage- Subdivision: 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 energy, ' 67.84 2 DESCRIPTION OF WORK 1 - / (with above sq. g) O f w i c. 1 W V () L L/T ! Limited energy, multi-family 67.84 2 [� residential with above sq. a) I h IOW, , 1 j r Services or feeders installation, alteration, and/or relocation or less 100.70 2 ❑ PROPERTY OWNER I ❑ 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 1,900 amps or volts 55226 2 City /State!QP: Temporary services or feeders Installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 i 1 Owner installation: This installation is being made on property that I own which is not . 201 amps to 400 amps 125.08 2 . intended for sale, lease, rent, or exchange, according to ORS 447, 449 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT Cl CONTACT PERSON . above service or feeder fee, 7.42 2 I n / each branch circuit Business name: J\ei 1 (Lf i- — l _e C - c (c, OXJI�YL ,, B. Fee for branch circuits —{ Contact nerve: ff �}�f `�` without service or feeder fee, � 1 I l 1 Ya .Y I r4 d'Yl f first breach circuit 56_ IS r ( 2 Address: 2-0 2.00 J �i 01 G t C { p-_ -) Each add'l broach circuit 1 7.42 1 ,1 - 2 Mircellaneous (service or feeder not Included) City/State/ZIP: 5�� g7811 5 g7811117153 Each 67.84 ' 2 dwelling, service and/or feeder j Phone: ( ) jo Lf -�J�( Fax:: (53) & g _ t o / 0 Reconnect only 67.84 2 E-mail: r''L i r a /2fsfi ki ' art co,--ri Pump or irrigation circle 67.84 , 2 96NTR� Sign or outline lighting 67.84 2 Business name: Signal circuit(s) or Limited- energy panel, alteration, or Address: ^ extension- Describe: Page 2 2 City/State/ZIP: (((7J2 7)(Q_.. // � Eac h additional •', , - • ■ over allowable be an of the above Per inspection 111111111231 - Phone: ( ) / f /� j ) Investigation per hour (1 hr min) 66.25 CCB Lie.: j Electrical Lie.: '--- Sapry r " • k 3 3.5 p�pe'hour' 78.18 � — ELECTRICAL PERMTF FEES Sp i. Electrician signature, required: /: . Subtotal: (p 3 : (p�') Print name: Lit p r c l` 1 . �. I Ul. Date: 3 --- 1 �= i { Plan review (25% of permit fee): - State surcharge (12% of permit fee): .... 2.7-0 2 -1-- re y/ i r c Authorized signature: ( j \ � ,h& . TOTAL PERMIT FEE: - i . , )-3 >�,^ .1 7Ms permit application mires If a permit is not obtstaed within 180 Print name: J 2 C e �-� j Yl i a L.Yr 1 ka,47) ( Date: 3 '-1 f ( * Nam>ar of is Jays a i ft has been per pc accepted as complete. r:.Bai dtnguoniatEt. - Perai(App_dnc 30'01/x9 44a4615 (11609 7DM'WFB d 06 rv - 899 uo eZ17:80 l6 8 l leW