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Permit
il ,•:-/'., CITY OF F T I GA Ft D ELECTRICAL PERMIT COMMUNITY DEVELOPMENT PERMIT#: ELC2007-00409 m 3 _ DATE ISSUED: 6/15/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S136DA-R-0-W SITE ADDRESS: SW NO ADDRESS ZONING: SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: OREGON DEPT OF TRANSPORATION Project Description: WORK IS IN ROW NEAR HI HAT. Service for VMS signs 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: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 ' W /SERVICE OR FEEDER: 2 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 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: OREGON DEPT. OF TRANSPORATION SUNDOWN ELECTRIC CO 355 CAPITAL ST. NE RM. 411 PO BOX 129 SALEM, OR 97301 FOREST GROVE, OR 97116 Phone: Contact #: PRI 359 -0604 FEES Description Date Amount Reg #: ELE 37 -445C [ELPRMT] ELC Permit 6/15/2007 $93.60 LIC 67442 [TAX] 8% State Surcharge 6/15/2007 $7.49 SUP 3427S Total $101.09 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: Permittee Signature: /1 Z vv — 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. 4 * tic. �, p_ . Electrical Per tit` li> o `� • .. roll o use ON IX . City of Tigard G� 2001 Date /B ' / C/_ P, -.0 13125 SW Hall Blvd., Tigard, OR 97 h' v Plan Revi: • Phone: 503.639.4171 Fax: 503.598.1960 g ® / a + i' Date /B . Other Permit: Inspection Line: 503.639.41 ' �� 1 �V I . ! `• Date Ready/By: IIMI El See Page 2 for Internet: www.ci.tigard.or.us '� Notified/Method: Supplemental Information UTe Y PE , PLAN REVIEW ii New construction ❑ Addition /alteration/replacement Please check all that apply: ❑ Demolition ❑ Other: ❑ m ['Hazardous over 225 amps, com'I Hardous location ❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. It, CATEGORY OF CONSTRUCTION of I and 2 family dwellings 4 or more new residential ❑ 1- and 2 family dwelling a] Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑ Master builder ❑ Other: ['Building over three stories [(Feeders, 400 amps or more ❑Occupant load over 99 persons ❑Manufactured structures or JOB SITE INFORMATION AND LOCATION • ❑Egress/lighting plan RV park _�v� / ❑Health -care facility DOther: Job no.: 4 p 5 Job site �adddress: ��` :94.---- e...- / 00.> ` Submit 2 sets of plans with any of the above. / City/State/ZIP: r 0 I The above are not applicable to temporary construction service. FEE* SCHEDULE Suite/bldg. /apt. no.: Project name: 649V 9;4 L. /jtS Descr I Qty. I Fee. Total I •• Cross street/d ections to 'ob sit /1 New residential single- or multi - family dwelling unit. �5 Includes attached garage. l 4 1 gt Lot no.: 1,000 sq. ft. or less 145.15 4 • Subdivision: V l./ lam( / , / V U Ea. add'I 500 sq. ft. or portion 33.40 I Limited energy, residential 75.00 2 Tax map /parcel no.: L,5] I. A — - R-0- 1 01 Limited energy, non - residential 75.00 2 DESCRIPTION OF WORK Each manufactured or modular 1 r, /� A C dwelling, service and/or feeder 90.90 2 it h Lc. L I e Ufa. ►2n+ 3 o — lj�� — rA� V' vt J Services or feeders installation, alteration, and /or relocation • S- 200 amps or less 80.30 O D „3p 2 ' P O W 'PROPERTY ONER ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps , 160.60 2 Name: 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits — new, alteration, or extension, per panel ❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with ' service or feeder fee, each L • Business name: branch circuit 6.65 /3 �� 2 B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 Address: each branch circuit Each add'l branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) • Phone: Pump or irrigation circle 53.40 2 ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited - 0%'” CONTRACTOR . • energy panel, alteration, or extension. Describe: Page 2 2 Business name: Sundown Electric Co. . \ Address: P . 0 . BOX 129 Each additional inspection over allowable in any of the above M Per inspection 62.50 City /State/ZIP: Forest Grove 97116 II 01 Investigation per hour (1 hr min) 62.50 Phone: ( 503 ) 359 -0604 Fax :(503) 359 -0206 1DIt Industrial plant per hour 73.75 • l . ELECTRICAL PERMIT FEES * L CCB Lic.:6 7 4 4 2 Electrical Lic.: 37_445c Suprv. Lic.: 34 7- S Subtotal (i 5.6,0 . Suprv. Electrician signature, required: g. '7 /,/G Plan review (25% of permit fee) Print name: G e n e N e l s o n Date: 6. is .. ©~] State surcharge (8% of permit fee) , /// TOTAL PERMIT FEE / Authorized signature: This permit application expires if a permit is not obtained within 1 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i:\ Building \Permits\ELC- PermitApp.doc 12/03 440-46 15T(1 0/02/COM/WEB . Electrical Permit Application - City of Tigard Page 2 - Supplemental Information . LIMITED ENERGY PERMIT FEES: ( WORK:ONLY:. Fee for all residential systems combined $75.00 Check Type of Work Involved: I. ❑ Audio and Stereo Systems * - ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: F COMMERCIAL WORK ONLY: - Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations i:\ Building \Permits\ELC - PermitApp.doc 04/03 CITY OF TIGARD BUILDING DIVISION r PERMIT #: ELC 007 00409 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/15/2007 Phone: (503) 639 -4171 , a , Iyu�iq�1`j�± Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/18/2007 TIME: 7:01AM PAGE: 82 SITE ADDRESS: 5\A/ NO ADDRESS CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: OREGON DEPT OF TRANSPORATION DESCRIPTION: WORK IS IN ROW NEAR HI HAT. Service for VMS signs OWNER: OREGON DEPT. OF TRANSPORATION, PHONE #: CONTRACTOR: SUNDOWN ELECTRIC CO ' PHONE #: 359-0604 Inspection Request Scheduled For: Date: 10/18/2007 Pour Time: Code # Inspection Description /Confirmft Contact # Message 199 Electrical final 057802 -01 503 - 849.6659 Y QS Corrections/Comments/Instructions: H I 1 T? f aR u \ \`\ A \K\ 711 \ d � o- PASS H PARTIAL APPROVAL CANCEL NO ACCESS n FAIL { I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G' . N69) L. Date: 10(i� O Phone #: (503) 718- 2446