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Permit t a , t CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00150 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/05/2011 Parcel: 2S101AC01800 Jurisdiction: Tigard Site address: 7585 SW HUNZIKER RD Project: Artistic Autobody Subdivision: Lot: 0 Project Description: Electrical for spray booth. Contractor: FIVE STAR ELECTRIC, INC. Owner: MOSTUL, TERRY A & DEBBI C PO BOX 555 7585 SW HUNZIKER ST BANKS, OR 97106 TIGARD, OR 97223 PHONE: 503 - 324 -0948 PHONE: FAX: 503 - 324 -0973 FEES Quantity Description Date Amount 2 ea Services or Feeders - 200 04/05/2011 $201.40 Specifics: amps or less 2 crt Branch Circuits w /Purchase 04/05/2011 $14.84 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea Plan Review Electricial 04/05/2011 $54.06 4 ea Info Process /Archiving - Sm 04/05/2011 $2.00 Type of Const: Sheet (up to 11x17) Occupancy Grp: 1 ea 12% State Surcharge - 04/05/2011 $25.95 Electrical Total $298 25 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 ma • - •. - • • !, direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Ai/ Permittee Signature: _ I / , 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 roll 01. 1, lull'. I til. ()NIA Received . Permit No.: L dvh S City of Tigard Date/B : its I PIII 13125 SW Hall Blvd., Tigard, OR 97223 •, Plan Reviet Other Permit: Phone: 503.639.4171 Fax: 503.5 &,3960 Date By: • ti Inspection Line: 503.639.4175 ,_ t . Date Ready/By. ]uric: ® See Page 2 for I it, ,\ RI) Internet: www.tigard or.gov Notified Method: j' Supplemental Information TYPE OF WORK PLAN REVIEW ❑ddit ion/alteration/re lacement Please check all that apply (submit 2 sets of plans w /items checked below i New construction p ❑ Service or feeder 400 amps or more 0 Building over three stories ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 12 1- and 2- family dwelling ' Commercial /industrial ❑ Accessory b uilding amps for all other installations. buildings Multi-family ❑ Master builder 0 Other: um KVA pp. ❑ Installation of 75 A or ❑ y ❑ Emergency system. larger separately derived eysten JOB S TE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "l - 2 ". "1 - ". 100HP or more. occupancy. Job no.: SZZZO Job site address: 7 5 v (") /- e ��. 0 or more residential units. 0 Recreational vehicle park, .L=1 Health -care facilities. ❑ Supply voltage for more than City /State /ZIP: i 9 6 I c ��3 Hazardous locations. 600 volts nominal j /7 � f" ,) /n,, �� ❑ Service or feeder 600 amps or more. Suite/bldg. /apt. no Pro ect name: ' �(( t,L //ICJ -t- YEE SCHEDULE Cross street/directions to job site: Description [ Qty. I Fee. I Total I ' New residential single- or multi - family dwelling unit. Includes attached garage. .- Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 Ea. add'I 500 sq ft. or portion 33.92 Tax map /parcel no.: Limited energy, residential 75.00 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi- family 75.00 I' `1 �� N residential or feeders above s ti w Uj. Lt._ Services or fee installation, alteration, and/or relocation 200 amps or less 'Z 100.70 it , 4r- ❑ PROPERTY OWI'!ER 1 © TENANT 201 amps to 400 amps 133.56 401 amps to 600 amps 200.34 Name: A 601 amps to 1,000 amps 301.04 I1/ Address: rrr��� (, Jit_"op�" t I! () l Over 1,000 amps or volts 552.26 Temporary servi ces or feeders installation, alteration, and /or City/State /ZIP: relocation , 2 00 amps or less 59.36 Phone: ( ) Fax: ( 201 amps to 400 amps 1 25 . 08 Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with 0 APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7.42 I t [ L p O (� each branch circuit - Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 Contact name: branch circuit Each add'l branch circuit 7.42 Address: Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 City/State /ZIP: dwelling, service and/or feeder Reconnect only 67.84 Phone: ( ) Fax: ( ) Pump or irrigation circle 67.84 B -mail: Sign or outline lighting 6 7.84 CONTRACTOR Signal circuit(s) or limited - energy Business name: Fi e panel, alteration, or extension. Page 2 vQ S-t-cu- e ,� i Y i C I I Y►G • Each additional inspection over allowable in any of the above Address - "PC) — 3,, 5 S Additional inspection (1 hr min) 66.25/ hr I Investigation (1 hr min) 66.25/ hr City/State /ZIP: -an V--S a•Z cr 7 P D lO In d ustrial plant (1 hr min) 78.18 / hr 5D Phone: a . _Del 1f -g Fax: (`03� � j i.- _pc? 7 / Inspections for which no fee is 90.00 / hr (� / specifically listed (/x hr min) CCB Lic.: ) "J�23 i Electrical L p S ,rv. Lic.: 410 22,S : ELECTRICAL "PERMIET' FEES Subtotal: 7j tp . 24, Suprv. Electrician signature, required: �r r Plan review (25% of permit fee); 5q". $(„0 Print name: � � �-e �r� s Date: c 5 — 1 / . State surcharge (12% of permit fee): 5 • �S TOTAL PERMIT FEE: 2$ Ce - 2.,s Authorized signature: This permit application expires if a permit is not obtained within l8(1 days after it has been accepted as complete. Print name: Date: * Number of inspections allowed per permit. 1: \ Building `Permits\ELC- PermitApp,doc 07/01 /10 440-46157V I/OS/COM/WEB