Permit (198) CITY OF TIGARD ELECTRICAL PERMIT
; COMMUNITY DEVELOPMENT Permit #: ELC2011 -00671
T[,GAR:D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2011
Parcel: 2S103DD00500
Jurisdiction: Tigard
Site address: 13727 SW PACIFIC HWY
Project: Tigard Retail Center Subdivision: MELROSE Lot: 7 -8
Project Description: Panel replacement.
Contractor: BOBS ELECTRIC Owner: WILSON'S TIGARD RETAIL CENTER IN
2700 NE BURTON ROAD STE A BY ORIX CAPITAL MARKETS, LLC
VANCOUVER, WA 98662 ESCROW ADMIN
1717 MAIN ST, 8TH FL
DALLAS, TX 75201
PHONE: 360- 254 -7200 PHONE:
FAX: 360 - 254 -8219
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 11/30/2011 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 11/30/2011 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 OAR 952 - 001 -0090. You may obtain - • • • • : - o - t.questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/ _ /
Issued By: �, ___ - ermittee Signature:
8 WNER 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.
FROM (THU)DEC 1 2011 0:O7/ST. 0: 00 /No. 9302925211 P 2
Electrical Permit Applicati i:olt o i ic(•. (st: f)xl:v
�� City of Tigard IVEED Received
Tid OR Date/B : PePens* t No.: ;=/ / 'y �I -/r /`_ � � f
13125 SW Hall Blvd., gar, 97223 . •„ r ;jaw. fps.. ri0 W!N
Phone: 503.639.4171 Fax: 503.598. i96‘0.,/ 3 o / D an Review
f J te/By: Other Permit:
TI G A R a Inspection Line: 503.639.4175 ,_ 4 1J IYa Date Ready /By: iwi: ® See Page 2 for
Internet: w ww.ti rd -or v ��r
^� ga •go ,� Notified/Method: Supplemental Information
e /.�� Supple
,.= ,viy, :_ r..".. ;1 .,.r - ti ,^ H , i.) i i j r.:. ,, 3 .. ;.... i� , ?5,v .: a t :;z4. ".:3= "..
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❑ New construction ® Addition/alteration/replacement 1 tl Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
exceeds 10,000 amps at 150 volts or
t=., " �t. �` r �.: h "- •`�����. ,'��� F p ❑ Floating buildings.
r,dc less to ound, or exceeds 14,000 agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ C ommercial -use n
❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder
❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
a v :. »ie .iY" -°'• ;° "" ii "�• - -- •;cs:.. ro::,.p »; ' M :,..ny .. ❑Emet y Y
,,, ,- "° , ;day -� gent system. larger separately derived system.
•� ' •' ��- ..� ` '�.= =.stra;.'.� " ' = <�5 ❑ Ad dition of new motor load of
� "A” "E» "i -2" •• I -3"
Job no.: 11-8 1 2 lob Site address: 100HP or more, occupancy.
13 7 2 7 SW Pacific Hwy. . ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, DR 9 7 Z 2 4 El Health-care facilities. ❑ Supply voltage for more than
n ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: �� l , p 17`f [ ,/ ,ice _ .. ❑ S Y i e _ fzi f .
rvice or feeder 600 amps or more.
r :.. �_. .5.:•- a' " g..
Cross street/directions to job site: �`'� — ~ 4
:
_ Description I Qty. 1 Fee. I Total I
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: La. add'! 500 sq. ft. or portion 33.92 1
_ ; : Limited energy, residential
- : fir« z a'f ,. h :;. t _ a z•.I 'f. s _:=• � g j ":q ""' 67.84 2
: 4 ••r - - : �� r !a I*. a � � ,:...i •v „_. w ( with above ft.
Limited energy, multi - family 67.84 2
Replace 100 amp panel for outside lights & signs residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
k 2- 200 amps or Icss 1 100.70 100. 2
Y
": a . " ,� � "e "'pr ,,,,"t._ - _ - r ' s%• 201 amps to 400 amps 133.56 2
- , ...rte t d .�...�..'. . _ . ° �x
Name: Tigard Retail Center 401 amps to 600 amps 200.34 z
601 amps to 1,000 amps 301.04 2
Address: 13 701 SW Pacific Hwy. Over 1,000 amps or volts 552.26 2
City/State/ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, , er panel
Owner signature:
Date: A. Fee for branch circuits with
. , .. ....q -.w ".= �^ ---T• .ate. � _ :rMr_� •^: ° :,<...;;. �... _
=� 4 /�^��''/}. WWW-j ...xi - = `. Q&0 t [",',��i$ -a"r' 2
..: .::�.'E. . SI!n"'mm- • 1 .r. .+u. v'r',+,+''&' �`.'dSC.`^ +•. above service or feeder fee,
Mir' each branch circuit 1
Business name: B. Fee for branch circuits without
service or feeder fee, first
Contact name: branch circuit 56.18 2
Address:
Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/Z1P: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67,84 2
E - mail:
Pump or irrigation circle 67.84 2
__, . .
•- an= }- = w�� -•�- °•.:: -• - �; ._. _. __ „_ Sign 6 7.84
....,. ° .� ......r�;:a:�” -. .. -- . ° , mo w.,
<=.aa: ::$• ;'.;'.'s-,, -y:.^ - r' i 4 `' .Yj . ; :�:tr "^ • i �c- �:>.siiz>w✓'. .'i .,.. � .' _ 2
,:,'- " LL , ,,,�r;.r:��,,,�,,,�Y.�,�,�, Signal circuit(s) or limited-energy
Business name: t panel, alteration, or extension. Page 2 2
Bob S Electric Each additional inspection over allowable in any of the abov
Address: 2700 NE Burton Rd. , Ste. A Additionalinspection(1 hr min) 66.25/h
City/State/ZIP: Investigation (I hr min) 66.25/ hr
Vancouver. WA 98662 Industrial plant (I hr min) 78.18/hr
Phone: ( 360 ) 254 -7200 1 F7 ' ( 3 )254 -8219 Inspections for which no fee is
CCB Lie JJ /r//r/ , specifically listed (%, hr min) 90.00 /hr
Electrical Lie.: yam, °max .....- d . , : _._._ ,
Su Suprv. Lie.: x : —• _
53136 4 C p 43225 r:, ;..r_. �_.s ` CiaRtC aP_ >itii? DES's _ =.
-
Suprv. Electrician signature, required: Subtotal: 100. 70 ~—
Plan review (25% of permit fee):
-
Print name: Kevin Broselle Date: 11/30/11 State surcharge (12% of pennit fee): 12.08
-
Authorized signature: TOTAL PERMIT FEE: 112.78
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.
I: Building 'Permits \ELC- PermitApp.doc I0 /01-09 440- 4615T(I I /05 /COM/WEB