Permit f%-'
CITY OF TIGARD ELECTRICAL PERMIT
�'1 r COMMUNITY DEVELOPMENT Permit #: ELC2009 -00379
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/28/2009
Parcel: 2S 101 DCO3900
Jurisdiction: Tigard
Site address: 7150 SW SANDBURG ST
Subdivision: Lot: 0
Project: Progressive Insurance •
Project Description: (15) branch circuits for TI
Owner: FEES
PROGRESSIVE CASUALTY Quantity Description Date Amount
INSURANCE COMPANY, REAL ESTATE
NOTIFICATIONS, PO BOX 89429 15 crt Branch Circuits 07/28/2009 $139.95
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 07/28/2009 $16.79
Electrical
Contractor:
WHISKEY HILL ELECTRIC INC
PO BOX 206
HUBBARD, OR 97032
PHONE: 503 -981 -4640
FAX: 503 -981 -4643
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
•
Total $156.74
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 5 or 1.800.332.2344.
Issued By: �� O Permittee Signature: 6 6 /eel - 7 /0 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 INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4176 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.
* ,' 0/23/2009 15:42 5039814643 WHISKEY HILL ELECTRI PAGE 02/02
4
•t ,4 lcatio RECEIVED
Electrical Permit pp i
_ FOR OFFICE IJSE ONLY
City of Tigard 2009 Kece1VC 9
4 DatcB : d o - P em, i t N Z - 0 3
1 11 13125 SW Hall Blvd., Tigard. OR 97 223 JUL 2 Plan Rcvlc Oilier Permit:
t3 Phone: 503.639.4171 Fnx: 503.598.m OF TIGARD Dnlc/liv:
Inspection Linc: 503.639.4175 D ate Ready /Ity: tvrii: RI See Page 3 Mr
,' I c A it n BUILDING DIVISION Nntificd/Mctltnd: 77 Supplementol loformatinn
. Internet: www.tigard- nr.Ruv _
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I' Ides check all that apply (submit Z rite- (IF plans w /items checked below):
❑ New construction ddition /alteration/rcplacemcnt ❑ Service or feeder 400 amps M more ❑ Building over three stories,
El Demolition ❑ Other: where the nvnihble Otul current boatyards.
Marinas and boaty,
:•.' rt:i; r; ' , �yd� j!; ,' '' I' giii;1� ;! iIti; iy; r lit ''•.1•:00:Iiil`l.'. tli ?;II;': exceeds 10,000 amps at 150 volts or ❑ Floating bui
i 4hl r 1
,... ,'� ,,,!.n1::;h, ..,;III'' �� !4 '�I;. , :r(,, .,... ... : �! �: i :id+';•a:,•n;,lei„+ %' I L 6 , ; , : '�' i ' mmercial- uac aFricultunl
'h _ ,: :i
. � r : . c .n °. � .. ::' •. ' ' " , -�.L •' Ics} IL grnitlld, or CxeecdS 14,000 I� CO
❑ I • and 2- family dwelling ['Commercial /industrial ❑ Accessory building nmps for all other Inslmllationa. building,
❑ Mufti ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation or 75 KVA or system.
Ip � � yy1 , ,P,1 ,.,
d fmcrRmtcy system. 1nrRcr.:apamtcly dcnvc
,,' u.!, ' i �!�Ij. � . '' � a>?�I;q ` ❑ Addition oF new motor load of "A" "F" - 1-2", `
"'vi�.t:ltt ����I�'�Z1�;�' ;Iry t
r— •-^ � Qn � 10011P or mare. occupancy.
Job no.: 77 5/ Job site address: /5 w t a I] SIN nr more residential unite, ❑ Recreational vehicle parks.
❑Hea -c facllilics. [1 Supply voltage for more tlnn
City/St 7' Q r Q 9 9 3 600 volts nominal.
❑ l ia7.erdous Incnlinns,
no.: Q Service feed 600 nmps or more.
Suitc/bldg. /ap fmject name: ��D - ! e5S1 J e �!'ISUl ° !r 1 ■:I a ! p I � 1� rs`
-�±� „ 1 , ..rx or fee e
U , r :,11 ; , t r +�:! I!;I" rcr. -, C
4s' ':'I
'f; yji' ijl�iiii�iilFiiu�l�ti� '•i! "�Ifdl� ,� II` 9ytW; aijl�! � T
t�Itlidkli +na1;I11i;
Cross street/directions to job site: Dc QJz� pre .Itnl •
..- New residential single- or multi - family dwelling unit.
Includes attached garage-
Subdivision: 1 Lot no.:
• 1.000 sq. ft. or less 145.15 4
,.._ •- Ea. add'I 500 sq. R. or portion 33.40
Tax map / parcel nO,: Limited energy. residential 75.00 2
.•,.. i r.e; . 1 �q ;WW� '( '''r','t 4 . i!y,.; ; . : ,4Iq ,
1 r ;.., .. .!. Pt :;; ) ' !. ;;:, ; i;l I , I :. ;'rvyri:., . h' :i .::. phiwc 5e- a. . -
f,''!':..,, .I,.,r� , . �� � _,:,,, ::i...:'.. .' • ..:,.r , r�' r;ur'�„ 'i'4 I.vr
- -- • - --'• • •'� - -- �' � Limited energy. multi-family
7 ?and
d e' "Ile)9 _ residential (with above ar 75.00 2
Services nr feeders instnllntion, alteration, and/or relocation
200 amps or less 80.30 2
r.i..• ; . �'�{ ii;:; 'n;:t . � I� ii" I; :lit: r: __i __E16!::l(l l''ili'Il i';r 20) amps to400 amps 106,85 2
,: , ,.,,: a ' _
, ,:,:L'.IJ ���-
y, i ".i , r -. � 1 ;1.4� ; t n I
' ,,FK�1( }. u 1 ; , ii!;N ";� � �1!
401 amps to 600 amps 140.60 2
Name:
601 amps to 1.000 nmps 240.60 2
Address: over 1,000 amps or volts . 2
Temporary services Or feeders instnlltion, alteration. and /or
City/State/ZIP:
rclncation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
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. Icasc. rent. or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 133.75 2
Branch circuit - new, alteration, or extension, per panel
Owner signature: - Date: A. Fee for branch circuits w ith
,<: feeder Fee
• ..,.;: � i',, .:hs..i.�n;q, ��', �i;n r �'I''� :i( 1 { !
. 'i<!1r''{11I�v '[�;;` service or fe 6.65 2
,
� ......... ...... ...d. a :i1 ......,,; ,'. 1 ••''k,:L ' ( ranch circuit
each ,
13usincss name: D. Fee For branch circuits
- - -^ without service or feeder Ice,
Contact name: first branch circuit 46.85 / /l 2
Address: V — Each udd'I branch circuit 11y__ 6.65 19,,/(J 2
•,•
— Miscellancons (service or feeder not included)
City /Statc/ZIP: Each manuftcturcd or modular 90.90 2
- dwelling, service and/or feeder _
Phone: ( ) Fnx:: ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
:;a'',at l' ('" ',i, : I I+!;ti7. i�S! irG ,I' i•,, �
: h Sign or outlinelightin 53,40 2
1 .
.� . .�..,...• �:.•�:. °:r +';• �: � '•'n::ii ..'r.r ,.. . � i � , ,. ... 'e-:: �: ';' s •I ='Pl • . , i .1•�•�'�!" �. .��
Rosiness name: 999 Signal circuits) or !Wiled-
/. : / / �n �� enemy panel. alteration, nr
extension, Describe: Page 2 2
Address: /� ,� ` Oo
City/Stale (ZIP: li /r/ , 97a • a Each additional inspection over allowable In nay of the above
- Per inspection 62.50
Phone: (5-03) 99/— `p Fax: (5/ 3) � _- Ct � c/3 Investigation per hour (I hr min) _ 62.50
CCB Lie.: /4a91� j lectrical Lie.: gip Su Lie / 5 Industrial plant per hour 73.75
' f ( 'Y':''' ? ,t` ;;1*ilihiG",,�,G11 1; ifll' 1 ,. .I' t ' : a l r!i'. r .
�`/ / �- � J.SiuS:i ';,��• tit. 1 1 - 1� „'. , {i:;i�,.r: .t .,�;;I
Suprv. Electrician signatTlrtt. gtrlrcd: gr ,_,P-A-"”. Subtotal: Aar �_
Print name• Date: J n Plan review (25% of permit fee):
�/ /' / �? / �� ;vs- Date: 9 s State surcharge (12a/n of permit fee): / i /
Aothori7ed signature: TOTAL PERMIT FEE: /��, ,/
This pornrit nppacntinn expires if a permit is not ',wwained within 18
Print name: I Date: days atter it boa been accepted as complete.
• Namber of Inspections allowed per permit.
Wnulldlni ArermieUELC-rermllApp.dne uSliMn6 140 461MiI /05fCOM/WIa