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Permit (38) CITY OF TIGARD ELECTRICAL PERMIT 7131.Po'- COMMUNITY DEVELOPMENT Permit#: ELC2017-00323 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/04/2017 Parcel: SEG419 Jurisdiction: Tigard Site address: Project: Scholls Ferry Apartments Subdivision: Lot: Project Description: (1)service and(1)branch circuit for Comcast cable box on northeast corner of Scholls Ferry Road and 135th Avenue. Contractor: GLOBAL ELECTRIC, INC. Owner: PO BOX 162 NORTH PLAINS, OR 97133 PHONE: 503-647-5650 PHONE: FAX: 503-647-5649 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 05/04/2017 $100.70 Specifics: amps or less 1 crt Branch Circuits w/Purchase 05/04/2017 $7.42 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 05/04/2017 $12.97 Electrical Type of Const: Occupancy Grp: Total $121.09 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 ru are set forth in OAR 952-001-0010 through 0 952-001-0 obtain a co of the rules or direct questions to OUNC by calling 50 . 2.198'or A Issued By: Permittee Signature: `% �� ��,� 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. Electrical Permit ApplicationFOR OFFICF ISE ON El Cl ofTigard 'RECEIVE �� Received __ Cityg DateB : 5 r of�)��- _ e 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review '_� �l Phone: 503.718.2439 Fax: 503.598.1960 4 2017 Date/B : Related Permit#: -, , L l czei c, ,AA A.'I Inspection Line: 503.639.4175 MAN? Ready Date/By: ® See Page 2 for T I v A K D Internet: www ti d ov r Notified/Method: Supplemental Information anor g gTIV ....., � «:.; ,JI°4. ''..' .77:0, ', \ it .:c, riT , .v ° 4 *., '&=,d t� ,, '.: .,._,, ti ❑New construction dition/altera i t. 1,I 11.'`I' t Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. " ,, t t f,v i,' "t_i. e ,,; „ li exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwellingCclmmercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multifamily 0 Master builder 0 Other: 0 Fireum . P p 0 Installation of 150 KVA or ' 9'4.4.760 '� " , � s r .� ❑Emergency system. lar er se aratel derived i .� : � w � g P Y Job#: I Job site address:Sdno 115 e ii ��-- ❑Addition of new motor load of system. YY' �C avid, 1 SJI 100HP or more. ❑"A" "E" "l-2» "l-3" City/State/ZIP: Q ❑Six or more residential units. occupancy. I 1 C!//eR 0 0 R. ` `y 02 ? 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: • 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal Cross street/directions to job site: .5-a„u D �; ,001 511 +-k e °ti � , - _ �;=ate. .. 07: 1,42.,t-,.A ;y> Description "I Qty. Each Total I t 11� c-t' 1'S'ec-4-)C�I/l on '115 '('V'y New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 ,, ;4,ux= 4. 8 e e ' //' s ,. /' : � Limited energy,residential i^t:C+JI(� G f i u ` j( (_.Eo M CCi`d` t Q t I �'(J (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) ® ii Renewable Energy 0 See Page 2 k s � Services or feeders installation,alteration,and/or relocation Name: 200 amps or less / 100.70 4 .7C 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 s } q' a Branch circuits—new,alteration,or extension,per panel ,,`� _. IC� : ` 1'2 ''_ m . , . ' '' A.Fee for branch circuits with Business name: , `)t I d �) E.-4e c+ei. above service or feeder fee, / 7 42 2 `� I each branch circuit t{ Contact name: ( - assn S'p i,e j,J 115, B.Fee for branch circuits without Address: 7 0 service or feeder fee,first „in I�"6.,t:.i 0_1 ,� + -if (�;.2 branch circuit 56.18 2 City/State/ZIP: \ 5' Each add'l branch circuit 7.42 I 2 Bi �C l v� Z``3 Miscellaneous(service or feeder not included) Phone:(soy) 6 4/ 7._ 5 519 Fax: :(C. 3 ) L/7- 54 Li'7 Each manufactured or modular dwelling,service and/or feeder 67.84 2 Q` , �AL ' lCj Email: yi e,r i ,lG, lG jidye tr „ Reconnect only 67.84 2 makt , tdaiCtOR .,. : Pump or irrigation circle 67.84 2 Business name: G (.o LCL) -'.c..-_, le _ - c i C Sign or outline lighting 67.84 2 Address: �' Signal circuit(s)or limited-energy 3 ( 7 00 AA,Vvi e-v-Gs a ) LJ 4- panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: N � jEach additional inspection over allowable in any of the above o'4-4, 9 10,...i A S © `2 t 7/ � Additional inspection(1 hr min) 66.25/hr Phone:(,5 i p 6'1 7..- 6-66-0 Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 15LI.az, Electrical Lic.: 339.-L55C Suprv.Lie.: 5z_Ie S specifically listed('A hr min) ELECTRICAL.PERM`F FEES w, Suprv.Electrician signature,required: p........9 Subtotal: -J — Print name: ` 9 I.iv‘ S n,42 rt Date: ,�/ /�T ❑Plan Review Required(25%of permit fee): / State surcharge(12%of permit fee): id, 1 7 Authorized signature: TOTAL PERMIT FE '01.,/,eiC This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. 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