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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00619 Date Issued: 11/03/2011 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Parcel: 1S 136CD00401 Jurisdiction: Tigard Site address: 8020 SW PFAFFLE ST 150 Project: Marshal Group Subdivision: 2006 -016 PARTITION PLAT Lot: 3 Project Description: (6) branch circuits for new TI Contractor: TREK ELECTRIC LLC Owner: E &S HOLDINGS LLC 2980 SE TUMBLESTONE DR 8020 SW PFAFFLE ST HILLSBORO, OR 97123 TIGARD, OR 97223 PHONE 503-430-8984 PHONE FAX 866 - 730 -5960 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 11/03/2011 $93 28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 11/03/2011 $11.19 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $104.47 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 ATTE •N Oreg•• law requires you to follow the rules adopted by the Oregon Utility Noti o Center Those rules are set forth in OAR 952- 001 -00 5 thr\ ugh OAR 95: -0r -00•1 ou may obtain a copy of the rules or direct questions to OUNC • m - or or 1 800 33 ' Issued . Permittee Sign. � � A ','' 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 IN ALLATION ONLY SIGNATURE OF SUPR. ELEC' ( 7-1/4._ 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. Nov 02 11 12:25p p.1 Electrical Permit Application RECEIVE'� . F OR OFFICE USE ONLY // // rt ... / , City of Tigard I` 1 Received 0 2 2011 DatelB_ t l a� A PenmtNo 4Ci . -�/� ,Cci a 13125 SW Hall Blvd Tigard, OR 97223 Plan Review ' i ' Phone: 503.718.2439 Fax: 503.598.1960 Dare/By Other Perron /0e6 423 'i i CiA R[3, Inspection Line 503.639.4175 CITY OF TIGARD Date ReearlyiBy. Ions E7 See Page 2 for Internet: www.tigard- or.gov BUILDING DIVISIO Noli6edjMethod . Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ® Additionlaltcrationn/replacement I Please check all that apply (submit 2 sets of plans w /items checked below) ❑ Service err feeder 400 amps or more ❑ Building over three stories ❑ Demolition ❑ Other: I where the available fault current © Marinas and boatyards. CATEGORY OF CONSTRUCTION i exceeds 10.000 amps at 150 volts or ❑ Floating btildirigs -. I 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 ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or ❑ Emergency system larger separately denved system JOB SITE INFORMATION AND LOCATION _ CIAdditton of new motor loaded' Job no.: Job site address: 8020 SW Pfaflle St looxr or mars occupancy ❑ Six or more residential units ❑ Reereauonal vehicle parks City /State/ZIP: Tigard, OR 9'7223 ❑ Health -care facilities D Supply voltage for more than ❑ Hazardous locations 600 volts nominal Suite/bldg./apt. no.: 1;50 Project name Piseefie{rtts�os(fs ❑ Service or feeder 600 amps or more job site: /� I FEE. SCHEDULE Cross street/directions to j 1 t lQ..l 3-dla - 121 �/B4410 Description I Qi5. Fee. f Total 1 • New residential single- or multi -family dwelling unit. _ Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'. 500 sq. R or portion 33.92 1 Tax snap /parcel no : Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq ft ) - Limited energy, multi- family 75.00 2 tenant improvement residential (with above sq. ft.) _ Services or feeders installation, alteration, and/or relocation 200 amps or less 100.70 2 ❑ PROPERTY OWNER 1 0 TENANT 201 amps to 400 amps 133.56 2 - 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP. Temporary services or feeders installation, alteration, and/or relocation Phone ( ) I Fax: ( ) 200 amps or less 59.36 ' 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 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 1 ® CONTACT PERSON above service or feeder fee, ? 42 2 each branch circuit Business name: Trek Electric LLC. B. Fee for branch circuits without service or feeder fee, rust 1 56.18 56.18 2 Contact name: Dana Arnz+en branch circuit Each add'1 branch circuit 5 7.42 3710 2 Address: 2980 SE Tumblestone Dr. Miscellaneous (service or feeder not included) City /State/ZIP: Hillsboro, OR 97123 Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone' (503) 430 -8984 Fax: : (866) 730 -5960 Reconnect only 67.54 2 E-mail trekelectric( comcast.net Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or homed-energy Business name: Trek Electric LLC. panel, alteration, or extension. Page 2 i 2 Each additional inspection over allowable in any of the above Address. 2980 SE Turnblestone Dr. Additional inspection (1 hr mire) 66.25/hr City /State/ZIP: Hillsboro, OR 97123 Investigation (1 hr min) 66 25/ hr . Industrial plant (1 lir min) 78.18/ hr Phone: (503) 430 - 8984 , Fax: (866) 730 - 5961) Inspections for which no fee is �/ hr + specifically listed (h hr min) CCB Lie.: 160427 6I¢i11 L1ectricalLac.: / ,6O( uprv. Lie.: 2468S ELECTRICAL PERMIT FEES Soppy. Electrician signature, requiredy�� �f� � , ? , „ ...-.-_. PO, Subtotal. 93.28 Plan restesv (25% of permit fee). Print name: Melvin L Jackson Date: 11/2/2011 State surcharge (12%ofpermit fee). 11.19 i afore' I TOTAL PERMIT permit FEE: 104.47 Authorized si /11.4,,i.,___:.” - This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. Print name: Melvin L Jackson i Date: I1/2/2011