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Permit
® CITY OF TIGARD ELECTRICAL PERMIT - g COMMUNITY DEVELOPMENT Permit #: ELC2012 -00558 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/25/2012 Parcel: 2S114AA00100 Jurisdiction: Tigard Site address: 9000 SW DURHAM RD Project: Tigard High School Quad Boxes Subdivision: 1993 -078 PARTITION PLAT Lot: 2 Project Description: (1) branch circuit for receptacles at soccer field shack Contractor: CHERRY CITY ELECTRIC Owner: TIGARD - TUALATIN SCHOOL DISTRICT 8100 NE ST JOHNS ROAD #D -101 6960 SW SANDBURG ST VANCOUVER, WA 98665 TIGARD, OR 97223 PHONE: 360 - 571 -4411 PHONE: FAX: 360 - 571 -4410 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 09/25/2012 $56.18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 09/25/2012 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 0 R 52 -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 11 . Issued By: Permittee Signature: D • 4• 0 u c411011/4t, 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. SEP- 25- 2012(TUE) 08:17 P. 002/003 vi r ' A-- Electrical Permit A IAD licatioe r(1t, 01-F ICI. t.l Ni: , : .l.1 City of Tigard SEP 2 5 2012 v ' . -Sf PemitNo. ate 3O Oas. 13125 SW Hall Blvd.. Tigard, OR 97223 Kw Keelew Phone: 503.718.2439 Fos: 503.598.19,60 �'i1 y„ e mit 'rIC.tiIt L7 inspection Line: 503.639.4175 L 1 1 f LA hEI Date Ready/Dr. Internet: wwv.li td- or.gov 131 !II 0, ihi ri N t ; } ;11 thalftedlMatnd EMIEEEHEMU TYIB - OF •WORK PLAN: It1yVIJ'tN • checked New construction Please all that apply (salmi! j SETS groins write= checked ID f � Addition/alteration/replacement © SEP iCC or f adad00 wnpt or more D BuUdina over Max stoner. ❑ Demolition 0 Other: _- where the available fault amens 13 Marinas and boatyards. '... . CATEGOR • OP CONSTRUC ION .:. • .' ' . exceeds 10,000 amps at 150 volts or p Floating buildings. © 1-and 2-uniIy dwelling 3 CammtzeiaVntiustrlol lentogtound,ormeals14.000 CI Commercial-use agricultural ❑ Accessory building amps for all caber lautha m. toilmttgt. ❑ Multi family ❑ Master builder ❑ Otter: O Fha pinta. p howtation ar•5 ICVA of • • • JOB •STYE'' INFORMATION AND-LOCATION .: • • • .. O o ° ` I > derives ayrt� • • p Addition nrnewmaartoador p"A",13",•1-2", •t4-. Job no.: 3S412434527 ( Job site address,: 9000 SW Durham Road toolmor°°" °`°yom-r' psi. or more reidennd rmax. 0 Rmaamal vehicle parka. City/Stale/Z/1 Tigard, OR 97224 13 Healtivcare thenule, []Supply voltage far morn than . 0 Ha>atdous locations. 600 vain nominal. Suite/bldg./apt. no.: 1 Project name:Tigard HS Quad Boxes deem c or feeder 600ampsorowe- Cross street/directions to job site: a.rn a.. ,, . r.., rot New re+ldmtW single. or moltl -numlly dwelling unit. Includes attached RaraOe. Subdivision: l Lot no.: 1.000 err, It or lean 168.54 I 1 4 • - . En. add'I 500 so, h. or portion 33.92 I Tax map/parcel no.: Limited energy. resideaam 75.00 = ..DNSCRII!1ION OP WORK. with above . . ft. MI Limited energy, multi-Wilily 7500 3 (1) circuit for receptacles at soccer field shark teudemiel (with Omer art. ft.) Se rvkna or f rmfrry InlrtatIatlao, atterntton, and/or relocation 200 amps or less 100.70 2 p •.pRoPER T •: • • :. '....:I.: : •' .: • ;:..' .0 • TSNANr•.. •:,',. ., • , 201 amps to 400 caps 133.56 . 401 amps to 000 amps 200,34 Name: 601 amps to 1.00 mans 30I.04 Address: Over 1.000 arms, or volts 55226 2 City/State/ZIP: services or feeders lastallatlon. alteration. and/or _ relocation Phone: ( ) I Fax: ( ) 200 amps or lea I 59,36 1 1 Owner installation: This installation is being made on property that 1 own which is not 01 Stators to taro amps 1 ,05 lease, ren or excc according to ORS 447 449 67 401 amps to 509 amps intended for sale 168,54 ` r 4 exchange. g , 0, and 101. Branch circuital - new, n(teration, or extension. Rey panel Owner sg3naturm Bute A. Fee for tunic. circuits with "�' ® ?CONTACT'FERSON•:' • . .. . ea cweswieear l'e « ler 7.42 2 each branch circuit Biotiness name: Cherry City Electric B. Fee for branch circuits Wilma Contact name service o feeder fee. find 1 56,15 56.18 2 Stephanie Woodward circuit Each oddl branch circuit 7.42 2 Address: 8100 NE St. Johns Road, # D-101 T__�.�__ _ M not {service or of included) City/state/ZIP: Vancouver. WA 98665 Each r ots service d modular ee d - 67.84 2 dwelling Service and/or feeder Phone: ( 360) 571 Fax:: ( 360) 571 D to only 67M 2 Pump or irrigation circle 67,17 E -mail: soodward@cherrycItyelectrlc.com Sign or outline litthtiaa 67.84 2 CONTRACLOR Signal cittrililab orlimitcd•eaerby Business name: Chevy City Electric panel, alteration, or extension. page 2 2 Each additional lmpeelloo wart. allowable in any of the above Address: 8100 NE St. Johns Road, # D-101 Additional inspection I I hr mho) 66._5/ hr City/State/ZIP: Vancouver, WA 98665 Investigation II Iv mint 66,5/ hr Industrial plant f 0 hr min) 78.18! hr Phone; ( 360) 571-4411 I Fax: ( 3601571-4410 Inspections for which no tee is speeifkotiv listml frh hr min) 90.00/ It CCB Lie.: 91668 J Electrical Lie.' -62 Su rv. Lic.: 5719S .:. ELECIRLC.AL i'ERMTr FEES • . • • • Sahtolai: 56.18 Suety. Electrician signature, required: Plan review 125% of t fee): Prim name: Trace Thompso I ate: 9/25112 site sum/large (12% of permit roe >: 6 4 Authorized sigmature: ' e....1 TOTAL PERMIT FEE Ms permit application expire. if a permit ti is not nbtatnod o tan Print name: Stephanie Woodward I Data • Numberaf 9125/12 days aneruhas !tape permit. earaplek• lmpatNam pamlt tvl•luunaun,mlmet.c.r.mati sadoc mrouro Mt- IetZfti IALCOMIWPA SEP- 25- 2012(TUE) 08:17 P.001 /003 (CP - 8100 NE St. Johns Rd, Ste D -101, Vancouver, WA 98665 I TELEPHONE: 360- 571 -4411 FAX: 360 - 571 - 4410 FAX DATE: 9/25/12 TO: C' of Ti • and FROM: Ste • hanie ATTN: Permit Dept. NO. OF PAGES: ' (Including Cover) RECEIVING LOCATION NUMBER: 503- 598 -1960 RE: MESSAGE: Following is an electrical permit application along with a credit card authorization form. Please process and send permit along with receipt to swoodward@cherrycityelectric.com If you have any questions please call (360) 571-4411 Thanks, Stephanie Woodward