Permit `.:'. CITY OF TIGARD ELECTRICAL PERMIT
>'
• ;< a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00081
T [ G R t? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/17/2010
i3
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 100
Subdivision: Lot: 0
Project: Pacific NW Title
Project Description: Reconnect UPS unit and MTS
Owner: FEES
WISCO REAL ESTATE EQUITY Quantity Description Date Amount
FUND I LTD PARTNERSHIP, BY WYSE
INVESTMENT SRVS CO, 1501 SW TAYLOR ST 1 crt Branch Circuits 02/17/2010 $56.18
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 02/17/2010 $6.74
Electrical
Contractor:
TEAM ELECTRIC
9400 SE CLACKAMAS RD.
CLACKAMAS, OR 97015
PHONE: 503 - 557 -7180
FAX: 503- 557 -8201
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $62.92
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. AT • • •. : egon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 1010 through OAR 95 -0' -I 00. You may obtain a copy of the rules or direct questions to OUNC by calling 50 ..6.6699 or 1.800.332.23.•
Issu•• By: ' ' I _� . PermitteeSign• ure:
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
_ _ c
SIGNATURE OF SUPR. ELEC' � - A — 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.
RE ArT 7a C417 O S'co7°s of &oleic. aher /d.
� n
CITY OF TIGARD ELECTRICAL PERMIT c �
` COMMUNITY DEVELOPMENT Permit #: ELC2010 00081
Date Issued: 02/17/2010
TIGAIRD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 100
Subdivision: Lot: 0
Project: Pacific NW Title
Project Description: Reconnect UPS unit and MTS
Owner: FEES
WISCO REAL ESTATE EQUITY Quantity Description Date Amount
FUND I LTD PARTNERSHIP, BY WYSE
INVESTMENT SRVS CO, 1501 SW TAYLOR ST 1 ea Services or Feeders 200 02/1812010 $100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 02/18/2010 $12.08
Electrical
Contractor:
TEAM ELECTRIC
9400 SE CLACKAMAS RD.
CLACKAMAS, OR 97015
PHONE: 503 - 557 -7180
FAX: 503 - 557 -8201
Type of Use: COM
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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 J or 1.800.332.2344. - /
Issued By: 7 ^1 '/ Permittee Signature: 17/✓ /PG/�e L 7 7 0 v
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.
02- 17- 10;07:20 :Team Electric ; 503. 557. 8201 # 1/
-6 3 •. �+l 'rte ° i ^� '
• Electrical Permit Application r i. r , ' , I t1R ( )r.r,It- 4 ) .
iFtir�0\1 -41 i a ..4.2::--,1'.':
II 'ra'• City of Tigard ' DatefB �� /O 1 Permit No.: F
i� 3 ay., Tigard, OR 97223
lF • 13125 SW HII Blvd., g Plan Review
;1: - Phone: 503.639.4171 Fax: 503.598.1960 FEB 1 6 ' ' Date/By: Permit: y: fa 9of 0 — DOD
rf Inspection Line: 503.639.4175 C. 1 Date Ready/By: funs: I G A k D fa See Pagc 2 for
Internet: www.tigard- or.gov CITY OF TIGAR L Notified/Method: Supplemental Information
TYPE OF W O I RCILDING DIVISION PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current
❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
1. / El Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
t y\ Job no.: 4170 Job site address: 9020 SW Washington Sq. Rd.
❑ Six Six or more. occupancy.
!!
I, or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard Or 97223 ❑ Health -care facilities. ❑ Supply voltage for morc than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 100 Project name: Pacific NW Title ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee 1 Total 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'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
Limited energy, multi - family
Reconnect UPS unit and MTS residential (with above sq. tt) 67.84 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 20034 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 1
Owner installation: This installation is being made on property that 1 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, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: B. Fee for branch circuits
without service or feeder fee, 1 56.18
Contact name: first branch circuit 56.18 2
Address: Each add'I branch circuit 7.42 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Team Electric Company Signal circuit(s) or limited -
Address: 9400 SE Clackamas Rd energy panel, alteration, or
extension. Describe: Page 2
City /State/ZIP: Clackamas Or. 97015 Each additional inspection over allowable in any of the above
Per inspection 66.25
. Phone: (503) 557 -7180 Fax: (503) 557 -8201 Investigation per hour (1 hr min) 66.25
•
CCB Lic.: 173043 Electrical Lic.: 3 -225C Suprv. Lic.: 4416 S Industrial plant per hour 78.18
---- ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 56.18
Print name: Mike Trusheim i 044/..41-/
ate: 2/16/10 Plan review (25 %of permit fee):
��� State surcharge (12 %ofpermit fee): 6.74
Authorized signature: i / ` ` -, ! TOTAL PERMIT FEE: 62.91.
J �+"" This permit application expires if a permit is not obtained within 180
Print ec 1. name: Mike Trusheim Date: 2/6/10 days after it has been accepted as complete.
Ro Pea... 1T /p (t- 1=E �1 T 7. 0 t � #IS .. ,
J
I/ /5 /;