Permit ✓ wf;
CITY OF TIGARD ELECTRICAL PERMIT
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` COMMUNITY DEVELOPMENT Permit #: ELC2010 -00132
"T[OARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/19/2010
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7228 SW DURHAM RD, STE# 100
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Style Shock
Project Description: Install (1) 100 amp panel and (8) branch circuits.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 1 ea Services or Feeders - 200 03/19/2010 $100.70
amps or less
PHONE: 503 - 624 -6300 8 crt Branch Circuits w /Purchase 03/19/2010 $59.36
Service or Feeder
1 ea 12% State Surcharge - 03/19/2010 $19.21
Contractor: Electrical
CURRENT ELECTRICAL CONST CO
P 0 BOX 19652
PORTLAND, OR 97280
PHONE: 503 - 245 -5997
FAX: 503 - 245 -2919
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $179.27
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. At 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 • h in OAR
952- 001 -0010 through OA 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.80 2 44.
Issued By: --e \ t \ 1 \ Permittee Signature:
i
OWNER INSTALLATION ONLY
The installation is being made on property 1 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.
Electrical Permit Application . j FOR OFFICE, USE ONLY
:t r , s ` • 00 2 y Dat/B , _;1 Permit No.: �l(�. ° 13125 SW of H all Tigard Blvd Tiga rd, OR 97223 Cit IriAR 8 t
' : Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit:
T I G A R D Inspection Line: 503.639 C I T , OF' A : to Ready /By: FE
Page 2 for
Internet: www.tigard or.gov i =I t ��� . 4ed/Method: Supplemental Information
TYPE OF WORK 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 ® Commercial /industrial ❑ 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.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ".
Job no.: A10106 Job site address: 7228 SW DURHAM RD 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZiP: 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 100 Project name: STYLESHOCK ❑ 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
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 I
Limited energy, residential
67.84 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 67 84 2
ADD 8 CIRCUITES AND ONE 100A FEEDER residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
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
El APPLICANT El CONTACT PERSON above service or feeder fee 8 7.42 42 59.36 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
ty dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: CURRENT ELECTRICAL panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: PO BOX 19652 Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: PORTLAND, OR 97280 Investigation (1 hr min) 66.25 / hr
Industrial plant (1 hr min) 78.18/ hr
Phone: 503) 245 - 5997 Fax: (503) 245 - 2919 Inspections for which no fee is
( ( ) 90.00 / hr
specifically listed ('/ hr min)
CCB Lic.: 46994 Electrical Lic.: 26 -471C upry • . 5232S ELECTRICAL PERMIT FEES
— 24' kl 10' l .10 Subtotal: 160.06
Suprv. Electrician signature, required:
Plan review (25% of permit fee):
Print name: JASON JACOBUCCI Date: 03/19/10 State surcharge (12% of permit fee): 19.20
(} j TOTAL PERMIT FEE: 179.26
Authorized signature: (5_, This permit application expires if a permit is not obtained within 180
days af it has been accepted as complete.
Print name: DAVID THOMPSON Date: 03/19/10
Number o inspections a llowed per permit.
I: \ BuildingPermits \ELC- PermitApp.doc 10/01/09 440- 4615T(11 /05 /COM/WEB