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Permit . 4 CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00226 .41"..irl DEVELOPMENT SERVICES DATE ISSUED: 4/28/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134DA-02500 SITE ADDRESS: 10750 SW NORTH DAKOTA ST ZONING: R -3.5 SUBDIVISION: LOT : JURISDICTION: TIG Project Description: Temporary power for remodel RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 1 PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNALJPANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR: • 401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: JIM ANDERSON CONDUIT ELECTRIC 10750 SW NORTH DAKOTA DBA DUIT LEVEL TOOL CO TIGARD, OR 97223 19461 SW 89TH AVE TUALATIN, OR 97062 Phone: 503 - 620 -8870 Contact #: PRI 503 - 692 -1428 FAX 503 - 692 -3652 FEES Description Date Amount Reg #: ELE 26 - 905C [ELPRMT] ELC Permit 4/28/2006 $66.85 LIC 109669 [TAX] 8% State Surcharge 4/28/2006 $5.35 SUP 4501 S Total $72.20 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those • rules are orthin OAR 2- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of the : ' - or direct questions to OUNC at 503-246- 699 or 1 -80 3 4. Issued B y: � ( v�� Permittee Signire: Si "iCd —/ 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'N. _.%A i It d.- 'wz DATE: `Yo'I'g l4 LICENSE NO: 4/50/ 5 Call 503 - 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. 2006 /APR /27 /THU 09:50 AM Conduit Electric FAX No. 5036923652 P. 001 .. � �. C P() It01'1•1(_}_.l LI Ellectri `cal Permit ADplie t ' r` : I L., • - ! R eceived City of Tigard • GI/ / ' rpm, Permit NO-1 :. // OD� Plan Re It 13125 SW Hall Blvd, Tigard, OR 97223 talon Revi Other Perr O Phone: 503.6391171 Pax: 503.598811 2 7 2 U n 6 �a Inspection Line: 503.639.4175 Date Ready/By RI Sea Page 2 for T 1 Ci n t; D Internet; www.t)gsrd- or.gov Notified/Meth r Supplemental Information - 1. /' 'A� - � '� J• �� � �.`i�:l }S' .lh'GA�{t•`Y;:ry:.}, 1��, "•� sY�L�;` t0." 7�' SCC:'., YS:. r ' �!, <q1�t1�Cif '�� �� ���"�?= 't��`'- .�i�r2a�� &t; �. pJ_;���°' i i ',r cr -. , �:i�zA�: r lY�a:�i ;4..37�'.�:t� � .�E �r. w =� New AY ; ' r + • please check all that apply_ 0 Ne construction �� Add a4�3'',: placcltlellt' ❑Swice k over all that amps, corm'! Elliazardous location ❑ Deinolition ❑ Other: _ 0serviceover320 amps - rating DBuildng over 10,000 sq. ft., - �, ,; • ;:, w; •, � : . ::x,: •. .. r °i : -;¢p3�. �!;�n%; '4'':;i0y �' ? ?r ": of 1- and 2- family dwellings 4 or more new residential r i ; „�• ,rr i T h- r � :, ,: - ; :s S' ?� d C " ,,,...i R 3( („,, . 0,1..... ,R, ,---•• ,.- ,V2A -- :; .,.. H.: units o ne structure � l� t ; j�iR' �li�ie),` x' U�, 1. G! r .;r�:t.xt:� _,.. ;?• _ ,. . », 0 System over 600 volts nominal ks in 7 and 2- family dwelling ❑Commercial /industrial ❑ Accessory building DBuilding over three stories DFeeders, 400 amps or more D Multi- family ❑ Master builder 0 Other: 0 Occupant load over 99 persons DManufaetured structures or r•° ,'~ �r c. nsr��.5fra RV park : �,:,, iKx Y =,e, w : �f.. ,l; 1 y . .., „,. ❑ Egress/light plan zi'�1",C'`��.� ` j v ,�JQ):ESIY31fY?�t1t:1N6G`A (- ; ',,;ia: t,_.:.,,: ;:_� ,, . _.. _� .,., � ❑Other. .. 01-tatre facility Job no.: 1 Job site address: IM5 p S [,k, NMI* D Y-.d Submit 2 sets of plans with any of the above. The above are not applicable to temporary construction service. City/State/ZIP: 'Zl�,�tRfD oRS srJ ,� .„. ,:�,A:. . � . . ,��, r ��.af 5L Sulte/bldg. /apt -no.: I Project name: Nt■1b ( -l___ � Deteriptian Qtr- Fm Total Cross street/directions to job site: Nev residential sink or multi- family dwelling milt. a Gam; ©u R "tt? `r + Includes attached garage, _ 10. \G �� e N OL t r N _ 1,000 sq. ft or less 145.I5 4 R l�S , ^ Ea_ add') 500 sq. ft or portion 33.40 1 Subdivision: r1b I Lot no.: E Limited energy, residential 75.00 2 Tax map /parcel no.: Y v\P P -D- 7 i Q QL W-- i SI3`• 1 b. ^O Limited energy, non-residential 75.00 • 2 � r.. v� %k's: �;< r r' F` �ti �' Each manufactured or modular t„ OR jS • w. C' $'* ** * �, 7Y,i. W �tc;;Y ,t�4 ''":r rrri!`•s f.,'Ub., {.:.r • �:' <'w' "�' "' dwelling, service and/or feeder _ ' 90.90 2 • - " =- no Services or feeders installation, alteration, and /or relocation a • .O&) fL 1 t .p ° £. _ 200 amps or less 8030 2 _ W • 106.85 2 ►��L- sGC�a�' � _�� :- �.�.�� _ L", -, •�;,, ,. 201 amps to 400ampe ..1 �: 4 f 1 J•�l�,µtrJ.6 iF � {n T'l � J..�� ti Y 1Y T z r+ t i �yy,1� .., 160.60 2 •- r',si�' �'�'O 1� ,,,�f,, ,.,�: �. �'- • y - *' � f 401 artlps to 600 amps . b l am e: '"Z NrV\- AN -J • 601 amps to 1.000 amps 240.60 2 _,Cv � Over 1,000 amps or volts 454.65 2 Address: 16'150 Std + b��' Reconnect only ' 66.85 2 City /State/Z1P: 64 -6fl'- . Cr) •: Temporary services or feeders installation, alteration, and/or relocation Phone: (553 ) 00 - MO I Fax: ( 56 %S 5 -9362. _ ' 200 amps or less I I 1 66.85 1 b La 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 -2 intended for sale, lease, rent, or 2.r, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per /auel F, zrJ r cG A Pee far branch circuits �virh a.,.�s }yt ' ' , ' t ' r- R.: r •i ,1C CTr grooN� x3•',�,i�� fee, -:" �?: 1^ L; ha,' i:''>'�n'-, ..,.'7�'a +S.'iy;i 2.i ?.r >.�C�;: � ... .. .C;� ".: +: nc., serviced feed fe, 6.65 2 . . . _ branch- circuit • Business name: B. Fee for branch circuits - Contact name:. without service or feeder fee, 46.85 2 first branch circuit Address: Each add') branch circuit 6.65 2 Miscellaneous (service or feeder not included) _ City/State/ZIP: Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2 Signal circuit(s) or limited - • E -mail: ��_ j �. ; .. ,... c en� 2.y del, alteration, or y tltl ��b ,y;, '"FF�'�1:�" Oyu. iii i�i�1�� �it4ai' i��`C:�N` -"' J,3�:'nS ii:f. �.'%. �� ^' +} 0 t's*I'�1�.9q" �i(.; �tiA,.r'_ .Gt' ., , .:'::t1.i:... �:'$.. "G :..- :io:' `�' :�� t:,M:t~;�:.;. .,, "i�a'�. ... .� extension- Describe: Page 2 2 Business name: ` - ' _ - Each additional inspection over allowable in any of the above Address: "l //;; y (i)1 1 1 _ r n o Per inspection 62.50 City /State/ZIP: 1 1 • ib r $• , - Investigation per hour (1 hr min) 62.50 .._ .- _____-_- _� - ._-'. . 3 •VC Industrial last hour 73. `7 Phone: _ �j _ FS?C. ) f .� ... l n :�i r'Y. �, ,, p '.;vr �` '_ ;,_1,11{_ +' ,a • CCB ]ria : i QCj Electrical Lic /.. lc 7 : - -4./ _ Subtotal• W0-_- /� ' " plan review (25% of permit fee): Suprv. Electrician signature, required: State surcharge (8% of permit fee): S Print nano: Clrof i L / 7. Date: TOTAL PERMIT FEE lo� --� Authorized signature: ' / / This permit application expires if a permit is not obtained within 180 days alter it has been accepted as complete I Date: y Fee methodology Set by T i County Building Industry Service Board Print dame: ' Number of inspections per permit slimmed doe 03!33/06 4404615701/051COM/W� I19vildinC�1 'amibiSLC�emiitA.pp. .