Permit CITY OF TIGARD ELECTRICAL PERMIT
g N COMMUNITY DEVELOPMENT Permit #: ELC2011 -00516
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/29/2011
Parcel: 2S110DB01600
Jurisdiction: Tigard
Site address: 15336 SW PACIFIC HWY
Project: SONIC Subdivision: Lot:
Project Description: Installation of solar photovoltaic system.
Contractor: NORTH LAKE CONTRACTORS Owner: MWF TIGARD LLC
12900 NW LOVEJOY CT BY THE WETSEL CO
PORTLAND, OR 97229 10110 SW NIMBUS AVE, STE B -9
PORTLAND, OR 97223
PHONE 503 - 709 -0985 PHONE
FAX: 503 - 641 -3168
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 09/29/2011 $100.70
Specifics: amps or less
5 crt Branch Circuits w /Purchase 09/29/2011 $37.10
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 09/29/2011 $16 54
Electrical
Type of Const:
Occupancy Grp:
Total $154.34
Required Items and Reports (Conditions)
This permit is 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 i accordance i 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 AT ENTION Oregon law re es you to follow the rules adopted by the Oregon Utility Notification C nter Those rules are set rth in OAR
952 -001- 010 throu h OAR 952 0 090 o . ay obtain a copy of the rules or direct questions to OUNC by calling 503 2 / 987 or 1 800 332 2344.
Issued B . �(' Permittee Signature:
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' , y� `; J Date: Op%
LICENSE NO. 149 S
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.
09/21/2011 09.08 FAX 11001 /001
Electrical _
i'ical Permit Application .� - { !' ,i " � }? �, J,t,�u t,rl It l i �I � .
City of Tigard n /B i ,s2o /i , per No • its A/- -e054/(0
13125 Surd Hall Blvd., Tigard, OR 97223 E p J II ;01,,, Plan Review
° Phone: 503,718 2439 Fax; 503,598 1960 " - p ate Other Permit.
I ``, ` 1•! 13
Internet: �vww ri 503.639.4175 see cage z for
o CITY '0 i sf t b Nonfied/Method; ?IS // / to
y��- D yy 5 �� Supplemental Information
ING DI 0'�` OM-- ,err . a tip
TYPE OF W i`s ' I' 4 / P - ' 'x' 1. 4 REVIEW
a h tai rya �,•, I I _ leas /• heck all that apply (s 7., it j sets of plans w /[terns checked below),
El New construction '� Addition/alteration /replacement 7
❑ Service or feeder 400 amps or more ❑ Building over three stories.
r -�� l
I ] Demolition 0 Other: S FP ?17n11 where the available fault current ID Marinas and boatyards,
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
+ ,, •er : r _ less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory butldlItg cl ; ° ��1GAtilD • am for all other installations buildings.
❑ Multi- family Master builder ❑ Other��. I�. 1{ 9r°,, DIVISI 1 \F❑ Fire pump ❑ installation of 75 KVA ar
JOB SITE INFORMATION AND LOCATION
El A ns of system. larger separately derived system,
❑Addtio of neW motor load of
Job site address: ��/ • t I00HP or more occupancy
Job no.:
�`J I 1�'t) %�I7�.d r1 0 Sot or more resideota1 units El Recreational vehicle parks
City/State/ZIP: A, J O' - ( �'z,7 ❑ Health -cart facilities 0 Supply voltage for more than
T
T ❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: Project name: -->f1/4.1'..c._ + El Service or feeder 600 amps or more
-- > �"' r FEE SCHEDULE
Cross street/directions to job site: D i otv. I Fa. 1 rasa T
- New residential single- or multi - family dwelling unit.
Includes attached garage.
00 s
1,0q ft or less 168.54 4
Subdivision: I Lot no.: . -
Ea add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy. residential
with above ft.) 75 00 2
DESCRIPTION OF WORK S sq•
""""" Limited energy, multi - family 75.00 2
n,'r A- T`'T -0 /0 tj 10 le. i,,, .50 f.• . S 'f-pg w1., residential (with above sq. ftl
Services or feeders installation, alteration, and/or relocation
200 amps_or less ( 100.70 /(7 2
PROPERTY OWNER { 0 TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 5 t)t zc, i 3 G , a 601 amps to 1.000 amps 301 04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP.. / State/ZIP: Temporary services or feeders installation, alteration, and/or
ty relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59 36 l
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 craps izs. 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 I OCONTACT PERSON above service or feeder fee, 5
7.42 %{ 7 - l0 2
each branch circuit of
Business name: /kik) PKP low fever A, Fee for branch circuits without
service or feeder fee, first
Contact name: ( fftivt/Jt$-...'riwf branch circuit
Each add'i branch circuit 7,42 2
Address: /err 7.4D tit•°) /14 0 ,RP/}.S r Miscellaneous (service or feeder not included)
Each manufactured or modular
City / State/ZIP; e 4 [ 67.84 z
. .. (� �('7� t Bwellin� service and/or feeder i--
Phone; (60:3) 4 Fax :: (6,53) d Reconnect only 67.84 , 2
pump or imgattott circle 67,84 2
� -mail: (sU Q lul.$) P1(0 '�'ta t4l'Jr.31x.t�.. �,:V .Cart -
si or outline lighting 67 84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: No y -r A- y L panel, alteration, or extension. Page 2 2
- - - - - -_ Each additional inspection over allowable in any of the above
Address: Additional inspection 1 hr min 66.25/ hr
City/State/ZIP: fopzi 01 b 2.2 7 investigation (1 min) 78 28/ hr
t Q � � / industrial plant (1 hr min) 7818/hr
Phone: c50/10 709_0 _0 1 Fax: ( ) inspections for which no foe is
/� specifically listed (i4 hr min)
1 i 90.00/ hr
CCB Lie.; / �t4 17 t Electrical Lie.: It C t ' y ' Suprv. Lie.: 4 C r S ELECTRICAL PERMIT FEES
� j Subtotal' . /5 7
Suprv. Electrician signature, required: l i ce ase -4.- _ Plan review (25% of permit fee): _______—
Print name: i, W ` l " 1 �- Date: q —24 ,, State surcharge (12% of permit fee); / (p • Si
TOTAL PERMIT FEE: / --L/ 3
Authorized signature: _ This permit application expires If a permit is not obtained within 1 8�
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit
1ABu ,ldingt\Permrts\Fi- C- PermlI App doo 07101h0 4 40- 46 1 51'(1I /es /C.014.1wF,a