Loading...
Permit CITY OF TIGARD ELECTRICAL PERMIT ° COMMUNITY DEVELOPMENT Permit#: ELC2016-00165 1 WARD13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/03/2016 Parcel: 251080001500 Jurisdiction: TIGARD Site address: 15225 SW 150TH AVE Project: Polygon at Bull Mountain Subdivision: 1998-005 PARTITION PLAT Lot: 2 Project Description: (1) 100 amp service&(2)branch circuits to feed 7 street lights. Located south of Cabernet St on SW 150th Ave. Contractor: LIGHTWORKS ELECTRIC CO Owner: DICKSON, KENNETH R&ROSA LEE 20915 SW 105TH AVE STE A DICKSON FAMILY TRUST TUALATIN, OR 97062 BOWMAN, DARLA J ET AL 11195 NE HWY 240 YAMHILL, OR 97148 PHONE: 503-691-2959 PHONE: FAX: 503-691-2918 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 03/03/2016 $100.70 Specifics: amps or less 2 crt Branch Circuits w/Purchase 03/03/2016 $14.84 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 03/03/2016 $13.86 Electrical Type of Const: Occupancy Grp: Total $129.40 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 i ccordance • th 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. ENTION: Orego la -. ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through OAR 9, -001-009. ••u may obtain a copy of the rules or direct questions to OUNCp by ca i • .i` 2.1987 or 1.800.332.231R. Issue By: / 4 Permittee Signa ` 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' f r�! Date: ,z15/4/ 7/ 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. Llectriieal Permit Apq e tjltIVE City of'fi alyd 11 ((,, eiVad .43 t " Datem : o� 01 /6 r ) Permit No.: Z��/6„'O0/46- " 13125 SW Hall Blvd.,Tigard,011 97223 Platt Review 0 Phone: 503.639,4171 Fax: 8.196D 2016 Daffy: Othet•Permit: p 02,• TI C A k o Inspection Line: 503.630.417,5- Dat)Ready/By: saris: ® See Page Z for Internet: www.tig:trd-or... OF fiGA D Notified/Metltod: Sunplsurenldtnfermntion PPPp Please check all that apply(submit 2 sets of plans wine= _. New construction ❑Addition/aeration/replacement' ars 4hectced below): 0 Service or feeder 400 maps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current la Manias and boatyards, rQ X..Ql':.,t'�NS 1 G r.c)1�1 exceeds 10,000 amps at 150 volts of ❑Floating buildings. lets to gt')puti,or exceeds 14,000 0 Commercial-um egricultnfal 0 1-and 2-family dwelling ►,; Cornrtlercial/industrial ❑Accessory building amps for all other installations. buildings. ❑Multi-family ❑ Master builder 0 Other; 0 Fire pinup. 01nstallation of 75 KVA or JOB`59 1'"'.](11} OJ M 11ON'A�l61 C7t��#"iIAIY snuc system, larger separately derived system. 0litaur y 1R .,.......-„ ll Addition of now motor lotni of 0"A""V',"1-2","1-3". Tub no.:jr..16 i Job site address 15,p.;....5 ct�- 150 ' ot_ Six iouti or more occupancy. r 0 Six or more residential units. 0 Recreational vehicle parks. City/St'ttte/GIF': ��+�r d� ') ❑Health-care facilities. 0 Supply voltage for more than ❑Hazardous locations. CUU volts nominal. Suite/bldg./apt.no.: Project name: CJ Service or feeder 600 amps or man. d4)-6., ad/ gi:6C11EDULL' Cross street/directions to job site: .5,774.4 G ks. / C4: rhe,(- SJ'4. onseriptioa 0 0 maul New residential single-or multi-family dwelling unit. t . (Lo/ /j' • Yududes attached garage. Subdivision: Lot no.: 1,000 sq.ft or less 145.15 4 Ea.add'I 500 set.fl,or portion 33.40 1 Tax map/parcel no.: /,� - ---• � Limited energy,residential 7500 t):csoori1oN or wo2 �. .. A .. , :;' (with above sq.ft.) Limited energy,multi-family '' 1'0.a ',# .t' . t`--- A_ !;e 6, 7--rA-e residential(with shove sq.it.) 75.00 2 *,"1 j Services r feeders installation,alteration,and/or re r less / 7On_2 Q?lOPRTY 40. • . [] ) NANT , . ,. 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: Ternporary services or feeders installation,alteration,and/or 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 10400 amps 100,30 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps I33.75 2 Owns signature: yaTe: Branch circuits-new,alteration,or extension, sr pano �_ - A.Pee for branch circuits with -7.il,Z AP1PL1CA T ,CQN 1'e#G".f'P. R'iS.QN above service or feeder fee, "] / „Id • ll. f each branch circuit L» ` 77 2 Business name: B.Pee for branch circuits without Contact name: service 01"feeder fee, 46.85 2 that branch circuit Address: Each add'l branch circuit 6.65 2 Miscellaneous(service or feeder not included) City/State/GIP: Each manufactured or modular 90.90 2 Phone; service and/or feeder 1 hone;( ) Fax::( ) Reconnect only 66.85 2 E-mail: r, , U \ t.ar - I a c t . OrP1 ,, Pump or irrigation circle 53,40 2 ('QNTRRAc'TOR ,, : Sign or outline lighting 53.40 2 Business name: ,v,�r /1`x71�1_ Cd- Signal cunei,{s)er mired• /L anergy panel,alteration.or Address; 20, -- rs -/a..(4,...4-e.r S✓,f t JJ extension.Describe: Page 2 2 City/State/ZIP; {7 •,( 6/7 �),b i �t Each additional inspection over allowable in any of the above -- Per inspection 62.50 Phone.(s•�jr1 ) `,7/ 22, r Fax:(953 ) 0/-. 25 I P. Investigation per hour(1 hr min) 62,50 GCB Lie.:/5g'r%S' Electrical Lic.:,3/-e 73( Suprv.Lic.:3014 (/ ir' tndustiial plant per hour 73.75 r Lai 7 F ,a✓ ", 7F 1G''C'.'� i:ICAi..'P1✓3[2Mbt FEES . Suprv,Electrician signature,required: � � Subtotal: //5--•S i/ Print name: tZ 6.vt a / / p Date: 7r.z..../i Plan review(25%ofpermit fee); 40 Authorized signature: //. state surcharge of permit fee):; !3•�l e././. (((���[l J TOTAL PERMIT Pft ; /429.44 Print name: ..[___ t_!______7,% ._,.2•-/i This permit application expires if a permit is not obtained within lac 4y� .fC✓/h clays— after it heti been accepted as complete. a Number of inspections allowed par permit, l:tnuitdinglt•crudwtFLC•partnitApp,doa x5123lo6 440-4615T(1UU5/COM/WFn E0/Z0 30Vd 0I610313 S>1dOM1HSI1 8t6ZI69E05 TZ:ZZ 9t0Z/8Z/Z0 1"^'1 L'G H TWO R KS 20915 SW 105'."AVE.,SUITE A ,� TUALATIN,OR 97062 �� PHONE 503.691.2959 �� ELECTRIC COMPANY FAX:503.691.2918 CCS#158595 Fmr: • 10 Tw. 671 (/d From: ZIWI/ZiJot)4 f Mc-43t _ S�b 3 .rf - /9Z d Pages: 3 ;17 C�rio 47, CSV !'°ne: S 7 ) �/7,-24/3-4/ Date: .4 Re:A/77,, cc: D Urgent D For Review D Please Comment D Please Reply ©Please Recycle E0/L0 39dd 0I610313 S7160MIH9I1 8T6Z169E09 TZ:ZZ 9Z0Z/83/Z0