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Permit (54) CITY OF TIGARD ELECTRICAL PERMIT s._ COMMUNITY DEVELOPMENT Permit #: ELC2013 -00228 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/22/2013 Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST 400 Project: Everest College Subdivision: ASHBROOK FARM Lot: PTS 5 & Project Description: (3) branch circuits to install ded. recepts. & data drops (1) low voltage for Data/Telecommunications Contractor: HEIL ELECTRIC CO Owner: SUN LIFE ASSURANCE CO OF CANADA 8425 SE STARK ST BY NORRIS BEGGS & SIMPSON PORTLAND, OR 97216 121 SW MORRISON ST #200 PORTLAND, OR 97204 PHONE: 503 - 255 -4074 PHONE: FAX: 503 - 255 -4139 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 04/22/2013 $71.02 Specifics:, Service or Feeder 1 ea 12% State Surcharge - 04/22/2013 $17.52 Type of Use: COM Electrical Class of Work: ALT 1 ea Limited Energy 04/22/2013 $75.00 Type of Const: Occupancy Grp: Total $163.54 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 OA 9 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: f / 11 t i Permittee Signature: ! .r 1 A PPu IA V o kk 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 503.638.4175 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. 04/18/2013 17:05 5032554139 ��t HEIL ELECTRIC CO PAGE 02 Electrical Permit Application RECEIVE City of Tigard Received Tigard, OR 97223 1 8 2 013 `f Permit N°.: 13125 SW Hall Blvd., Ti APR Pla R C� U1 J U J Phone: 503.7182439 Fax: 503.598.1960 Plan Rev OateBv: Other Permit F Inspection Line: 503 - 639.4175 CITY OF TIG . ' 1 D wady /sr. t e See Pap 2 for Internet: www,tigard -ocgov BI HIDING DIVISI.,y�n i ' ' Supplemental Inforeutoon - TYPE OF WORK ' . • PLAN REVIEW ❑ New construction l 'Addition/alteration/replacemcnt — Please check all that apply (submit a sets of plans w /hems checked below); ❑ Demolition ❑ Service or feeder 400 amps or more 17 Building over three stories, ❑ Other. whero the available fault current ❑ Marinas and boatyards, CATEGORY OF CONSTRUCTION exceeds 10.000 amps at t50 volts or ❑ Floating buildings. El l and 2 -famil dwcllin rb less to ground, or exceed, 14,000 ❑ Commercial -use agricultural Y g to Commcrcial/industrial ❑ Accessory building amps for all other installations. buildings, ID Multi - family 0 Master builder ❑ Other: D Fire pump. O Installation of 75 KVA or JOB SITE INFORMATION AND'LOCATIO V 0 Emergency system. larger separately derived system. ❑Addition of new motor load of ❑ "A ", "E'•, •'1 -2" , 7.3 ", Job no.: 1,"60 1-03 1 Job site address: q(900 .5 W Ocac.S- 44 00 wt.." or more, occupancy, CI Six or more residential units. El Recreational vehicle parka. City /Statc/ZlP: 1 1 / / . 0 O • Z D Healthcare facilities, ❑Supply voltage fbr more than ❑ Hazardous locations, 600 volts nominal. Suite/bldg./apt no.: Project name: Vey L 1 l e _ ,, 6 Service Or feeder 600 amps or more. FEE SCHEDI:LE Cross street/directions to job site: Description I tltr- I pry I Terce I New residential single- or multi-family dwelling unit. Includes attached garage. Subdivision: 1 Lot no.: 1,000 sq. fl. or less 16834 , 4 Tax map /parcel no.: Ea. add'I 500 sq. R or portion 33.92 , 1 Limited energy, residential 7500 2 DESCRIPTION OF WORK (with above sq, it,) i &5 „� r ` - • , rear f ,_T Limited energy, ith a s ) — ' (� cl i (x S residential with above , ft. 7 5.00 2 Renewable Energy ❑ See Page 2 r15 Services nr feeders installation, alteration, and/or relocation PROPERTY OWNER I 0 TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: - 401 amps to 600 amps 200.34 2 Address: _ 601 amps to 1,000 amps 301,04 2 City /State /ZIP: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or Phone: ( ) Fax: ( ) _ relocatio 200 amps or less 59.36 I 1 Owner installation: This installation is being made on property that 1 awn which is not 201 amps to 400 amps [25,08 2 intended for sale, !case, -rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits — new. alteration, or extension, per panel Q -APPLICANT I © CONTACT PERSON A. Fee for branch circuits with above service or fader fee, Business name: each branch circuit 7.42 2 B. Fee for branch Circuits without Contact name: service or feeder fee, first 56.18 1 �¢� 2 Address: — branch circuit 1 v Each add' I branch circuit 7.42 2 City /State /ZIP: Miscellaneous (service nr feeder not included) _ Each manufactured or modular 67.84 2 Phone: ( ) Fax: : ( ) dwelling service and/or feeder E -mail: Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting w 67.84 2 Business name: E - e,u,....., -e c , i ii r t U signal circuit(s) or limited- energy Address: O panel, alteration, or extension. Page 2 2 r CO I\ Cj J Each additional inspection over allowable in any Odle above City /State-/ZIP: {: r� L e r I Additional inspection (1 hr mjn) 66.25/ hr �� 1 Z Investigation (1 ht min) 66 25/ hr Phone: ✓ V - 5S • .4 I Fax: b)2 'e L 3 q Industrial plant (I hr min) 78.18/ hr p Inspections for which no the is CCB Lie.: O Electrical T ic.2ialaCo C/ Suprv. Lie.66 - _zpecifically listed (S4 hr min) 90.00 / hr Suprv. Electrician signature, required: ELECTRJCAX, :PEHJ4JT 1 :. A ' 4 4 • - /1 Su Print name: l l O Y Date: ' Plan review (25% of permit fee): Authorized signature: , f �l J _ state surcharge 02% ot'pcmrit fee): 7%," ,, _d _ TOTAL PERMIT FEE: 2,.2 _ IL" I Print name: 110 t1_ ( . I , fie: 4 k This permit implication expires if a permit is not ebtat yawn 130 k+ days after it has been accepted as complete. • Number of inspections allowed per permit. 1.layildla4lPrtmits\SLC PemutApp_p4p913 doe 4404015TC 1 /O5 /COM/waa f(, -3.'=:y 04/18/2013 17:05 5032554139 HEIL ELECTRIC CO PAGE 03 Electrical Permit Application — City of Tigard for all other installations Page 2 — Supplemental Information Limited Energy Permit Fees: RWENTL4LMORK ONLY:..: Fee for all residential systems combined , $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* El Other: .C.0 l l RC AL WORK ONLY: Fee for each commercial system $75.00 (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial Systems: C *No licenses are required. Licenses are required mouth mbiumix perrAtApp- 040913,404