Loading...
Permit F Co O Building Division TIGARD Request for Permit Action TO: - CITY OF TIGARD Permit System Administrator 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.718.2430 Fax: 503.598.1960 w■w.tigard- or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor ® City Staff (check one) REFUND OR Name: Team Electric INVOICE TO: (Business or Individual) (0 1 ® Mailing Address: 9400 SE Clackamas Rd. �P /o�9' 7 Cit /State /Zip: Clackamas, OR 97015 Phone No.: 503- 557 -7180 (CEN) PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): K i" . CANCEL PERMIT APPLICATION. REFUND PERMIT FEES (attach receipt, if available). ❑ INVOICE FOR FEES DUE (attach case fee schedule and explain below). TI REMOVE CONTRACTOR FROM PERMIT (do not cancel permit). Permit # : ELC2007 -00417 Site Address or Parcel # : 7380 SW Bonita Rd. Project Name: Washington County Commuter Rail Subdivision Name: Lot # : EXPLANATION: Street lighting permits (4) for this project will be issued by engineering division. /eE ^/!A /ert %d P , i,r /BEES . Signature: �� � � � . Z.. // Date: 6/21/07 (ler a Howse Print Name: Refund Policy 1. The Director or Building Official may authorize the refund of: a) any fee which was erroneously paid or collected. b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended. c) not more than 80% of the land use application fee for issued permits. c) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended. d) not more than 80 % of the building permit fee for issued permits prior to any inspection requests. 2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds. FOR OFFICE -USE ONLY Rte to Sys Admin: Date By Rte to Bldg Admin: Date 6 zrej 7 By Refund Processed: Date 6/20' By Invoice Processed: Date By, Permit Canceled: Date 4 f o ; By - �- Parcel Tag Added: Date By Receipt # 7 -697(y Date G /9 7 Method (, ( Amount $ I: \Building \Forms \RegPennitA.ction. oc v 05/24/06 JUN.18.2007 11:33AM TEAM ELECTRIC (� N0.585 P.2 /3 a .'f:' ''� � r)) a 4,029 O7 4Gr Balearics' 1'ermit Applicati m , � j hJ $ .� L '" GJ IOI:imlltl I I „ I (1\11 City of Tigard 2001 Date/By: 'F i 0 5 L Permit No.; E�2�^ , -3- J 13125 SW hall Blvd., Tigard, oR 97223 �i i B Phone: 503.639.4171 Fax= 503.398 .196 Daeoe/R thherl mix InspcetonLine: 503.6394175 , C TlU ce Data hale' Internet: www teased- or.gov 1 I LDII ' D ON Norised/Mef�ood: s T i ("7 8 opame ui locomotion TYPE oi' WORK PLAN REVIEW ❑ New construction ❑ Addition/alteration /replacement Please chat a0 that apply (aubmitg sets of plans w /items checked below): - ❑ S1e4 or fooder400 amps or mono ❑ Building over three stones. © Demolition ❑ Other: when the available fault caress 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps At 150 volts or ❑ Fleeting buildings. lest ❑ I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building s r ell °l or installations. ens. Cl buildings. al - exec ngricultuxal �$ ampaforallolheriasmQnROns. htlidinBt. ❑ Multi - family ❑ Master builder ❑ Other. One pump. CI Inetelletlon of 75 KVA or .TOla $IIT INFORMATION AND LOCATION L S 0 cY system .anger separately decry, system. ❑,4ddidon of new mater lead of Cl "A ^ °. "E”, "1-.2", "1-3", Job no.: C I Q(� I . lob site address: 7 Z' 8 se 100141) or more. =seamy. "� � ❑ Six or more residential units, Cl Recreational vehicle perks. City/State/ZIP: � 0 re 9 7 } Z , L ❑ Nea1Ux•care fawlitia Supply voltage for MOM thee i / � ❑ R dons locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: W0.S� \A Comma-1-4r _ Cl Service er Roder 600 amps ar more. FEE SCHEDULE _ Cross street/directions to job site' nerri,etou Ii Nee. I lad _ I • Q CC t� New residential single- or mold-family dwelling unit. 5y.I E O h t k e i t 1 &J 1 ss 4 yr Includes attached gei n e Subdivision: I Lot no.: 1,000 sq. It of less 145.15 _ 4 ! Ea_ add'I 500 sq. ft. or portion 33.40 1 Tax map/parcel no.: Limited energy, residential DESCRIPTION 01? WORK (with above sg. R.) 75.00 2 e Limited energy, multi - family S 7 1 / / z y 4 / 03 p residential (with above sq. 4.) 75.00 2 r J Q Services or feeders Mato Ile tion and/or rdoeation 200 amps or less 80.30 Lz.- CI PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 _601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City /State/ZIP: Temporary services or feeders installation, alteration, and/or r relocation J Phone: ( ) Fax: ( ) 200 amps or less 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 mope__ 133.75 2 Owner Signature Date: Branch eircnit,r- new alteradon. or eittensien. Qer panel A. Fee for branch circuits with Q APPLICANT I [] CONTACT PERSON above service or feeder fee, 6.65 2 Business name: t, each branch circuit e�A M- i-e.e_. } / L B. Pee for branch circuits * Contact name: K \ wi tout service or feeder fee, first branch circuit I 46.85 2 Address: latch add'I branch circuit I I I 6.65 J � 2 Miscellaneous (service or feeder not included) City/State/ZIP; Each mantd'aemred or modular . 90.90 2 Phone: ( ) - . I Fax:. ( ) - dwelling, service and /or feeder Reconnect only 66.85 2 E-mail: Pump or irrigation circle 53.40 - 2 CONTRACTOR - - - Sign or outline lighting 53.40 2 - Business name: TRAM ELECTRIC Signal circuit(s) or limited - energy panel, alteration, or Address: 9400 SE CLACKAMAS RD extension Describe: Page 2 2 City /State /ZIP: CLACKAMAS, OR Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (503) 557 -7180 I Parr (503) 557 -8201 Investigation per hour (1 hr min) . 62.50 CCB Lic.: 173043 I Electrical Lie.: 3225 -C J Suprv. Lic.: 4416 S Industrial plant per hour 73.75 Suprv. Electrician sigratutq rzgnired: 4 ELECTRICAL PERMIT PEEK ./ f / /24r� 4i.d.i. ?'f Subtotal: 5 .4 .50 Print name: MICHAEL TRUSHEIM Dam „ - Plan review (25% of permit fee): State surcharge (8% of perm Authorized signature °7 „ _ /— TOTAL mom PEE: 4 57 . Thie permit application expires ire permit is net olitaleed wit ISv ' Print name: M / c:Le .7714„,c h of mei I Date: days utter It has been accepted as eompiete. . ..ac- ..--.. ,.. AL...4 .....,..... ... JUN. 18.2007x1811 :34AM TEAM ELECTRIC NO.585 YP /301 • ..... _as- l ' .. — ---:. ---' fig ii , . i AL ....., MA 7384 Sw Bonita Rd 4. Tigard OR • 97224 -8027 US .Notes: 1 1 1 1 1 1 1 ., 1; 91 ,! I I A' , I l i j Only text visible within note field will print. a great night's sleep. Cloud Nine;• naiuv in ..II uun ili5144a 1, j/wiple-4 ,I Stdy with us • 7: IAAPO JE5T : '1(44.N. ' "* �_ AN I_S I ' „T �— ' � 1 s l + A w r 4 I Yd lib, `' a 5w Ted% CegI51 r 1292 8 x. P � I ,„, 4,„ T ; , G� �ioy Creek Ct \ \ 7, r4\ y Sw �a�dmerk i ■ I mo creek oi( +, /' 1 \ N ; V . r Ol �` -^'� _ �,-� t �� 7 ( 5 - " 1 - 7 . . , , , . i q„ - I ii nlda S i I a �t11 �� ��IL � 1 w t I - -. ` r 129-1 I ' # , - I Ii , I IF . '1 :s. - 1 17 i I ' � � i , ]Sw Kenton u7 `_ J ° I . � ryI :ff`` • l '2 1- , 5 i j . Syt•• shford St ) i I it Ka V 41 4 to COP MIaPQ4°st IPc... �. ; r -_ . _ • .. . I : , i •• r 0 2 i � „ohyrgcp All rights reserved. Use Subiect to License /Copyright ThIB map Is Informational only. No representation is made or warranty given as to its content. User assumes all risk of use. MapQuest and Its suppliers assume no responsibility for any loss or delay resulting from such use. • http: / /www.mapquest-cam/maps/ print. adp? mapdata= p5kgyoo6yZJ V'c1ZZYdASp %252fVY... 6/17/2007 JUN. 18.2007 12 :39PM TEAM ELECTRIC NO. 59% P.2/ Electrical Pertniit Application 11 1 l; Ill i 1 II 1 1. i i a. i City of Tigard Received Permit No.: ,�� u :view 13125 SW Hall glvcL, Tigard, OR 97223 a Phone: 503.639.4171 Fate 503.598.19 � �� .. • ' Pm,laDat&By- Other Paint 11( 01 t Inspection Line: 503.639.4175 Dnrc Ready/By Jerrie to See Page 2 for Internet www.tigard.or.gov JUN 1 8 Z00/ Notifred/Method: Suppleme+ interfamily& TYPE of WORK(TY_Q¢ TIGARD PLAN REVIEW ❑ N e w construction ❑ AdditionhifteratiattILONSCIVISION Please chock n11 14&t apply (submit 2 s e m of A sps w/itema checked below): ❑ Service or feeder 400 amp; or 01010 CI Building over duao sronea. ❑ Demolition ❑ Other: whore the available fault csma at ❑ Mariana and boatyatda CATEGORY OF CONSTRUCTION weeds 10,000 amps at 150 volts or ❑ Flouting bwlding& less to ground, or exceeds 14,000 ❑ Commercial -n agrioultoral 0 1- And 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. hmld'mgs• o Multi- family ❑ Master builder ❑ Other. ❑ DR lump. ❑ Installation of l5 RVA or JOB SITE INFORMATION AND LOCATION [3 Additi o m of now m otor laid of ❑ "A", separately derived 6yitettL �� ❑ Additin of new motor "A , "E", . "l-2 , °1 -3", � coca Gale Job no.: I I D I Job site address :/� 8 s f i u41.1 i aka. . ❑ six or more residential unite. ❑ Rey ntlonal vehicle parks. 1 A ❑ Hemllhraae cati6oa. El Supply voltage for more than City/State/ZIP: ��t reJ 0 i 7 9 2.2 //�� ❑ waurdoas locations. 600 volts nammat_ Suite/bldgJapt no.: I Project name: Va $A, Col `D m frud fC* R ❑ Ser io or feeder 600 um as or more. ,_,^ FEE SCHEDULE Cross strcet/direetions to job site: n.eriMlea. I Otv I 7 rota I • (� New residential single- or multi- Enmity dwelling milt- II - 0 i - i / , I dtG Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft, or less 145.15 4 r � En. adds 500 sq. R or portion 33.40 1 Tax map/parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above ark It.) 75.00 2 , �, Limited energy, multi-family 75.00 2 y L residential (with above sq. d Services or feeders installation, alteration. and/or relocatio 200 amps or Ices 8030 2 ❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name 401 amps to 600 amps 160.60 2 - - 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State/ZIP: Tem rorllation. alteration, and/or I relocation .--, Phone: ( ) Fax" ( ) 200 amps or less 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, aocordiog to O11S 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits - new, alteration. or extension, perjanel _ Owner signature: Date: A. Fee for branch circuits with Q APPLICANT L ❑ CONTACT PERSON above service or feeder fix, 6.65 2 each branch circuit Business name: 7 4 H E J jz •<_, _ B. Fee for branch circuits without service gr feeder tee, 1 4615 4 2 Contact name: M Ito - rnAslit I viti first branch circuit Address: 4400 (la&kav ias Rd . Each add'I branch cinmit 1 6.65 2 Miscellaneous (service or feeder not indnderl� City/State/ZIP: (4aGkf wl As t D 6110IC Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: (06*) 0/0 I gt) Fax: : (j3) t - sto I Reconnect only 66.85 2 E mail: Pump or irrigation circle 53.40 2 CONTRACTOR ` Sign or outline lighting 5 3.40 2 Business names TEAM ELECTRIC Signal panel, or limited- d- energy p alteration, or Address: 9400 SE CLACKAMAS RD extension. Describe Page 2 2 City/State/ZIP: CLACKAMAS, OR Each additional inaction over allowable in anYof the above Per inspection 6250 Phone: (503) 557 - 7180 I Flux: (503) 557 -0201 Investigation per hour (1 hr min) 62.50 CCB Lic.: 173043 I Electrical Lic.: 3225 -C I Suprv. Lie.: 4416 S Industrial plant per hour 73.75 _ ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: m A s e�` Subtotal: 53i, 5Q Print name: MICHAEL TROSHEIM •� I Date: to 1 oi ' 0.--7 Plan review (25% of permit He): �V1,. State surcharge (8 $ % of permit fee): Tr 2 Authorized signature: j i TOTAL PERMIT FEE: ,$ 7. 7A ,�/ '' �' ll This permit application expires Ira permit Is not Wilma within 180 Print name: / / / , --- . e , " D81e: 10 $ 0 days after it hue bean nominee as complete. JUN. 18.2007M 12: 39PM TEAM ELECTRIC NO. 590 FP.3 /3 Of 1 : ' e • � A+ TRAVEL DEALS from Sherman's Top 25 _ _ MPQE Published on 06.13.07 12800 Sw Hall Blvd $83 & up Maior US air ale 97223 - 81 $37 &up La. V= , '.r -a ,,. ValUIP 97223 8147 US _ Notes: $303 & UP t er te rsu to LJros ` • - Only text visible within note field will print. 5399-. AIl4nclusive roci ya ions $4Z 3 -plant I?isneutrius this summer $349+ New shinsto Htllrin l & more 50% off ;Compare and save on Frights! Hrnore **;11A.e0LIEW.C.:. 'Li( 4. ' , z, s , �� " � .3 / ‹_. / 1 \ i N\S L k- -- Ak, , ‘ ' , , .r N • �� c , . -.,„ .‘, ' 4:N..\.% ??.. 1 4 i 4. , 7 .,,. _....,.;\ N,c?*;:./ '1 cf "'V \\,... ' 1 ‘ s., ' /e\) .. •' ' \:' /; .,c e,, , c'-'>,.\ Fiona Aid; J ); x , / L A. ' /II/ i \ /.. „ _ x--,,,,. ,,,,,, ,..,_...:.,,...*, '%i (rA_. tor, " i t r AS . '•: '-i t ..., 1 j 1 ) I 21 1 .. \N... oF '': \ ,....) ) _ii St I L L ._.... r 1--- - .1 1,1,, / �,... eweod St, . I Xt., y J6! 2007 MRpOuest Inv. .1" — . • ; Q 200?NMTEQ All riahteryed. Use Sublect to License /Coovriaht This map Is informational only. Na representation Is made or warranty given as to its content. User assumes all risk of use. MapQuest and Its suppliers assume no responsibility for any loss or delay resulting from such use. http: / /w.ww.mapquest.com/ maps / print. adp? mapdata=p5kgyoo6yZJx %252bgazgzXhIoaXb.,. 6/17/2007 MN. 18.2007 11 :40AM TEAM ELECTRIC NO.58' P.2/ .Electrical Permit Application t i t r: c i i i l c, l s• t i ; 1 rer� 9 City of Tigard Received permit No.: u 13I25 SW Hall Blvd Tigard, OR 97223 Plan Review • ' 8 • Phone: 503.639.4171 Fax 503.598.1960 Dete/B . der Permit Inspection Line: 503.639.4175 Jvi1 1 '' 2007 DameRady/By: lyric td SeePepe2for ` ■ Internet: www.tigard•or.gov Notified/Method: I Sopplemcnlmtlttformation CITY OF TI , \RD - TYPE OF IMC DIVISION PLAN REVIEW CI New construction ❑ Addition/alteration/replacement Please cheek all that apply (submit acts of plans wftama obeeaod befmv) ❑ $eeviee oribeder 400 amps or more D Building over them stories. 0 Demolition 0 Other. where the available fault ceamet ID Mariana and boatyards. CATEGORY OF CONSTRUCTION exceeds 1 0,000 amps at 150 volts or ID halting buildings- teas to ground orexsnods 14,000 0 Commercial - use [ grimlttaal ❑ 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building amps for all other inanllntions. buildings. 0 Multi - family 0 Master builder 0 Other: 173 Fire pump. D Installation of 75 RVA or 8 17111311 huger system• larger mpe�ately derived system. JOB SITE INFORMATION AND LOCATION anew motor load of 13'A', ", "1 "13 ", 9 /M� lob site address:/2 ` t00HP or mane. uer�apaucy. Job no.: I / W �2 $LTD � � i I E I uest • ❑ Sic er more residential units. ❑ RACmatienal vehicle pode• � 0 T� 9 O Hc!Wrsne facilities. Q Supply voltage for more than City/State/ZJP: . r 54k 0 a\ % 7 2. 23 ❑ X Hadoaa location'. 600 volts nominal. ( � / /� O service or feeder 600 amps ear more. Suitt:/bldghtptno.: I Pro)ettname :WQS�. eat `Dlmt,�y'>Fe!ri�At� PEE SCHEDULE Cross street/directions to job site: neatriaras _ I Qty. I pee I 'Total i ^ / New residential single- or multi- family divining unit M .. / / 5 hid Coat e iiii i ;17 PaC A I .• irttc - Includes attached garage. — Subdivision: I Lot n o. : 1,000 sq. ft. or less 14515 4 - l Ea. add'I 500 sq. it or portion 33.40 1 Tax map/parcel no.: _ Limited energy, residential - DESCRIPTION OF WORK (with above salt 75.00 2 at. St Re L i3 A 14 Limited energy, (, di above sq. I 7500 2 residential (wide above it) Services or feeders installation. alteration, and /or reloanon 200 amps or less 8030 2 0 PROPERTY OWNER - 1 0 TENANT 201 amps to 400 amps 106.85 2 Name: 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 Ciry /State/ZIP Temporary services or feeders installation, alteration, and/or I relocation t Phone: ( ) J Fees: ( ) 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 am 10030 2 intended for Sale, lease, rent, or exchange, according to ORS 447. 449, 670, and 701. 401 amps to 599 amps 133.75 2 Branch circuits— new, alteration, or ectelrslon, per panel Owner signature: - Date: _ A. Fee for brunch circuits rank ' ❑ APPLICANT l 0 CONTACT PERSON above service or feeder tee, 6.65 2 �� �r[ -f l / � B. each branch Sufic Business name: Fee for branch circuits Contact name: without' service or feeder fee, 1 46.85 ins" 2 _ first branch circuit Address: y Each arld'I branch circuit _ I 6.65 Misceftineous (service or fbeder not included) City/State/ZIP: Each manufactured or modular 90.90 2 dwelling. service and /or feeder Phone: ( ) I Fax: : ( ) _ Reconnect only 66.85 2 • E -mail: Pump or irrigation circle 53.40 2_ CONTRACTOR Sign or outline lighting 53.40 ` 2 Signal circuit(s) or limited- Business name: TEAM ELECTRIC energy panel, alteration, or Address: 9400 SE CLACKAMAS RD extension. De.ecnbe Page 2 City /State/ZIP: CLACKAMAS, OR Each additional inspection over allowable in a or the above Per inspection 62,50 Phone: (503) 557 -7120 I Fax: (503) 557 -0201 Investigation per hour (1 brmin) 6240 ` - CCB Lie.: 173043 Electrical Lit.: 3225 -C Suprv. Lie.: 4416 5 Industrial plant per horn 73.75 , ELECTRICAL PERK )FETES Suprv. Electrician signature, required: M a g Q� Subtotal: 53, 5Q Print name: MICHAEL TRUSIIEIM f Dom; Plan review (2596 of permit iii): : _ State surcharge (8% of permit fee) 4'e z Authorized signature: '' II / A ,7 .. TOTAL PE1.MITFEE: ,� 7, 7 st Print nam 7F l - Date' nu This pelt application ealut>a if a permit is pet obtained within 1 io • / �� R j e / yd I datys after it last been accepted as complete. • ...4 -..r:- ..,..:., -.. - n—,,.w.- -...a. :r .ZUN. 18.2007M11:41AM TEAM ELECTRIC .. NO. 589 lP.3 /3 Of I. _ ..... _ T RAVEL DEALS f rom S herrn n's Top 25 Pubhshed on 06.13.07 ` 12800 Sw Hall Blvd a .$8311 up Malor US air sale Tigard OR $37 up - rr ,. son , ,. . 97223 -8147 US Notes: $303 & up Rpm fares to Europe? _ _ - •=.,, , I Only text visible within note field will print. $309+ All-Inclusive Mexicovacations $420+ 3- niN1lt Disnovttins this summer - - $349+ New ships to Hawaii & more 50% off Compare and Sane on Flights( kmgbY* ▪ T non 1.1-- aw 11�.�- �.,� . r it \it fir,, ' is 'rye'. �`. / - ! C __ 11?------- • -�� 0 ..„.„<„, / :..., '' ‘ N-4 \ 0 , -\ i Eii /4:3- ‘8, 4 ......--- 0 Th 0;,.." 4 •::::*R 1 ,0, 1 '.):: ` f •' �� x., •.�./'� i �.`,! �.�` .a� �`_ = ri .. .,, 5 N0) 1 ' -••• \ ) 1/4 \ I X:: ... :. 2.1c.yx.I. x ' /o f ,. J \\ C.e.\ PbrAmo - Fork ii/ ,00,. IL , \ / 2.5 \ ‘ / ■• I 1 1 (4) % I, i • •'a \ fir , '1 .) V .. - . • � fS ' rnara St I L I I. : , 1 �jr / 4 A4:_a �� • -- • ____SYAl9?d 5t i I� �24Gri e+apOuestloc.. . ,, ; 02130iN6VTE0 All . ri. h .. &A - . • - y. , •: e �• This map is informational only. No representation Is made or warranty given as to its content. User assumes all risk of use. MapQuest and Its suppliers assume no responsibility for any loss or delay resulting from such use. http: / /www.mapquest oom/ maps/ printadp?mapdat 'a=p5kgyoo6yZrx %252bgnzg XhioaXb... 6/17/2007 E'JUN.18.2007 11:354 TEAM ELECTRIC NO.58- P.2/ ... .s s � � Lsht; is wtuu 1 1) I: t ,1 11 4 t i ,1 11\ I 1 City of Tigard Received II 1312,5 SW Boll Blvd„ Tigard, rd, OR 5i 1�ateBy Permit No.. n Phone: 503.639.4171 Fax: 503.598119h -- PlanRcview OthaPermit 1 i , , , I ,1 ■ Inspection Line: 503.639.4175 Date( Dam R4ldy/fly. lorb: 0 Sec Page 216` Mien= www.tigard-0T.gov 1:. , ; 1 ?no Notifcd?Method: i t>oppl ®ennl Information TYPE OF WORK ' ' T 1 C n fl D PLAN REVIEW ❑ Ncw construction ❑ Addition /altefet ' h t1 t. Please cheek all ttmt apply (submit a sets of plans vita= chocked below): B U I L I G u lV 1 S I O N ❑ Service or 400 amps or morn ID Building over dune stories. 0 0 Other: where the avairabie fault current 13 Modem and boatyards. CATEGORY OF CONSTRUCTION escecds 10,000 amps at 150 volts or 0 Floating buildings. 0 1 and 2 dwelling 0 Commercial/industrial ❑ Accessory building less to ground. or exceeds 14,000 p Co ding l agricultural 12 Multi amps for all orbs installations. 4mldmgs y 0 Master builder ❑ Other „ ` , O F= pump. 0 Installation of 75 KVA or JOE SiTE INFORMATION AND LOCATION el? ❑ Emergency system. larger separately derived sysee ❑ Addition of new motor load of 0 "A ", "E", "1-2", "l -3", Job no.: 9100 J lob site address: 12.3x sv,1 0. S+ 1001IP or more, oe troy. I 4 0 sec or more residential units. ❑ Recreational vehicle pada. C i t y / S t a t e / Z I P : 1 I8Q. r -) 9 7 22.3 ❑ Hwh6-cate foalitlm. ❑ Saptlty voltage for more than El Hasamons locutions. Suite/bldg. /apt. no.: + Project > ame:1 , 0 Service Cr feeder amps or mare 600 voles 4etgim►l. W t�$h ,�D Co r►l/n(t i Y Jai,' 0 FEE SC)IEDY1LE Cross street/directions to job site` Description I QM I Dec. I Ufa I J L New residential single- or multi - family dwelling unit. / + n S f . ow ci g ! + ie. lc., S+ Includes attached =rage. Subdivision: I Lot no.: 1,000 sq. if or less 145.15 _ 4 Ea- add'l 500 sq. R. or portion 33.40 1 Tax map/parcel el no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. g.) 76.00 2 ..57- / r Limited energy, multi-family 2 g L / �l % "rr residential (with above sq. ft.) �/ / Services or feeders installation, alteration. and/or relocation 200 amps or less _ Q PROPERTY OWNER l 8030 2 ❑ TENANT 201 amps to 400 amps 106.85 2 Name: -- r - jtI - A-fi t 401 amps is 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation, alteration. and /or I relocation Phone: ( ) Face ( ) 200 turps or less 66.85 1_. Owner installation: This installation is being made on property that I own which is not 201 arms to 400 amps 10030 2 intended for sale, least, rem, or exchange, according to OlIS 447, 449, 670, and 701. 401 tamps to 599 amps 133.75 2 Owner signature: Date: Branch circuits- new. alteration, or extension, p rpanel A. Pee for branch circuits 0 APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: •7 Elec../ Z.!c... B. Fee for branch circuits Contact e: without service or feeder fee / 46.85 / b Q 2 first branch circuit -vcr C, Address: Each add'l branch circuit t 6.65 (0,16 2 - - - Miscellaneous (service or feeder not included) City/State/ZIP: Each manufactured or modular ' 90.90 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 g CONTRACTOR Sign or outline lighting 53.40 53.40 - 2 Business name: TEAM ELECTRIC Signal cirtwit(s) or limited- energy panel, alteration, or Address: 9400 SE CLACKAMAS RD extension_ Descri Page 2 2 City/State/ZIP: CLACKAMAS, OR Each additional In peetion over allowable in anxof the above Phone: (503) 557 -7180 I Fax: (503) 557 -8201 I Investigation inspection li 62.50 g pax hotQ (i hr min) 62.50 CCB Lie.: 173043 I Electrical Lie_: 3225 -C I Suprv. Lie.: 4416 S Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: �1e., Act e Subtotal: 53 St) Print name: MICHAEL TRUSIO.JM Date: Plan review (2S% of permit fee): State surcharge (8% ofpermit fax): Q Authorized signature: � '�- TOTAL PERMrP FEE: 5 ! 7 A, Print name: � / L _ Date: This permit o,lioa expires ire permit Is not oh.atn artt in`��t0 r Gw / �U S l / I has days • . �� � �fter It . ham accepted as complete. JUN., 18. 20074x)11 :36AM TEAM ELECTRIC NO.586 r 1: 3 . 3/3' 11 O LIFE 6P e - ES , ., �1, r . / 12300 Sw Main St Tf " I � ` Tigard OR - ' n Yy crrdi�F , :,i 97223 -6223 US at ¢ . , � Notes: 1 r ' Only text visible within note field will print. .. - A ,,, •`' Al Iw,cl +r,II,,,g,,,I ¢.dL tKIL I !LIFE lr.,� Qu ill u9y i TAKES . VISA r M Mju s * Lit 1., il E To n,� 2nm �r� r 1� A r —3 t 1.n Sw T� S I 1 c" `' N j Q1).1.g--Catillt ..11k \\?4,‘,,0 • 47.1.,„/ . N.,,,„, L ib . s ...., ...,. ..... .A j 117 \'`z,... NN •), .49 \\<< ( 21 '''..., L. A. .)./ <.... ;\\\''\ i \ �' ti r''� ern RS.IL K x ^t yv � p � �`. )1 N `x 'y. to '1/ i.s.,<. : \ _In> , • A \ 1 \\''• ''`' � Arena PaHc ��� f r 6 2007:11apQua 111C. ,r, Z4 1 lfa , '.1 r :�iS. W . I e MO rowf Q ill rrlghts reserved Use Subjec to Ucei3 a /CoRyricah This map Is informational only. No representation is made or warranty given as to its content. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. http: / /www.mapquest.com/ maps / prim. adp? mapdata.=pSkgyoo6yZLzY2kw6nkk02GbSgI ... 6/17/2007 •