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Permit CITY OF TIGARD ELECTRICAL PERMIT B - COMMUNITY DEVELOPMENT Permit #: ELC2009 -00234 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/22/2009 Parcel: 2S102AA02302 Jurisdiction: Tigard Site address: .12198 SW MAIN ST Subdivision: Lot: 0 Project: Fletchco Project Description: Install /alter (3) branch circuits. Owner: FEES B -B -B- PROPERTIES Quantity Description Date Amount C/O FLETCHCO PROPERTIES LLC, BY JEFFREY B FLETCHER, 2065 FAIR OAKS CT 3 crt Branch Circuits 05/22/2009 $60.15 wo /Purchase Service or PHONE: Feeder 1 ea 12% State Surcharge - 05/22/2009 $7.22 Electrical Contractor: DUNIGANS ELECTRIC LLC 135 NE 9TH AVE PORTLAND, OR 97232 PHONE: 503 - 233 -7551 FAX: 503 - 233 -7552 Type of Use: Class of Work: Type of Const: Occupancy Grp: Total $67.37 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 OAR 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: Y\ � U 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' Date: LICENSE NO. Call 603.639.4175 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. ' 5/18/2009 3:01 PM FROM C Electric TO: 5035981960 PAGE: 002 OF 005 RE C E V EO w. • . Electrical Permit Application MAY 18 2009 FOR OFFICE USE ONLY City of Tigard R eceived .� . • 13125 SW Hall Blvd., Tigard, OR 9722OITY OF TIGARD Date/B view r r ' ?� I Phone: 503.639.4171 Fax: 503.598 6" LDING DIVISIO Date/BY Other Permit: T I G.\ 1: D inspection line: 503.639.4175 D V Date Ready /By: kris: ® See Page 2 for Internet: www.tigard- or.gov Notified/Method: - fl Supplemental Information e $ter_'" w - �y=� yct� - n .a' a- ,r- it:1i.° '/-='-' ,ir.� -T 'n - T�r'`r (5 +' ':CF .^" -ate' i _ . '7r -� ``` (:n s ae t. e C'-:�_:r, - €'3 ka _ c.- t' A . a : .� ,-` .- .. ?�� :n> �.11nL:_:_. ._ "'.' � y .� , .. cz��' fi ��• �. .,.,. P :. ba '.�.Lb'�'s - •�_ El New construction Addition /alteration/replacemenl , Please check all that apply (submit 2 sets of plans w /items checked below): El Demolition ❑Other. ❑ Service or feeder 400 amps or more ❑ Building over three stories. _ where the available fault current ❑ Marinas and boatyards. r ? t om SY i ry � � :7 i ❑ Floating buildings. 'L , tr " H' Per 6 : :"- NIC, '' . ,�: " '' ="` ' a ^- .' * exceeds , or exceeds 150 volts or ' 'y ` b ' ! `' " -" ' " 3 ` '� ` less to ground, 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ® CommerciaVindustrial ` Accessory building amps for all other installations. buildings. ❑ Multi- family _ ❑Master builder ❑Other ❑ Fire pump. ❑ Installation of 75 KVA or 5 ,., nom?"`. T �� ; ....�,�� ..,i x �ro {fr s ❑Emergency system, larger separately derived system. a'3 E : ,;; .hy1 se ... ` �4_:_ . - 1?cL..'4x�T;a$'g ,. a 6.57'; r ❑ Addition o f new motor load of ❑ °A» »E'•, "1 -2" »I.3• Job no.: - -p9 - 76 Job site address: 12 /9 5 t-✓ MA/ ' 5 T I00 or more. occupancy. O ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: n 6A i2i) / p 2 / C} S ❑ Health-care facilities. ❑ Supply voltage for more than I / ❑ Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: I Project name: ❑ Service or feeder 600 amps or more Cross street/directions to job site: A/FA r re, P'0 c7FF=( ' . "E Description P Qiy. Fee Total • New residential single- or mold- family dwelling unit. Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential ..ia�>; -."^ 'o:�,s+c��� t °_.x £ �twia�rF -cn '�.L Y} - 75.00 2 ' , F �„ i f_ l : Y � 1;5-Va T= ' 2 �1- 3 'tis ,._A -1 (with above sq. it) Limited energy, multi - fa 75.00 2 FWERG Y ri?L)5 T L, ( (, y77i4.)( R/�T/Z O /=/ r residential (with above aq. a) , Services or feeders Installatlon,alteratlon, and/or relocation 200 amps or less 80.30 2 §� � A `' t t ''�' f ` r �'� }s�.' ° �`'�r d� tT `` - ''" fi r , -=< 201 s 106.85 -�`= 77: I rs I T f3tnf 1: r<.�:ti� .,, 1: r 'ri` k, '1,fG ''. + � a4:rsII' - �n amps to 400 amps 2 Name: Fl-r PRDPR LL.. 401 amps to60oamps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: / 7:2 (," L.,/ / vi al /Al <7- Over 1,000 amps or volts 454.65 2 City/ State/ZIP: ;1',/6 f :; p / p/ / e 22 2 `s Temporary services or feeders installation, alteration, and/or relocation Phone: (,,q3) ‘3 ? - 2 / 6 9 I Fax: ( ) 200 amps or less 1 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 599 amps 133.75 2 Owner signature: • Date: Branch circuits - new, alteration, or extension, r panel A. Fee fur branch circuits with C G ' - � ' - ' - '' , -_,• i - . . r � --- ` , x @ r i o Vr i. 2` 1 r � ' l l F f... � - above service or feeder fee, -�` `i � %. •2•Zi .rf. m _ -, aF.f..f- ,:17. -1 r._:v .r.'• :' -a7 _ ....._ 6.65 2 Business name: ( f c- tf.t'C Fee for branch circuits branch circirc B. Fee cuits without service or feeder fee, I 46.85 Y6. 2 Contact name: i I 1 7 .L first branch circuit Address: / � / •,p n/ - Each add'l branch circuit 6.65 f 3� ) t 2 /" 7 l4 1' r Miscellaneous (service or feeder not included) City/State/ZIP: ',_.. , / i . / i Each manufactured or modular 90.90 2 X • 75 / r � ( ) Q `�. , 5 Reconnect and/or feeder ( Phone: l l Fax: : �/ J 7 .. J Reconnect t onlonly 66.85 - 2 E -mail: Pump or irrigation circle 53.40 2 - '�t:Vrxc }9 } .,,, -r p i_ ' I 3 f P0 n � > VAZ x 1 i Sign or outline lighting 53.40 2 ' rimer. a 'a,.. ' .._... - 24 3- - ....a>a4�_3:s : •_�.., a �`vu , .- IL»....i.Fz. - . ' . ` �, S c irc u it(s) or limited - . r A I IMIffill. energy panel, alteration, or Address: 13,`5 / //� Q . �r i lIF'f,�f,,-.t _ C- extension. Describe: Page 2 2 City/ State/ZIP: .3 / ` C~ j- iit .d , 7 ,23 J Each additional inspection over allowable in an of the above Per inspection 62.50 Phone: (../9 �3 , P7 Fax: SZ' ,,?3...3 7'5 5,a Investigation per hour (1 hr min) 62.50 CCB Lie.: // Electrical Lic. , . « Suprv. Lic.: j7)C .S strial p lant per h our Suprv. e signature, tequired: 1•l ' • ` IO.1 • 1.0 �' ' r. lIndu d -, - t,...1:,...- 73.75 h ' __., • f Subtotal: 60• /C l 5/, - Plan review (25% of permit fee): Print name: I � � .A_ Date: G' � / i - State surcharge (12% of permit fee): 7, 22 Authorized signature: - � , 41116-------.- TOTAL PERMIT FEE: 6 7, 3 7 Print name: This permit application expires If a permit is not obtained within 180 a e , u u,� �,� i �!, ,• A-1x , I Date: J/f S -Dl' days after it has been accepted as complete. /, J t V 1 • Number of inspections allowed per permit. 1. Building'\PermhdELC- PermitApp.due 05/23/06 440. 46157(11/05 /COM/WEB