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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMEN Permit #: ELC2010 -00082 T I G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/18/2010 Parcel: 2S 101 DC04000 Jurisdiction: Tigard Site address: 7550 SW TECH CENTER DR 220 Project: Cochran Subdivision: Lot: 0 Project Description: TI, (1) temp service and (42) branch circuits. 2/19/10, removed temp service and added (1) 200 amp service. 2/3/11, reprinted to correct suite number from 250 to 220. • Contractor: COCHRAN INC Owner: WALTON CWOR SOUTHRIDGE 12 LLC 626 SE MAIN ST BY TTA/EPROPERTYTAX DEPT 325 PORTLAND, OR 97214 PO BOX 4900 SCOTTSDALE, AZ 85261 PHONE: 503 - 234 -6564 PHONE: FAX: 503 - 238 -2098 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 02/18/2010 $100.70 Specifics: amps or less 42 crt Branch Circuits w /Purchase 02/18/2010 $311.64 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 02/18/2010 $49.48 Electrical Type of Const: Occupancy Grp: Total $461.82 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. ATTENT : I: Orego aw re• ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set fort in OAR 952 - 001 -0010 hrou. h OAR 952 -11 -0091 You may obtain a c y of the rules or direct questions to OUNC b >= in. ss V .1987 or 1.800.332.2344. Issued By. / / Permittee Signa re: � �� 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. oZ t Ito t � d -✓�cg to L ELECTRICAL PERMIT CITY F TIGARD COMMUNITY DEVELOPMENT Permit #: ELC2010 -00082 Date Issued: 02/18/2010 T 1 GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 25101 DC04000 Jurisdiction: Tigard Site address: 7550 SW TECH CENTER DR 250 Subdivision: Lot: 0 Project: Cochran Project Description: TI, (1) temp service and (42) branch circuits. 2/19/10, removed temp service and added (1) 200 amp service. Owner: FEES WALTON CWOR SOUTHRIDGE 12 LLC Quantity Description Date Amount BY TTA/EPROPERTYTAX DEPT 325, PO BOX 4900 1 ea Services or Feeders - 200 02/18/2010 $100.70 amps or less PHONE: 42 crt Branch Circuits w /Purchase 02/18/2010 $311.64 Service or Feeder 1 ea 12% State Surcharge - 02/18/2010 $49.48 Contractor: Electrical COCHRAN INC 626 SE MAIN ST PORTLAND, OR 97214 PHONE: 503 - 234 -6564 FAX: 503 - 238 -2098 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $461.82 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 wit 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 thr• .. • • 952 -00 8100. You may obtain a copy of the rules or direct questions to OUNC by calling 58 . •.6699 or 1.800.332.2344. Issued By: r � 4 124 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' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. .,v CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2010-00082 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/18/2010 Parcel: 2S101 DC04000 Jurisdiction: Tigard Site address: 7550 SW TECH CENTER DR 250 Subdivision: Lot: 0 Project: Cochran Project Description: TI, (1) temp service and (42) branch circuits. Owner: FEES WALTON CWOR SOUTHRIDGE 12 LLC Quantity Description Date Amount BY TTA/E PROP ERTYTAX DEPT 325, PO BOX 4900 1 ea Temp Services or Feeders - 02118/2010 $59.36 200 amps or less PHONE: 42 crt Branch Circuits 02/18/2010 $360.40 wo/Purchase Service or Feeder Contractor: 1 ea 12% State Surcharge - 02/18/2010 $50.37 COCHRAN INC Electrical 626 SE MAIN ST PORTLAND, OR 97214 PHONE: 503-234-6564 FAX: 503-238-2098 Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $470.13 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 ante wi roved 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. NTION: Oregon law uir s you to follow the rules adopted by the Oregon Utility Notifica' Center. Those rules are set forth in OAR 952-0 -0010 through OAR 952-0 - 100. o y obtain a copy of the rules or direct questions to OU 03.246.6699 or 1.800.332.2344. ssued By: Permitted nature: 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 an inspection that business day. 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 COCHRAN -BROADWAY (FR I ) FEB 1S 2010 10 : SS /ST . 10 : 587No. 7'500000852 P 1 Electrical Permit Application 1. orrici.: I NI. ()NIA City of Tigard Received Date/By: Permit No.: EL C.? 0, 0- 000SQ ; 111 4 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' II Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: G A k Inspection Line: 503.639.4175 Date Ready/By: Juris: 1 fil See Page 2 for T 1 1) Internet: www.tigard-or.gov Notified/Method: Supplemental Information itifC.WOittiV Wf.;0 0 New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans witenn checked below): 0 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition El Other: where the available fault current 0Imarinas and boatyards. .irttOlftV-4Fa)Oglitten01-..-'r.:47t4e: 14 exceeds 10.000 amps at 150 volts or 0 Floating buildings. - less to ground. or exceeds 14.000 0 Commercial-use agricultural El 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: ['Fire pump. 0 Installation of 75 KVA or larger separately derived system. - . -7 -'-;-' - ::JOILSetta . itklifoRMMili* 'AN-6-:'LeitAtiON,7,:',',,',.:::.:,-..,.,7,-,..•L 0 Addition of new motor load of Job no.: 0 t70 Job site address: 155o 5 "1 Cefr Dv- 100HP or more. 0 Six or more residential units. 0 occupocy. Recreational vehicle parks. City/State/ZIP: f1 - A r)e 0 Health-care facilities. o Hazardous locations. 600 Supply voltage for tnore than 600 volts nominal. Suite/bldg./apt. no.: 2. "o Project name: 0061, va 1 0 c . ID Service or feeder 600 amps or more. j 'fz -- ;.. - 1 .2.;_. , '.' : .0.:■.Y;Z:f s f'.. -- :."YEe' i gtlitijiAtf' - ''. - r 2 stri c .:.T.t . .: , :: ; .. - ;'::, Cross street/directions to job site: Descriplitm LQ4. I Fee. 1 Total i • New residential single- or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 sq. fi. or portion 33.92 I Tax map/parcel no.: : ited energy, residential iust.:im, -gt;r Lim (with above sq. ft.) 67.84 2 Limited energy, multi4mily ( ID \pVt k31,d * el.-cap )0-000 a. residential (with above s ft.) _ _ 67.84 2 Services or feeders installation, alteration, and/or relocation 200 amps or less / 100.70 in):7 2 201 amps to 400 amps 133.56 2 Name: 401 amps 10 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation %. Phone: ( ) Fax: ( ) 200 amps or less ,( C 59.36 ,S j.36 1 2 Owner installation: This installation is being made on property that I own which is not 201 amps 10 400 amps 125.08 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,per panel Owner signature: Date: A. Fee for branch circuits with ,.... above service or feeder fee, 7.42 2 each branch circuit Business name: Sa i a Con-fractoir B. Fee for branch circuits - - wiihout service or feeder fee, Contact name: ...ie c( tine S first branch circuit . 56.18 2 _ Address: Each add'I branch circuit 7.42 2 Miscellaneous (service or (eeder not included) City/State/Zl P: Each manufactured or modular 67.84 2 (....co,) • Qt-ac361 : ( ) 0 9 Fax.: dwelling, service and/or feeder Phone: Reconnect only 67.84 2 _ E-mail: Pump or irrigation circle 67.84 2 _ , Sign or outline lighting 67.84 2 Signal circuit(s) or limited- Business name: 0 Och rah I Y1 C . energy panel, alteration, or Address: ( ( sE mato. extension. Describe: Page 2 2 City/State/ZIP: po {4 - ta,n 8 Cie_ 9 72--A- Each additional inspection over allowable in any of the above Per inspection 66.25 Phone: ( 5155) 2,34 i ,sk,e1. Fax: ( 503) 2:6 g a Investigation per hour (i hr min) 66.25 _ (CB Lic.: [ vi 42_ Electrical Lic.: 31541,, c Suprv. Lic.: ,34-14 7 - 1,5 Industrial plant per hour 4 78.18 , .- . - --- -- .V Suprv. Electrician signature, required: V ...... Q_ A 't ,_ ,r_:,,,_4,:. Subtotal: I .1 1 . <.1 _ Plan review (25% of pennit fee): Print name: K_cyi 11 e .,rh Karc.:. Date: 9-fi q b 0 State surcharge (12% of pennit fee): Li 9 Authorized signature: TOTAL PERMIT FEE: Litc) 0 - This permit application expires if 2 permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. - • Number of inspections allowed per permit. Budding Permits ELC mit Apt) doc 10'01'09 440.4615T( 1 I Os.CONt WETS FROM COCHRAN— BROADWAY (THU)FEB 18 2010 7:59/ST. 7:59 /No.7500000829 P 1 Electrical Permit A llca it—CEIVED • e 01,4 :-. i ,ltd l lil. L 1 4KO 9 l W yu 1 � Y G T F R eeciyeii �/ O �� CC a 10 v� Ci o an PcrmtCNo i, w f Ti Date/13 13125SW H 97223 1 t LU '}t4I Plan Review s gar ' r ad�O' Qt t 8 Phone 503:6391 U1 Fax. ,503.59 •?i 1 Date/By: Other Penult: �lktraK M 1 G "n �. ➢rw ''p Inspection Liner 503.639.4175 �� pp Date Ready /By: kris: gl See'Page�2 for [ TIC 12 Internet wwwtigard orgov yr �, y r OF'T1Cjtii�D Notified /Method Supplemental Information 1 yy r q , r .< ..- ..-..;.e._,,. rY. , . r--�-"'_�, �f'Y� *?, . - , .w_,':.:.. -4VV `. . .. .,. - ..c s . : '- "°491 -1 +� v . Wu .. W ❑ :New cot1Struction ❑ Addition /alteration /replacement Please check all that apply -(sum uiit,2 sets of plans w /items checked below). 0 Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fatilt current 0 Marinas and boatyards. '', ""' t r ;r - s x s - �°` _ exceeds 10:000 amps 150 volts or Floating buifdiri s. • P ❑ K K '' "''`� � �� W '� = °`�'x -' "' less to ground, or exceeds 14.000 ❑ Comincrcial -use agricultural ❑ 1 - and 2- family dwelling [}Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ M ulti - family ❑ Master builder ❑ Other: ❑ Fire' pump. ❑, Installation of75 KVAor JOLSITE 1NF,,O! _, , O s ❑ E system. larger separately derived system. ' - - .. _ ,;• ...^, •. 1,1, cf... t ,kN r_: .,_ ,._.,r __ `t, m .._, -__-,. ❑ .Add ition of new motor load of ❑ A" " ,. l 2 "1 1 Job no.: C'� ( � .lob site d address :" (560 SO l te d�... N ec h Cer Dr IOOHP o re res occupancy. 1 ❑ Six or more residential units, El Recreational vehicle parks. City /State/Zl P: ' r �� Y • /•� cj � ❑ Health -care facilities. ❑ Supply voltage for more than l 1 v� ❑ Hazardous locations 600 volts twmmal- Suite/bldg. /apt.rno.: 2 U Project.name: aDCit VZ,,,,„ ) Vt El Service or feeder 600ainpsorn tore Cross street/directions to job site: Description 1` qty. I Fee. 1 1 • New residential single- or multi - family dwelling unit. Includes attached garage. • Subdivision: Lot no.: 1,000 sq. ft- or less . 168.54 4 Ea. add' 1 500 sq. ft. or portion 33.92 l Tax map /parcel no.: Limited residential 4 _.._ �. �z a r rat energy, cs en ra ,�p� 67.84 2 Lit t t .?'- ...:. =?-°^' r -,x .., '?_:..�5 ..4 ' . 3 . 1? ,. . , >¢ ., �,.,x `s ,_-. r-7.• ' . (will' above sq. ft:) ti Limited energy, multi- family Ti bI.(II 6( ('J" , £L4rL) residential (with above sq. ft.) 67.84 2 Services or feeders installation alteration, and/or relocation ,. 4 -s- .�., 200 amps or less "" 2 100.70 - h a O R t _'- :; ="' ..�._ , .,_. , , 4 ,,, . . ,- -,-,--2--- 2 01 amps to 400 am 133.56 2 Name: 401 amps to 600 amps 200.34 2 601 amps,to 1.000 amps 301.04 2 Address: Over,1.000 amps or volts 552.26 2 City /State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less / 59.36 s' 36, 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 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel A. Fec.for branch circuits with Q, pp —teas �-z F.. . - A +r j)t(_ „ , , above service or feeder lee • --_,, ,;. ,:,.. w. . n (�;` -.,_...:.rs� _ ,. Sn „r-- - .. „_ . -� 7.42 2 name: each branch circuit Business Sa .0 a Co ir drin ✓' B . Fee, for branch circuits /��} J am,, without service nr feeder fee, i Contact name: 56.18 57 2 J "f 'j {-^ 1 IV (t, �M ,, C.- first blanch circuit Address: t ' Each add'I branch circuit (� / 7.42 , „),.. 2 Miscellaneous (service or feeder not. included) City /State /ZIP: ' Each "inanufacturedormodular 67.84 2 dwelling, service and/or feeder Phone: ( ) - Fax: : ( ) Reconnect only '67.84 2 £ -mai I: • Pump or irrigation circle 67.84 2 Z - . 0e r X r Po v�; . - lighting 67.84 r: Sign or outline i 2 Business name: ' 0 Oc h lea n' 1 vl C Signal circuit(s) e r limi[ed- energy panel, alteration, or Address: ( v e L S E a si-- , extension: Describe: Page 2 2 City /State /ZIP: pe,. ✓44- 10.,Y1d Off' 9/zi 4 Each additional inspection over allowable in any of the above Per inspection 66.25 'Phone: ( ) '2-3 4- tp 504 Fax: (5j) 2--:g V Investigation per hour (1 hr min) 66,25 • CCB Lic, ' ZQ Electrical Lic.: 3/5440 a Suprv. Lic.: 34c.i -1,' Industrial plant per hour 78.18 7 111'A".a.> y t p. .. Mi t IT Suprv. Electrician signature, required: _ ,� <r:c p Subtotal: i_ JR 7 / Plan review (25% of pennitfee): Print name: �n e: K et KG(,TU Date: i g(/ 0 State surcharge (12% of permit fee): �, 3 7 Authorized signature: TOTAL PERMIT FEE: l.'I? 0 , / 3 • 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 Peunes'F.I.C- PermilApp.doc 10`01109 440- 4615Tt1 I.05 WEB City of Tigard, Oregon ° 13125 SW Hall Blvd. ° Tigard, OR 97223 • February 19, 2010 Cochran Inc. 626 SE Main St. Portland, OR 97214 • Re: Permit No. ELC2010 -00082 Dear Sir /Ms.: The City of Tigard has processed a refund for fees on the above referenced permit(s) for the following: • Site Address: 7550 SW Tech Center Dr. Project Name: Cochran Job No.: 017026 Refund: ❑ Check # in the amount of $ ® Credit card "return" receipt in the amount of $8.31. ❑ Trust account "deposit" receipt in the amount of $ Notes: Scope of work changed (see attached copy of permit) resulting in a refund. If you have any questions please contact me at 503.718.2430. Sincerely, Dianna Howse Building Division Services Supervisor Enc. I: \Building \Refunds\ Administration \LtrRefund- RefundOnly.doc 01/16/07 Phone: 503.639.4171 e Fax: 503.684.7297 . ® www.tigard- or.gov e TTY Relay: 503.684.2772 I C City of Tigard T I G A R D Accela Refund Request This form is used for refund requests of land use, engineering and building application fees. Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be attached to this form. Refund requests are due to Accela System Administrator by Friday at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Accela System Administrator for distribution. Please allow 1 -2 weeks for processing. PAYABLE TO: Cochran Inc. DATE: 02/19/2010 626 SE Main St. Portland, OR 97214 REQUESTED BY: Dianna Howse DEB TRANSACTION INFORMATION: Receipt #: 176954 Case #: ELC2010 -00082 Date: 02/18/2010 Address /Parcel: 7550 SW Tech Center Dr. Pay Method: CreditCard Project Name: Cochran EXPLANATION: Scope of work changed resulting in a refund. REFUND INFORMATION: Fee Description From Receipt Revenue Account No. • . Refund , Example:. [BUILD] Permit Fee Example: 245- 0000 - 432000 $ Amount Branch circuits 2200000 -43103 $7.42 12% State Surcharge 1003100 -24001 .89 TOTAL REFUND: $8.31 APPROVALS: , 1 If under $500 Professional Staff -- C;( ,4 A t -i If under $7,500 Division Manager If under $22,500 Department Manager If under $50,000 City Manager If over $50,000 Local Contract Review Board _ FOR ACCELA SYSTEM ADMINISTRATION USE ONLY.... ' . Refund Request Reviewed: Date: - ;2 / /'• /,s0 By: J-„� Case Refund Processed: _ Date: ..TV/ 'f'7,/"./ By: • ,. I: \Building \Refunds \RefundRequest.doc 04/13/09 , CITY OF TIGARD RECEIPT i a : 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 T [GARD Receipt Number: 176954 - 02/18/2010 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2010 -00082 Temp Services or Feeders - 200 amps 2200000 -43103 $59.36 or less ELC2010 -00082 Branch Circuits wo /Purchase Service or 2200000 -43103 $360.40 Feeder ELC2010 -00082 12% State Surcharge - Electrical 1003100 -24001 $50.37 Total: $470.13 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 018356 DADAMSKI 02/18/2010 $470.13 Payor: Cochran Inc Total Payments: $470.13 Balance Due: $0.00 Page 1 of 1 71 CITY OF TIGARD RECEIPT $ :: 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 176954 - 02/18/2010 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2010 -00082 Services or Feeders - 200 amps or less 2200000 -43103 $100.70 ELC2010 -00082 Branch Circuits w /Purchase Service or 2200000 -43103 $311.64 Feeder ELC2010 -00082 12% State Surcharge - Electrical 1003100- 24001 $49.48 Total: $461.82 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 018356 DADAMSKI 02/18/2010 $470.13 Payor: Cochran Inc Total Payments: $470.13 Balance Due: ($8.31) Page 1 of 1 I IIII q CITY OF TIGARD RECEIPT g 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 176964 - 02/19/2010 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2010 -00082 $-8.31 Total: $ -8.31 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 018356 DHOWSE 02/19/2010 $ -8.31 Payor: Cochran Inc. Total Payments: $ - 8.31 Balance Due: $0.00 Page 1 of 1