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Permit CITY OF TIGARD ELECTRICAL PERMIT II I I • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00476 Date Issued: 08/14/2012 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S 113AB00500 Jurisdiction: Tigard Site address: 16083 SW UPPER BOONES FERRY RD 300 Project: Therapeutic Associates Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37 Project Description: Electrical for TI. Low voltage for fire alarm included. Contractor: LEAR ELECTRIC CO INC Owner: G&S FC LLC 5140 SE CIRCLE AVE 16083 SW UPPER BOONES FERRY RD, PORTLAND, OR 97236 STE TIGARD, OR 97224 PHONE: 503 - 849 -4723 PHONE: FAX: 503 -661 -6389 FEES Quantity Description Date Amount 1 ea Limited Energy 08/14/2012 $75.00 Specifics: 32 crt Branch Circuits wo /Purchase 08/14/2012 $286.20 Service or Feeder Type of Use: COM 1 ea 12% State Surcharge - 08/14/2012 $43.34 Class of Work: ALT • Electrical Type of Const: Occupancy Grp: B Total $404.54 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 1 V Permittee Signature: ON ()) f L..D C-h -SU'✓ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project Approved plans are required on the Job site at the time of each inspection. 08/10/2012 15:51 5036616389 LEAR ELECTRIC PAGE 01/03 • RECEIVED • Electrical P e r m i t A p p l i c a t i o n AUG 1 3 2 0 ion o rrt c: I : 1i SL o:\ L\ City of Tigard Received . Tend, OR 9� CITY©FTIGAf �!�✓ `i��Nl�� `�°' £�c a - ovy76 II. ?Lou : 5Q3.6394171 Tex: 50.591.1 X10°' , , : ;, D on 1� 503.639A17$ � DIVI� t7maroemtt ' is rIgr �, ..co/5y www.11geotor�v � '° ei rage lto c - . 7 a � ._-,.._ \ '] w :71-7. 7 , d ,� i c,,. '�� - ter - -" -- - c ptea Athetaptyr0 tasen a?pt= cbodoedbake4 _ CI Demolition 0O L7senloeortbed?400aa�psortame O over0aa�e. C " - _ - . `:r'1 :. - "toemesraeg*baan tJM sal bosom: - . il _ ', .. - e�sds 1 = 9 st 13D - ., - pODamys volts or D F` : D 1- and 2•lSmlr dwtlrmg r, ,p i ❑ y b�diitg ba<ta ar instantiate. t 1b0 o Oc t.ase D Maki-family El Master bait& aminmraao�es bm . :,:- r ^�--.. .� � -,-- - y - - ..,, D Otbtr. f7�et� Obmaeetfeeat7s lamer mina* &Moo.' gran& .'.' . . _;�`:. , . . . -` . .... ` .. . .; ! v f . ....' . . , ..:. .- '� : � D Ad�O� C�tlO W IDO mT10l d0t A i K lob n /a— t i t ( 5 lob site ad&+ s e I UPS 3 5 t j U - . O �. r.�a f300na °c'°. �1 � -a Osbe� oe o� lxevetadeswda C 4 4 431011 ": S it Ga'G1 d le-- - T c rr . p ! 0 k.olx whoa Ete erne am Suit bldgJapt. no.. PM" nametr ':. ° ' .J d_ A- r Pt..taeafbeder6002m Cross eo eeddinagians to job sib 7. - --"--*-1 = Ne0vresidents' t+dlta-er mtly dtr aux laidadeeatt :gibed - .', • Sabdvskn I.44 no.: 1;000aq.Loners • =1111=1 0 Taxffiap/ps�d t o: sa.ad81s00 eq. e:arpo� MI 33.92 tl - - limited any, moki-tlecaly III zoo • �4GGP/Y aR� or feedQ7 • ..r„ ARtrOr> en El _ 01 rl 200 mow or kas 100.70 MINIM FF - . 7.. I ��"'� - xf F NMI] • - � —I � s 401 e atip at0 4 0 0 m� ps � 133 56 Nona , — . 4011mpste600amps 20034 Q Addreor 601 aaipsta1,000:. - , _ 301,04 • Over 1,000 amps aconite ME 55226 MOB Taz services sr feeders I lan,'altastion,=Afar cleanse Pie:( ) Fsa:( ) 200 amps arless . = 5936 MI= El Owner t allation: This installation is being made en pnbperty that 1 own arlrieh is not 201 ampsto400 amps 125.08 fnteudod formic. test, to ORS 447, 449, 670, and 701. 401 amps** 599 amps = 169.54 d Owner sigma= Datc &Pee kir teaooh &calls with iii • •v,,...,,_,:::,,,,,,,;.:,;,.:_,:i:ii:77,7 ' :-:.",-,;,, ' :,::- 7 - ;.. ". : -5 -f- ' 7.rl':' -:';';'7.‘'..-, .T -7- n" 7 : -:-:, ':' - : : 5 - ' '‘ - abr am** " keder (4; Va Business mina 1141Argitill 111 Contact s6 to 56,x$ Adder hadd7bmeabciaraut FIB Phone ( ) RUC : ( ) Reconnect oils MI 67.94 . >{maik tu rf gol circle 1 6724 — : ,.� —_�_ ' ,. y .. _ j t 1 SignmaadtmeFighemg MI .1 By nama: Lear Electric Co. Inc. s 1 ,.. . .,_.. Foch Adder PO Box 573 a 0 � o�v�traDatvableIn oftbeabove Adritionfi Mipeetken 0lambt) In 6625/hr - �: Gresham, OR 97030 1°Pas60°a�` 662s�br �■ Ph*wc 503) 665 -9840 x (503) 661 -6389 0 hr � : 52278 wtUa:26 -411C ►- lia:3786. ".1 9aomly David Mumford MI6' State Authorized signaturec IOTALPF3t1V1T['1'i1E: MIMI ...gswwwoh„, .., ' , . Tilb weak artAkedtt wit= Ifa Mutt iroetabttlaea Plitmcmc David Mumford p dagsa It hi boa seetcla,aeama)p04 • • Maker of i snowcap:ge m& - a7AVto aeatetsnttatCgWiss 08/10/2012 15:51 5036616389 LEAR ELECTRIC PAGE 02/03 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined cc mbined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Pleating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: • COMMERCIAL WORK ONLY: Fee for each, commercial - $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation I 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'IBuilding1Pemits1s C.permitppp,doc 07/01/10